The following are the more common forms of unacceptable behaviour that occur in a dysfunctional relationship.
Please check off each type of abuse that you have done in the past three months.

PHYSICAL VIOLENCE:

_____ Slap, punch, grab, kick, choke, push, restrain, pull hair, pinch, bite.

_____ Rape (use of force, threats or coercion to obtain sex).

_____ Use of weapons, throwing things, keeping weapons around which frighten her/him.

_____ Abuse of furniture, home furnishings, pets, destroying her/his possessions.

_____ Intimidation (standing in the doorway during arguments, angry or threatening gestures, use of size to intimidate, standing over her/him, out-shouting, driving recklessly).

_____ Threats (verbal or nonverbal, direct or indirect).

_____ Harassment (uninvited visits or calls, following her/him around, checking up on her/him, embarrassing her/him in public, not leaving when asked).

_____ Isolation (preventing or making it difficult for her/him to see or talk to friends, relatives or others).

_____ Other - Please list.

PSYCHOLOGICAL AND ECONOMIC ABUSE

_____ Yelling, swearing, being lewd, raising your voice, using angry expressions or gestures.

_____ Criticism (name-calling, swearing, mocking, put-downs, ridicule, accusations, blaming, use of trivializing words or gestures).

_____ Pressure tactics (rushing her/him to make decisions, using guilt or accusations, sulking, threatening to withhold financial support, manipulating the children, abusing feelings).

_____ Interrupting, changing topics, not listening, not responding, twisting her/his words.

_____ Economic Coercion (withholding money, the car, or other resources; sabotaging her/his attempts to work).

_____ Claiming "The Truth", being the authority, defining her/his behaviour, using "logic".

_____ Lying, withholding information, infidelity.

_____ Withholding help on childcare or housework; not doing your share, not following through on your agreements.

_____ Emotional withholdings (not expressing feelings; not giving support or validation; not giving attention or compliments; not respecting her/his feelings, rights and opinions).

_____ Not taking care of yourself (not asking for help or support from friends, abusing drugs or alcohol, being a "people-pleaser").

_____ Other forms of manipulation.