Client Area

Internal Trigger Questionnaire

During recovery certain feelings or emotions often trigger the brain to think about using substances or Gambling. Read the following list of feelings and emotions, and place a check- mark next to those that might trigger thoughts of using or gambling for you. Place a zero next to those that are not connected with using. 
   Afraid     Frustrated     Neglected     Angry     Guilty     Nervous     Confident     Happy     Passionate
   Criticized     Inadequate     Pressured     Depressed     Insecure     Relaxed     Embarrassed     Irritated     Sad
   Excited     Jealous     Bored     Exhausted     Lonely     Envious     Deprived     Humiliated     Anxious
   Aroused     Revengeful     Worried     Grieving     Resentful     Overwhelmed     Misunderstood     Paranoid     Hungry 
What emotional states that are not listed  above  have triggered you to use substances or gamble?     
Was your use or gambling in the weeks  before entering  treatment 
  Tied primarily to emotional conditions? 
  Routine and automatic without much emotional triggering?  
Were there  times  in the recent past  when you were  not using or gambling and  a specific  change  in your mood  clearly resulted in your wanting to use/gamble (for example,  you got  in a fight with someone and  wanted to use in response to getting angry)? Yes ____No    ___If yes, describe: