Abuse Checklist
Adapted from Patrick Carnes, Ph.D.,
Don't Call It Love: Recovery from Sexual Addiction, NY: Bantam Books, 1991
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Emotional Abuse
___Neglect (i.e, significant persons are emotionally unavailable, inadequate emotional or physical care)
___Perceived harassment or malicious tricks
___Being screamed or shouted at
___Deemed unfair or excessive punishments
___Perceived cruel or degrading task
___Perceived cruel confinement (i.e., locked in a
closet, excessive long-term grounding)
___Abandonment (i.e., lack of supervision, lack
of security, being left or perceiving desertion
___Touch deprivation
___Overly strict dress code
___No Privacy
___Being required to hide injuries or wounds
from others
___Forced to keep secrets
___Being required to take on adult
responsibilities as a child
___Being required to watch a beating of family
members
___Being put in the middle of your parent's
verbal arguing
___Being blamed for perceive problems in the
family
___Other forms of "emotional" abuse that you
perceive
Specify:
___________________________________________
___________________________________________
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Sexual Abuse
___Flirtations and suggestive language
___Household exhibitionism (i.e., unsuitable
household nudity, ect in a non-nudist
lifestyle)
___Household voyeurism (unsuitable
voyeurism of your own nudity, ect)
___Exposure to pornography by adults
___Sexually oriented hugs
___Jokes about your physical body
___Use of sexual language
___Criticism of your physical development
___Others preoccupation with your physical
development
___Propositioning by adults
___Unsuitable holding, hugging or kissing
___Sexual fondling
___Asked to watch masturbation
___Being touched in a sexually oriented way by
others
___Forced to receive oral sex
___Forced sexual intercourse
___Forced sodomy
___Forced sex with animals
___Penetration with objects
___Other forms of sexual abuse you perceive
Specify:
___________________________________________
___________________________________________
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Physical Abuse
___Shoving
___Slapping or hitting
___Beatings or whippings
___Deemed inadequate medical attention
___Pulling and/or grabbing of hair, ears, etc
___Deemed inadequate food or nutrition
___Scratches or bruises
___Burns
___Cuts or wounds
___Broken bones
___Damaged to internal organs
___Permanent injury
___Other forms of physical abuse
Specify:
___________________________________________
___________________________________________
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