Real Women Talking - Add Your Voice - Marriage Questionnaire

Positive Selfishness Questionnaire

We are researching and writing a book called Rx for Real Women: Positive Selfishness (because all of this leaning in and out has left us bent and contorted). Positive Selfishness is a compassionate and validating how-to book exploring the critical and everyday experience of modern motherhood with a “how-to” focus on the very real need to turn selfishness on its head and re-frame what too many women see as selfish into a fuller understanding of the vital need to take time and care of self. The happiest mothers we've encountered in our research seem to be the ones that figure out imaginative ways to put themselves on their ever growing “to-do” list. The research is clear, we need to give ourselves permission to take some time away from that daunting list and meeting the needs of others, so that we can meet our own needs. We hope that you will join our think tank by sharing real stories of how real mothers like yourself find the time to practice self-care, and that you will also reveal any obstacles that stand in your way from practicing it. We know it is not always easy to make self-care a priority, and we look forward to collectively exploring “why?”

We sincerely hope you will take some of your precious "free" time to answer any or all of the following questions. In the interim, try using “Positive Selfishness” as your go-to phrase, and while doing so, help us learn how to thrive in, and not just survive modern motherhood. Please elaborate and be as specific as possible. We thank you in advance for your time.

1. What does self-care mean to you? How do you define it?

2. What do you do for your own self-care? How do you fit “you” into your family calendar?

3. Do you regularly practice self-care? If not, what stands in your way? Tell us about any obstacles or barriers.

4. When you do practice self-care, tell us how you feel before, during and afterwards.

5. We have heard that some mothers feel “guilty” when taking time for self. Is this true for you? If so, how do you cope with the guilt?

6. How do you think society views a mother taking time away from her “to-do” list to focus on her needs, happiness, etc.?

7. How supportive do you feel your community, workplace, family is of your desire to devote time for self-care?

8. We think self-care is also about setting limits and boundaries, so we do not self-deplete. Do you set any boundaries? What, if anything, makes it challenging to do so?

9. We have heard that many moms reserve self-care for special occasions, i.e. birthdays, Mother’s Day, anniversaries, etc. If this is true for you, tell us why. Do you think self-care should be a “luxury item?”

10. Do you have any advice, insight, or a saying of your own or quote that keeps you inspired to care for self? If so, please share it.

I (the "Contributor") understand that by submitting any responses, stories or other information, whether verbal or written, herein or subsequently ("Contributions"), in connection with the Real Women Talking about Marriage Questionnaire, I grant to Jennifer Finkelstein and Shari Berman (the "Authors") and their agents, publishers and assigns the right in perpetuity to publish, reproduce or otherwise use my Contributions, in any way, at their discretion, in any and all media and all communication channels (such as, without limitation, print, mail, email, internet, broadcast, blogs, etc.), as authorized below. I hereby release the Authors, their agents, publishers and assigns, from any obligation to make payment hereunder and from any liability incurred in connection with the use of the text or materials submitted. The Authors may edit my Contributions for content, length, and/or clarity. Nothing herein shall constitute an employment, joint venture or partnership relationship between the Contributor and the Authors. In no way is the Contributor to be construed as the agent or to be acting as the agent of the Authors in any respect. Participation in the Questionnaire constitutes Contributor's consent to the Authors‘ use of name, biographical information and state(s) of residence, as authorized below for promotional and commercial purposes in any media, without limitation, and without payment.

     I have read and agree to the above language. *

     I am comfortable with my first name being used in the Book or
     I would prefer an alias be used in lieu of my name.

Just so we can capture demographic information, please tell us about yourself:

Name: *		City, State of residence:
Your Age		E-Mail *

Marital status How many years married, first marriage? Perhaps Separated?

If you have children, please answer the following:

Number of children:

Ages:

	Stay-at-home Mom.
	Working outside the home. If yes, please briefly describe type of work and whether work is full-time, part-time, telecommute, job-share, etc.

	“Hybrid Mom.” Self-employed, run a business from home, freelance, etc. Please explain:

If you work outside the home, tell us “what you do?”

Where are you from? City and State please

How did you hear of us?

* Required information.

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