Domestic Violence: Does your partner .... (or have you ever felt your partner ....)

_______ Makes you beg for money
_______ Puts you on an allowanceyou an allowance
_______ Requires you to turn over paycheck
_______ Ignores your request to curtail spending
_______ Make major purchases without your knowledge
_______ Hides bills from you
_______ Makes you ask for necessary items, i.e., food, personal hygiene items, children's items
_______ Takes your money behind your back
_______ Rejects separate bank accounts/demand a joint account
_______ Demands pre-nuptial agreement limiting your access to their money
_______ Not letting you know about family income or resources
_______ Asks where you're going when you leave a room or house
_______ Asks you to wake them up
_______ Blames you if they're late for work
_______ Restricts your access to church or other civic groups
_______ Tells you how to vote or demands to know how you voted
_______ Prevents you or children from getting or keeping a job;
_______ Limits your outside activities
_______ Determinies who you can/cannot see
_______ Controlling where you goes/what you does;
_______ Moving you and children to isolated area with no contact with friend or family;
_______ Restricting your use of phone/vehicle.
_______ Male priviledge
_______ Partner assists equally in home chores
_______ Partner shares child rearing responsibilities equally
_______ You have to get permission to socialize with your friends?
_______ Your accused of cheating when you leave the house to do errands, etc.?
_______ Your afraid to talk about certain topics unless partner is in a good mood?
_______ Controls the money and monitors your spending?
_______ Tells you no one else would ever want you?
_______ Threatens to harm self if you leave relationship?
_______ Goes through your wallet or purse.
_______ Opens your mail.
_______ Disposes mail before you see it
_______ Demands use of Caller-ID on phone line
_______ Erases Caller ID log before you get home
_______ Makes disparaging remarks about the way you look or dress?
_______ Uses things against you that you've confided or shared in the past?
_______ Sabotages your efforts to be involved in pleasant social or family events?
_______ Compares you negatively to members of same sex?
_______ Are you nervous about being on the phone when he is around?
_______ Is it okay to return home later than scheduled without being fearful?
_______ Does it feel more like you have a parent than a partner?
_______ Gives you the 'silent treatment' when you want to talk or work things out?
_______ Tries to turn the children against you?
_______ You feel manipulated by partner's kindness or gifts?
_______ You feel obligated to be sexual with your partner?
_______ Are your activities and interests looked upon as unimportant and trivial?
_______ Sabotages your schedule and outside commitments?
_______ Feel dominated by your partner
_______ Uses intimidation which plays on your guilt, fear, compassion and values
_______ Abusive expectations in which unreasonable demands are placed upon you.
_______ Has unpredictable responses which are drastic mood changes or sudden emotional outbursts.
_______ Uses threats and intimidation
_______ Makes people afraid by using looks, actions, gestures;
_______ Smashes things;
_______ Kills pets;
_______ Destroys property;
_______ Threatens to hurt you* or family members;
_______ Threatens to commit suicide;
_______ Displays weapons
_______ Using children
_______ Making you feel guilty about the children;
_______ Threatening to kill/kidnap children;
_______ Using visitation to harass you;
_______ Minimizing, denying or blaming
_______ Making light of the abuse;
_______ Denying the abuse ever happened;
_______ Exaggerating self importance
_______ Shifting responsibility for abuse, i.e. "It's your fault."
_______ Lieing/ Hiding information
_______ Changes in banking practice
_______ Unauthorized ATM withdrawals
_______ Addition of names to bank signature card
_______ Sudden changes in a will
_______ Disappearance of funds or possessions
_______ Unpaid bills despite adequate financial resources
_______ Inadequate care despite adequate financial resources
_______ Relatives suddenly claiming rights to elder's possessions
_______ Sudden transfer of money to a relative or non-family member
_______ He tries to invoke sympathy from you or your family and friends.
_______ He is overly charming, reminds you of all the good time you've had together.
_______ He tries to buy you back with romantic gifts, dinners, flowers, etc.
_______ He tries to seduce you when you're vulnerable.
_______ He uses veiled threats - to take the kids away, to cut off financial support
_______ His promises to change do not match his behavior.
_______ Bruises, black eyes, lacerations, and welts
_______ Broken bones and fractures
_______ Burns
_______ Cuts, open wounds, and wounds in various stages of healing
_______ Sprains, dislocations, and internal injuries
_______ Poor skin condition
_______ Dehydration or malnourishment
_______ Weight loss
_______ Broken eyeglasses
_______ Signs of restraint
_______ Sudden change in behavior
_______ Lab findings indicating an overdose or deprivation of medication
_______ Caregiver's refusal to allow visitors to see the older person alone
_______ Pushing, shoving, slapping, kicking, punching or biting
_______ Physically restraining you to prevent you from leaving;
_______ Locking victim in or out of home;
_______ Abandoning victim in dangerous places;
_______ Ripping victim's clothing off;
_______ Threatening victim with a weapon;
_______ Throwing objects at people;
_______ Refusing to allow medical attention when victim is ill, injured or pregnant.
