Working Out of Pain: How Trauma Fuels the High Achiever’s Grind

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 When Success Masks Struggle: Understanding Trauma in High Achievers

In my clinical work, I’ve had the privilege of helping many high-achieving clients—entrepreneurs, executives, physicians, researchers, and other successful professionals—work through trauma that most people in their lives never even suspected was there. From the outside, these individuals often appear composed, confident, and in control. But inside, many are carrying unresolved pain, much of it buried beneath years of nonstop achievement and responsibility.

Trauma can impact anyone. But what I’ve observed in many high performers is a unique response: they “work out of pain.” That is, rather than shutting down or visibly struggling, they pour their energy into achievement—whether it’s building a business, earning advanced degrees, or climbing the ranks of a demanding career. In this way, high-functioning individuals often cope by pushing forward, always reaching higher, not because they are unbothered, but because the striving helps them manage the weight they carry.


Achievement as a Coping Mechanism

For many gifted professionals and high performers, the response to trauma is not to slow down—it’s to speed up. The internal narrative might sound like: “If I just keep moving, I won’t have to feel this.” Or, “If I become successful enough, maybe what happened to me won’t define me.” This strategy can be incredibly effective in the short term. It can even lead to impressive accomplishments that earn admiration from others.

But the pain doesn’t just disappear. I’ve worked with many clients who reached the top of their fields, only to find that the feelings they had worked so hard to outrun were still there, waiting to be addressed. Trauma often continues to affect sleep, relationships, and emotional regulation—regardless of how impressive one’s résumé is.

Studies indicate that untreated trauma can lead to long-term psychological effects, including anxiety, depression, and burnout.
(SAMHSA)


Why People Don’t Always Know You’re Carrying Trauma

One of the reasons trauma in high achievers often goes unnoticed is because of how successfully these individuals function in their public and professional lives. The assumption others often make is, “You’re doing so well—you must have had an easy life.” But this couldn’t be further from the truth for many of my clients.

In fact, some of the most driven and capable people I’ve worked with are also the ones who have endured significant adversity. Emotional neglect, childhood abuse, complex family dynamics, or unexpected tragedies—these are experiences that don’t disappear just because someone is excelling in their field. Trauma can be carried silently, beneath the surface of every promotion, award, or new milestone.

Because high achievers are often relied upon and looked up to, they may feel an added pressure to conceal any vulnerability. This creates a dynamic where they support others but often feel there’s no one truly supporting them.


The Good News: Trauma Is Treatable

While processing trauma can be difficult—and yes, in some forms of treatment it can feel worse before it gets better—it is also one of the most meaningful and life-improving steps a person can take. There is a strong base of evidence showing that trauma is treatable with the right therapeutic approaches.

One of the most effective treatments is Cognitive Processing Therapy (CPT), which helps individuals challenge and modify unhelpful beliefs related to their trauma.
(APA CPT treatment guide)

Another highly supported option is Prolonged Exposure (PE) therapy, which involves gradually facing trauma-related memories and situations to reduce distress over time.
(APA PE treatment guide)

In therapy, I often help high-functioning professionals learn how their trauma responses may have shaped their behavior over time—not to take away their accomplishments, but to build a healthier, more sustainable foundation beneath them.


What Healing Can Look Like

Healing from trauma doesn’t mean forgetting the past. It means no longer having the past control the present. Many of my clients have found that working through their trauma improves not just their emotional state, but their physical well-being and relationships too.

Some have reported sleeping better, being more present with their partners or children, feeling less reactive in high-pressure situations, or being able to enjoy downtime without guilt or anxiety. For many, therapy creates space to not only resolve past wounds, but to live life with more freedom and connection.

And importantly, none of this healing takes away from who they are. In fact, it often makes them even stronger, more grounded versions of themselves—no longer running on fumes, but leading from a place of clarity and emotional strength.


Final Thoughts

Trauma doesn’t always look like what we expect. It doesn’t always show up as crisis or collapse. In many gifted, ambitious, and high-functioning people, it shows up as relentless drive, perfectionism, or emotional distance.

If you’re someone who has accomplished a lot but still feels like something unresolved is pulling at you beneath the surface, you’re not alone—and you’re not broken. You may have been working out of pain for years. But it’s never too late to process, heal, and build something healthier from the inside out.

To read more from Dr. Jackson's personal blog: View More Posts