SHAME QUESTIONAIRE

FROM "LOOKING GOOD OUTSIDE-FEELING BAD INSIDE" BY CURTIS LEVONG, PhD

Answer "true" or "false" to each of the following.

1. I have been told that I have poor eye contact, slump my shoulders, or blush easily.

2. I am more perfectionistic than I would like to be.

3. I get defensive when others criticize me.

4. It is relatively easy for me to criticize members of my family, people at work or school, God, or myself.

5. I don't accept compliments well.

6. When I'm lost I find it difficult to ask for directions or help.

7. When I make mistakes I feel bad for hours, even days.

8. I find it difficult to trust that others will meet my needs.

9. When things go wrong I have a hard time accepting blame.

10. I can not talk to my friends and family about my fears and disappointments.

11. I feel down, hopeless, and overwhelmed a good deal of the time.

12. I feel that I get angrier or angry more often than most people.

13. I find it hard to rest or relax without feeling guilty.

14. I was teased and called names when I was young.

15. I rarely reveal my feelings.

16. If someone does me a favor, I worry about having to return it.

17. I am sure I have addictive qualities in my personality.

18. I have difficulty holding a job or maintaining a friendship for a long period of time.

19. As a child I felt neglected or abused.

20. I have a hard time believing that God can fully love & accept me.

21. I never allow myself to get angry.

22. My family of origin did not encourage or nurture my self worth.

23. I have great difficulty getting close to people.

24. I have secrets that would surprise and shock others.

25. I feel embarrassed or humiliated by certain things from my past.

26. Growing up I received little of no support or praise for my accomplishments.

27. I have trouble praying to God after I do something wrong.

28. When with my family of origin, I rarely feel as if I'm treated as an adult.

29. I feel things must be done my way.

30. I take myself too seriously.

SCORING: TOTAL THE NUMBER OF THE TRUE RESPONSES: ____

INTERPRETING YOUR SHAME INDICATOR SCORE:

0-9= Limited,

10-15=Moderate

15 or more= Significant.

A low score may also indicate DENIAL.