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| 1. Are you experiencing or have you recently experienced any chronic pain (i.e. back pains)? |
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| 2. Have you recently experienced or are you experiencing rejection by another individual for whom you had or have feelings for? |
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| 3. Are you experiencing or have you recently experienced an argument with a close friend or relative (i.e. regarding a monetary dispute, philosophical differences, etc.)? |
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| 4. Have you recently or are you currently dealing with the loss of a former or current a significant other? |
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| 5. Are you experiencing or have you recently experienced betrayal by a close or trusted friend (i.e. divulged secret)? |
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