If you still love your partner but want to leave, try writing down what happened, what you needed and what changed. This worksheet helps you identify an unanswered question or a next step. It is not a validated test or a breakup score.
Use four fields for one event
- Event: when and what happened. Record what you saw or heard without assuming intent.
- Need: what you wanted, or what your everyday life requires.
- Discussion: what you communicated and what response or agreement followed.
- Change: what has actually happened since. What is still unknown?
If there are several events, give each its own entry. Replace “always” and “never” with what you can describe.
Worked example: a plan changed at the last minute
Invented example: “Two plans changed shortly before meeting this month. I had moved my work time to make them possible. I said I need earlier notice of changes. My partner agreed, but our next plan has not happened yet.”
This tells you that a need was communicated and the later outcome is still unknown. It does not prove that your partner does not care, or that two cancellations mean you must leave.
Keep fact, interpretation and request separate
Fact: “There was no message at the agreed time.” Interpretation: “Perhaps I am not a priority.” Request: “Please let me know if you will be late.” You can ask about an interpretation using the event as a starting point. If asking feels unsafe, support matters more than completing this sheet.
If there are threats, violence or monitoring, seek support before arranging a private breakup conversation. The Hotline’s safety planning guidance is a US resource; elsewhere, use local support. If your device is monitored, use a safer device if you can. For immediate danger, contact local emergency services.
Review the unresolved question, not the number of entries
One issue may be enough for you not to want to continue. Several differences may still allow an arrangement both people want. There is no rule here that two or more entries mean you should break up.
- Something is unclear: if it is safe, ask about one concrete need.
- You want to try an adjustment: specify who will do what and review the actual burden.
- You no longer want to continue: move toward communication and practical preparation rather than repeatedly proving your reason.
Choose one next step
Keep the note if your view changes; add what you learned rather than treating your earlier feelings as an error. For feelings and conditions together, read the main guide. If tiredness is the immediate concern, see the page on relationship exhaustion.
If you have decided to leave, use preparation before the conversation. Other starting points are in the Night Chapter guide.