Image by Thomas Robinson.
The following questionnaire comes from Leslie Vernick’s book, The Emotionally Destructive Relationship: Seeing It, Stopping it, Surviving it (Harvest House, 2007), 40-45. I have found this questionnaire helpful in identifying unhealthy and possibly destructive patterns in relationships. As Leslie Vernick (LCSW) writes, “Complete this questionnaire once for each relationship you are concerned about. You can apply the questionnaire to each of your relationships. It will help you not only identify whether your relationships are destructive, but in what way they are destructive” (The Emotionally Destructive Relationship: Seeing It, Stopping it, Surviving it, by Leslie Vernick; Harvest House, 2007; 40). Vernick, a licensed clinical social worker with a private counseling practice encourages anyone who may be in an abusive relationship to seek appropriate help: “If answering this questionnaire has revealed to you that you are in an abusive relationship, please seek appropriate help from those in your church or community who are experts in helping victims of abusive relationships” (The Emotionally Destructive Relationship, 44).
Each time you complete this questionnaire, do so in relationship with one specific other person, logging in your name and the name of the person with whom you are in relationship.
Name of Person Completing Questionnaire:__________________
Relationship Being Evaluated:_________________
The Emotionally Destructive Relationship Questionnaire
1. Does the person use physical force or threats of force to make you do something you don’t want to do or to keep you from doing something you want to do?
Never Seldom Sometimes Frequently Almost Always
2. Does the person use verbal weapons such as cursing, name calling, degrading comments, constant criticism, or blaming to get you to do something you don’t want to do or to keep you from doing something you want to do?
Never Seldom Sometimes Frequently Almost Always
3. Does the person curse at you, call you names, humiliate you in public, or degrade you when he or she is unhappy with something you do?
Never Seldom Sometimes Frequently Almost Always
4. Does the person force or manipulate you to perform sexually in ways you do not want to?
Never Seldom Sometimes Frequently Almost Always
5. Do you ever feel afraid of the person?
Never Seldom Sometimes Frequently Almost Always
6. Does the person yell, scream, curse, or hurt you physically when he or she is frustrated or angry?
Never Seldom Sometimes Frequently Almost Always
7. Does the person threaten to alienate your children from you or use them to intimidate you into giving in to what he or she wants?
Never Seldom Sometimes Frequently Almost Always
8. Are you afraid to disagree with the person?
Never Seldom Sometimes Frequently Almost Always
9. When you share your thoughts and feelings about something important to you, does the person ignore you, make fun of you, or dismiss you?
Never Seldom Sometimes Frequently Almost Always
10. Are you verbally or physically abusive, or both, toward the person?
Never Seldom Sometimes Frequently Almost Always
11. Does the person always think he or she is right to the point of arguing with you until you concede or give up?
Never Seldom Sometimes Frequently Almost Always
12. Does the person make most of your decisions for you?
Never Seldom Sometimes Frequently Almost Always
13. Does the person control the family money, giving you little or no say?
Never Seldom Sometimes Frequently Almost Always
14. Have you given up things that were important to you because the person pressured you?
Never Seldom Sometimes Frequently Almost Always
15. Does the person pout or withdraw from you from extended periods of time when he or she is angry or upset with you?
Never Seldom Sometimes Frequently Almost Always
16. When you ask for a time-out or don’t want to talk about something anymore, does the person keep badgering you to engage?
Never Seldom Sometimes Frequently Almost Always
17. Does the person lie to you?
Never Seldom Sometimes Frequently Almost Always
18. Have you observed the person lying to others?
Never Seldom Sometimes Frequently Almost Always
19. Does the person tell you something didn’t happen, when you know it did?
Never Seldom Sometimes Frequently Almost Always
20. Does the person question or challenge your certainty of what he or she said or did?
Never Seldom Sometimes Frequently Almost Always
21. Does the person depend on you to meet all his or her needs?
Never Seldom Sometimes Frequently Almost Always
22. Do you feel more like a child than an adult in the relationship?
Never Seldom Sometimes Frequently Almost Always
23. Are you emotionally devastated when the person is upset with you or doesn’t want to be in a relationship with you?
Never Seldom Sometimes Frequently Almost Always
24. When you try to talk with the person about your feelings or something that’s bothering you, do you end up feeling like the trouble is entirely your fault?
Never Seldom Sometimes Frequently Almost Always
25. When the person does something wrong, does he or she blame you or anyone else for it?
Never Seldom Sometimes Frequently Almost Always
26. Does the other person make excuses for his or her behavior (anger, jealousy, lies)?
Never Seldom Sometimes Frequently Almost Always
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27. Do you feel loved and cared for in the relationship?
Never Seldom Sometimes Frequently Almost Always
28. Can you safely express an opinion that is different from the person’s?
Never Seldom Sometimes Frequently Almost Always
29. Does the person show interest in you and your needs?
Never Seldom Sometimes Frequently Almost Always
30. Are you able to express your honest thoughts and feelings with the person?
Never Seldom Sometimes Frequently Almost Always
31. When the person does something wrong, does he or she admit it and take responsibility for it?
Never Seldom Sometimes Frequently Almost Always
If you answered any question up through question 26 with anything other than never, you are likely in an unhealthy relationship.
If you answered most of questions 1-26 with sometimes, frequently, or almost always, you are definitely in a destructive and likely an abusive relationship. Now go back and look at which questions in particular you answered with any answer other than never.
Questions 1-16 describe the main characteristics of an abusive relationship where the abuser’s desire for power and control is at the root. If answering this questionnaire has revealed to you that you are in an abusive relationship, please seek appropriate help from those in your church or community who are experts in helping victims of abusive relationships. If you answered seldom to any question in this group, you still may be in danger, depending upon the severity of the abuse. Once a year is seldom, but it is still too often in a long-term relationship such as a marriage.
Question 10 looks in particular for patterns of mutual abuse. If you answered this question with frequently or almost always, then your relationship might be more mutually abusive. Review questions 1-16 and ask them about yourself. Are you engaging in the same abusive behaviors that you cite in the other person.
Questions 11-17 reflect less obvious ways in which the relationship may be controlling. That does not mean it is not abusive, but if you answered never to questions 1-9, you may be in a controlling relationship that is not obviously abusive.
Questions 17-20 describe a relationship where deceit is present. If most of your answers reflect problems in this area, your relationship is built on lies and it is unstable. You cannot trust someone who does not tell you the truth. And without trust, no relationship can endure.
Questions 21-23 describe a relationship that is overdependent.
Questions 24-26 describe a person who does not take personal responsibility for behavior or wrongdoing.
Stop here and name some of the specific destructive elements in your relationship with this particular person. Is there physical, verbal, or sexual abuse? How about controlling behaviors and attitudes? Is there more mutual abuse? Are you too dependent? Is there deceit or a lack of personal accountability or responsibility?
Questions 27-31 describe the basic elements of a healthy relationship. If you answered never or seldom to any of these questions, your answers indicate that your relationship is unhealthy and probably destructive.
Questionnaire is quoted from, The Emotionally Destructive Relationship. Copyright © 2007 by Leslie Vernick. Published by Harvest House Publishers, Eugene, OR.
