THE RESEARCH
The first study of High-Functioning Survival Mode™
1,003 women across 29 countries were asked what it feels like to keep functioning while living in survival mode. The same pattern emerged across cultures, careers, and life circumstances, revealing an experience that had never been clearly named.
WHY THIS STUDY
Burnout, trauma, and masking each explain part of the picture. But the pattern underneath it, staying highly functional while your nervous system remains in survival, has never been studied as its own construct. This is the first study to name it and measure it.
HOW IT WAS DONE
Methodology at a glance
Sample
1,003 women, 29 countries
A large, international sample of high-achieving, high-masking women, spanning cultures, ages, industries and life stages.
Method
Mixed Methods
Quantitative measures paired with qualitative open-ended narrative responses, so the numbers and lived experience could be read together.
Measure
The 5-point HFSM™ scale
A scale developed to gauge how strongly the survival-through-performance pattern shows up in a person’s daily life.
WHAT WE FOUND
Key findings
01
The pattern is widely shared and consistent across cultures
Across 29 countries, women described the same core experience in strikingly similar language, suggesting a pattern that crosses cultural and geographic lines.
02
It shows up in the body
91% reported physical symptoms of chronic stress, supporting the idea that HFSM is a nervous-system state, not just a mindset or a mood.
03
Recognition brought relief
Being given language for the pattern was itself meaningful. Many women described the naming as the first thing that finally resonated, so they could begin to make changes.
The full list of findings can be found in the white paper
“Therapy was cute, but it didn’t reach the core.”
— STUDY PARTICIPANT, 1 of 1,003
This page houses the original frameworks and research developed by Dr. Samantha-Rae Dickenson. All frameworks, theories, and models are proprietary intellectual property. © 2023-2026 Dr. Samantha-Rae Dickenson. All Rights Reserved.





