Great Relations
Questionnaire:
Do we need couples therapy?
01
EFT-BASED COUPLES SELF-ASSESSMENT
How secure is our emotional connection?
How to use the Questionnaire:
-
Read each statement and choose the option that best describes your relationship most of the time.
-
Scale:
1 = Strong yes
2 = Yes, sometimes not often
3 = Unsure
4 = Yes, sometimes quite often
5 = Strong no -
Go through the questionnaire individually not together
02
Emotional Safety & Bond
EFT views emotional safety as the foundation of a secure relationship.
-
I feel emotionally safe being vulnerable with my partner.
-
When I share difficult feelings, my partner responds with care and interest.
-
I trust that my partner is emotionally there for me when I need it.
-
I feel accepted by my partner, even when I’m upset or imperfect.
03
Accessibility & Responsiveness
A key EFT question is: “Are you there for me?”
-
My partner notices when I am emotionally distressed and address it in kind way.
-
When I reach out for comfort, my partner responds rather than withdraws or attacks.
-
I experience my partner as emotionally accessible, not distant or shut down.
-
I believe my partner seeks to understand what’s going on - on the inside of me.
04
Negative Interaction Patterns
EFT focuses on identifying cycles (e.g. pursue–withdraw, criticize–defend).
-
We often get stuck in the same arguments without resolution.
-
During conflict, one of us tends to withdraw while the other pushes harder.
-
Our arguments escalate quickly and feel emotionally overwhelming to me.
-
After conflict, it´s hard for us to reconnect emotionally.
05
Emotional Awareness & Expression
EFT helps couples move from secondary reactions (anger, blame) to core emotions (fear, longing).
-
I can identify and express my deeper emotions (fear, sadness, longing) to my partner.
-
I am not afraid to say out loud what really goes on -on the inside of me.
-
I feel understood when I talk about what really hurts underneath the anger.
-
I know what my partner is most afraid of losing in our relationship.
-
​We are able to talk about unmet emotional needs without blaming each other.
06
Attachment Needs & Longing
EFT is attachment-based: love is about connection and reassurance.
-
I feel emotionally safe being vulnerable with my partner.
-
When I share difficult feelings, my partner responds with care and interest.
-
I trust that my partner is emotionally there for me when I need it.
-
I feel accepted by my partner, even when I’m upset or imperfect.
07
Reflection & Guidance (EFT-aligned)
Mostly 4–5s:
Your emotional bond shows many secure elements. Therapy may still be valuable for deepening connection, repairing specific wounds, or preventing negative patterns from becoming worse.
​
Mix of 2–4s:
This suggests emotional disconnection or unstable responsiveness. EFT couples therapy can help you slow down negative cycles, express underlying needs, and rebuild safety.
​
Many 1–2s:
This often indicates attachment distress—feeling unseen, unsafe, or alone in the relationship. EFT therapy is strongly recommended to help repair the bond and restore emotional security.
​
Core EFT Question to Discuss Together
“When I am vulnerable or hurting, do I experience you as emotionally there for me?”
If this question feels difficult, painful, or unanswered, EFT couples therapy can provide a structured facilitated and safe way to help you understand the current situation of your relationship and communicate with freedom to express what you really want to say in a way that is not hurting your partner.
​
Important Note
Please be very aware not to push your partner to go through this reflection tool.
Ask: " Is this a good time for you?" If not - respect the boundaries set. You are free to do what is right for you as an individual. Your partner might feel differently.
The answer should come as a clear yes founded in curiosity.
This questionnaire is not a relationship diagnosis, but an EFT-based reflection tool. If answering these questions brings up strong emotions, that in itself is a sign that professional support could be helpful.
