Informed by the work of Dr. Stephen Porges & Dr. Deb Dana
Section 1 of 50% complete
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?
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."