Your Healing Blueprint

Your Healing Blueprint

JS Coaching
Hello and welcome to the Healing Blueprint tool.

You are taking an important next step towards learning skills to feel more, not less, so you can experience more vitality and connection with Life itself.

My name is Jennifer, and I hold a comprehensive background in neurophysiology, psychology, counselling, somatic psychology and mindfulness. I have been told by clients that my approach is unique because it blends science with soul.

I have a comprehensive approach. And, I have spent many hours contemplating and identifying the common denominator that was blocking my clients from accessing deeper healing.

As simple as it may sound, fear of feeling, was/is the presenting problem. Therefore, I am invested in helping you safely feel so that fear no longer prevents you from healing.

Jennifer Summerfeldt, MACP, CCC
READ FIRST

Before you begin, take a moment to check-in with yourself to confirm that you are ready to engage with your feeling and healing process.

Can say yes to these things:
- Yes, I can carve out the time to engage in learning a new skill.
- Yes, I have access to financial resources to invest in my healing.
- Yes, I am currently living within a supportive and safe environment.
- Yes, I understand that learning a new skill requires a committment of time and energy.
This is NOT an automated survey with a standardized results page. You will receive a personal email from me, Jennifer, with an intuitive assessment.

Please take a moment to check ALL boxes and statements that best describe your current experience within each phase of healing, as outlined below.

It is important to note: This is not a professional or standardized assessment tool. It is a customized assessment form to help you and me (Jennifer) ascertain your level of readiness; what your feeling needs are; and suggestions to access next level support.

Your information will be held confidential and will not be used for outside purposes. By answering this questionnaire and submitting it for evaluation, you are granting permission for Jennifer, from JS Coaching, to review, intuitively assess, and offer general feedback. You will not receive any medical advice; this is not a diagnostic tool.

All copyrights reserved for JS Coaching.

The proposed phases of healing that are being assessed throughout this form:
- Acknowledgment : Identifying crisis and finding the necessary support to help remove you from the crisis.
- Information: Gathering information that informs and inspires.
- Skill building: Learning feeling skills that support the health of your system.
- Tending : Working with your nervous system to declutter emotional debris
- Inquiry: Engaging the mind to ascertain limiting beliefs and ego-parts.
- Emoting: Releasing deep emotions that are connected to your core wound.
- Expanding: Navigating the interior soul world.
- Action: Identifying and living with purpose and conscious choice
- Relating: Connecting to your environment - people, place, nature, animals
Name

First Name Last Name
Email
example@example.com
Acknowledgment: Identifying crisis and finding the necessary support to help remove you from the crisis.

I am currently experiencing a crisis of sorts that is rattling my sense of ‘normal’ or ‘stable’ function I went through a turbulent time and I am no longer in the muck of it I went through a turbulent time, things have calmed down, but there is still unfinished business I have to take care of I have a childhood history of unprocessed trauma and I only just ready to open the lid on my past I know how to access social services in my local area for additional support if needed I am in a crisis or highly stressful situation and I am in need of safety and support My life has been stable with no major traumas, but I feel stuck and uninspired I have a history of highly stressful events; however, I have received a ton of support throughout my life and I am aware of how they have impacted me My life and environment is currently stable and safe
Information: Gathering information that informs and inspires the process of healing.

I have spent a lot of time researching trauma and mental health I am new to trauma theory, neurobiology, and the stress response as it pertains to mental and emotional health I spend a lot of time reading material about mindfulness, consciousness, mental health and healing I know a lot about attachment theory, epigenetics, and early childhood trauma I know a little about attachment theory, epigenetics, and early childhood trauma I am just starting to learn about attachment theory, epigenetics, and early childhood trauma I love learning new information I dislike learning new information I would rather skip this step and let someone else tell me what is best for me
Skill building: Learning regulation skills that support the health of your system.

I feel very skilled to be with felt sensations in my body I am not afraid of feeling the harder emotions – grief, anger, guilt I often feel overwhelmed by emotions; flooded by them and I cannot separate myself from the emotion Feeling my emotions scare me I am confident that whatever emotion I feel I can be with the felt experience without disembodying I have a lot of skills up my sleeve to help me calm down when I feel too much I know that an emotion is a burst of energy that will subside in a short period of time I can’t separate myself from my emotions I am afraid that I will explode or implode if I feel too much Even though I might sometimes feel like I will explode or implode, I know this is not true I often ‘lose control’ of my temper; outburst of anger is common for me I need someone or something (like a pet or nature) to help me regulate my emotional system I have a regular yoga practice I have a regular meditation practice I have a regular exercise regime I have never done yoga or meditation I have worked with a therapist in the past I have never worked with a professional therapist I am currently working with a therapist I have the experience of feeling too much and calming down my system within a few minutes
Tending: Supporting the nervous system to discharge trapped emotional material so it can move towards coherence, health, and regulation

I have learned to titrate and pendulate when my system is activated I can identify when my system is in hyperarousal or hypoarousal I have received support in one of the following: EMDR; Somatic Experiencing; Rosen Method; Experiential Art Therapy; Interpersonal Neurobiology therapy Supporting the nervous system is a new concept for me; I have no experience with this I am familiar with the concept of heart coherence I feel fear about releasing trapped emotional material within my nervous system I feel ready to release trapped emotional material within my nervous system I feel competent to engage my nervous system with mindful awareness I have no idea what ‘trapped emotional material’ means I have lived most of my life in dysregulation of my system I have never known ‘calm’; calm feels foreign to me
Inquiry: Engaging the mind to ascertain limiting beliefs and ego-parts.

