Before we begin

A little about you

Answer as honestly as you can. There are no right answers — only accurate ones.

Your name

Today's date

What brings you here today?

Not the story — the pattern underneath it. What keeps recurring?

How long has this been present in your life?

Less than a year

1–3 years

3–10 years

Most of my life — it has always been this way

What have you already tried?

Therapy, medication, diet changes, coaching, bodywork — anything.

Section 01

Your body

These questions are about how your body actually feels day to day — not how you think it should feel.

Breathing

When you breathe at rest, where does the breath move?

Place one hand on your chest and one on your belly. Notice which rises first.

Mostly my belly — the lower hand rises first

Mostly my chest — the upper hand rises first

Upper chest and neck — my shoulders lift when I inhale

I am not sure — I have never noticed

Do you often feel like you cannot get a fully satisfying breath?

No — my breathing feels easy

Sometimes — particularly under stress

Often — I sigh or yawn frequently trying to get a deep breath

Almost always — I feel tightness or restriction across my chest or ribs

Physical tension and pain

Where do you carry chronic tension in your body?

Select all that apply.

Jaw, neck, or base of skull

Upper back and shoulders

Chest or ribcage — a feeling of tightness or constriction

Solar plexus or upper abdomen — a gripping or held feeling

Lower back

Hips or pelvis

I do not notice chronic tension anywhere

Do you experience bloating, abdominal discomfort, or digestive irregularity?

No — digestion feels consistent and easy

Occasionally — particularly with certain foods or stress

Frequently — bloating or discomfort is a regular presence

Constantly — I have been diagnosed with IBS, SIBO, GERD, or similar

Do you experience widespread pain, joint pain, or inflammation?

No chronic pain

Localised — specific area or joint

Widespread — multiple areas, difficult to locate precisely

Inflammatory — diagnosed autoimmune or inflammatory condition

Section 02

Energy and your nervous system

How your body manages activation, rest, and recovery.

Daily energy

How would you describe your energy across a typical day?

Stable and consistent — I feel resourced most of the day

Reasonable in the morning, drops significantly in the afternoon

Low most of the day — I rely on caffeine or stimulants to function

Wired but exhausted — mentally activated but physically depleted

I get a second wind at night — most alive when I should be sleeping

How well do you recover from exertion — physical, emotional, or mental?

Quickly — I bounce back without much deliberate rest

Moderately — I need recovery time but get there

Slowly — it takes me significantly longer than it should

I often feel worse the day after exertion, not better

Sleep

Describe your sleep.

Good — I fall asleep easily, stay asleep, and wake feeling rested

Difficulty falling asleep — mind activated, body tense

I wake between 1am and 4am and struggle to return to sleep

Unrefreshed — I sleep enough hours but wake exhausted

I have diagnosed or suspected sleep apnoea

Nervous system baseline

How does your nervous system feel most of the time?

Settled and regulated — I can move between calm and activated without getting stuck

Persistently activated — alert, scanning, difficulty settling even when safe

Anxious — a baseline hum of worry or dread that does not fully lift

Flat or collapsed — low motivation, disconnected, difficult to mobilise

Swinging between both — activated one day, collapsed the next

After a stressful event, how long does it take you to genuinely return to baseline?

Minutes — I process and settle relatively quickly

Hours — I carry the activation for most of the day

Days — a difficult interaction or event can affect me for the rest of the week

I am not sure I return to baseline — it just builds

Section 03

Hormones and metabolism

These questions map how your chemical regulation system is functioning.

Weight and metabolism

How does your body respond to what you eat and how much you move?

Responsive — my body changes predictably when I change inputs

Resistant — I eat carefully and exercise but see minimal change

Gaining — my weight creeps up regardless of what I do

Cycling — I lose weight on a programme then regain it all and more when I stop

Where does excess weight primarily accumulate?

Abdomen and waist — a central, visceral pattern

Hips, thighs, and lower body

Evenly distributed

Weight is not currently a concern

How is your relationship with blood sugar and hunger?

Stable — I can skip meals without significant impact

I crash if I go too long without eating — shaky, irritable, foggy

Strong carbohydrate cravings — particularly in the afternoon or at night

I have diagnosed insulin resistance, pre-diabetes, or type 2 diabetes

Thyroid

Do you experience any of the following? Select all that apply.

Persistent cold hands and feet, difficulty staying warm

Hair thinning or loss

Brain fog, slow thinking, or difficulty with word retrieval

Dry skin, brittle nails

Heart palpitations or heat intolerance

I have a diagnosed thyroid condition

None of these

Hormonal cycle (skip if not applicable)

In the week or two before your period, what typically happens?

Minimal — I barely notice a shift

Moderate mood and energy shift — manageable

Significant — mood, energy, and physical symptoms that disrupt daily life

Severe — I am a different person in my luteal phase. Diagnosed PMS, PMDD, or endometriosis.

I am in perimenopause or post-menopause

Not applicable

Section 04

The pattern beneath it all

These are the questions that go deeper. Answer from what you actually know, not what sounds right.

When you make progress — in your health, work, or relationships — what tends to happen?

It holds and builds — progress compounds over time

It holds partially — some things stick, others drift back

It reverts — I return to baseline within weeks or months

Something derails it — an event, a relationship shift, an internal pull back

What is the recurring theme in your life right now?

Not the circumstances — the structural theme. Stuckness, invisibility, overextension, collapse, disconnection.

How do you tend to hold your body under pressure?

I brace and tighten — hold my breath, stiffen my shoulders or jaw

I collapse and withdraw — chest drops, I make myself smaller

I disconnect — I stop feeling the body entirely and operate from my head

I do not notice what I do — my body feels separate from my experience

What is one thing you already know about your own structure that no one has confirmed?

The thing you sense about yourself that keeps getting bypassed in treatment or conversation.

What would resolution actually require from you?

Not what you wish would happen — what you know it would take.

Before we close

A structural reset

Before you leave, we are going to do one thing together. This is not an exercise. It is the beginning of the structural change we have just mapped.

What this does

Sit comfortably. Place one hand on your chest, one on your belly. The goal is simple: only the lower hand moves. Every breath you take this way is mechanically reversing the cascade we identified in your body today.

Breathe into your belly

Cycle 0 of 8

Session complete

Your structural read

Below is what your answers reveal about what is structurally operating in your system.

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A little about you

Your body

Energy and your nervous system

Hormones and metabolism

The pattern beneath it all

A structural reset

Your structural read

Send this record

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