Staff Perspective: A Complicated Shield: Trauma, PTSD and Identity in High- Stakes Professions
June is PTSD Awareness Month, and one of the most important things to understand about posttraumatic stress is that it often doesn't look the way people expect. In military service members, veterans, first responders, emergency medical personnel, and others who work in high-pressure environments, PTSD frequently doesn't look like falling apart. It can look like competence.
Hypervigilance, one of PTSD's hallmark symptoms, often resembles professional excellence. The ability to anticipate problems, scan for danger, stay emotionally controlled, and remain prepared for the unexpected can be lifesaving in environments where mistakes carry serious consequences. The body and brain adapt accordingly, tuning their threat-detection systems to meet the demands of the job.
The challenge is that those adaptations do not automatically switch off when the danger is over. A nervous system that has learned to prioritize threats can, through sheer repetition, persist in operating as though risk remains present, even in objectively safe environments. A family gathering, a quiet evening at home, or a conversation with a loved one may trigger the same physiological readiness that was once essential during a deployment, emergency call, or traumatic event.
When this happens, people often find themselves confused by a gap between what they know and what they feel. They know they are safe, yet their bodies continue to respond as though they are not. This can show up as emotional numbing, irritability, avoidance, sleep disruption, or difficulty trusting others. These are not signs of weakness. They are understandable adaptations that have outlived the circumstances that created them.
When Symptoms Become Identity
For many people in high-stakes professions, another challenge emerges over time: symptoms begin to blend with identity. Hypervigilance becomes "situational awareness." Emotional distance becomes "professionalism." Reluctance to rely on others becomes "self-sufficiency." The overlap is real. Many of these traits were valuable and necessary in the environments where they developed. But when survival strategies become permanent ways of relating to the world, they can quietly narrow a person's life. The internal narrative often sounds like: “I am the one who stays alert, who carries the responsibility, who cannot let their guard down.”
When symptoms become part of how someone defines themselves, the idea of recovery can feel threatening. If I am not constantly vigilant, who am I? If I trust someone else to take the lead, what happens if they fail? These concerns are understandable. Yet they can create an invisible trap, one that slowly erodes quality of life while making relationships increasingly difficult to sustain.
The Long-Range Cost to Relationships
Relationships are often where the impact of PTSD becomes most visible. Healthy relationships require trust, vulnerability, and the willingness to share responsibility. PTSD can make each of those feel risky. A partner may experience guardedness as distance. Children may sense a parent who always seems braced for impact. Friends may stop reaching out after repeated cancellations or emotional withdrawal.
Over time, isolation grows.
The original trauma often involved a disruption of safety and trust. Without realizing it, many people find themselves recreating that same distance in the relationships that matter most. This is not a personal failing. It is what happens when protective strategies remain active long after they are needed.
Different Possibility: What Recovery Actually Feels Like
One of the most persistent myths about PTSD is that it is permanent. That is not, however, what research or lived experience tells us. PTSD is treatable, and many people experience substantial symptom resolution. Recovery does not mean forgetting what happened or losing the strengths developed through difficult experiences. The memories remain. The lessons remain. The skills remain. What changes is your relationship to them. The hypervigilance that once ran automatically becomes something you can turn toward when needed and set aside when it is not. The skills that helped you survive no longer have to dominate every moment of your life.
Many people describe recovery not as becoming someone different, but as becoming more fully themselves. We see this when real rest becomes possible, not passive disconnection, but the kind of engaged stillness that comes from feeling genuinely safe. Relationships feel safer. Curiosity, humor, joy, and connection begin to take up more space. Life requires less management and offers more participation.
Perhaps most importantly, recovery often unfolds through small moments that challenge old assumptions. A spouse handles the situation, and things go well. A colleague takes responsibility, and the outcome is fine. Someone else carries part of the burden, and nothing falls apart. These moments may seem ordinary, but they provide something powerful: evidence. Each experience of "I didn't have to be in control, and everything was okay" gives the nervous system new information. Over time, those experiences can reshape long-held beliefs about safety, trust, and responsibility.
What emerges is not weakness, but a broader definition of strength, one that includes the ability to trust, rest, receive support, and remain connected to others.
