My partner tries to catch me at inconsistencies to show that I'm Lying.

	Never
	Rarely
	occasionally
	Very Often

My partner tries to convince other people that I'm crazy.

	Never
	Rarely
	occasionally
	Very Often

My partner tells other people that there is something wrong with me.

	Never
	Rarely
	occasionally
	Very Often

My partner says things to hurt me out of spite.

	Never
	Rarely
	occasionally
	Very Often

My partner has told me that I am sexually unattractive.

	Never
	Rarely
	occasionally
	Very Often

My partner tells me that I am sexually inadequate.

	Never
	Rarely
	occasionally
	Very Often

My partner insults my religious background or beliefs.

	Never
	Rarely
	occasionally
	Very Often

My partner insults my ethnic background.

	Never
	Rarely
	occasionally
	Very Often

My Partner talks me into doing things that make me feel bad.

	Never
	Rarely
	occasionally
	Very Often

My partner tells me that no one else would ever want me.

	Never
	Rarely
	occasionally
	Very Often

My partner humiliates me in front of others.

	Never
	Rarely
	occasionally
	Very Often

My partner makes me do degrading things.

	Never
	Rarely
	occasionally
	Very Often

My partner questions my sanity.

	Never
	Rarely
	occasionally
	Very Often

My partner tells other people personal information or secrets about me.

	Never
	Rarely
	occasionally
	Very Often

My partner swears at me.

	Never
	Rarely
	occasionally
	Very Often

My partner verbally attacks my personality.

	Never
	Rarely
	occasionally
	Very Often

My partner has insulted me by telling others that I am incompetent.

	Never
	Rarely
	occasionally
	Very Often

My partner ridicules me.

	Never
	Rarely
	occasionally
	Very Often

My partner forces me to do things that are against my values.

	Never
	Rarely
	occasionally
	Very Often

My partner questions whether my love is true.

	Never
	Rarely
	occasionally
	Very Often

My partner compares me unfavorably to other partners.

	Never
	Rarely
	occasionally
	Very Often

My partner intentionally does things to scare me.

	Never
	Rarely
	occasionally
	Very Often

My partner threatens me physically during arguments.

	Never
	Rarely
	occasionally
	Very Often

My partner warns me that if I keep doing something violent will follow.

	Never
	Rarely
	occasionally
	Very Often

Our arguments escalate out of control.

	Never
	Rarely
	occasionally
	Very Often

I'm worried most when my partner is quiet.

	Never
	Rarely
	occasionally
	Very Often

My partner drives recklessly or too fast when angry.

	Never
	Rarely
	occasionally
	Very Often

Your first Name:
Your Email Address:
date:
gender:
I would like more info: