A final message
Below are five self-assessment questionnaires. Two are original, created specifically for this book; two (the ACE and the PHQ-9) are instruments used widely around the world; and the fifth is a brief safety screen.
IMPORTANT: These tests serve as self-help tools, not substitutes for professional diagnosis. If your results raise concerns, please consult a mental health professional.
QUESTIONNAIRE 1. THE INNER JUDGE SCALE (an original questionnaire by K. Ragimov)
What it measures: The level of destructive self-criticism.
Instructions: Rate each statement on a scale from 1 (almost never) to 5 (almost always).
| No. | Statement | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|---|
| 1 | When I make a mistake, I tell myself I am a failure | ☐ | ☐ | ☐ | ☐ | ☐ |
| 2 | I feel that I must be perfect in everything | ☐ | ☐ | ☐ | ☐ | ☐ |
| 3 | When I feel bad, I tell myself that others cope better | ☐ | ☐ | ☐ | ☐ | ☐ |
| 4 | I scold myself for my flaws | ☐ | ☐ | ☐ | ☐ | ☐ |
| 5 | When I fail, I feel unworthy | ☐ | ☐ | ☐ | ☐ | ☐ |
| 6 | I think my mistakes make me worse than others | ☐ | ☐ | ☐ | ☐ | ☐ |
| 7 | When I am in pain, I become harsh with myself | ☐ | ☐ | ☐ | ☐ | ☐ |
| 8 | I feel that I have to earn love | ☐ | ☐ | ☐ | ☐ | ☐ |
| 9 | When I am upset, I think I am weak | ☐ | ☐ | ☐ | ☐ | ☐ |
| 10 | I compare myself with others and feel inferior | ☐ | ☐ | ☐ | ☐ | ☐ |
Scoring: Add up all your points.
| Result | Interpretation | Recommendation |
|---|---|---|
| 10–20 | Low self-criticism | Maintain current state |
| 21–35 | Moderate level | Practice self-compassion daily |
| 36–50 | High level | Therapy recommended (CBT, CFT) |
How to use it: Take the test every three months to track your progress.
The author developed this questionnaire drawing on the work of Paul Gilbert and Kristin Neff on self-criticism and self-compassion. It is meant as a simple tool for self-reflection, not as a validated clinical scale.
QUESTIONNAIRE 2. “BEHAVIOR OR IDENTITY?” (an original questionnaire by K. Ragimov)
What it measures: Your typical response to missteps (shame vs. guilt).
Instructions: Imagine each scenario and select the reaction you’d most likely have.
| Situation | Response A (Shame) | Response B (Guilt) |
|---|---|---|
| 1. You were late for a meeting | “I am an irresponsible person” | “I did something wrong, I need to apologize” |
| 2. You forgot about an important event | “I am a terrible friend/partner” | “I made a mistake, I can fix it” |
| 3. You were criticized at work | “I am incompetent” | “What can I improve?” |
| 4. You failed to complete a task | “I am a failure” | “I need more practice” |
| 5. You hurt someone | “I am a bad person” | “I caused pain, I need to make amends” |
Scoring: Count how many Response A and Response B answers you have.
| Result | Interpretation |
|---|---|
| More A | Shame dominates (destructive pattern) |
| More B | Guilt dominates (constructive pattern) |
| Equal | Mixed type, belief work required |
The author developed this questionnaire based on the distinction between guilt and shame (H. B. Lewis, 1971; J. Tangney & R. Dearing, 2002). For a rigorous assessment, validated instruments such as the TOSCA-3 should be administered by a professional.
QUESTIONNAIRE 3. ADVERSE CHILDHOOD EXPERIENCES (ACE) QUESTIONNAIRE
What it measures: A childhood trauma score correlated with disease risk.
Instructions: Answer “Yes” or “No” to each question about the period before age 18.
| No. | Question | Yes | No |
|---|---|---|---|
| 1 | Did an adult regularly insult or humiliate you? | ☐ | ☐ |
| 2 | Did an adult regularly threaten you physically? | ☐ | ☐ |
| 3 | Did an adult touch you sexually or force you to touch them? | ☐ | ☐ |
| 4 | Did you regularly feel unloved or unvalued? | ☐ | ☐ |
| 5 | Did you lack enough food or clean clothes? | ☐ | ☐ |
| 6 | Did your parents separate or divorce, or were you abandoned? | ☐ | ☐ |
| 7 | Was your mother or father physically abused? | ☐ | ☐ |
| 8 | Did anyone in the household abuse alcohol or drugs? | ☐ | ☐ |
| 9 | Did anyone in the household suffer from depression or mental illness? | ☐ | ☐ |
| 10 | Was a family member in prison? | ☐ | ☐ |
Scoring: The total number of “Yes” responses equals your ACE score.
Important: A high ACE score is not a life sentence. It is simply information to explore with your therapist.
Source: Felitti, V. J., Anda, R. F., et al. (1998). American Journal of Preventive Medicine, 14(4), 245–258 (CDC–Kaiser Permanente ACE Study).
QUESTIONNAIRE 4. DEPRESSION SCALE (PHQ-9: Patient Health Questionnaire)
What it measures: The severity of depressive symptoms over the past two weeks.
Instructions: Rate the frequency of each symptom from 0 (not at all) to 3 (nearly every day).
| No. | Symptom | 0 | 1 | 2 | 3 |
|---|---|---|---|---|---|
| 1 | Lack of interest or pleasure in activities | ☐ | ☐ | ☐ | ☐ |
| 2 | Feeling down, depressed, or hopeless | ☐ | ☐ | ☐ | ☐ |
| 3 | Trouble falling asleep, staying asleep, or excessive sleepiness | ☐ | ☐ | ☐ | ☐ |
| 4 | Fatigue or lack of energy | ☐ | ☐ | ☐ | ☐ |
| 5 | Poor appetite or overeating | ☐ | ☐ | ☐ | ☐ |
| 6 | Feeling like a failure or guilt | ☐ | ☐ | ☐ | ☐ |
| 7 | Difficulty concentrating | ☐ | ☐ | ☐ | ☐ |
| 8 | Psychomotor retardation or agitation | ☐ | ☐ | ☐ | ☐ |
| 9 | Thoughts of death or self-harm | ☐ | ☐ | ☐ | ☐ |
Scoring:
| Total score | Level | Action |
|---|---|---|
| 0–4 | Minimal | Self-help, monitoring |
| 5–9 | Mild | Self-compassion practices, CBT |
| 10–14 | Moderate | Professional consultation recommended |
| 15–19 | Moderately severe | Therapy required |
| 20–27 | Severe | Seek help immediately |
Important: If your score on item 9 is greater than 0, seek help immediately.
Source: Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613.
QUESTIONNAIRE 5. BRIEF SAFETY SCREENING
This section isn’t a test. It consists of three direct questions that psychiatrists ask when assessing risk.
Have you had thoughts in the past two weeks that you’d be better off not living?
Have you thought about how you might actually hurt yourself?
Have you ever attempted to harm yourself?
If you answered “yes” to even one of these questions, please don’t sit with it alone and don’t put it off: reach out to a psychiatrist or psychotherapist, or, if you are in acute distress, call a 24-hour crisis hotline (a list is provided in Section 4). Suicidal thoughts are a symptom of a treatable condition. They are not a weakness, not a verdict, and not something you should try to handle on your own.
Professionals assess risk using standardized tools like the Columbia Suicide Severity Rating Scale (C-SSRS), which must be administered by trained clinicians rather than self-administered.