Your Experiences Survey

1. I believe I have to keep people from finding out what I am thinking, what I am feeling, or what I do when I am alone.

• Rarely
• Sometimes
• Often

2. When I am with other people I try to appear as if everything is OK to keep them from knowing my secrets.

• Rarely
• Sometimes
• Often

3. Fantasies or urges to engage in secret behaviors intrude on my ability to be fully involved in my regular daily activities.

• Rarely
• Sometimes
• Often

4. I am impatient to get time by myself to engage in secret behaviors.

• Almost never
• Sometimes
• Regularly
• Often

5. I use my secret fantasies and behaviors to get away from the problems in my life.

NOTE: Fifteen additional questions follow these samples.

© 2007 True You Recovery, Inc.
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