PHLMS©

Instructions:Please circlehow often youexperiencedeach of thefollowing statementswithinthe past week.

1.I amaware ofwhatthoughts are passingthroughmymind.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

2.I tryto distractmyselfwhen I feel unpleasantemotions.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

3.Whentalking with other people, Iamawareof their facial andbodyexpressions.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

4.Thereareaspects of myselfI don’twant tothinkabout.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

5.When I shower, Iamawareof howthe waterisrunningovermy body.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

6.I try to stay busy to keepthoughts or feelings fromcoming tomind.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

7.When I amstartled, I noticewhat is going oninsidemy body.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

8.I wishI couldcontrol my emotionsmore easily.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

9.When Iwalk outside, I am aware ofsmells orhow theair feels against my face.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

10.I tellmyselfthat I shouldn’thavecertainthoughts.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

11.When someone asks how I amfeeling, Ican identify my emotionseasily.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

12.Therearethings I trynottothinkabout.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

13.I amawareofthoughts I’mhaving whenmymoodchanges.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

14.I tellmyselfthat I shouldn’tfeelsad.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

15.Inoticechangesinsidemybody,likemyheartbeatingfasterormymusclesgettingtense.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

16.IfthereissomethingI don’twant tothinkabout,I’lltrymany thingsto getitoutof mymind.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

17.Whenever my emotionschange, Iamconscious ofthem immediately.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

18.. I try to putmy problems outofmind.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

19.Whentalking with otherpeople,I amawareoftheemotions I amexperiencing.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften

20.When I have a badmemory, I try to distractmyselfto makeit go away.

1 / 2 / 3 / 4 / 5
Never / Rarely / Sometimes / Often / VeryOften