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“Am I Getting There?” Self-Assessment

Welcome to our website once again and to the second self-assessment. Please answer the following questions as honestly as you can.

Instructions: Below is a questionnaire that asks about where you are in your life after having completed the reading and the exercises in the book ‘Stop Surviving – Live Your Life.’ This exercise will help you to understand if ‘you are getting there’, i.e. if you are closer to getting to where you want to be. Simply click on the spot which most resembles your honest response.


Name:

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Email:

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Lifestyle Indices

A. Consumption habits

I am happy with my consumption of: -

 

Yes

  

Getting There

  

No

Fats and oils.

Sugary foods (cakes, sweets).

Fruit and/or vegetables.

Junk food.

Alcohol.

Tobacco.

Caffeine.

Other Drugs.

I am happy with my: -

 

Yes

  

Getting There

  

No

Weight.

Levels of cholesterol.

Blood pressure.
 

Yes

No

I have regular medical checkups.

One belief I have adopted or wish to cultivate towards my consumption habits is:

What improvements can I make to my consumption habits?

B. Exercise

I am happy with my: -

 

Yes

  

Getting There

  

No

Exercise Levels.

My energy levels

One belief I have adopted or wish to cultivate towards exercising is:

What improvements can I make to my exercising?

C. Sleep

I am happy with my Sleep habits regarding: -

 

Yes

  

Getting There

  

No

Getting enough sleep.

Sleep patterns.

My bedroom's suitability for sleep.

Not thinking about work in bed.

Being sufficiently relaxed before bed.

Waking up feeling fresh and energetic.

One belief I have adopted or wish to cultivate towards sleep is:

What improvements can I make to my sleeping habits?

D. Stress Management

I am happy with: -

 

Yes

  

Getting There

  

No

Not being stressed at home.

Not being stressed at work.

Relaxing.

Taking rest breaks during the day.

Taking holidays away from the home on a regular basis.

One belief I have adopted or wish to cultivate towards my relaxation is:

What improvements can I make to my relaxation habits?

E. Housing

I am happy with my Housing needs regarding: -

 

Yes

  

Getting There

  

No

Comfortable and safe.

Being satisfied with where I live.

Having enough privacy.

Not wanting to move.

Size of my home.

One belief I have adopted or wish to cultivate towards my housing and where I live is:

What improvements can I make to my housing situation?

F. Work

I am happy with: -

 

Yes

  

Getting There

  

No

Doing what I am doing eg. career, voluntary work, being at home or raising children.

My 'personality' fitting the work I do.

Financial and intrinsic rewards.

Work satisfaction levels.

Amount of work I do.

One belief I have adopted or wish to cultivate towards my work situation is:

What improvements can I make to my career?

G. Financial Security

I am happy with: -

 

Yes

  

Getting There

  

No

My beliefs about money.

Level of debt.

Enjoying my money.

Achieving my long-term financial objectives.

Freedom from gambling.

One belief I have adopted or wish to cultivate towards my financial security is:

What improvements can I make to my financial situation?

H. Intimate Relationship (Optional)

I am happy with my Intimate Relationship regarding: -

 

Yes

  

Getting There

  

No

Being satisfied with my relationship.

Prioritising my needs

Being emotionally committed to my partner.

Feeling free of guilt.

Satisfaction with my sex life.

One belief I have adopted or wish to cultivate towards my intimate relationship is:

What improvements can I make to my intimate relationship?

I. Parenting (Optional)

I am happy with: -

 

Yes

  

Getting There

  

No

Being a confident parent.

Effective use of discipline.

Spending quality time with my children.

Taking ‘time out’ from my children.

One belief I have adopted or wish to cultivate towards my parenting skills is:

What improvements can I make to my parenting skills?

J. Happy Home

I am happy with: -

 

Yes

  

Getting There

  

No

Having a happy home environment.

Communication at home.

Stability of home life

One belief I have adopted or wish to cultivate towards having a happy home is:

What improvements can I make to my home environment?

K. Extended Family

I am happy with: -

 

Yes

  

Getting There

  

No

My relationships with my broader family (including in-laws).

Communication with extended family members.