I have a regular practice of inquiry of the mind I regularly question my thoughts and beliefs I am skilled at bringing into focused attention what I am thinking and feeling in any given situation I have rarely paid attention to my inner thoughts I know the difference between analyzing vs noticing I often hear loud critical thoughts/voices but I do not know what to do about it I am aware of my core limiting beliefs (often only one or two) I have never accessed my core limiting beliefs I have a vibrant inner community and can name the parts I have never united with my inner community/parts I only know myself as my personality and identity I think that ego is a part of my personality I think that ego is a part of my inner community I think that ego is a part of the human experience I think that I am my ego I know that I am not my ego I get lost in ego talk I know how to shift out of negative self-talk I know how to shift out of limiting beliefs I know how to redirect my energy and thus, thinking I do not know how to do any of the above three things (but would like to learn)
Emoting: Releasing deep emotions that are connected to your core wound.

I have touched my inner core wound I know what my core wound is I understand how my core wound has given rise to my lived experience I have felt my core wound I have experienced deep grief I have made sense out of my core wound I know that I am not my core wound I am grateful for my core wound I have not experienced any of the above I do not think that I have a core wound I am not interested in excavating my core wound I think focusing on the past is a waste of therapeutic time I want to know what to do with the information that is arising out of the core wound I am afraid that if I feel my core wound, I might die, explode, implode, or go crazy
Expanding: Navigating the interior soul world to wake up to your true nature.

I live in soul territory I know my soul I am stuck between worlds – soul world vs ego world I am in love with my soul I am confused by soul language I believe that I have a soul, but I have not connected with it (or not often anyways) I am ready to dive into soul territory and learn how to live from this expression I feel disconnected from soul; lost and empty I do not resonate with this language I believe that my soul is beyond my ego I want to learn how to align with my soul desires I am more interested in what is behind the veil versus life out there in the ‘real world’ Life in soul territory feels real, if not more real, than life out there I am ready to leap and learn how to trust in Life Itself I need soulful guidance
Action: Re-entering your environment and community with purpose and conscious choice

I feel deeply connected to my external community I feel deeply connected to my family I feel compassion and understanding around my family history I feel alive when I am in service I have a good sense of purpose in my life I feel like I am living my life purpose I feel connected to the natural environment Life feels meaningful I am an active participant in my life I feel disconnected from the natural world I feel disconnected from my body I feel disconnected from my family I feel disconnected from my children I do not know my life purpose; I doubt that I have one Life feels meaningless Life is happening to me; I do not feel like an active participant
Relating: Re-connecting and attaching in love to all in your environment - people, place, mammals and natural surroundings.

I feel love I know that I am loved I feel compassion for myself and others I feel alive in nature I feel safe in my environment I know that Life itself is kind and is on my side I have a deep trust in Life itself I have healthy relationships I have healthy boundaries I can articulate my needs with clarity I know that I matter I know that I am not my past wounds I am not afraid of conflict; conflict is a part of life I experience none of the above I have toxic relationships and feel trapped in them I am afraid to relate to others I feel isolated and alone I do not know where I begin and end in a relationship I am afraid to articulate my needs; I do not even know what they are I do not trust humans I do not trust in the non-human realm (in the Mystery) I believe that I am bad or foundationally flawed I am still tormented by my past wounds and cannot separate from them
Closing Remarks

Please read before submitting for results
Thank you for completing this assessment. I hold each submission close to the heart and will treat your answers with the utmost care. You will receive an email within 48 hours that will outline the following:
1. A general assessment of which phase of healing to focus on.
2. Highlighting a few points that stood out.
3. Some tangible action steps.
4. Potential services and external supports that might be of assistance
Please note, by submitting this form you are engaging in an online exchange with Jennifer from JS Coaching. This tool is for personal use only and is not in replacement of professional or medical evaluation. Although all content will be held confidential, due to the online nature of the correspondence there is no guarantee that your information is 100% protected. JS Coaching will not share any information received. Your results will be held confidential. You are personally responsible for seeking out the appropriate medical or professional care you deem necessary. All results and evaluations are not to be taken as medical or therapeutic advice.

Sincerely,

Jennifer Summerfeldt, MACP, CCC
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Your Healing Blueprint

Closing Remarks