Self Function - Wonderfeelz Neuropsy Power Meditation

Name *

Phone

Email Address *

Date of Birth (Actual) *

The following questionnaire has a series of statements that involve people’s perceptions about themselves. There are not right or wrong responses, so please answer honestly. Respond to each statement by writing the number from the scale below, which you feel most accurately characterizes your response to the statement.

1. I think it is better to be yourself, than to be popular. *

2. I don’t know how I really feel inside. *

3. I am strongly influenced by the opinions of others. *

4. I usually do what other people tell me to do. *

5. I always feel I need to do what others expect me to do. *

6. Other people influence me greatly. *

7. I feel as if I don’t know myself very well. *

8. I always stand by what I believe in. *

9. I am true to myself in most situations. *

10. I feel out of touch with the ‘real me. *

11. I live in accordance with my values and beliefs. *

12. I feel alienated from myself. *

13. I often compare how my loved ones (boy / girl friend, family members etc) are doing with how others are doing *

14. I always pay a lot of attention to how I do things compared with how others do things *

15. If I want to find out how well I have done something , I compare what I have done with how others have done *

16. I often compare how I am doing socially (social skills, popularity) with other people *

17. I am not the type of person who often compares with others *

18. I often compare myself with others with respect to what I have accomplished in life *

19. I often like to talk with others about mutual opinions and experiences *

20. I often try to find out what others think who face similar problems as I face *

21. I always like to know what others in similar situation would do *

22. If I want to learn more about something, I try to find out what others think about it *

23. I never consider my situation in life relative to that of other people *

24. . I often question my own character *

25. I can easily imagine myself as the kind of person that should definitely feel guilty *

26. I often question my own sanity *

27. . I am sometimes afraid to look inside of myself because I am afraid of what I could find *

28. I worry about being the sort of person who might do very immoral things *

29. I’m afraid of the kind of person I might become if I’m not very careful. *

30. I often feel that I do not honestly show the negative reality inside myself *

31. I must be very careful in order to avoid doing something awful *

32. I could list a few things that I can do very well *

33. I don’t remember how I felt and thought as a child, I am now like a different person *

34. I can trust my inner voice, it usually leads me in the right direction *

35. My friendships usually last only a few months *

36. I feel I don’t really belong anywhere *

37. When I look in the mirror, I am often surprised and don’t like how I have changed. *

38. I often don’t know how I feel right now *

39. I'm not sure if my friends really like me *

40. When people see me in new situations, they are very surprised how I can be *

41. I feel that I have different faces that do not fit together well *

42. I often feel lost, as if I had no clear inner self *

43. When I’m alone I feel helpless *

44. If I am criticized or others see me failing, I feel really worthless and "devastated". *

45. If someone has offended me, I don’t want to talk to him or her ever again *

46. I often have a block when I ask myself why I did things. *

47. I am confused about what kind of person I really am *

Me - Authentic Living - Out of 20

Me - Accepting External Influence- Out of 20

Me - Self-Alienation - Out of 20

IOWA - NETHERLANDS Comparison Orientation - ABILITIES (Out of 30)

IOWA - NETHERLANDS Comparison Orientation - OPINION (Out of 25)

Frederick Aardema (et.al 2013) Fear of Self (OCD) Scale (out of 48)

Kirstin Goth (et.al 2012) Identity Diffusion Scale - DISCONTINUITY (Attributes / Goals) (out of 18)

Kirstin Goth (et.al 2012) Identity Diffusion Scale - DISCONTINUITY (Relationships / Roles) (out of 18)

Kirstin Goth (et.al 2012) Identity Diffusion Scale - DISCONTINUITY (Emotional Self - Reflection) (out of 12)

Kirstin Goth (et.al 2012) Identity Diffusion Scale - INCOHERENCE (Consistent Self Image) (out of 18)

Kirstin Goth (et.al 2012) Identity Diffusion Scale - INCOHERENCE (Autonomy / Ego Strength) (out of 18)

Kirstin Goth (et.al 2012) Identity Diffusion Scale - INCOHERENCE (Cognitive Self Reflection) (out of 12)