Is Your Nervous System Running Your Career? A Self-Assessment

Is Your Nervous System Running Your Career? A Self-Assessment

Burnout & Leadership • Mar 19, 2026

LAST UPDATED: APRIL 2026

If what you’ve read here resonates, I want you to know that individual therapy and executive coaching are available for driven women ready to do this work. You can also explore my self-paced recovery courses or schedule a complimentary consultation to find the right fit.

One of the most important things I tell clients in early sessions is this: the patterns we’re going to look at together aren’t character flaws. They’re the residue of strategies that once kept you safe. The over-functioning, the difficulty resting, the way you find yourself absorbing other people’s moods before you’ve registered your own — every one of these adaptations made sense in the original environment that shaped them. The work isn’t to shame the strategy. It’s to update the system that keeps generating it.

Steps Toward Healing: When Your Nervous System Has Been Running the Show

In my work with ambitious professional women, the self-assessment moment is often the one that changes everything. Not the first read of an article like this one, but the second — when the client sits with it again and realizes: yes, this is me. The anxiety before big presentations that feels like threat, not just nerves. The way conflict in a meeting can derail the rest of the day. The inability to fully decompress even on vacation. The sense that no matter how well things are going, something in her body is always bracing for what comes next. That recognition — that the nervous system has been running the career more than she has — is genuinely unsettling. It’s also the most useful thing you can know.

What happens next matters. Because the most common response I see to that recognition is either to double down on control — to try to regulate the nervous system through more discipline, more habits, more optimized routines — or to dismiss it: “I’ve always been anxious, it’s fine, it’s worked so far.” Neither of those responses actually addresses what’s happening. The nervous system isn’t misbehaving. It’s operating from a blueprint that was formed under different circumstances, and it needs updating — not suppression, not acceptance as fixed, but genuine updating through the right kind of work.

The most effective starting point I know for this kind of update is Somatic Experiencing. Somatic Experiencing works directly with the nervous system — tracking its activation patterns, helping the body complete stress responses that never fully discharged, and gradually expanding what’s called the window of tolerance: the range of experience within which you can function, feel, and make choices without tipping into overwhelm or shutdown. For driven professional women, the window is often very narrow at the top — they can function brilliantly in moderate stress, but the moment pressure escalates, the system spikes in ways that feel ungovernable. Somatic Experiencing expands that range.

EMDR (Eye Movement Desensitization and Reprocessing) is often the second modality I introduce, particularly when the nervous system dysregulation is linked to specific experiences — early environments where hypervigilance was adaptive, past professional experiences that were genuinely threatening or humiliating, or attachment experiences that calibrated the threat-detection system too sensitively. EMDR reprocesses those experiences at a neurological level, helping the brain update its assessment of threat so that present-day situations can be appraised more accurately rather than through the lens of the past.

Practically, I want to offer one experiment for women who are wondering whether their nervous system is running their career: for the next two weeks, keep a brief daily log. Rate your subjective stress level at three points in the day (morning, midday, end of workday) on a simple scale of one to ten. Note any specific events that seem to spike it. What you’re looking for are patterns: times of day, types of interactions, categories of situation that reliably take you to a seven or above. That data is incredibly useful — both for your own awareness and for a therapist or coach who can help you understand what it means.

I’d also encourage you to look honestly at what you’re asking your nervous system to sustain week after week. Many of the professional women I work with are operating at a baseline stress load that would be unsustainable for anyone, let alone someone with an already sensitized system. Addressing that load — through boundaries, delegation, structural changes to how work is organized — isn’t a soft request. It’s a clinical one. The nervous system cannot regulate itself from the inside if it’s perpetually overwhelmed from the outside.

If your nervous system has been running your career and you’re ready to change that, I’d invite you to begin with our short self-assessment quiz — it can help you identify what’s happening and what kind of support would be most useful. And when you’re ready to work on this in a sustained, supported way, therapy with Annie provides the kind of trauma-informed, somatically-grounded space where this kind of nervous system work actually happens. You’ve been running so hard. It’s time to find out what you’re like when you’re not bracing.

