The Self Esteem Institute Self Esteem Questionnaire

Self-Esteem Questionnaire
The Self-Esteem Institute
By Marilyn J Sorensen, PhD, Clinical Psychologist & Author

www.getesteem.com Adapted from her book, Breaking the Chain of Low Self-Esteem
Do you think you may suffer from low self-esteem? This questionnaire will help you
find out. Low self-esteem (LSE) is often misunderstood, and it is even misdiagnosed by
many therapists as being a secondary concern. Rather than being merely a symptom,
LSE is frequently the root cause of many psychological, emotional, personal and
relationship issues. Treatments that do not focus on recovery from LSE may not be
be effective, because they are not dealing with the core issue.
INSTRUCTIONS: Click to place a check next to the number of each statement that you find to be true.
RESET
Your score will be displayed and explained at the bottom of the second page.
1. ___ I generally feel anxious in new social 15. ___ I often feel depressed about things I’ve said
situations where I may not know what is and done, or things I failed to say or do.
expected of me.
16. ___ I have avoided making changes in my life
2. ___ I find it difficult to hear criticism about because I was fearful of making a mistake
myself. or failing.
3. ___ I fear being made to look like a fool. 17. ___ I often get defensive and strike back when
I perceive I am being criticized.
4. ___ I tend to magnify my mistakes and
minimize my successes. 18. ___ I have not accomplished what I am
capable of due to fear and avoidance.
5. ___ I am very critical of myself and others.
19. ___ I tend to let fear and anxiety control many
6. ___ I have periods in which I feel devastated
of my decisions.
and/or depressed.
20. ___ I tend to think negatively much of the time.
7. ___ I am anxious and fearful much of the time.
21. ___ I have found it difficult to perform
8. ___ When someone mistreats me I think that I
adequately or without embarrassment
must have done something to deserve it.
when involved in sex.
9. ___ I have difficulty knowing who to trust and
22. ___ I’m one of the following: The person who
when to trust.
reveals too much personal information
10. ___ I often feel like I don’t know the right about myself or the person who seldom
thing to do or say. reveals personal information.
11. ___ I am very concerned about my 23. ___ I often get so anxious that I don’t know
appearance. what to say.
12. ___ I am easily embarrassed. 24. ___ I often procrastinate.
13. ___ I think others are very focused on—and 25. ___ I try to avoid conflict and confrontation.
critical of—what I say and do.
26. ___ I’ve been told I’m too sensitive.
14. ___ I fear making a mistake which others
27. ___ I felt inferior or inadequate as a child.
might see.
Copyright © 2005, Marilyn J Sorensen – All Rights Reserved. www.GetEsteem.com.

This questionnaire may be distributed or repreduced, but must remain unchanged.
Interactive PDF by
CreativeP rogression
The Self-Esteem Institute
“Offering a program for recovery from low self-esteem”
www.getesteem.com
28. ___ I tend to think that I have higher standards 40. ___ I am easily discouraged.
than others.
41. ___ I am not very aware of my feelings.
29. ___ I often feel like I don’t know what is
42. ___ I grew up in a dysfunctional home.
expected of me.
43. ___ I think life is harder for me than for most
30. ___ I often compare myself to others.
other people.
31. ___ I frequently think negative thoughts
44. ___ I often avoid situations where I think I will
about myself and others.
be uncomfortable.
32. ___ I often feel that others mistreat me and or
45. ___ I tend to be a perfectionist, needing to
take advantage of me.
look perfect and to do things perfectly.
33. ___ At night, I frequently review my day,
46. ___ I feel too embarrassed to eat out alone or
analyzing what I said and did or what
to attend movies and other activities by
others said and did to me that day.
myself.
34. ___ I often make decisions on the basis of
47. ___ I often find myself angry or hurt by the
what would please others rather than on
behavior and words of others.
what I want or without even considering
what I want. 48. ___ At times I get so anxious or upset that I
experience most of the following: heart
35. ___ I often think that others don’t respect me.
racing or pounding, sweating; tearfulness;
36. ___ I often refrain from sharing my opinions, blushing; difficulty swallowing or lump in
my ideas, and my feelings in groups. my throat; shaking; poor concentration
dizziness, nausea or diarrhea; butterflies.
37. ___ I sometimes lie when I feel that the truth
would result in criticism or rejection. 49. ___ I am very fearful of criticism, disapproval,
or rejection.
38. ___ I’m fearful that I will say or do something
that will make me look stupid or 50. ___ I rely on the opinion of others to make
incompetent. decisions.
39. ___ I do not set goals for the future.
Your Score If you checked: 00-04 Statements . . . . . . . . . You have fairly good self-esteem
05-10 Statements . . . . . . . . . You have mild low self-esteem
11-18 Statements . . . . . . . . . You have moderately low self-esteem
0
___________ 19-50 Statements . . . . . . . . . You have severely low self-esteem
It’s important to realize that your score on this ques- Be aware that it will be difficult to raise children with
tionnaire in no way indicates that you are not a healthy self-esteem, if you yourself suffer from low
quality person. Instead what it does is to measure self-esteem. Without realizing it, you will pass on
how you view yourself. If you have a healthy view of the attitudes, fears, and thinking that accompany
yourself, your score will be low. If your view of your- low self-esteem.
self is unhealthy, your score will be high.
Click here to visit www.getesteem.com and learn how to overcome low self-esteem!
Copyright © 2005, Marilyn J Sorensen – All Rights Reserved. www.GetEsteem.com.
This questionnaire may be distributed or repreduced, but must remain unchanged.
Interactive PDF by
CreativeP rogression

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Self-Esteem Questionnaire

The Self-Esteem Institute

By Marilyn J Sorensen, PhD, Clinical Psychologist & Author

Copyright © 2005, Marilyn J Sorensen – All Rights Reserved. www.GetEsteem.com.

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