You Have Changed Before. You Can Change Again.
There is something worth remembering: you are not the same person you were at twenty-two, fifteen, or during the hardest year of your life. Human beings are not fixed. We are continually shaped by our experiences, relationships, and choices. The symptoms that feel permanent are not character traits. They are patterns. Understandable patterns, often deeply practiced patterns, but patterns, nonetheless. And patterns can change.
PTSD Awareness Month is an opportunity to move beyond awareness and toward possibility. To consider that life after trauma can look different than it does today. Believing that the relationships you want are still available. To recognize that allowing others to help is not a surrender of competence but an expansion of freedom.
Emerging through the other side of this work is not a diminished version of yourself. It can be the renewed ability to feel safe enough to connect, to be present enough to choose, and to be flexible enough to respond to life as you want to. It is the return of your full humanity.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.
David Obergfell, DSW, LCSW, BCD, DAAETS, is a Military Behavioral Health Social Worker and Subject Matter Expert with the Consortium for Defense Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this capacity, he supports military behavioral health faculty on assignments and bandwidth across the center, providing professional development and performance management
Resources
Treatment & Clinical Information
- Star Behavioral Health Providers: A no-cost tiered training program for providers interested in working with service members, veterans, and their families. And a public, online directory of trained providers that is easily searchable by military- connected individuals seeking mental health care.
- National Center for PTSD: VA’s comprehensive resource for veterans and the public; includes a treatment locator and symptom information
- PTSD Coach App: A free VA-developed mobile app for self-guided symptom management
Evidence-Based Treatments (Learn More)
- Cognitive Processing Therapy (CPT)
- Prolonged Exposure Therapy (PE)
- EMDR International Association: Find a Therapist
For First Responders & Healthcare Workers
- Safe Call Now: 24/7 crisis support line specifically for public safety and healthcare workers: 1 (253) 243-3701
- First Responder Support Network: Residential and outpatient retreat programs for first responders
Crisis & Suicide Response
- 988 Suicide & Crisis Lifeline: Call or text 988; also available via chat online.
- Dial 988 & press 1 for the Service Members, Veterans and Families Crisis Lifeline
June is PTSD Awareness Month, and one of the most important things to understand about posttraumatic stress is that it often doesn't look the way people expect. In military service members, veterans, first responders, emergency medical personnel, and others who work in high-pressure environments, PTSD frequently doesn't look like falling apart. It can look like competence.
Hypervigilance, one of PTSD's hallmark symptoms, often resembles professional excellence. The ability to anticipate problems, scan for danger, stay emotionally controlled, and remain prepared for the unexpected can be lifesaving in environments where mistakes carry serious consequences. The body and brain adapt accordingly, tuning their threat-detection systems to meet the demands of the job.
The challenge is that those adaptations do not automatically switch off when the danger is over. A nervous system that has learned to prioritize threats can, through sheer repetition, persist in operating as though risk remains present, even in objectively safe environments. A family gathering, a quiet evening at home, or a conversation with a loved one may trigger the same physiological readiness that was once essential during a deployment, emergency call, or traumatic event.
When this happens, people often find themselves confused by a gap between what they know and what they feel. They know they are safe, yet their bodies continue to respond as though they are not. This can show up as emotional numbing, irritability, avoidance, sleep disruption, or difficulty trusting others. These are not signs of weakness. They are understandable adaptations that have outlived the circumstances that created them.
When Symptoms Become Identity
For many people in high-stakes professions, another challenge emerges over time: symptoms begin to blend with identity. Hypervigilance becomes "situational awareness." Emotional distance becomes "professionalism." Reluctance to rely on others becomes "self-sufficiency." The overlap is real. Many of these traits were valuable and necessary in the environments where they developed. But when survival strategies become permanent ways of relating to the world, they can quietly narrow a person's life. The internal narrative often sounds like: “I am the one who stays alert, who carries the responsibility, who cannot let their guard down.”
When symptoms become part of how someone defines themselves, the idea of recovery can feel threatening. If I am not constantly vigilant, who am I? If I trust someone else to take the lead, what happens if they fail? These concerns are understandable. Yet they can create an invisible trap, one that slowly erodes quality of life while making relationships increasingly difficult to sustain.
