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Mind Ease
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Mind Ease
MindEase – Self-Assessment
Name
*
First
Last
Email
*
I get so anxious that my heart rate increases and my thoughts become scattered.
*
Often
Seldom
I find it difficult to focus on any one thing for too long as I am easily distracted by noise or people’s demands.
*
Often
Seldom
It’s difficult for me to find any peace in my day.
*
Often
Seldom
At times my life feels out of control and I cannot bring any positive influence to bear.
*
Often
Seldom
Even small things can upset my whole day and I find it difficult to focus on the task at hand.
*
Often
Seldom
Life is against me and no matter what I do I will not be able to change it in a positive direction.
*
Often
Seldom
I have no control over events in my life and feel like I do not have the power to change anything.
*
Often
Seldom
I no longer feel motivated or able to control negative experiences that come into my life.
*
Often
Seldom
I can’t change my life.
*
Often
Seldom
Peace is difficult for me to attain.
*
Often
Seldom
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