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Breaking the Anger Habit Retreats

 

Thank you for your interest in the Breaking the Anger Habit Weekend Retreats.

We currently host private retreats in Arizona, California, Chicago, Albania, Italy, and Spain. Please set aside about 15 minutes to complete this application; it helps us confirm that this retreat is the right, safe and supportive fit for you before we move forward.

Click the button below to start.

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Question 1 of 21

Full name:

Question 2 of 21

Email Address:

Question 3 of 21

Phone number (with country code):

Question 4 of 21

Where are you located (city, state/province, country):

Question 5 of 21

How did you hear about the Breaking the Anger Habit Retreat?

Question 6 of 21

Which location are you interested in?

 

(Select all that apply)
A

Sedona, Arizona

B

Chicago, Illinois

C

Malibu, California

D

Tirana, Albania

E

Rome, Italy

F

Barcelona, Spain

Question 7 of 21

In 2–3 sentences, what feels hardest for you right now around stress, anger, or conflict?

Question 8 of 21

How are your stress and anger currently affecting:

1. Your closest relationships

2. Your work or business

3. Your physical or emotional health

Question 9 of 21

What have you already tried (therapy, books, courses, anger management, coaching, etc.) and what did/didn’t help?

Question 10 of 21

Are you currently seeing:

 

A

Therapist or counselor

B

Psychiatrist

C

Neither

Question 11 of 21

Are you currently taking any psychiatric medications?

A

Yes

B

No

C

Prefer not to say (you may invite me to discuss this privately later)

Question 12 of 21

In the past 12 months, have you:

(Select all that apply)
A

Been hospitalized for mental health reasons

B

Had a suicide attempt or active self-harm

C

None of the above

Question 13 of 21

Are you currently in active addiction, detox, or withdrawal from alcohol or substances?

 

A

Yes

B

No

Question 14 of 21

On a scale of 1–10, how emotionally and mentally stable do you feel on an average week

(1 = extremely unstable, 10 = very stable)?

Question 15 of 21

Is there anything about your physical or mental health that would make an intensive weekend difficult for you (energy, mobility, sleep, panic, etc.)?

Question 16 of 21

What would a “win” look like for you by the end of this retreat?

Question 17 of 21

If we work together, which of these outcomes is most important to you right now?

(Select all that apply)
A

Staying calm in triggering situations

B

Communicating without blowing up or shutting down

C

Creating a calmer home for my kids/family

D

Healing from past relationship or family patterns

Question 18 of 21

On a scale of 1–10, how ready are you to actively practice new tools and take responsibility for your part in patterns (not just learn information)?

Question 19 of 21

Is there anyone (partner, ex, family member, boss) who might strongly oppose you making this change?

Question 20 of 21

Are you prepared to invest financially in a private retreat experience if it feels like the right fit?

A

Yes

B

No

Question 21 of 21

Is there anything else you’d like me to know before I review your application?

Confirm and Submit