Please complete this document however feels best for you and return it along with the Confidential Intake Form.

A Time Line History is a document which logs all the major events in your life, positive and negative from pre-birth to the present day. It provides brief details along with the dates of when these events happened. In particular include:

If you are not sure, include it or ask me.

Please simply write; grammar or spelling are not important for this exercise. Some people do it free hand, some on the computer in a document or table, it is entirely up to you, do what feels right for you.

  • Your medical history including the specific dates of diagnosis and the treatments you have had whether conventional or alternative.
  • Details of anything which begun as a child, that stressed you, and that may have started a pattern e.g Fear of being separated from significant people, worry or arguments with major people in your life, parents, loved ones.
  • Also include any major arguments with significant people, traumas, stresses, losses or any other significant events which you feel have shaped you.
  • Include conflict shocks, these are things that catch you completely off guard. They are Unexpected, Dramatic, make you feel as if they are only happening or happened to you ( Isolating), and where you have no strategy to deal with the shock. We call this a UDIN as an acronym for Unexpected, Dramatic, Isolating, No Strategy.
  • Please also highlight any stresses you are going through at the moment. What triggers the stress off; family stuff, past or present partners, friends, work etc?
  • Please simply write; grammar or spelling are not important for this exercise. Some people do it free hand, some on the computer in a document or table, it is entirely up to you, do what feels right for you.
  • If while writing any emotions arise such as sadness, anger, fear, please add a brief description of the emotion next to the event e.g I remember when my X passed away * ( I still feel sad here).
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