GNM Questionnaire 3

Thank you for taking the time to complete this questionnaire.

This will assist us in identifying sub-conscious tracks and triggers that contribute to your symptoms.

For each major symptom, we want to identify anything that might have been happening at the time that you experienced the conflict shock.  Things that were happening when you experienced at the time of the conflict shock, can re-trigger the symptoms.  By identifying these ‘triggers’ we can begin to reframe and rescript our relationship to the trigger which will assist in allowing the body to complete the healing process.

We are now going to look at your body in general to increase your awareness of when you are Conflict Active. This may or may not be related to your Core Issue.  Referring to the list of symptoms below, put a check next to the ones that you have noticed are more prevalent in your life. 

Some people notice they have cold hands and feet often while others notice they are more apt to obsess over a distressing event. Which symptoms on this list are more common to you?  

Signs of being in conflict activity include:

• Preoccupied mind
• Sleeplessness
• Lack of appetite
• Cold hands and feet
• Fast heart beat
• High blood pressure
• Low blood sugar
• Nausea
• Cold skin
• Chills
• Shivers