Polyvagal Parenting Application

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I am SO glad you are here.

Apply below for Polyvagal Parenting, a 3-month long program beginning on April 11th. Together in this intimate, small container we will learn about self-regulation and co-regulation so you can fully trust yourself and experience more joy as a parent.

Because of the nature of this offering, spaces for Polyvagal Parenting are very limited.

After you submit your application, I will be in touch with you to schedule a call together to discuss next steps.

Email *

Name *

Phone Number *

This program is a very sacred container. I accept applicants who are ready to rise up, and see themselves in a very clear way. This means that you may feel activated at times. This means that you may be asked to explore parts of you that are hard to look at. This is a rebirth, an expansion, a deep growth... and with that, sometimes growth can be challenging and intense. Does this feel aligned? *

Yes, I am ready!

Not today.

What kind of work have you done already? (ie. therapy, another coaching program, etc.) *

Which best describes your parenting style:
*

I am able to show up consistently for my child’s needs. I can set and implement boundaries and limits for my child fairly easily. When I’m frustrated or overwhelmed I can get the support I need.

I am always thinking about or anticipating my child’s needs. I never want my child to get hurt. I am afraid to let my child explore or leave the home because when I’m not with them I get anxious. Sometimes I’ll show up consistently, other times it depends on my mood or energy levels. I tend to make empty promises or empty threats, even when I don’t mean to. I don’t always know how to “control” my child’s behavior, and things can feel hectic or out of control.

I show up for my child when they have a need or there’s something task oriented, like home work, laundry or chores. We don’t spend much time snuggling or being affectionate. Sometimes we talk about things, but I don’t usually initiate it. I either work a lot or I’m busy with other things, like cooking, cleaning, chores or tending to other children’s needs. I don’t often have time for 1:1 time with my child.

I tend to yell a lot, or default to yelling, despite my best efforts not to. My child seems to always get everything wrong, and really has a hard time getting things “right.” There’s nothing a lot of structure in the home. I say things I don’t mean a lot. I feel overwhelmed. I want to be close to my child but I don’t really know how to get close. I’m afraid I may hurt my child’s feelings, or sometimes I’m afraid of my own anger toward my child.

Would you describe yourself as self-motivated? *

Yes, absolutely.

Sometimes, if I'm in the right mood.

Not really, I tend to need a push from someone I trust.

What does personal responsibility and personal accountability mean to you? *

Do you tend to practice the things that you learn and work to apply them to your own life? *

What are you hoping to get out of this coaching container? *

What is getting in the way of your parenting? *

How would you describe your current self in 3-5 words. *

What are your biggest challenges or obstacles in the way of your healing? *

Which one sounds most like you? *

"I feel overwhelmed a lot. I always feel like I have so much to do and I never know what to do first so I end up doing nothing."

"I feel like I don't have much energy. I don't really want to do anything. I like lounging. I'm not very social. I prefer to be alone."

"I really like the company of others. I feel anxious, angry, or irritable a lot of the time. I feel overwhelmed sometimes. I want to know what I need to do to feel better!"

"I feel calm. I have a good balance of energy. I feel productive a lot of the time. I feel safe to come and go into and out of connection with others. I know what is expected of me, and I understand my own internal limits."

The financial commitment of this group program is $2500 (with a payment plan available). Do you feel ready to make this investment? There is no wrong answer. *

I can pay in full

I can do a payment plan (3 payments of $850)

I can do an extended payment plan

I'm not ready for this financial commitment

Is there anything else you'd like me to know? *

Do you have any questions for me? *

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