Bach Flower Self-Assessment

Bach Flower Self-Help Questionnaire                                                   

Check all that apply. If you have to think about it,skip it. Don’t limit your choices.

 

Agrimony                                                            

___I hide my feelings behind a facade of

cheerfulness

___I dislike arguments and often give in to avoid conflict

___I turn to food, work, alcohol, drugs, etc. when down

 

 

Aspen

___I feel anxious without knowing why

___I have a secret fear that something bad will happen

___I wake up feeling anxious

 

 

 

Beech

___I get annoyed by the habits of others

___I focus on others’ mistakes

___I am critical and intolerant

 

 

 

Centaury

___I often neglect my own needs to please

___I find it difficult to say “no”

___I tend to be easily influenced

 

 

 

Cerato

___I constantly second-guess myself

___I seek advice, mistrusting my own intuition

___I often change my mind out of confusion

 

 

 

Cherry Plum

___I’m afraid I might lose control of myself

___I have sudden fits of rage

___I feel like I’m going crazy

Chestnut Bud

___I make the same mistakes over and over

___I don’t learn from my experience 

___I keep repeating the same patterns

 

 

 

Chicory

___I need to be needed and want my loved ones close

___I feel unloved and unappreciated by my family

___I easily feel slighted and hurt

 

 

 

 

Clematis

___I often feel spacey and absent minded

___I find myself unable to concentrate for long

___I get drowsy and sleep more than necessary

 

 

 

 

Crab Apple

___I am overly concerned with cleanliness

___I feel unclean or physically unattractive

___I tend to obsess over little things

 

 

 

Elm

___I feel overwhelmed by my responsibilities

___I don’t cope well under pressure

___I have temporarily lost my self-confidence

 

 

 

Gentian

___I become discouraged with small setbacks

___I am easily disheartened when faced with difficulties

___I am often skeptical and pessimistic

 

 

Gorse

___I feel hopeless, and can’t see a way out

___I lack faith that things could get better in my life

___I feel sullen and depressed

Heather

___I am obsessed with my own troubles

___I dislike being alone and I like to talk 

___I usually bring conversations back to myself

 

 

 

Holly

___I am suspicious of others

___I feel discontented and unhappy

___I am fully of jealousy, mistrust, or hate

 

 

 

Honeysuckle

___I’m often homesick for the “way it was”

___I think more about the past than the present

___I often think about what might have been

 

 

 

Hornbeam

___I often feel too tired to face the day ahead

___I feel mentally exhausted

___I tend to put things off

 

 

 

Impatiens

___I find it hard to wait for things

___I am impatient and irritable

___I prefer to work alone

 

 

 

Larch

___I lack self-confidence

___I feel inferior and often become discouraged

___I never expect anything but failure

 

 

 

Mimulus

___I am afraid of things such as spiders, illness, etc.

___I am shy, overly sensitive, and modest

___I get nervous and embarrassed

 

 

 

Mustard

___I get depressed without any reason

___I feel my moods swinging back and forth 

___I get gloomy feelings that come and go

 

 

 

Oak

___I tend to overwork and keep on in spite of exhaustion

___I have a strong sense of duty and never give up

___I neglect my own needs in order to complete a task

 

Olive

___I feel completely exhausted, physically, and/or mentally

___I am totally drained of all energy with no reserves left

___I’ve just been through a long period of illness or stress

 

Pine

___I feel unworthy and inferior

___I often feel guilty 

___I blame myself for everything that goes wrong

 

 

Red Chestnut

___I’m overly concerned and worried about my loved ones

___I’m distressed and disturbed by other people’s problems

___I worry that harm may come to those I love

 

 

Rock Rose

___I sometimes feel terror and panic

___I become helpless and frozen when afraid

___I often have nightmares

 

 

Rock Water

___I set high standards for myself

___I am strict with my health, work&/or spiritual discipline

___I am very self-disciplined, always striving for perfection

 

 

 

Scleranthus

___I find it difficult to make decisions

___I often change my opinions

___I have intense mood swings

 

 

 

Star of Bethlehem

___I feel devastated due to a recent shock

___I am withdrawn due to traumatic events in my life

___I have never recovered from loss or fright

 

 

 

Sweet Chestnut

___I feel extreme mental or emotional heartache

___I have reached the limits of my endurance

___I am in complete despair, all hope gone

 

 

 

Vervain

___I get high-strung and very intense

___I try to convince others of my way of thinking

___I am sensitive to injustice, almost fanatical

 

 

 

Vine

___I tend to take charge of projects, situations, etc.

___I consider myself a natural leader

___I am strong-willed, ambitious, and often bossy

 

 

 

Walnut

___I’m experiencing change in life-a move, new job, etc.

___I get drained by people or situations

___I want to be free to follow my own ambitions

 

 

 

Water Violet

___I give the impression that I’m aloof

___I prefer to be alone when overwhelmed

___I often don’t connect to with people

 

White Chestnut

___I am constantly thinking unwanted thoughts

___I repeatedly relive unhappy events or arguments 

___I’m unable to sleep at times because I can’t stop thinking

 

 

Wild Oat

___I can’t find my path in life

___I am drifting in life and lack direction

___I am ambitious but don’t know what to do

 

 

 

Wild Rose

___I am apathetic and resigned to whatever happens

___I have the attitude, “It doesn’t matter anyhow”

___I feel no joy in life

 

 

Willow

___I feel resentful and bitter

___I have difficulty forgiving and forgetting 

___I think life is unfair and have a “Poor me attitude”

 

Determining Your Custom Remedy

After completing the questionnaire, circle

the remedy names where two or more

checks appear to determine which remedies

are needed. Try to limit the number of

remedies to six or fewer by choosing

only the ones that are needed.