Nervous System Assessment

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?

Section 2 — Polyvagal Ladder

Safety & Connection

Ventral vagal is your social engagement system — the state of calm alertness, genuine connection, and regulated presence.

Dr. Deb Dana describes this as being "at the top of the ladder" — where we feel safe enough to be curious, playful, and fully present with others. It is not the absence of challenge, but the capacity to meet it with resource.

Q4

How often do you feel genuinely present and at ease in your own body?

Rarely

Sometimes

Often

Q5

I feel safe enough to be seen, honest, and emotionally open with people close to me.

Rarely

Sometimes

Often

Q6

When I complete something I've been working toward, I can actually pause and feel good about it.

vs. immediately moving to the next thing

Rarely

Sometimes

Often

Q7

My breathing tends to feel open and easy throughout the day.

Rarely

Sometimes

Often

Section 3 — Polyvagal Ladder

Mobilization & Protection

The sympathetic branch activates when the nervous system detects threat — real or perceived. Fight, flight, urgency, and hypervigilance live here.

Porges' work reminds us this isn't pathology — it's protection. The system is doing its job. The question is whether it's stuck in this gear, even when the danger has passed.

Q8

My mind tends to race or loop on worries, what-ifs, or mental to-do lists.

Rarely

Sometimes

Often

Q9

I feel a low-grade urgency, restlessness, or irritability — even when nothing specific is wrong.

Rarely

Sometimes

Often

Q10

I have difficulty winding down at night — sleep onset is slow, or I wake with a "busy" mind.

Rarely

Sometimes

Often

Q11

I notice physical signs of activation: tension in my jaw, shoulders, or gut; shallow breathing; or a sense of "bracing."

Rarely

Sometimes

Often

Q12

I use busyness, productivity, or achievement to manage how I feel — it's hard to stop.

Rarely

Sometimes

Often

Section 4 — Polyvagal Ladder

Withdrawal & Conservation

The dorsal vagal branch governs the body's ancient shutdown response — collapse, disconnection, and immobility when the nervous system decides the threat is too much to fight or flee.

Dana describes this as "the bottom of the ladder" — not laziness or weakness, but the nervous system's oldest protective move. It can look like depression, numbness, fogginess, or profound exhaustion that sleep doesn't fix.

Q13

I experience a flatness, numbness, or emotional "greyness" — like I'm watching my life from a distance.

Rarely

Sometimes

Often

Q14

I feel a deep fatigue that doesn't improve with rest — a "bone-tired" quality.

Rarely

Sometimes

Often

Q15

I withdraw from social contact — not because I'm introverted, but because connection feels like too much effort.

Rarely

Sometimes

Often

Q16

I struggle to feel motivation, drive, or hope — even for things that used to matter to me.

Rarely

Sometimes

Often

Section 5 — Body & Resources

Your Window of Tolerance

The Window of Tolerance (Siegel, integrated with Polyvagal Theory) describes the zone in which we can experience sensation, emotion, and challenge — without going over or under threshold.

Q17

Which of these feels most true to your experience of your body? Select all that apply.

Q18

When I'm under significant stress, my first instinct is to:

Q19

Which practices or resources genuinely help you come back to yourself? Select all that apply.

Q20

What does feeling regulated look like for you — when it happens? What do you notice?

Nervous System
State Assessment

About You

Safety & Connection

Mobilization & Protection

Withdrawal & Conservation

Your Window of Tolerance

Your Autonomic
Baseline Map

What This Means for Our Work

All The Tools You Need To Build A Successful Online Business

Stay Connected

Nervous SystemState Assessment

About You

Safety & Connection

Mobilization & Protection

Withdrawal & Conservation

Your Window of Tolerance

Your AutonomicBaseline Map

What This Means for Our Work

All The Tools You Need To Build A Successful Online Business

Stay Connected

Nervous System
State Assessment

Your Autonomic
Baseline Map