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Mother Wound Assessment for Women

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Introduction

In many women's lives, the mother wound is a deep, often hidden pain that shapes how they view themselves and relate to others. When the nurturing, validation, and support of a caring mother are missing or distorted, it can lead to chronic feelings of unworthiness and an incessant need for external approval. This emotional void may manifest as self-sacrifice, difficulty setting boundaries, and challenges in embracing one's true identity. Healing the mother wound means reclaiming your inherent worth, nurturing the inner child, and cultivating relationships that honor and support your authentic self.

This assessment is a guide that provides valuable insights to help refine our therapeutic approach and create a customized plan tailored to your most important needs and goals.

Please take your time with each question and answer as honestly and openly as you can. There are no right or wrong answers—just your experience, which is valuable and important.

I look forward to our time together.

Warmly,

Monika

Monika Grace, CCTP-II
Integrative Somatic Psychotherapist, Trauma Specialist, EMDR, IFS, SE, PSYCH-K
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What is your full name?

What is your email?

What is your mobile number?

What is your location?

Country

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Instructions
This short form contains 15 questions specific to how the mother wounds impact women —or those with dominant feminine energy.
Please read each statement carefully and choose the number that best reflects your experiences with your mother. There are no right or wrong answers. Your responses will help in understanding areas that may need attention and healing.
Use the following scale to answer:
Rating Scale:
1 – Not at all true: This means the statement does not describe your experiences or feelings at all.
2 – Rarely true: This means the statement applies to you only on very rare occasions.
3 – Sometimes true: This means the statement is moderately reflective of your experiences—sometimes you feel this way.
4 – Often true: This indicates that you frequently experience or agree with the statement.
5 – Completely true: This means the statement fully captures your experiences or feelings.

1. ​I often feel unworthy of love and affection.​

1. ​I often feel unworthy of love and affection.​
Not at all trueSometimes trueCompletely true

2. ​I struggle with setting boundaries with others.​

2. ​I struggle with setting boundaries with others.​
Not at all trueSometimes trueCompletely true

3. ​I tend to put others' needs before my own.

3. ​I tend to put others' needs before my own.
Not at all trueSometimes trueCompletely true

4. ​I feel guilty when I prioritize my own well-being.

4. ​I feel guilty when I prioritize my own well-being.
Not at all trueSometimes trueCompletely true

5. ​I have difficulty trusting others, especially in intimate relationships.

5. ​I have difficulty trusting others, especially in intimate relationships.
Not at all trueSometimes trueCompletely true

6. I often seek external validation to feel good about myself.

6. I often seek external validation to feel good about myself.
Not at all trueSometimes trueCompletely true

7. ​I experience feelings of shame without understanding their origin.

7. ​I experience feelings of shame without understanding their origin.
Not at all trueSometimes trueCompletely true

8. ​I find it hard to express my emotions openly.​

8. ​I find it hard to express my emotions openly.​
Not at all trueSometimes trueCompletely true

9. ​I feel disconnected from my own identity or passions.

9. ​I feel disconnected from my own identity or passions.
Not at all trueSometimes trueCompletely true

10. ​I tend to attract or stay in unhealthy relationships.

10. ​I tend to attract or stay in unhealthy relationships.
Not at all trueSometimes trueCompletely true

11. ​I struggle with feelings of anger or resentment towards my mother.

11. ​I struggle with feelings of anger or resentment towards my mother.
Not at all trueSometimes trueCompletely true

12. I often feel like I'm not good enough, no matter what I do.

12. I often feel like I'm not good enough, no matter what I do.
Not at all trueSometimes trueCompletely true

13. I have a tendency to self-sacrifice, even at the expense of my own happiness.

13. I have a tendency to self-sacrifice, even at the expense of my own happiness.
Not at all trueSometimes trueCompletely true

14. ​I avoid confronting emotional issues, hoping they will resolve on their own.

14. ​I avoid confronting emotional issues, hoping they will resolve on their own.
Not at all trueSometimes trueCompletely true

15. ​I feel uncomfortable with physical affection or intimacy.

15. ​I feel uncomfortable with physical affection or intimacy.
Not at all trueSometimes trueCompletely true
Thank you for completing this questionnaire. Your responses will be discussed during your next session to identify areas for support and healing.
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