_______ Has stopped being violent or threatening to you or others.
_______ Acknowledges that their abusive behavior is wrong.
_______ Understands that they do not have the right to control and dominate you.
_______ You don't feel afraid when you are with them
_______ Does not coerce or force you into having sex when you don't want to.
_______ You can express anger toward them without feeling intimidated.
_______ Does not make you feel responsible for their anger or frustration.
_______ Respects your opinion even if they don't agree with it.
_______ Respects your right to say "no."
_______ You can negotiate without being humiliated and belittled by them.
_______ They listen to you and respect what you have to say.
_______ Engages in Male/Female priviledge
_______ Frequently calls partner "useless"
_______ Forbidding you to see friends, male or female, or you family
_______ Controlling you activities
_______ Puts you down, sulks for days, makes you feel guilty and blames you for the violence
_______ Refusal to participate in counselling
_______ Refusal to admit they are abusive
_______ Tells anti-male/female jokes or making demeaning remarks about women/men (of sexual nature)
_______ Getting angry/jealous and assuming you are having sex with any available man/woman;
_______ Minimizing feelings about sex
_______ Calling you a whore/slut
_______ Withholding sexual affection
_______ Touching sexually when not wanting to be touched
_______ Forcing sex with others
_______ Forcing to watch while having sex with others;
_______ Forcing unwanted sexual acts;
_______ Forcing sex with weapons.
_______ Shouting for no good reason
_______ Teases partner about their tastes or choices
_______ Threatens suicide or to kill you if you express doubts about the relationship.
_______ Threatens, intimidates, humiliates, yells at, or blames, and made to feel inferior or stupid;
_______ Constant emotional or verbal assaults that make someone feel sad, worthless and/or unwanted;
_______ Name calling, making them feel crazy, playing mind games, and blame shifting;
_______ Using words and feelings to strike out, embarrass, shame, insult or reject
_______ May include excessive, aggressive or unreasonable demands that are beyond a persons capacity;
_______ Constant criticizing, belittling, insulting, and rejecting are all examples of emotional and verbal abuse.
_______ Refusal to try to understand the way you see a situation; labels the your thoughtsas incorrect, or immature.
_______ Claiming that the client has overreacted to something that the therapist has said.
_______ Makes inappropriate jokes about your attributes or behaviour.
_______ Refusing to talk about subjects which you view as important.
_______ Making threats, particularly threats to end the therapy.
_______ Forgets appointments, being late for sessions, or being mentally "elsewhere" when communicating.
_______ Denies that certain events occurred or that certain things were said (also known as Gaslighting .
_______ Making unpredictable responses, such as drastic mood changes, sudden emotional outbursts
_______ Puts you down in front of others
_______ Stopped or tried to stop you from going to work or school
_______ Threw, hit, kicked or smashed something
_______ Physically forced you to have sex
_______ Became very upset because dinner, housework or laundry was not ready when they wanted it
_______ Made you do something humiliating or degrading (e.g., begging for forgiveness, having to ask permission).
_______ Threatened you with a knife, gun, or other waepon
_______ Kicked or bit you.
_______ Threw you around.
_______ Choked or strangled you.
_______ Used a knife, gun, or other weapon to hurt you.
_______ Called you names and /or criticized you.
_______ Tried to keep you from doing something you wanted to do (e.g. going out with friends,going to meetings.)
_______ Screamed at you.
_______ Pressured you to have sex when you didn't want to.
_______ Used withdrawal of sex and/or affection as means of getting you to do what they wanted.
_______ End the discussion with you and made the decision themselves
_______ Threatened to hit or throw something at you.
_______ Put down your family and friends
_______ Restricted your access to family or friends
_______ Gave you angry stares or looks
_______ Slapped, hit, or punched you.
_______ Bossed you around
_______ Threatened you or used a weapon against you
_______ Said things to scare you
_______ Checked up on you (e.g., listened to your phone converstions)
_______ Checked up on you (e.g., checked mileage on car)
_______ Checked up on you (e.g., called you repeatedly at work or home)
_______ Hid or destroyed ATM ,credit cards, check or savings books
_______ Used children to threaten you (You'd lose custody)
_______ Drove recklessly while you were in car
_______ Interfered with visitation
_______ Denied phone access to children
_______ Refused to share in housework or child care
_______ Injured you by causing bruises, cuts, broken bones, etc.