CANCER PERSONALITY PROFILE SURVEY
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The above information is confidential and will not be given to anyone other than those people directly compiling the
results. If you rather not submit your name or contact information it is optional, excluding state and country. Both are
required, to track location of responses.
.A. BASIC PERSONALITY
1. I am highly conscientious.
TRUE                   FALSE           1
.E. TYPICALLY, THE CANCER-SUSCEPTIBLE
INDIVIDUAL REACTS ADVERSILY TO STRESS BY
INTERNALIZING AND SUPRESSING EXTERNAL
REACTIONS, OFTEN BECOMING UNABLE TO
COPE ADEQUATELY WITH SUCH STRESS.

1. Experienced an especially damaging event/events about 2
years before onset of detectable cancer.
TRUE                     FALSE          20
2. I am dutiful.
TRUE                   FALSE           2
3. I am responsible.
TRUE                   FALSE           3
2.  Felt at the time, that I was unable to
cope with this "last straw".    
TRUE                     FALSE         21
4. I am caring.
TRUE                   FALSE           4
F.  SHOWING AN INABILITY TO RESOLVE
DEEP-SEATED EMOTIONAL PROBLEMS AND
CONFLICTS, USUALLY ARISING FROM
CHILDHOOD, OFTEN EVEN BEING UNAWARE OF
THERE PRESENCE.

1. I had/have a cumulative of unresolved emotional issues such
as fear, shame, guilt &/or grief.
TRUE                  FALSE          22
5. I am hardworking.
TRUE                   FALSE           5
6. I have an above average intelligence..
TRUE                   FALSE           6
.B. OTHER PERSONALITY TRAITS
1. I ofter exhibit a strong tendency toward carrying other
people's burdens.
TRUE                   FALSE           7
2.  I had/have a deep hurt that I was
unable to resolve.
TRUE                  FALSE         23
2. Need to take on extra obligations.
TRUE                  FALSE           8
3. I had/have a deep secret or grief eating
away at me..
TRUE                  FALSE         24
3. Worry for others.
TRUE                  FALSE           9
4.  I had/have a deep seated feeling of
"What's the use?".
TRUE                  FALSE         25
4. I have a deep-seated need to make other people
happy.
TRUE                  FALSE          10
5.  I had/have the feeling of "powerlessness
rage".
TRUE                  FALSE         26
5. I have a tendency to be a people pleaser.
TRUE                  FALSE          11
6. I did/or do feel overwhelmed and
devastated.
TRUE                  FALSE         27
6. I also have a great need for approval.
TRUE                   FALSE          12
7. I had/have a deep hurt and long-standing resentment arising
from frustrated plans and felt blockages by other people or
circumstances, I have no power or control of.
TRUE                  FALSE         28
.C. HISTORY RELATIONSHIP TO PARENTS
AND OTHERS:

1. Lack of closeness to one or both parents as a child.    
       
TRUE                   FALSE          13
8. Afraid to express rage about a certain "rotten situation", that
I hate and see no way out of.
TRUE                  FALSE         29
2. Lack of closeness to one or both parents as an adult..
TRUE                   FALSE          14
9. Had/have strong feelings of failure and incompetence, with
little sense self-accomplishment, or closeness to someone who
felt that was true.
TRUE                  FALSE        30
3. Lack of closeness with spouse or significant other at
onset of illness.
TRUE                   FALSE          15
10. I had/have many years of inner conflict, guilt, hurt, grief,
resentment, confusion, and/or tension surrounding deepest
personal issues. That are connected with feelings of
hopelessness, inadequacy and self-rejection.
TRUE                  FALSE         31
4. Lack of closeness with friends/family at onset or
before illness was diagnosed, creating a basic lack of a
strong emotional support system.    
TRUE                   FALSE          16
11. I had/have great troubles and sorrows that I have had or
chose to suffer silently and stuff.
TRUE                  FALSE         32
D. TYPICALLY, THE CANCER -SUSCEPT
-IBLE INDIVIDUAL INTERNALIZES
EMOTIONS SUCH AS ANGER, RESENTMENT
AND/OR HOSTILITY AND HAS GREAT
DIFFICULTY EXPRESSING THEM

1. I may have long-suppressed anger, it is hard for me to
express that emotion.
TRUE                     FALSE          17
12. Are self-chastising and have an alone feeling, due to
severely (or perceived) critical parenting and/or past/present
critical relationships and victimization.
TRUE                  FALSE         33
2. I may have long suppressed resent - ment, it has
always been hard for me to express that emotion (not an
acceptable emotion to have).    
TRUE                     FALSE          18
13. May of had/have a considerable unresolved hate, revenge
desires, envy, jealousy, and anger, that is expressed subtly,
subterranean and subconsciously in such things as
passive-aggressiveness, errors of omission,
self-inconveniencing and guilt-induction.
TRUE                  FALSE         34
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De-Stressing the Diagnosis of Cancer"
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Yes                                  No
3. I may have long suppressed hostility, it has always
been hard for me to express that emotion (ie. not an
acceptable emotion to have).    
TRUE                     FALSE          19
THANK YOUR FOR PARTICIPATING IN OUR SURVEY!
I would like to thank www.healingcancernaturally.com for information provided.
"Natural Forces for Health & Wellness"
CANCER PERSONALITY PROFILE SURVEY
PREPARED AND CONDUCTED BY
SYLVIA SUTTON ROSS
3012 JASMINE DR. ~ CONWAY, SC 29527 ~ (843) 381-8488
E-mail ~nfhw@sc.rr.com.com
 
FIRST NAME:
 LAST NAME:
ADDRESS:
 SEX:*
MALE:
CITY:
FEMALE:
STATE:*
DATE OF BIRTH:*
ZIPCODE:
COUNTRY:*
 EX. 12-23-1944
PHONE:
E-MAIL: *
TYPE OF CANCER:
ORIGINAL SITE:
DATE OF ORIGINAL DIAGNOSIS:
SECONDARY SITE:
DATE OF DIAGNOSIS:
R-11-26-07
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