After experiencing a compulsive urge, it is critical in early recovery to explore these urges to
master the elements surrounding them. This worksheet is geared to help you do just that .
It is not necessary to complete this worksheet every time you experience a compulsive behavior; nor is
it when only an urge is experienced but no compulsive action taken. As a guide, if you are experiencing
compulsions once every few weeks or months, complete this form with each compulsion you act upon. Should
they be occurring often, there is no need to submit more than two assessments per week.
First Name and Last Initial:
Step 1: List each element of this specific behavior:
Remember, elements are those times in the progression of your 'behavioral chain' that trigger emotional stimulation. This could be positive (sensory stimuli, fantasy, power, etc.) or it could be negative (guilt, anger, frustration, anxiety, etc.).
- Saw girl in supermarket
- Triggered romantic fantasy
- Felt guilty for not being able to stop thinking about her
- Anticipated wife going to bed
- Recreated romantic fantasy of women in store
- Switched to sexual fantasy of girl in store
- Searched internet for a 'body double'
- Masturbated while fantasizing about girl; staring at photo
- Achieved orgasm
Step 2: Utilizing the scale below to estimate your emotional level at each of the following times:
Emotional Comfort Scale:
||Emotional Comfort Level|
||Complete lack of anxiety/stress; Euphoria; Contentment|
||Mild Anxiety; Irritation; Minor Stressors|
|| Moderate Anxiety; Uncomfortable; Bored; Moderate Stressors|
||Considerable Anxiety; Major Stressors|
|0 and below
||Extreme Anxiety; Painful|
(Example: Past week: 120 — Emotionally Comfortable
I. Over the past week (generally):
II. Just prior to the first element of the 'behavioral chain' appearing:
III. Just after the initial urge to engage in some type of action (e.g. fantasy, masturbation, porn search, etc) was felt:
IV. As you struggled to deny acting on the urge (if applicable):
V. During the last few elements of the chain:
Step 3: Focusing on the elements of this specific ritual, when would have been the best time to make a realistic, value-based decision. Why?
There is no right or wrong answer, only one that is geared towards your becoming more familiar with the emotional patterns
involved with your compulsive behavior. For most behaviors, that time would be between the first and second elements — but not
for all. Identifying such vulnerable times will assist you in developing healthy decision-making down the road.
Step 4: Finally, you have acted in a way that has disrupted the progress of your value development. This needs to be reversed now.
- List (at least) one value that was affected by your decision to engage in this behavior.
- List all current, unresolved elements of this behavior that may affect future decisions to act out (e.g. new e-mail accounts, images burned to CD, a lunch date, a phone number
- List what immediate action you are going to take to strengthen the value(s) that you have neglected.
- I spent three hours downloading porn which forced me to put off balancing the family's budget and left me emotionally exhausted. Afterwards, I was frustrated and disaapointed...and took that out on my wife by withholding intimacy and affection.
- No unresolved elements. (Or, I created a favorites link to a porn site that I hid and renamed so as not to draw suspicion).
- I am going to delete that hidden link. I am going to ask my wife to go to dinner with me this weekend.