Private Power Session: Exiting the Loop
Help me understand your experience so I can determine the best support for your Private Power Session.
Basic Information
Full Name
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First Name
Last Name
Email Address
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example@example.com
Time Zone (e.g., PST, EST, GMT+1)
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Present-Moment Check-In
In one or two sentences, describe what currently feels “stuck” or unresolved for you.
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How long has this issue or feeling been present?
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Please Select
Less than a week
1–4 weeks
1–6 months
More than 6 months
As long as I can remember
Does this situation feel more like:
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A sudden event or recent change
A recurring pattern or theme
A mix of both
Thought & Energy Orientation
When you think about this situation, which feels most accurate?
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I feel overwhelmed or flooded by it
I feel numb or disconnected from it
I feel both overwhelmed and numb at different times
I feel calm and curious about it
Which statement best reflects your current inner state around this issue?
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I want to fix or change this as soon as possible
I want to understand this before doing anything
I feel resigned or hopeless about this
I’m open to seeing this differently
When you pause and bring awareness to your body, what do you notice? (Select all that apply)
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Tension or tightness
Restlessness or agitation
Numbness or blankness
A sense of heaviness
A sense of lightness
Other (please specify)
Previous Attempts & Patterns
Have you worked on this issue before through any of the following? (Select all that apply)
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Therapy or counseling
Coaching
Self-help books or courses
Meditation or mindfulness
Talking with friends or family
Other (please specify)
If you have worked on this before, what best describes the result?
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I experienced some relief or change
I felt stuck or unchanged
I noticed new patterns or insights, but the issue remains
Not applicable / I haven't worked on this before
Awareness & Readiness
Which feels most true right now?
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I'm ready to explore this with support
I'm unsure but willing to try
I'm hesitant or resistant
Are you willing to become fully present with this experience without trying to fix it?
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Yes
No
Not sure
Scope & Support Check
Do you sense that this issue touches multiple areas of your life?
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Yes, it affects many areas
No, it feels isolated to one area
I'm not sure
Closing Reflection
In one sentence, what do you most want from this session?
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Submit
Should be Empty: