Example: Willingness & Valued Living Worksheet DATE INTENTION VALUED ACT AWARENESS WILLINGNESS & TIME Date: I was making I did the following Awareness Skills used? Was I willing to my life be about: ACTION: (circle one) have these 10/17/05 'passengers‘ for listened to my YES NO what they are: ―Compassion ―I thoughts I hear, toward and love wife speak of her Time: sensations I feel, for my wife worries. I told her These 'passengers‘ and images I 1330-1500 showed up on my that I care, that I am see? ‗bus‘: willing to listen, (circle one) Thoughts : and that I am heard thoughts ―I willing to help in YES NO that I have treated her any way I can. poorly, thoughts that I have been a poor husband. I heard thoughts that now she will know how I feel. I heard thoughts about wanting to help her. Physical Sensations: felt tightness in ―I my shoulders, a dull ache in my forehead, and heaviness in my chest. Memories/Images saw images of how ―I I have treated her. I saw images of how my father treated me and my mom.
Example: Willingness & Valued Living Worksheet DATE & TIME INTENTION VALUED ACT AWARENESS WILLINGNESS Date: 10/17/05 Time: 1330-1500 I was making my life be about: ―Compassion toward and love for my wife I did the following ACTION: ―I listened to my wife speak of her worries. I told her that I care, that I am willing to listen, and that I am willing to help in any way I can. Awareness Skills used? (circle one) YES NO These 'passengers‘ showed up on my ‗bus‘: Thoughts : ―I heard thoughts that I have treated her poorly, thoughts that I have been a poor husband. I heard thoughts that now she will know how I feel. I heard thoughts about wanting to help her. Physical Sensations: ―I felt tightness in my shoulders, a dull ache in my forehead, and heaviness in my chest. Memories/Images ―I saw images of how I have treated her. I saw images of how my father treated me and my mom. Was I willing to have these 'passengers‘ for what they are: thoughts I hear, sensations I feel, and images I see? (circle one) YES NO
value-work.docx