Bach Flower Questionnaire

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Instructions

1. Read each statement and check the ones that reflect your emotional state at this time.
2. Choose a max of 7 remedies.

3. If you have selected more than 7 remedies, think about your current situation and what you want to improve now, this will help you narrow down your previous selection.

4. If you need my services: Bach Flower Mix, Consultation or other questions, please send me an email at andreaterapiadebach@gmail.com and I get back to you.

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First and Last Name *

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Agrimony

I hide my feelings behind a facade of joy.

I prefer to keep the peace by not expressing how I really feel.

When I feel bad I take refuge in food, work, alcohol, drugs.

Aspen

I feel anxious without knowing why

I'm afraid that something bad is going to happen, but I don't know what.

I can't find the source of my fears

Beech

I can be very critical of the behaviour of others

I find it difficult to understand the defects of others.

Sometimes I wish I were more tolerant and empathetic.

Centaury

I often forget my own needs to please or help others.

I find it difficult to say "No."

I give more than I really can, since I don't like to disappoint anyone.

Cerato

I constantly doubt my decisions.

I seek advice from other people, not trusting my own intuition.

I often change my mind because of my own confusion.

Cherry Plum

I'm afraid I may lose control of myself.

I have sudden outbursts of anger or rage.

I have impulses to hurt others or myself.

Chestnut Bud

I make the same mistakes over and over again.

It is hard for me to learn from my experiences.

I keep repeating the same patterns.

Chicory

I have the need to be loved and / or needy.

I care for my loved ones, but I feel unappreciated by them.

I have a strong motherly / fatherly spirit and I am often overprotective.

Clematis

I often feel in the clouds; distracted and / or fantasizing.

I find it hard to concentrate and I get bored easily.

I occupy my time thinking about my dreams or the future, rather than living the present.

Crab Apple

I am too concerned about cleanliness, order.

I am afraid that germs, bacteria, viruses can contaminate me.

I feel unattractive and / or there are parts of me or my body that I really do not like.

Elm

I feel overwhelmed by my work and / or family responsibilities.

The pressures of this moment make me feel overwhelmed and exhausted.

I have momentarily lost confidence in myself

Gentian

I am put off by setbacks or problems that arise even if they are small.

I feel discouraged or not confident in finding a solution

I am skeptical and sometimes even pessimistic.

Gorse

I feel hopeless, and I can't see a way out.

I have lost faith that things could get better in my life.

I don't think anyone or nothing can help me.

Heather

I am somewhat obsessed with my own problems.

When I'm alone or without someone to talk to, I feel empty.

I love talking about myself, my problems, family, illness, etc.

Holly

I feel like my heart has hardened.

I feel discontented , unhappy, frustrated without knowing why.

I feel jealousy, anger, distrust, revenge or hatred.

Honeysuckle

I often feel homesick.

I think more about past experiences than the present.

I often wish my life were as before.

Hornbeam

I often feel too tired to face the day ahead.

I have the feeling of "Monday morning" every day.

I tend to put things off, since I don't have the energy to do them.

Impatiens

I find it difficult to wait and I get irritated easily.

I am impatient, restless and nervous

I prefer to work alone, as I don't like to keep up with others.

Larch

I lack self-confidence or have low self-esteem.

I am afraid of failure and I don't trust my own abilities.

I expect nothing but failure despite not having tried it yet

Mimulus

I am afraid of specific things like spiders, darkness, illness, etc.

I am shy, overly sensitive and / or modest.

I get nervous and easily embarrassed.

Mustard

I get depressed, but I can't find a reason.

My moods are unstable, they change unexpectedly.

I have feelings of grief, sadness that come and go.

Oak

I tend to overwork and continue despite exhaustion.

I have a strong sense of duty and I don't give up.

I suppress my own needs in order to complete tasks or obligations.

Olive

I feel completely exhausted, physically and / or mentally.

I am completely drained of energy and without any further reserves.

I am coming out or I am from a period of illness or prolonged stress.

Pine

I am always apologizing.

I feel guilty for past or present events, sometimes even for others people's mistakes

I feel inferior or that I do not deserve good things in life.

Red Chestnut

I am too occupied and /or worried about the well-being of my loved ones.

I am concerned about the problems of my loved ones more than my own.

I am very concerned that something bad could happen to the people I love.

Rock Rose

Sometimes I feel terror and panic.

My fears paralyze me and I feel helpless.

I suffer from nightmares and / or panic attacks

Rock Water

I am very demanding and hard on myself to achieve the best.

I am strict with my health, work and / or spiritual discipline

I am very disciplined and I aim perfection

Scleranthus

For me it is a dilemma to make decisions.

It takes me time to choose and when I do I easily doubt or regret it.

I have a hard time choosing between two options.

Star of Bethlehem

I am devastated due to a recent event.

There are traumatic events in my life that I have not been able to overcome.

I have not recovered from losses and / or difficult times in my life.

Sweet Chestnut

I am in extreme emotional pain, mentally I feel distressed and desperate.

I have reached the limit of my endurance.

Hope is gone and I can't see the joy in life.

Vervain

I get involved in many activities, without giving myself time to rest or relax.

I try to convince others of my way of thinking, ideals, principles.

I am very sensible to injustice, inequalities.

Vine

I refuse to be discussed, as I am right and the last word.

I consider myself a natural leader at work and at home I command.

I am strong-willed, self-confident, bossy and domineering.

Walnut

I am experiencing changes in my life; a move, new job, menopause, etc.

I feel I am being questioned by my current project, by people or situations.

I need help to adjust to my new situation or change.

Water Violet

Others believe that I am unapproachable, arrogant, or that I feel special.

I prefer solitude when I feel overwhelmed and I don't like talking to others about my problems.

I don't often connect with people and prefer to be alone.

White Chestnut

I am constantly thinking about unwanted things.

I relive in my mind unwelcome events or discussions over and over again.

Sometimes I am unable to sleep, because I cannot stop thinking.

Wild Oat

I can't find my way in life.

I feel adrift and lacking in direction.

I have tried several careers or jobs and still can't find the right one for me.

Wild Rose

I feel apathetic and resigned to what happens to me.

I have the indifferent attitude towards myself, I don't want to do something to improve my situation.

I do not feel joys in life or inner motivation.

Willow

I feel resentful, bitter.

I feel that I am not responsible for my problems but a victim.

I think that life has been unfair and I wonder what I have done to deserve it.

(Optional) If you want, you can describe briefly how you feel now or what situation you want to improve at the moment

Send me a copy of my responses.

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