The Relationship Reset Questionnaire

Partner 1's name(Required)
Partner 2's name(Required)
It helps me feel more connected with you when I can picture who I'm talking with. This isn't a requirement, but if you feel comfortable uploading a photo of yourselves, please do!
Drop files here or
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    Each question has two entry boxes so that both of you can share your perspectives. While the second box isn't required, it’s incredibly helpful to get input from each of you in your own words. Please DO NOT fill out the second box as if you were your partner. If you have thoughts on what they might be thinking or how it’s contributing to the conflict, include those in your own box. The second box is only for your partner to complete.

    Describe the conflict(s) in your relationship, in your own words, including how long it has been an issue.

    What do you believe is at the heart of this conflict? Feel free to share your thoughts, feelings, values, previous hurts - anything that might be contributing to your unease.

    Do you have any past traumas around sex or relationships that might be contributing to how you think about this? This might include watching your parents fight, poor treatment in previous relationships, Purity Culture teachings, and other past verbal, emotional, physical, or sexual abuse.

    When the conflict comes up, how do you typically respond? How does your partner respond?

    How have you tried to resolve this issue in the past? Were there things that helped? Were there things that made it worse?

    How do you feel this conflict is impacting your relationship?

    What would a resolution to this issue look like for each of you? How do you imagine your relationship would feel if this were no longer an issue?