Bessel van der Kolk, MD, psychiatrist and trauma researcher and author of The Body Keeps the Score, has written extensively about how relational trauma changes the way the brain processes threat, attention, and self-perception. The amygdala becomes hypervigilant. The medial prefrontal cortex — the part of the brain that helps you contextualize what you’re feeling — goes quiet. The default mode network, where the felt sense of self lives, becomes muted. None of this is metaphor. It’s measurable, and it’s reversible. The therapies that actually move the needle for driven women — somatic work, EMDR, IFS, attachment-based relational therapy — are all therapies that engage the body and the implicit memory systems where this material is stored.

The Neurobiology: What a Dysregulated Nervous System Is Actually Doing

The self-assessment in the previous section is designed to surface patterns that often go unnoticed — because the nervous system is a background system, running beneath conscious awareness, shaping everything from your decision-making to your physical health without announcing itself. Understanding what’s actually happening biologically can help move this from abstract to actionable.

The autonomic nervous system operates through two primary branches: the sympathetic (fight-or-flight) and the parasympathetic (rest-and-digest). Under stress, the sympathetic branch activates — releasing cortisol and adrenaline, increasing heart rate and blood pressure, preparing the body for rapid response. This is useful in genuine emergencies. The problem, as described by Stephen Porges, PhD, Distinguished University Scientist at the Kinsey Institute, Indiana University Bloomington, professor of psychiatry and developer of Polyvagal Theory, is that when the nervous system has been chronically conditioned to treat ordinary stressors as emergencies, it never fully returns to baseline.

The research on chronic nervous system dysregulation is increasingly clear about its downstream costs. A persistently activated stress response system elevates cortisol chronically — which, over time, contributes to immune suppression, sleep disruption, metabolic changes, and increased vulnerability to anxiety and depression. For driven women who are already running high cortisol loads due to workplace demands, this creates a compounding effect: the job activates the stress response, the stress response degrades sleep and recovery, the degraded recovery makes the next day’s activation worse, and so on. This is not a productivity problem. It is a physiology problem that requires a physiological response.

How Nervous System Dysregulation Shows Up in Your Career: The Patterns to Watch

Dysregulation doesn’t always look like panic or breakdown. In driven and ambitious women, it’s far more likely to look like high performance — at a cost. Here are the professional patterns I see most consistently in women whose nervous systems are running their careers:

Decision-making that’s driven by urgency rather than strategy. When the nervous system is in a sympathetic state, everything feels urgent — because urgency is a feature of threat response, not of clear-headed leadership. If you find yourself chronically reactive rather than thoughtful, making decisions from a place of “I need this to be over” rather than “what’s the best path here,” your nervous system may be setting the agenda for your leadership.

Difficulty tolerating ambiguity at work. Ambiguity is a feature of leadership — strategy inherently involves uncertainty. But for the dysregulated nervous system, ambiguity reads as threat. The result is a driven woman who pushes for premature closure, who struggles to sit with “we don’t know yet,” who is constantly seeking certainty in a domain that rarely offers it.

Using achievement to regulate emotion. If finishing a project, receiving positive feedback, or hitting a metric temporarily quiets the anxiety — and the anxiety returns quickly after the dopamine hit passes — you may be using achievement as a nervous system regulation tool. This is a setup for the treadmill: you need the next achievement to feel temporarily okay, which means you can never actually stop. Not because you’re ambitious. Because your nervous system has learned that doing more creates momentary safety.

Physical symptoms that cluster around work cycles. Frequent illness at the start of vacations (the body finally releasing held tension), tension headaches that correlate with specific meetings or people, gut symptoms that appear on Sunday evenings, waking between 3–4 a.m. with racing thoughts. These aren’t random. They’re the body’s communication about what the nervous system is carrying.

Tessa is a 40-year-old managing director at an investment firm. From the outside, she’s a model of controlled excellence — never ruffled, always prepared, consistently meeting her targets. But in our work together, what emerged was a picture of a woman who hadn’t taken a vacation in three years because the anxiety of not being at work was worse than the exhaustion of staying. “When I stop, it all catches up with me,” she told me. “So I just don’t stop.” That’s not ambition driving the train. That’s a dysregulated nervous system keeping her on the treadmill because stopping feels dangerous. Trauma-informed coaching helps her learn to stop — safely, gradually, with support for what comes up when she does.

