Couples Interaction Consent

Interaction Questionnaire

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To help you better in our journey together, I’d like to review your strengths and some important characteristics about how you interact with others. There are no right or wrong responses to the questions below. Please mark only ONE response. We’ll go over you and your partner’s responses together and see how to apply it to our work going forward.

Almost everyone has a dominant style in which they interact with others: Would you say that, in relationship to others, predominantly, you :

feel independent & self-reliant , with a tendency to prefer to be alone if you had a choice.

focus more on taking care of others, with a tendency to prefer other’s company than being alone.

easily feel flustered and overwhelmed by your feelings, alternate moving close then pulling away from others.

adapt easily to the needs of the moment—your needs as well as others’ needs.

What would you say about your partner? does s/he:

feel independent & self-reliant , with a tendency to prefer to be alone if you had a choice.

focus more on taking care of others, with a tendency to prefer other’s company than to be alone.

easily feel flustered and overwhelmed by his/her feelings, alternate moving closer then pulling away from others.

adapt easily to the needs of the moment – your needs as well as others’ needs.

When you get upset, & feel somehow threatened, your first [predominant] reaction is:

to flee, run away, often literally remove yourself from the context;

to fight, disagree, talk back;

to fade, withdraw, become silent.

People also have styles in how they regulate their emotions; Would you say that you are:

“quick to temper”, i.e. go from -0- to -100- in a flash?

more of a “slow burn”, you’re fine fine fine, then suddenly blow?

you’re an “even slope”, step by step feeling more emotional?

When your partner gets upset, & feels somehow threatened, his/her first [predominant] reaction is:

to flee, run away, often literally remove yourself from the context;

to fight, disagree, talk back;

to fade, withdraw, become silent.

Would you say that your partner is:

“ quick to temper”, i.e. goes from -0- to -100- in a flash?

more of a “slow burn”, s/he’s fine fine fine, then suddenly blows?

s/he’s an “even slope”, step by step getting more emotional?

Untitled Survey Field

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
You are aware of when your emotions are getting aroused?
Your partner is aware when his/her emotions are getting aroused?
After becoming upset, you recover easily
After becoming upset, your partner easily recovers:
You appreciate other[s] reaching out to help [soothe] you
Your partner appreciates others reaching out to help [soothe] him/her
You are able to take your partner’s perspective when different from yours
S/he is able to take your perspective when different from his/hers:
You easily take responsibility for your own thoughts, feelings, actions
S/he easily takes responsibility for his/her own thoughts, feelings, actions

Zoom and In-person sessions offered.

JOY A. DRYER Ph.D

Interaction Questionnaire