Child Healing: Mistrust Checklist

Mistrust Checklist

Rate your child on how often he or she behaves in the following ways.

0 - Never | 1 - Very Little | 2 - Moderately Often | 3 - Very Often

Behaviors

Numerous controlling behaviors

Never Very Little Moderately Very Often

Restlessness and hyperactivity (an absence of feeling safe)

Never Very Little Moderately Very Often

Inability to show affection (fearful of being vulnerable)

Never Very Little Moderately Very Often

Scapegoat mother or siblings with anger

Never Very Little Moderately Very Often

Difficulty praising others (fearful of allowing anyone to be close)

Never Very Little Moderately Very Often

Excessive social isolation

Never Very Little Moderately Very Often

Poor eye contact

Never Very Little Moderately Very Often

Few close friends

Never Very Little Moderately Very Often

Compulsive eating

Never Very Little Moderately Very Often

Excessive drinking or drug usage

Never Very Little Moderately Very Often

Addiction to pornography (escape to fantasy world)

Never Very Little Moderately Very Often

Tendency to isolate oneself

Never Very Little Moderately Very Often

Difficulty in receiving help or advice from others

Never Very Little Moderately Very Often

A need to have things his/her own way

Never Very Little Moderately Very Often

Not open to date

Never Very Little Moderately Very Often

Withdrawal from others in front of TV, books, computer, etc.

Never Very Little Moderately Very Often

Overly strong dealing with others (caused by fear of being hurt)

Never Very Little Moderately Very Often

Poor team player

Never Very Little Moderately Very Often

Compulsive masturbation

Never Very Little Moderately Very Often

Poor personal hygiene

Never Very Little Moderately Very Often

Aggressive behaviors

Never Very Little Moderately Very Often

Passive-aggressive behaviors

Never Very Little Moderately Very Often

Emotions

Regularly irritable or hostile (anger keeps others at distance)

Never Very Little Moderately Very Often

Overly anxious

Never Very Little Moderately Very Often

Over-reaction emotionally to minor life events

Never Very Little Moderately Very Often

Rarely relaxed or peaceful

Never Very Little Moderately Very Often

Bad temper

Never Very Little Moderately Very Often

Overly upset if things don't go as planned

Never Very Little Moderately Very Often

Very lonely (fearful of being vulnerable and of receiving love)

Never Very Little Moderately Very Often

Fearful of the future

Never Very Little Moderately Very Often

Emotional rigidity

Never Very Little Moderately Very Often

Lack of gentleness

Never Very Little Moderately Very Often

Panic attacks

Never Very Little Moderately Very Often

Thinking

Catastrophic thinking (something bad is going to happen)

Never Very Little Moderately Very Often

Rigid thinking - a lack of openness

Never Very Little Moderately Very Often

Excessive criticism of others (as a unconscious way to distance people)

Never Very Little Moderately Very Often

Negative thinking

Never Very Little Moderately Very Often

Suspiciousness

Never Very Little Moderately Very Often

Hypochondriacal thinking (fear of serious illness)

Never Very Little Moderately Very Often

Excessive fantasy life

Never Very Little Moderately Very Often

Obsessional fearful thoughts

Never Very Little Moderately Very Often

Paranoid thinking

Never Very Little Moderately Very Often

Obsessional thoughts of controlling others

Never Very Little Moderately Very Often

Physical Health

Irritable bowel syndrome

Never Very Little Moderately Very Often

Muscle spasms in different parts of the body

Never Very Little Moderately Very Often

Colitis

Never Very Little Moderately Very Often

Severe headaches

Never Very Little Moderately Very Often

Dizziness/lightheadedness

Never Very Little Moderately Very Often

Spiritual Life

Limited ability to receive love

Never Very Little Moderately Very Often

Anger with God

Never Very Little Moderately Very Often

Refuse to go to Church

Never Very Little Moderately Very Often

Limited ability to pray

Never Very Little Moderately Very Often

Withdrawal into religion (excess religiosity)

Never Very Little Moderately Very Often

Mistrust Total: