1. When talking to him, do you feel like you're able to express yourself easily, or does he make you feel like there's a wall between you?
A. Unfortunately, yes
B. I don't see him enough to cultivate meaningful relationships with him
2. Has he emotionally changed?
A. No, he is the way he used to be
B. Yes, he’s changed a lot
C. Well, I am not sure
3. He loses interest in you. You feel:
B. I truly don’t know. But in my gut I don't feel he's losing interest
4. How willing is he to spend time with you?
A. A lot
B. A little
C. Sometimes willing, sometimes not.
5. What do you want to have happen for your relationship if you could wave a magic wand?
A. I want him to be in love with me forever
B. I’m not sure
C. I want he was faithful to me forever
6. Do you think of him all the time?
7. How often do you fight?
B. We hardly fight
C. It depends on my mood.
8. Has anything major happened lately?
A. Not that I know of
B. Some personal tragedies we're dealing with
C. Who knows
9. Do you think he spends less time with you than before?
A. Yes, I can see that he's annoyed, and I think that's because he feels distant from me
B. I don’t know, I’m not sure
C. No, he spends the same amount of time with me as he used to
10. Does he often criticize things about you and your relationship?
A. Yes, he keeps saying I should stop doing things that he doesn't like
B. No, not at all
C. No, but I feel like I bother him