Statement 1 1. I find it hard to take time for myself and have fun
0 Seldom or never1 Sometimes2 Frequently
Statement 2 2. I supply words for others when they hesitate
0 Seldom or never1 Sometimes2 Frequently
Statement 3 3. I set limits for myself which I then exceed
0 Seldom or never1 Sometimes2 Frequently
Statement 4 4. I believe I am responsible for keeping or making others happy
0 Seldom or never1 Sometimes2 Frequently
Statement 5 5. I tend to do things for others that they can do themselves
0 Seldom or never1 Sometimes2 Frequently
Statement 6 6. I believe others are not sufficiently grateful for my help
0 Seldom or never1 Sometimes2 Frequently
Statement 7 7. I take care of others more than I take care of myself
0 Seldom or never1 Sometimes2 Frequently
Statement 8 8. I find myself interrupting when others are talking
0 Seldom or never1 Sometimes2 Frequently
Statement 9 9. I make excuses for others, either openly or mentally
0 Seldom or never1 Sometimes2 Frequently
Statement 10 10. I look for clues on how to be helpful to others
0 Seldom or never1 Sometimes2 Frequently
Statement 11 11. I do more than my share and work harder than others
0 Seldom or never1 Sometimes2 Frequently
Statement 12 12. When others are unsure or uncomfortable, I step in quickly
0 Seldom or never1 Sometimes2 Frequently
Statement 13 13. I give up doing things because others would not like it
0 Seldom or never1 Sometimes2 Frequently
Statement 14 14. I find myself thinking that I know what is best for others
0 Seldom or never1 Sometimes2 Frequently
Statement 15 15. I think others would have difficulty coping without me
0 Seldom or never1 Sometimes2 Frequently
Statement 16 16. I use the word “we” and then find I don’t have others’ agreement
0 Seldom or never1 Sometimes2 Frequently
Statement 17 17. I stop myself from saying what I think others will feel bad about
0 Seldom or never1 Sometimes2 Frequently
Statement 18 18. I find it hard not to respond to anyone who seems hurt or in need
0 Seldom or never1 Sometimes2 Frequently
Statement 19 19. I find myself being resented when I was only trying to help
0 Seldom or never1 Sometimes2 Frequently
Statement 20 20. I give advice that is not welcome or accepted
0 Seldom or never1 Sometimes2 Frequently