Lauren Carpenter Wellness

Nervous System
State Assessment

A Polyvagal-informed intake tool to map your autonomic baseline and guide our work together.

Ventral Vagal — Safety & Connection Sympathetic — Mobilize & Protect Dorsal Vagal — Withdraw & Conserve

Informed by the work of Dr. Stephen Porges & Dr. Deb Dana

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Section 1 — Orientation

About You

Before we explore your nervous system patterns, share a little context. There are no right answers — only honest ones.

Your autonomic nervous system is always scanning for safety. How it learned to respond — to protect you, to keep you moving, or to shut things down — is shaped by your entire history.

This assessment draws on Polyvagal Theory (Dr. Stephen Porges) and the Polyvagal Ladder framework (Dr. Deb Dana) to help us understand your current baseline, not to diagnose or label you.

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Your results will be shared with Lauren to support your coaching work.

Q1 What brings you to this work right now?
Q2 In general, how would you describe your current life demands?
Q3 How long have you been in this pattern?
✓ Your results have been sent to Lauren. She'll be in touch before your next session.
Your Nervous System Profile

Your Autonomic
Baseline Map

This is a map, not a verdict. Your nervous system learned to respond this way for good reasons. Together, we'll build new pathways — with curiosity, not judgment.

Dominant Autonomic State
—

Ventral VagalSafety & Connection
—

Capacity for calm presence, genuine connection, and flexible response to challenge.

Sympathetic ActivationMobilize & Protect
—

Nervous system in mobilization mode — fight, flight, urgency, hypervigilance, or chronic activation.

Dorsal VagalWithdraw & Conserve
—

Nervous system in conservation or shutdown — flatness, numbness, disconnection, or collapse.

Your Nervous System Archetype
—

What This Means for Our Work

"Regulation is not a destination. It is a practice of returning."

— Informed by Deb Dana, Anchored
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