We will ask you to complete this form before you start SSP and after completion.
Prior Listening Experience:
Nervous System Tendency:
When reacting to distressing events in our lives (become dysregulated or destabilized), it is normal for us to quickly move out of a restful (ventral vagal) state of social engagement and connection, and into a survival state.
There are two general types of survival responses or states and we usually tend to move towards one more than the other.
Please use the lists of descriptors below to help you consider which you tend more towards
Please note that while these words may have a negative tone, both systems are important and valuable supports of the body. You may find it helpful to select the words that apply to you.
Please answer the following to describe your current home environment according to your perceptions:
Access to support (co-regulation) from others and yourself:
Although there is always the possibility of unforeseen circumstances, it is helpful to know if there are any significant events likely to happen in your life or those close to you which may have an impact on your ability to benefit from SSP. It is helpful to be aware of these in advance, if possible, so they can be factored into the timing of SSP delivery for you.
Please provide any details of events happening or expected in the next few weeks or months so these can be considered: such as exams, job stress, medical procedures or operations, house moves, recent bereavement or life change, holiday/family celebrations, or transitions.
In addition to considering your current personal circumstances, it is also helpful to reflect on the larger world and how current events and the background situation (i.e. weather, politics, crime, contagious diseases...) may be affecting you.
Before starting your SSP journey it is important you understand that this is a process you are engaging in for yourself and you will have the opportunity to learn new ways to help you stay more steady and regulated in the future. Although the listening is passive, the work to sustain the experience is intentional, and requires active engagement from you throughout.