Emotional Pain Inventory

All pain is not physical. Some pain is emotional. It is the pain of the heart. (Not the organ that pumps blood, but that organ may be affected.) Emotional pain can eventually result in physical symptoms and even disease. Emotional pain should be identified and dealt with before such unhappy outcomes occur. But physical pain is not the only outcome of emotional distress. When people have emotional pain it spreads out into their relationships with others. The following questionnaire has been developed to help your counselor assess the degree of emotional pain you may be in. When you approach these questions seriously it will also help you to understand your self better because you will be thinking through some things in a systematic way. Then the feedback you receive from the counselor will be of additional benefit.

How to do this inventory: On the line if front of each statement write in the number from 0 to 5 that best describe how true the statement is in your life.

A zero (0) means that the statement is never true in your life;

A one (1) means that statement is rarely true in your life;

A two (2) means that the statement is occasionally true in your life;

A three (3) means that the statement is true about half the time in your life;

A four (4) means that the statement is more of true for you than not;

A five (5) means that the statement is always or nearly always true about you.

Caution: It is possible to lost track of what each number means as you try to go through a number of responses. Should you find yourself hesitant about the appropriate response go back and review what each number means. Take your time. Try to be accurate and think about your responses. Feel free to write any comments you wish to share with the counselor on the side or on the back of this paper.

___ 1. I feel sad.

___ 2. I feel lonely

___ 3. I lose track of what I am thinking about.

___ 4. I get distracted from what I am doing.

___ 5. I feel I never come out on top at anything.

___ 6. I can’t stand to lose.

___ 7. I think about people who have hurt me.

___ 8. I feel hopeless and depressed.

___ 9. I withdraw from people including friends and family.

___ 10. I lay in bed for long hours.

___ 11. When people do not want to cooperate with me or do what I want I get angry.

___ 12. In conflicts I usually give in.

___ 13. In conflicts I feel hopeless or helpless.

___ 14. I don’t like myself.

___ 15. I feel others, even when they are nice to me, do not really like me.

___ 16. I feel I must do something special for a person for them to be my friend.

___ 17. I feel a real friend should be my friend exclusively.

How to do this inventory: On the line if front of each statement write in the number from 0 to 5 that best describe how true the statement is in your life.

A zero (0) means that the statement is never true in your life;

A one (1) means that statement is rarely true in your life;

A two (2) means that the statement is occasionally true in your life;

A three (3) means that the statement is true about half the time in your life;

A four (4) means that the statement is more of true for you than not;

A five (5) means that the statement is always or nearly always true about you.

___ 18. I try to make friends with people I really do not like.

___ 19. I act nice outwardly.

___ 20. I am angry on the inside.

___ 21. I think about getting even for things done to me.

___ 22. I do not trust the people who have authority over me.

___ 23. I feel resentment toward the people in authority over me.

___ 24. People in authority over me have done me wrong many times.

___ 25. I want to change my environment. (Where I live)

___ 26. I want to change my environment. (How I live) 

___ 27. I want to change my environment. (With whom I live)

___ 28. I use sarcasm to tease others.

___ 29. I use sarcasm to defend myself from others.

___ 30. I numb emotional pain I feel with alcohol.

___ 31. I numb emotional pain I feel with drugs. (Prescription of nonprescription.)

___ 32. I numb emotional pain I feel with sex.

___ 33. I numb emotional pain I feel through daydreaming or fantasizing.

___ 34. I stay busy so I do not have to think too much.

___ 35. I stay busy because it helps me to keep from feeling lonely.

___ 36. I have a difficult time keeping myself active.

___ 37. I am often late in accomplishing tasks.

___ 38. I have a list of unfinished projects.

___ 39. My dreams are disturbing.

___ 40. I am often embarrassed in my dreams.

___ 41. I have a weight problem.

___ 42. I lose my appetite.

___ 43. People tell me I speak in a monotone.

How to do this inventory: On the line if front of each statement write in the number from 0 to 5 that best describe how true the statement is in your life.

A zero (0) means that the statement is never true in your life;

A one (1) means that statement is rarely true in your life;

A two (2) means that the statement is occasionally true in your life;

A three (3) means that the statement is true about half the time in your life;

A four (4) means that the statement is more of true for you than not;

A five (5) means that the statement is always or nearly always true about you.

___ 44. People tell me my voice is shrill and loud.

___ 45. I do not show much expression.

___ 46. I sigh frequently.

___ 47. I have headaches.

___ 48. I have stomach and/or digestive problems.

___ 49. I go back and check things because I cannot remember whether I have done them or not.

___ 50. I have an abnormally high or low interest in sex.

___ 51. I get tired easily.

___ 52. I am tired.

___ 53. I sleep too much.

___ 54. I sleep too little.

___ 55. I clench or grind my teeth at night.

___ 56. I feel guilty that I cannot make people healthy.

___ 57. I call myself names.

___ 58. I try to not let people get the best of me.

___ 59. I am impatient; I do not like to wait.

___ 60.  I am critical of myself.

___ 61. I am critical of others.

___ 62. I feel tense when I have something that needs doing.

___ 63. I go over and over conversations I have had in my mind.

___ 64. I rehearse conversations I expect to have over and over.

___ 65. I compare myself (appearance, status, speech, performance, possessions, speech) with

 others.

___ 66. When somebody hurts me I don’t get over it easy.

___ 67. I get so discouraged I can’t keep going.

___ 68. When I get angry I lose control.

How to do this inventory: On the line if front of each statement write in the number from 0 to 5 that best describe how true the statement is in your life.

A zero (0) means that the statement is never true in your life;

A one (1) means that statement is rarely true in your life;

A two (2) means that the statement is occasionally true in your life;

A three (3) means that the statement is true about half the time in your life;

A four (4) means that the statement is more of true for you than not;

A five (5) means that the statement is always or nearly always true about you.

___ 69. I have had a string of unhealthy relationships.

___ 70. I feel nobody really knows me.

___ 71. I worry about what others think of me.

___ 72. I try to make people laugh when I feel things are too tense.

___ 73. I withdraw when I feel things are too tense.

___ 75. The same people hurt me over and over again.

___ 75. I have difficulty making new friends.

___ 76. I feel I deserve the way people treat me.

___ 77. I prefer to be by myself.

___ 78. I watch people very closely to detect changes in their moods.

___ 79. People seem to go out of their way to hurt my feelings.

___ 80. If things go wrong it is usually my fault.

___ 81. My friends are “sort of” friends, not real friends.

___ 82. I am charming.

___ 83. I am vicious.

___ 84. I can intimidate others to make them go along with me.

___ 85. I don’t trust nice people.

___ 86. I use words like “always” and “never” to make my point.

___ 87. I get upset when people are unfair.

___ 88. I can read people. I know what they are up to.

___ 89. When I irritate people I feel powerful.

___ 90. I feel impatient with indecisive people.

___ 91. I want to know everything that is going on around me.

___ 92. I do not trust anybody until they prove they are trustworthy.

___ 93. If I have a problem with people I confront them.

___ 94. I enjoy answering probing questions.