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Name How important is it to you?
Gender Are you satisfied with being who you are?
Body Are you satisfied with your physical appearance? Abilities What are you particularly good at? Mind Do you feel OK about your intellectual ability? Age Are you comfortable with the age you are now? Birth How do you feel about where you were born? Culture(s) Where were you brought up? If you have moved between different cultures, what influences has this had? People Who influenced you most when growing up? Mother What is your opinion of your mother? Father What is your opinion of your father? Siblings What is your opinion of your brothers/ sisters? If you have no brothers or sisters what influence has that had? Education What influence did your education have? What would you like to have achieved which you did not? Employment List the various jobs you have had, the people you remember associated with those jobs, and the overall influence of the work and the associated people. Spouse If you are married, how has your spouse influenced you? Children How have your children influenced you? If you wanted children, and were unable to have them, how has that influenced you? Unmarried If you are unmarried, or have no partner, what influence does that have? Preferences How do your sexual preferences influence you? Values What values do you have, and what influence do they exert? Have you taken them over from other people without thought? Beliefs What are your fundamental beliefs? How did you acquire them? Religion If you are religious, what influence does that exert? If you have no religion, what influence does that exert? Experiences What life experiences are significant for you, and why? Health How have any illnesses or accidents influenced you? Memories What memories do you treasure, and what memories do you try hard to forget? Relationships What relationships in the past are you glad you had, and what relationships do you wish you had never had? Circumstances What life circumstances, past or present, do you welcome, and which do you regret? Authority Who represents authority for you, in the past and now? What influence do these authority figures exert on you? Strengths What are your major strengths, and how might these influence your listening to clients? Weaknesses What are your major weaknesses, and how might these influence your ability to listen to clients? Virtues What do you consider to be your virtues? How do they influence your behaviour? Vices Do you have any vices, and how do they influence your relationships?