| 1 | I feel angry at my
      body | 5   
      4    3    2    1 | 
  
    | 2 | I used to accept my
      body's limitations, but now I fight limits I feel in my body | 5   
      4    3    2    1 | 
  
    | 3 | I am careful to eat
      well so that my body can heal itself | 5   
      4    3    2    1 | 
  
    | 4 | Lately I have been
      feeling good about my body | 5   
      4    3    2    1 | 
  
    | 5 | I feel betrayed by my
      body | 5   
      4    3    2    1 | 
  
    | 6 | I am careful to rest
      so that my body can heal itself | 5   
      4    3    2    1 | 
  
    | 7 | I try not to think
      about the part of my body that has cancer | 5   
      4    3    2    1 | 
  
    | 8 | I believe my body has
      the capacity to fight cancer | 5   
      4    3    2    1 | 
  
    | 9 | I've always felt good
      about my body and continue to do so | 5   
      4    3    2    1 | 
  
    | 10 | I do not think it's
      important to pay attention to my body | 5   
      4    3    2    1 | 
  
    | 11 | I am in a lot of pain | 5   
      4    3    2    1 | 
  
    | 12 | Because I am in so
      much pain I try to dissociate from my body | 5   
      4    3    2    1 | 
  
    | 13 | I feel ashamed of my
      body | 5   
      4    3    2    1 | 
  
    | 14 | I have always felt
      unattractive | 5   
      4    3    2    1 | 
  
    | 15 | I want to get rid of
      the part of my body that has cancer | 5   
      4    3    2    1 | 
  
    | 16 | I feel basically
      healthy and whole in my body | 5   
      4    3    2    1 | 
  
    | 17 | I feel scared of my
      body | 5   
      4    3    2    1 | 
  
    | 18 | I find it difficult to
      relax my body and release the tension I feel | 5   
      4    3    2    1 | 
  
    | 19 | I tend to think about
      things a lot and thus do not notice much about my body | 5   
      4    3    2    1 | 
  
    | 20 | I like my body | 5   
      4    3    2    1 | 
  
    | 21 | Now that I've had
      surgery I feel some essential part of me is missing | 5   
      4    3    2    1 | 
  
    | 22 | It is important to me
      to be sensitive and caring toward my body | 5   
      4    3    2    1 | 
  
    | 23 | I have given up on my
      body | 5   
      4    3    2    1 | 
  
    | 24 | I used to feel
      attractive but now I feel unattractive | 5   
      4    3    2    1 | 
  
    | 25 | I distrust my body | 5   
      4    3    2    1 | 
  
    | 26 | I tend to get
      impatient with my body | 5   
      4    3    2    1 | 
  
    | 27 | I feel less adequate
      as a person now because my body has experienced a disease | 5   
      4    3    2    1 | 
  
    | 28 | Lately I have felt
      more relaxed | 5   
      4    3    2    1 | 
  
    | 29 | I regularly take time
      to relax my body | 5   
      4    3    2    1 | 
  
    | 30 | I feel stronger as a
      person now that I trust the healing capacity of my body | 5   
      4    3    2    1 |