The Long-Range Cost to Relationships
Relationships are often where the impact of PTSD becomes most visible. Healthy relationships require trust, vulnerability, and the willingness to share responsibility. PTSD can make each of those feel risky. A partner may experience guardedness as distance. Children may sense a parent who always seems braced for impact. Friends may stop reaching out after repeated cancellations or emotional withdrawal.
Over time, isolation grows.
The original trauma often involved a disruption of safety and trust. Without realizing it, many people find themselves recreating that same distance in the relationships that matter most. This is not a personal failing. It is what happens when protective strategies remain active long after they are needed.
Different Possibility: What Recovery Actually Feels Like
One of the most persistent myths about PTSD is that it is permanent. That is not, however, what research or lived experience tells us. PTSD is treatable, and many people experience substantial symptom resolution. Recovery does not mean forgetting what happened or losing the strengths developed through difficult experiences. The memories remain. The lessons remain. The skills remain. What changes is your relationship to them. The hypervigilance that once ran automatically becomes something you can turn toward when needed and set aside when it is not. The skills that helped you survive no longer have to dominate every moment of your life.
Many people describe recovery not as becoming someone different, but as becoming more fully themselves. We see this when real rest becomes possible, not passive disconnection, but the kind of engaged stillness that comes from feeling genuinely safe. Relationships feel safer. Curiosity, humor, joy, and connection begin to take up more space. Life requires less management and offers more participation.
Perhaps most importantly, recovery often unfolds through small moments that challenge old assumptions. A spouse handles the situation, and things go well. A colleague takes responsibility, and the outcome is fine. Someone else carries part of the burden, and nothing falls apart. These moments may seem ordinary, but they provide something powerful: evidence. Each experience of "I didn't have to be in control, and everything was okay" gives the nervous system new information. Over time, those experiences can reshape long-held beliefs about safety, trust, and responsibility.
What emerges is not weakness, but a broader definition of strength, one that includes the ability to trust, rest, receive support, and remain connected to others.
You Have Changed Before. You Can Change Again.
There is something worth remembering: you are not the same person you were at twenty-two, fifteen, or during the hardest year of your life. Human beings are not fixed. We are continually shaped by our experiences, relationships, and choices. The symptoms that feel permanent are not character traits. They are patterns. Understandable patterns, often deeply practiced patterns, but patterns, nonetheless. And patterns can change.
PTSD Awareness Month is an opportunity to move beyond awareness and toward possibility. To consider that life after trauma can look different than it does today. Believing that the relationships you want are still available. To recognize that allowing others to help is not a surrender of competence but an expansion of freedom.
Emerging through the other side of this work is not a diminished version of yourself. It can be the renewed ability to feel safe enough to connect, to be present enough to choose, and to be flexible enough to respond to life as you want to. It is the return of your full humanity.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of War.
David Obergfell, DSW, LCSW, BCD, DAAETS, is a Military Behavioral Health Social Worker and Subject Matter Expert with the Consortium for Defense Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this capacity, he supports military behavioral health faculty on assignments and bandwidth across the center, providing professional development and performance management
Resources
Treatment & Clinical Information
- Star Behavioral Health Providers: A no-cost tiered training program for providers interested in working with service members, veterans, and their families. And a public, online directory of trained providers that is easily searchable by military- connected individuals seeking mental health care.
- National Center for PTSD: VA’s comprehensive resource for veterans and the public; includes a treatment locator and symptom information
- PTSD Coach App: A free VA-developed mobile app for self-guided symptom management
Evidence-Based Treatments (Learn More)
- Cognitive Processing Therapy (CPT)
- Prolonged Exposure Therapy (PE)
- EMDR International Association: Find a Therapist
For First Responders & Healthcare Workers
- Safe Call Now: 24/7 crisis support line specifically for public safety and healthcare workers: 1 (253) 243-3701
- First Responder Support Network: Residential and outpatient retreat programs for first responders
Crisis & Suicide Response
- 988 Suicide & Crisis Lifeline: Call or text 988; also available via chat online.
- Dial 988 & press 1 for the Service Members, Veterans and Families Crisis Lifeline