FACSAFOUNDATION.ORG SHATTERING THE SILENCE TOUR DOCUMENTARY PROJECT Volume 7 | Page 69

37) During busy days, I find myself needing to withdraw into bed, into a darkened room or any
place where I can have some privacy and relief from stimulation. Circle One.
Strongly

Agree

Agree

Disagree Strongly

Doesn’t

Disagree

Apply

38) I make it a high priority to arrange my life to avoid upsetting or overwhelming situations.
Circle One
Strongly

Agree

Agree

Doesn’t

Disagree Strongly
Disagree

Apply

39) What would you like to change about yourself?

40) What would you like to change about your life?

41) My instincts told me this is the wrong partner for me? Circle One

I married that person

I left the relationship

I am still in the relationship