DIRECTIONS: For each of the statements below, the rate in your journal what is your level of exhibiting these behaviors in your life. Use the following rating scale:

1 = never 2 = rarely 3 = sometimes 4 = frequently 5 = almost always

1. I seek approval and affirmation from others, and I am afraid of criticism.

2. I guess at what normal behavior is, and I usually feel as if I am different from other people.

3. I isolate myself from and am afraid of people in authority roles.

4. I am not able to appreciate my own accomplishments and good deeds.

5. I tend to have difficulty following a project through from beginning to end.

6. I get frightened or stressed when I am in the company of an angry person.

7. In order to avoid a conflict, I find it easier to lie than tell the truth.

8. I have problems with my own compulsive behavior, e.g., drinking, drug use, gambling, overeating, smoking, use of sex, shopping, etc.

9. I judge myself without mercy. I am my own worst critic, and I am harder on myself than I am on others.

10. I feel more alive in the midst of a crisis, and I am uneasy when my life is going smoothly; I am continually anticipating problems.

11. I have difficulty having fun. I don’t seem to know how to play for fun and relaxation.

12. I am attracted to others whom I perceive to have been victims, and I develop close relationships with them. In this way, I confuse love with pity, and I love people I can pity and rescue.

13. I need perfection in my life at home and work, and I expect perfection from others in my life.

14. I seek out novelty, excitement, and the challenge of newness in my life with little concern given to the consequences of such action.

15. I take myself very seriously, and I view all of my relationships just as seriously.

16. I have problems developing and maintaining intimate relationships.

17. I feel guilty when I stand up for myself or take care of my needs first, instead of giving in or taking care of others’ needs first.

18. I seek and/or attract people who have compulsive behaviors (e.g., alcohol, drugs, gambling, food, shopping, sex, smoking, overworking, or seeking excitement.)

19. I feel responsible for others and find it easier to have concern for others than for myself.

20. I am loyal to people for whom I care, even in the face of evidence that the loyalty is undeserved.

21. I cling to and will do anything to hold on to relationships because I am afraid of being alone and fearful of being abandoned.

22. I am impulsive and act too quickly, before considering alternative actions or possible consequences.

23. I have difficulty in being able to feel or to express feelings; I feel out of touch with my feelings.

24. I mistrust my feelings and the feelings expressed by others.

25. I isolate myself from other people, and I am initially shy and withdrawn in new social settings.

26. I feel that I am being taken advantage of by individuals and society in general; I often feel victimized.

27. I can be over-responsible much of the time, but I can be extremely irresponsible at other times.

28. I feel confused and angry at myself and not in control of my environment or my life when the stresses are great.

29. I spend a lot of time and energy rectifying or cleaning up my messes and the negative consequences of ill-thought-out or impulsive actions for which I am responsible.

30. I deny that my current problems stem from my past life. I deny that I have stuffed-in feelings from the past which are impeding my current life.

____ TOTAL SCORE
SCORING AND INTERPRETATION
Add the ratings for all 30 items in your journal. This score indicates the degree to
which you are affected by low self-esteem.
SCORE INTERPRETATION
0-30 Not affected by low self-esteem.
31-45 Traces of low self-esteem. Take preventive action to reduce its impact on
your life.
46-61 Presence of mild low self-esteem in your life. Take steps to treat this.
62-90 Presence of moderate low self-esteem. Take steps to treat this as soon as
possible.
91-120 Presence of severe low self-esteem. Take steps to treat this immediately.
121-150 Presence of profound low self-esteem. Take an immediate step to treat this
and seek out professional help to assist you in this process