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Fatigue
Not At All Very Much
Nausea
Not At All Very Much
Insomnia
Not At All Very Much
Dizziness
Not At All Very Much
Headaches
Not At All Very Much
Loss of appetite
Not At All Very Much
Rapid heart rate
Not At All Very Much
Overall Tenseness
Not At All Very Much
Confusion
Not At All Very Much
Hypervigilance
Not At All Very Much
Memory problems
Not At All Very Much
Lack of concentration
Not At All Very Much
Poor decision making
Not At All Very Much
Poor problem solving
Not At All Very Much
Easily reminded of the event
Not At All Very Much
Intrusive thoughts and images
Not At All Very Much
Fear
Not At All Very Much
Guilt
Not At All Very Much
Anger
Not At All Very Much
Denial
Not At All Very Much
Anxiety
Not At All Very Much
Sadness
Not At All Very Much
Shame
Not At All Very Much
Depression
Not At All Very Much
Self-blame
Not At All Very Much
Longing
Not At All Very Much
Agitation
Not At All Very Much
Emotional outbursts
Not At All Very Much
Avoidance of others
Not At All Very Much
Impaired work performance
Not At All Very Much
Increased need to keep busy
Not At All Very Much
Increased or decreased appetite
Not At All Very Much
Increased alcohol consumption
Not At All Very Much
Increased interpersonal conflicts
Not At All Very Much
Decreased interests in usual activities
Not At All Very Much
Excessive sleeping
Not At All Very Much
1. My heart will always have this wound so I will never be happy again.
Not At All Very Much
2. My grief and mourning should be focused on my departed. Self-care is selfish.
Not At All Very Much
3. I must do grief alone because no one can possibly understand the pain I am going through.
Not At All Very Much
4. I will never be happy again.
Not At All Very Much
5. I would never see a grief therapist/guide. It would do no good.
Not At All Very Much
6. My departed is gone. If I stop longing for them, I may forget him/her.
Not At All Very Much
7. If I move forward, that is dishonoring my departed.
Not At All Very Much
8. Loss is a part of life. Grief is a natural consequence of loss.
Not At All Very Much
9. I am not broken. I am broken open to feel emotions, heal through the guidance of the body and discover Integrated Wellbeing.
Not At All Very Much
10. Grief is a gateway to growth.
Not At All Very Much
1. When grief overwhelms me it feels like…
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
2. The one thing I wish would change is…
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
3. My biggest fear is…
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
4. What I would like to have happen is…
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
5. What is working to release your grief?
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
6. Is there a ray of hope in all of this? If so, what is it?
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
7. What is not working to release your grief?
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
8. Where is grief in your body?
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
9. What would you like to have happen as an outcome of us working together?
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10. By when?
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