1 – Rarely
2 – Occasionally
3 – Fairly often
4 – Almost always
¹
1
2
3
4
1
I am open to the experience of the present moment.
2
I sense my body, whether eating, cooking, cleaning or talking.
3
When I notice an absence of mind, I gently return to the experience of the here and now.
4
I am able to appreciate myself.
5
I pay attention to what's behind my actions.
6
I see my mistakes and difficulties without judging them.
7
I feel connected to my experience in the here-and-now.
8
I accept unpleasant experiences.
9
I am friendly to myself when things go wrong.
10
I watch my feelings without gelng lost in them.
11
In difficult situations, I can pause without immediately reacting.
12
I experience moments of inner peace and ease, even when things get hectic and stressful.
13
I am able to smile when I notice how I sometimes make life difficult.
The presented answer sheet is not an original form and is not intended for printing or use as a handout.
The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.