My level of unconditional giving to my extended family.

One belief I have adopted or wish to cultivate towards my extended family and relatives is:

What improvements can I make to myrelationships with extended family and relatives?

L. Friendship

I am happy with: -

 

Yes

  

Getting There

  

No

My network of friends.

My special, close friends.

Having time for new friendships.

My level of participation in clubs and community events.

One belief I have adopted or wish to cultivate towards friendships is:

What improvements can I make to my relationships with my friends?

Personal Fulfillment Indices

I am happy with the progress I have made in relation to my learning:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards my learning is:

What improvements can I make to my learning?

I am happy with my thinking habits:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards the way I think is:

What improvements can I make to the way I think?

I am happy with how I express and manage my feelings:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards how I express and manage my feelings is:

What improvements can I make to the way I manage and express my feelings?

I am happy and satisfied with my level of self-commitment:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards self-commitment is:

What improvements can I make to my level of self-commitment?

I am happy and satisfied with my level of change:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards change is:

What improvements can I make to enable change to be easier in my life?

I am happy and satisfied with my self-management skills:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards self-management is:

What improvements can I make to my self-management?

I am happy and satisfied with the level of my inner strength:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards my inner strength is:

What improvements can I make to my inner strength?

I am happy and satisfied with the level of my self-responsibility:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards self-responsibility is:

What improvements can I make to my level of self-responsibility?

I am happy and satisfied with my level of trusting others and myself:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards trusting others and myself is:

What improvements can I make to trust others and myself more?

I am happy and satisfied with my spirituality:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards my spirituality is:

What improvements can I make to enhance my spirituality?

I am satisfied with how happy I am:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards happiness is:

What improvements can I make to be happy?

I am happy and satisfied with my life’s purpose:

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards having a life purpose is:

What improvements can I make to my life’s purpose?

I am happy and satisfied with the level of my gratitude

Yes

  

Getting There

  

No

One belief I have adopted or wish to cultivate towards gratitude is:

What improvements can I make to the way I appreciate my life?

 

Values

Assertiveness

 

Submissive

Assertive

Aggressive

I see myself being more:

Compassion

 

Cruel

Compassionate

Sentimental

I see myself being more:

Courtesy

 

Rude

Courteous

Servile

I see myself being more:

Enthusiasm

 

Apathetic

Enthusiastic

Over-the-top

I see myself being more:

Excellence

 

Ineffectual

Excellent

Perfectionist

I see myself being more:

Forgiveness

 

Blaming

Forgiving

Justifying

I see myself being more:

Friendliness

 

Hostile

Friendly

Sycophantic

I see myself being more:

Generosity

 

Selfish

Generous

Self-sacrificing

I see myself being more:

Honesty

 

Deceiving

Honest

Obvious

I see myself being more:

Humility

 

Pretentious

Humble

Humiliating

I see myself being more:

Joyfulness

 

Desperate

Joyful

Hysterical

I see myself being more:

Justice

 

Prejudicial

Fair

Self-righteous

I see myself being more:

Kindness

 

Malevolent

Kind

Interfering

I see myself being more:

Love

 

Loathing

Loving

Obsessed

I see myself being more:

Moderation

 

Indulgent

Moderate

Abstinent

I see myself being more:

Patience

 

Exasperated

Patient

Unresisting

I see myself being more:

Peacefulness

 

Strife-torn

Peaceful

Humdrum

I see myself being more:

Purposefulness

 

Aimless

Purposeful

Preoccupied

I see myself being more:

Reliability

 

Irresponsible

Reliable

Pedantic

I see myself being more:

Self-Discipline

 

Weak

Self-disciplined

Rigid

I see myself being more:

Tolerance

 

Narrow-minded

Tolerant

Gullible

I see myself being more:

You have now completed a full assessment of all your needs once again. A new Report titled “Am I getting there?” Self-assessment Report will appear for you to read and/or print. This report will help you to answer the question of whether or not you are getting to where you want to go in your life – hopefully bringing you closer to fulfilling your potential. After you finish reading the report, please resume reading the book from page 203, Chapter 6 and continue through to the book’s end.

 

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