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SECTION 1: Body + Nervous System

1. I feel tense, wired, exhausted, or overstimulated more often than I want to admit.

2. My body feels like it is constantly bracing for something.

3. I struggle to fully relax, even when nothing is technically wrong.

4. I feel disconnected from my body’s signals until they become loud or urgent.

5. I push through fatigue, hunger, pain, stress, or overwhelm because things still need to get done.

Section total: ____ / 15

Section 2: Emotional Life

1. I feel irritable, resentful, anxious, numb, or emotionally heavy more often than I show.

2. I minimize my own feelings because other people “have it worse.”

3. I often don’t know what I actually feel until I’m already overwhelmed.

4. I suppress emotions to keep the peace or keep functioning.

5. I feel like I should be grateful, but something still feels off inside.

Section total: ____ / 15

Section 3: Identity + Self-Trust

1. I don’t feel fully like myself anymore.

2. I question my decisions or need outside validation before trusting myself.

3. I have built a life that looks “fine” or “successful,” but doesn’t always feel like mine.

4. I have spent years being who everyone needed me to be.

5. I struggle to know what I want, need, desire, or prefer.

Section total: ____ / 15

Section 4: Relationships + Family

1. I feel responsible for everyone else’s emotions, needs, comfort, or success.

2. I say yes when I want to say no.

3. I feel unseen, unsupported, taken for granted, or emotionally alone.

4. I avoid hard conversations because I don’t want conflict, guilt, or disappointment.

5. I give so much of myself that there is very little left for me.

Section total: ____ / 15

Section 5: Work, Purpose + Daily Life

1. I am productive, capable, and high-functioning, but I often feel depleted underneath.

2. I feel like I am constantly managing life instead of actually living it.

3. My calendar, responsibilities, or business/work demands run me more than I run them.

4. I have dreams, ideas, or desires I keep postponing.

5. I feel like I am waiting for life to calm down before I can finally become myself again.

Section total: ____ / 15


 

Your Score

Add all five section totals.

Total Score: ____ / 75
 

0–15: Mild Disconnection Stress

You may have moments of stress or self-abandonment, but you still have access to yourself. This is a powerful time to strengthen self-trust, nervous system regulation, and intentional choice before patterns become deeply embedded.
 

16–35: Moderate Disconnection Stress

You are likely functioning well on the outside while overriding yourself on the inside. You may notice anxiety, resentment, fatigue, emotional eating, people-pleasing, overthinking, or a quiet sense that something needs to change.
 

36–55: High Disconnection Stress

Your system may be carrying the cost of years of self-sacrifice, emotional suppression, over-responsibility, and disconnection from your own truth. This is where burnout, anxiety, body symptoms, relationship strain, and loss of self often become harder to ignore.
 

56–75: Severe Disconnection Stress

This may feel like living in survival mode while still trying to perform, caretake, lead, manage, and hold everything together. Your body, emotions, and life may be signaling that surface-level stress management is no longer enough. The deeper pattern needs attention.
 

Your Biggest Disconnection Pattern

Look at your section scores. Your highest section shows where Disconnection Stress may be most active right now.
 

Highest section: ____________________

This may be the area where your system is asking for the most support.