Compulsive, Habitual Behaviors...please choose ALL that apply
I have struggled with "addictive" compulsive behaviors in the past.
I STILL struggle but I am not overcome by them anymore.
I have NEVER struggled with habitual, besetting thoughts or behaviors.
In all honesty, I have little success resisting my temptations.
The term "addict" or "addictions" describes where I am right now.
I have paid a significant price because of my behavior.
I think we make too big a deal about all this - we all have our weaknesses.
No one really knows the depth of my struggle.
There is no one I have ever really talked to about this.
I am married and my spouse KNOWS about my struggle(s).
I am married and my spouse IS UNAWARE of my compulsion(s).
I am currently having relationship problems because of my issue(s).
I am concerned about my behavior's effect on my personal relationships.
I am worried about potential legal consequences of my behavior.
I am bothered by the possible financial impact of my behavior.
My job may be jeopardized because of my actions.
I try not to think about how discovery would affect my reputation.
I am troubled by how this impacts my relationship with God.
I am single.
I am engaged.
I am married.
I am divorced.
I am separated.
I am living together with someone but not married to them.
I am remarried.
I am widowed.
I am MALE.
I am FEMALE.
I am heterosexual.
I am gay.
I am bisexual.
I am transgendered.
I am uncertain about my sexual orientation..
My age is 13 - 18
I have children living at home with me.
My children do not live with me.
My children are adults.
I do not have children.
If I died today, I am CERTAIN I would go to heaven.
If i died today, I WOULD NOT go to heaven.
I'm not sure where I would go if I died today.
I don't believe in heaven AND/OR I don't believe in hell.
I frequently attend church.
I sometimes go to church.
I go to church mostly for special occassions.
I basically never go to church.
I have no religious beliefs or denominational preference.
I am Catholic.
I am Buddihst.
I am Muslim.
I am Evangelical Protestant.
I am Mormon.
I am Hindu.
I am Jewish.
My faith or belief is none of those listed.
I am willing to share the basic issue(s) I am struggling with.
I struggle with gambling.
I struggle with the Internet.
I struggle with abusing prescription medications.
I struggle with drug use.
I struggle with pornography.
I go to strip clubs.
I go to massage parlors.
I live the "hook-up" culture.
I seek out prostitutes.
Self-gratification/masturbation is one of my issues.
I have other sexual behaviors or attitudes not listed here.
I would like very much to talk to someone confidentially (CALL TOLL FREE (866)-341-3828)
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