Bach Flower Self-Assessment
Bach Flower Self-Help Questionnaire
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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.