Below is a structured, professional intake framework suitable for Case Study 00206.
These questions are designed to help a hypnotherapist identify subconscious patterns, emotional blocks, trauma imprints, attachment styles, belief systems, and developmental needs—so the healing program can be precisely customized.

---

Case Study 00206

Date: 8 Jan 2026
Focus: Relationships Challenges · Past Traumas · Personal Development
Method: Hypnotherapy (Integrative, Trauma-Informed)

---

Section 1: Presenting Relationship Challenges

1. What specific relationship challenges are you experiencing right now?

2. Do these challenges show up in romantic relationships, family, friendships, or all of them?

3. What patterns do you notice repeating in your relationships?

4. When conflict arises, how do you typically respond—withdraw, fight, please, or freeze?

5. What emotions do you struggle with most in relationships (fear, anger, jealousy, shame, abandonment)?

6. Do you feel safe being emotionally open with others? Why or why not?

7. What do you fear most might happen if you fully express your needs?

8. How do you experience trust—easy, difficult, or conditional?

9. What does “love” mean to you based on your lived experience?

10. In relationships, do you feel more often valued or taken for granted?

---

Section 2: Attachment, Boundaries & Self-Worth

11. Growing up, how were affection, safety, and emotional support expressed in your home?

12. Did you feel seen, heard, and protected as a child?

13. How comfortable are you setting boundaries and saying “no”?

14. Do you tend to over-give, under-give, or withdraw emotionally?

15. What beliefs do you hold about your own worth in relationships?

16. Do you feel responsible for other people’s emotions or happiness?

17. When relationships end or feel threatened, what is your strongest internal reaction?

18. What role do you often play—rescuer, pleaser, controller, avoider, or observer?

19. Do you feel you must earn love, or believe you deserve it naturally?

20. How do you treat yourself when a relationship fails or becomes difficult?

---

Section 3: Past Trauma & Emotional Imprints

21. Have you experienced emotional, physical, or psychological trauma that still affects you?

22. Are there past relationships that continue to influence your thoughts or emotions?

23. Do certain triggers instantly activate intense emotional responses?

24. When triggered, where do you feel the emotion in your body?

25. Have you ever felt abandoned, rejected, betrayed, or powerless?

26. What coping mechanisms did you develop to survive difficult experiences?

27. Are there memories you avoid thinking about because they feel overwhelming?

28. Do you notice dissociation, emotional numbness, or hyper-vigilance?

29. What emotions feel unsafe or forbidden for you to express?

30. If your subconscious could speak freely, what unresolved pain would it want healed first?

---

Section 4: Personal Development & Healing Goals (Optional for Program Design)

(Use these to refine session structure and outcome goals)

• What kind of relationship do you want to create going forward?

• What emotional state do you want to experience more consistently?

• What would healing look like if it were successful?

• Are you open to inner-child work, regression, parts therapy, or somatic release?

• How committed are you to changing long-held patterns?