The Radical SELF
Forgiveness/Acceptance Worksheet
A Worksheet for Healing Guilt and Shame Date:____________
1. T E L L I N G T H E S T O R Y
1. What I am blaming myself for and what I hear my judging self saying to me about it is........
2a. The way I feel about myself with regard to this situation, or in general, is... 2b. SELF ESTEEM
(List your feelings here.) On a scale of 1 - 10 (1 being extremely low and 10 being very high), my self-
esteem is: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, (Circle One.)
2. F E E L I N G T H E F E E L I N G S
(Check one: Be truthful — whichever one is OK)
3. I lovingly recognize and accept my Willing: Open: Skeptical: Unwilling: 4b. Regarding this situation, I am feeling part GUILT (remorse over what I
feelings, and judge them no more:
have done) and part SHAME (remorse over who I am or have become).
4a. I own my feelings. No one can make (Indicate the percentage of each.)
me feel anything. My feelings are a re- Willing: Open: Skeptical: Unwilling:
flection of how I see the situation: GUILT _________ % SHAME __________ %
5. My guilt over it is appropriate/inappropriate. (Circle One and Explain.)
6. As I really examine how I feel about myself, I realize that underlying my feeling of shame, there is a belief or a set of beliefs that I hold about myself that are not true.
My self-judgments have been based in what others, particularly my parents, saw in me and taught me about myself. For example:
3. C O L L A P S I N G T H E S T O R Y
7. I now realize that what I judge in others Willing: Open: Skeptical: Unwilling: SPACE FOR ADDITIONAL COMMENTS
represents what I hate about myself and
SELF ACCEPTANCE
have repressed and projected onto them.
8. People I dislike are therefore reflecting Willing: Open: Skeptical: Unwilling:
what I need to love and accept in myself.
9. In forgiving myself, I heal myself and Willing: Open: Skeptical: Unwilling:
totally recreate my perception of who I
am.
10. I now realize that nothing I, or anyone Willing: Open: Skeptical: Unwilling:
else, has done is either right or wrong. I
drop all judgment.
11. I release the need to blame myself and
to be right and I am WILLING to see the Willing: Open: Skeptical: Unwilling:
perfection in what is just the way it is.
12. I am willing to see that my mission or Willing: Open: Skeptical: Unwilling:
'soul contract' included having experiences
like this - for whatever reason.
13. Even though I don't know why or how, Willing: Open: Skeptical: Unwilling:
I now see that my soul has created this
situation in order that I learn and grow.
SPACE FOR ADDITIONAL COMMENTS
14. Even though I may not know what, why or how, I now Willing: Open: Skeptical: Unwilling:
realize that I, myself, and the others involved have been
receiving exactly what we each had subconsciously chosen
and were doing a healing dance with and for each other.
15. I bless you _________________________ for being willing Willing: Open: Skeptical: Unwilling:
to play a part in my healing and honor myself for being willing
to play a part in your healing.
16. I release from my consciousness all feelings of: (As in Box # 2.)
17. I completely forgive those who implanted the ideas in me that I am.... (As in Box 5.) The people I am forgiving are:
18. I now realize that what I was experiencing (my story about me victimizing myself) was a precise reflection of my ignorance of the truth. I now understand that if I were
able to see the spiritual big picture, I would really see how it all fits and that everything is indeed perfect. At the same time, I am willing to take responsibility for my actions
4.REFRAMING THE STORY
in this world of humanity. I also understand that the more I act with integrity in this world, and with love in my heart, the more likely it is that I will be in alignment with the
World of Divine Truth. I can change my old self-destructive 'reality' by simply being willing to see myself in the light of truth. For example, I now see myself as.......
19. I completely forgive myself, _______________________________ 20. I now SURRENDER to the Higher Power I think of as ______
and accept myself as a loving, generous and creative being. I release ___________________________and trust in the knowledge that this
all need to hold onto any and all ideas of lack and limitation I created in situation will continue to unfold perfectly and in accordance with Divine
the past. I withdraw my energy from the past and release all barriers guidance and spiritual law. I acknowledge my Oneness and feel myself
against the love and abundance that I know I have in this moment. I totally reconnected with my Source. I am restored to my true nature,
create my life and I am empowered to be myself again, to unconditionally which is LOVE, and I now restore love to (X). I close my eyes in order
love and support myself, just the way I am, in all my power and magnifi- to feel the LOVE that flows in my life and to feel the joy that comes when
cence. the love is felt and expressed.
21. A Note To Anyone That I Hurt or Negatively Affected in Some Way: _____________________ Having done this worksheet, I
5. I N T E G R A T I N G T H E S H I F T
now realize that there was a Divine order to what happened. However, from the perspective of being in this physical world of pain and
suffering, I still wish to apologize, to make amends and ask for your forgiveness. My apology is as follows:
22. A Note To Myself:
I completely forgive you _____________________ for I now realize that you did nothing wrong and that everything is in Divine order. I acknowledge,
accept and love you unconditionally just the way you are. I recognize that I am a spiritual being having a human experience, and I love and support myself
in every aspect of my humanness.
On a scale of 1-10, having done this worksheet, my self-esteem now is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. (Circle One.)
Based on the books, "Radical Forgiveness" and "Radical Self-Forgiveness" by Colin Tipping. © 2000-09 Colin Tipping
For further information go to www.radicalforgiveness.com
