Sexuality Questionnaire 1

The following is a conditioned response test designed to help your Hypnotherapist assist you more
rapidly with your program. Go with the first answer that comes to mind after you read the
question. It is important that you answer these questions truthfully, keeping in mind there are no
right or wrong answers. Aoid dwelling on any question. !imply check "es or #o $eside
each question. The term %aternal or &aternal 'igure is used to designate the primary role
model who had the most influence upon you and your life.
QUESTION YES NO
1 When you were
between the ages of 9
and 14, was your
Paternal figure more
possessive of you
and/or more physially
and verbally expressive
of affetion for you than
your !aternal figure
was"
#$S
% &f your partner ends a
relationship that you
wish to ontinue, do you
find your thoughts
drifting ba' to your
partner, and your
energies turning toward
restoring the
relationship, to the point
where you find it diffiult
to onentrate on other
things"
#$S
( &s your relationship the
)number one priority* in
your life"
+,
4 -o you en.oy seleting
and giving gifts to your
partner"
#$S
/ -o you feel that you
demonstrate more
outward affetion and
love toward your partner
than he/she does
toward you"
With previous
relationships yes, but as
of late +,
0 1re you omfortable
when your partner
shows you attention or
flatters you when others
are present"
#$S
2 &f you suspeted your
partner of heating on
you, would you lay more
blame on the third party
who led him/her astray
than you would on your
partner for being led
astray"
,n both parties
3 &s it easier for you to
express intimate
feelings and attitudes
than it is for your
partner to do so"
+,
9 Would you find it easy
to aept your partner4s
hildren from a previous
marriage or
relationship"
Possibly
15 1re you more .ealous,
and/or possessive of
your partner then
he/she is of you"
+,
11 When you and your
partner are having sex,
do you desire to prolong
the at as long as
possible, or to repeat
the at at one or
following a short rest"
+,
1% Would you li'e your
partner to approah you
sexually more than
he/she does at present"
not urrently appliable
but in the past +,
1( 6oo'ing ba' to a
previous relationship,
were you ever re.eted
so badly that you
experiened
tremendous physial
and/or emotional pain
as a result"
#$S
14 &n a past relationship
where you felt you had
been re.eted, were you
apable of extreme
anger, tantrums,
vinditive behaviour
toward your partner, or
violene" 1nswer *yes*
if you felt apable of
one or more of these
behaviours7
+,
1/ When you first meet a
person to whom you are
sexually attrated, is
your attention initially
drawn to the area of the
body below the waist,
rather than above the
waist"
+,
10 1re you more soially
outgoing and
extroverted than your
partner"
&t has depended on the
relationship, but
reently, +,
12 When there is a
problem in your
+,
relationship, do you feel
that, rather than .ust
lettings things *blow
over,* you need to *tal'
it out* with your partner
before you an again
feel seure in the
relationship"
13 &n a relationship, do you
have a need for your
partner to tell you
*where you stand* with
him/her"
+,
19 -o you want to have
sex more often than
your partner does"
+/1
%5 Would you li'e your
partner to tal' about
what he/she is feeling
and experiening while
you are ma'ing love"
#$S
TOTAL
Sexuality Questionnaire 1
!imply check "es or #o $eside each question. The term %aternal or &aternal 'igure is used
to designate the primary role model who had the most influence upon you and your life.
QUESTION Y
E
S
N
O
1 When you were between
the ages of 9 and 14, was
your Paternal figure less
possessive of you and/or,
less physially and
verbally expressive of
affetion for you than your
!aternal figure was"
+,
% -oes your antiipation of
the pleasure you will
reeive from sex often
exeed the pleasure you
atually experiene from
the at itself"
+o
( -uring sex with your
partner, do you often
fantasi8e about a different
partner or sexual at in
order to beome or remain
sexually aroused"
+o
4 -o you often find yourself
wanting to hurry up and
end the sex at before
your partner does"
no
/ -uring sex with your
partner, is it more of a turn
off than a turn on if your
partner 'isses you
heavily"
+o
0 -uring a single evening or
session of lovema'ing,
after you and your partner
have had sex, does he/she
usually want to have sex
again before you do"
+o
2 Shortly after you omplete
the sexual at do you feel
a desire to fall asleep,
move away from your
partner, or to engage in
some non9sexual ativity
:reading, wathing
television, ta'ing a
shower, et7; rather than
*uddle* with your partner"
1nswer yes if you feel the
desire, whether or not you
atually do engage in the
other ativity7
+o
3 1fter the newness of a
relationship wears off do
you find that your sex drive
diminishes to a level
where it is appreiably
lower than your partner4s"
+o
9 <hin'ing ba' to the end
of a previous relationship,
did you already have a
new partner in mind,or
were you already involved
with someone else, before
the relationship ended"
+,
15 &f your partner tal's about
the sex at while you are
having interourse do you
find it harder to
onentrate on your
sexual feelings"
+o
11 -o you feel omfortable if
your partner touhes,
'isses, or handles you in
publi"
yes
1% -o you find exuses not to
have sex with your partner
more often than your
partner ma'es exuses
not to have sex with you"
+o
1( 1fter you and your partner
have resolved an
argument or
disagreement, does it
usually ta'e you a longer
time than your partner to
*forgive and forget* and
get ba' into the mood to
have sex with him/her"
+o
14 -oes it bother or annoy
you to have to give your
partner fre=uent
reassuranes and
ompliments"
+o
1/ -o you seem to need
more *alone time* away
no
from your partner than he
or she needs away from
you"
10 &nstead of tal'ing about
your relationship, do you
usually ta'e the attitude
that as long as you don4t
omplain, everything is
,>"
+o
12 When you and your
partner are ma'ing love,
does it ma'e you
unomfortable if your
partner tal's expliitly
about what he or she is
feeling or doing, or as's
you to tal' about what you
are feeling or doing"
no
13 When you first meet a
person to whom you are
sexually attrated, is your
attention initially drawn to
the area of the body above
the waist, rather from the
waist down"
above the waist
19 -o you thin' you are
apable of being in love
with more than one person
at the same time"
yes ? no
%5 -oes your partner want
sex more often than you
do"
no
TOTAL
www7+u9@lear7o A Based on the wor' of -r7 Cohn >appas