Executive Peak Performance & State Regulation Questionnaire
Section 1: Understanding Your Performance States
1. How would you describe your typical mental and physical state before high-stakes situations (e.g., board meetings, negotiations, public speaking, major decisions)?
- Clear, focused, and in control
- Slightly anxious but functional
- Stressed or distracted, making it hard to think clearly
- Physically tense or overwhelmed
2. Do you notice fluctuations in your focus, confidence, or energy levels throughout your workday?
- Rarely – I stay consistently sharp
- Sometimes – I have strong and weak periods
- Frequently – My energy and focus feel unpredictable
3. During high-pressure moments, which of the following do you experience? (Check all that apply)
- Mental fog (difficulty thinking clearly, slowed decision-making)
- Racing thoughts (overanalysing, self-doubt, anticipating failure)
- Physical tension (tight shoulders, jaw clenching, stomach discomfort)
- Shallow or erratic breathing
- Struggling to stay present (distracted, reactive instead of strategic)
4. After intense work periods, how long does it take for you to mentally and physically recover?
- I bounce back quickly and feel refreshed
- I need some downtime but recover by the next day
- I feel drained for extended periods and struggle to reset
Section 2: Your Current Strategies for State Regulation
5. What methods do you currently use to prepare for high-stakes situations? (Check all that apply)
- Deep breathing or meditation
- Visualization or mental rehearsal
- Physical movement (exercise, stretching)
- Caffeine, stimulants, or energy boosters
- Nothing specific – I just push through
6. How do you handle moments of high stress or pressure in real time?
- I have a structured approach to stay focused
- I use quick mental or breathing resets
- I try to power through, but stress often builds up
- I feel reactive and struggle to maintain control
7. At the end of a demanding workday, how do you downshift into recovery mode?
- I have a structured wind-down routine (exercise, mindfulness, breathwork, etc.)
- I use distractions (TV, alcohol, social media) to relax
- I struggle to switch off and often bring stress home
Section 3: Exploring New Approaches to Peak Performance
8. Have you ever used breathwork techniques to enhance focus, manage stress, or recover from mental fatigue?
- Yes, regularly
- Yes, but only occasionally
- No, but I’m curious
- No, I don’t think breathwork would help me
9. If you could improve one aspect of your professional performance, what would it be?
- Managing pre-meeting or pre-presentation anxiety
- Sustaining deep focus and mental clarity throughout the day
- Remaining calm and composed under pressure
- Recovering faster to prevent burnout and maintain long-term resilience
10. Would you be interested in a tailored breathwork strategy to optimise your performance, clarity, and stress resilience?
- Yes, I want to learn how breathwork can enhance my leadership
- Maybe, I’d like to understand more before committing
- No, I don’t see breathwork as relevant to executive performance
Next Steps
Based on your responses, I can create a customised breathwork protocol to help you:
✔ Improve decision-making clarity in high-stakes situations
✔ Enhance focus and mental endurance throughout the workday
✔ Stay calm and composed under pressure
✔ Recover faster, preventing burnout and fatigue
Would you like to schedule a 15-minute consultation to explore how breathwork could support your executive performance?
1. How would you describe your typical mental and physical state before high-stakes situations (e.g., board meetings, negotiations, public speaking, major decisions)?
- Clear, focused, and in control
- Slightly anxious but functional
- Stressed or distracted, making it hard to think clearly
- Physically tense or overwhelmed
2. Do you notice fluctuations in your focus, confidence, or energy levels throughout your workday?
- Rarely – I stay consistently sharp
- Sometimes – I have strong and weak periods
- Frequently – My energy and focus feel unpredictable
3. During high-pressure moments, which of the following do you experience? (Check all that apply)
- Mental fog (difficulty thinking clearly, slowed decision-making)
- Racing thoughts (overanalysing, self-doubt, anticipating failure)
- Physical tension (tight shoulders, jaw clenching, stomach discomfort)
- Shallow or erratic breathing
- Struggling to stay present (distracted, reactive instead of strategic)
4. After intense work periods, how long does it take for you to mentally and physically recover?
- I bounce back quickly and feel refreshed
- I need some downtime but recover by the next day
- I feel drained for extended periods and struggle to reset
Section 2: Your Current Strategies for State Regulation
5. What methods do you currently use to prepare for high-stakes situations? (Check all that apply)
- Deep breathing or meditation
- Visualization or mental rehearsal
- Physical movement (exercise, stretching)
- Caffeine, stimulants, or energy boosters
- Nothing specific – I just push through
6. How do you handle moments of high stress or pressure in real time?
- I have a structured approach to stay focused
- I use quick mental or breathing resets
- I try to power through, but stress often builds up
- I feel reactive and struggle to maintain control
7. At the end of a demanding workday, how do you downshift into recovery mode?
- I have a structured wind-down routine (exercise, mindfulness, breathwork, etc.)
- I use distractions (TV, alcohol, social media) to relax
- I struggle to switch off and often bring stress home
Section 3: Exploring New Approaches to Peak Performance
8. Have you ever used breathwork techniques to enhance focus, manage stress, or recover from mental fatigue?
- Yes, regularly
- Yes, but only occasionally
- No, but I’m curious
- No, I don’t think breathwork would help me
9. If you could improve one aspect of your professional performance, what would it be?
- Managing pre-meeting or pre-presentation anxiety
- Sustaining deep focus and mental clarity throughout the day
- Remaining calm and composed under pressure
- Recovering faster to prevent burnout and maintain long-term resilience
10. Would you be interested in a tailored breathwork strategy to optimise your performance, clarity, and stress resilience?
- Yes, I want to learn how breathwork can enhance my leadership
- Maybe, I’d like to understand more before committing
- No, I don’t see breathwork as relevant to executive performance
Next Steps
Based on your responses, I can create a customised breathwork protocol to help you:
✔ Improve decision-making clarity in high-stakes situations
✔ Enhance focus and mental endurance throughout the workday
✔ Stay calm and composed under pressure
✔ Recover faster, preventing burnout and fatigue
Would you like to schedule a 15-minute consultation to explore how breathwork could support your executive performance?