Form: Fear of Intimacy Scale, FIS

1 – Not at all characteristic of me
2 – Slightly characteristic of me
3 – Moderately characteristic of me
4 – Very characteristic of me
5 – Extremely characteristic of me
¹
1
2
3
4
5
1
I would feel uncomfortable telling O about things in the past that I have felt ashamed of.
2
I would feel uneasy talking with O about something that has hurt me deeply.
3
I would feel comfortable expressing my true feelings to O.
4
If O were upset I would sometimes be afraid of showing that I care.
5
I might be afraid to confide my innermost feelings to O.
6
I would feel at ease telling O that I care about him/her.
7
I would have a feeling of complete togetherness with O.
8
I would be comfortable discussing significant problems with O.
9
A part of me would be afraid to make a long-term commitment to O.
10
I would feel comfortable telling my experiences, even sad ones, to O.
11
I would probably feel nervous showing O strong feelings of affection.
12
I would find it difficult being open with O about my personal thoughts.
13
I would feel uneasy with O depending on me for emotional support.
14
I would not be afraid to share with O what I dislike about myself.
15
I would be afraid to take the risk of being hurt in order to establish a closer relationship with O.
16
I would feel comfortable keeping very personal information to myself.
17
I would not be nervous about being spontaneous with O.
18
I would feel comfortable telling O things that I do not tell other people.
19
I would feel comfortable trusting O with my deepest thoughts and feelings.
20
I would sometimes feel uneasy if O told me about very personal matters.
21
I would be comfortable revealing to O what I feel are my shortcomings and handicaps.
22
I would be comfortable with having a close emotional tie between us.
23
I would be afraid of sharing my private thoughts with O.
24
I would be afraid that I might not always feel close to O.
25
I would be comfortable telling O what my needs are.
26
I would be afraid that O would be more invested in the relationship than I would be.
27
I would feel comfortable about having open and honest communication with O.
28
I would sometimes feel uncomfortable listening to O's personal problems.
29
I would feel at ease to completely be myself around O.
30
I would feel relaxed being together and talking about our personal goals.
31
I have shied away from opportunities to be close to someone.
32
I have held back my feelings in previous relationships.
33
There are people who think that I am afraid to get close to them.
34
There are people who think that I am not an easy person to get to know.
35
I have done things in previous relationships to keep me from developing closeness.

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.