When the Nervous System and the Organization Are at Odds: The Double Burden of Driven Women

One more layer deserves attention — because dysregulated nervous systems don’t exist in isolation. They exist within organizational cultures that often actively reward dysregulation and punish regulation.

In many high-performance work environments, the visible signs of a sympathetically activated nervous system — the constant availability, the 10 p.m. email responses, the inability to take a full weekend — are read as dedication and commitment. The woman who protects her boundaries, takes her full vacation, and leaves at a reasonable hour is frequently read as less committed than her counterpart who is visibly depleted and visibly grinding. The organization, in this way, incentivizes the very patterns that are making its most driven people sick.

Gabor Maté, MD, physician, author of When the Body Says No: Understanding the Stress-Disease Connection, and leading voice on the mind-body interface of stress, has written extensively about how professional environments can exploit the nervous system vulnerabilities of high-functioning people — particularly those with early histories of conditional love or approval. When you learned that love had to be earned through performance, you are uniquely vulnerable to environments that make the same demand. You will perform yourself into depletion, and the organization will let you.

This doesn’t mean you need to leave your organization, or that ambition is the problem. It means that healing nervous system dysregulation in the context of a demanding career requires both internal work and environmental negotiation — adjusting how you relate to the demands as well as, where possible, the demands themselves. That’s a nuanced navigation that trauma-informed executive coaching and individual therapy are specifically equipped to support. You deserve a career that doesn’t require you to destroy yourself to succeed in it.

Both/And: You Can Be Healing Your Nervous System and Still Get Dysregulated

Driven women often approach nervous system regulation the way they approach everything else: as a skill to master, a problem to solve, a state to achieve and maintain. When dysregulation returns — and it will — they interpret it as failure rather than information. In my work, I try to reframe this: regulation isn’t a destination you arrive at. It’s a range you gradually expand.

Megan is a financial analyst who started somatic therapy after years of unexplained chest pain that every cardiologist cleared as non-cardiac. She made rapid progress — learned to identify her activation patterns, practiced grounding techniques, began sleeping through the night for the first time in years. Then a workplace conflict triggered a full-body shutdown, and she came to session convinced she’d “lost all her progress.” She hadn’t. Her window of tolerance had expanded enormously. This event just landed outside it.

Both/And means Megan can be genuinely further along in her healing than she was six months ago and still experience moments of intense dysregulation. It means her nervous system can be rewiring and still occasionally default to its original settings. Progress in somatic work looks less like the absence of distress and more like a faster return to baseline, a broader window of tolerance, and a growing ability to stay curious about sensation rather than consumed by it.

This reframe matters clinically because so many driven women abandon their healing work at exactly the wrong moment — the first setback after real progress. They interpret the return of dysregulation as evidence that the therapy isn’t working, that they’re beyond help, or that there’s something fundamentally wrong with their nervous system that can’t be fixed. None of that is accurate. What’s happening is that the nervous system is recalibrating in a nonlinear way — two steps forward, one step back, a new pattern, then an old one surfacing under pressure. That’s not failure. That’s healing.

I want to name something else about the Both/And frame here, because I think it matters for driven women specifically: the same goal-orientation that makes you exceptional at your work can make you a demanding and impatient patient with yourself. If you’ve hired a personal trainer and aren’t seeing results in twelve weeks, you find a different trainer. You’re not wrong to apply rigor to your investments. But nervous system healing doesn’t respond to that framework. It responds to patience, consistency, and the very tolerance of uncertainty that your dysregulated nervous system makes so difficult. Both/And, in this context, means: you can be rigorous about your healing and surrender the expectation that it will be efficient. Both things are necessary.

The Systemic Lens: Why Your Dysregulation Makes Sense in Context

From the earliest age, girls are taught to override their body’s signals. Sit still. Be quiet. Don’t make a scene. Don’t be too much. By the time a driven woman reaches adulthood, she has decades of practice ignoring the cues her nervous system is sending — hunger, fatigue, fear, anger, the need to cry. This isn’t a skill. It’s a systemic training program designed to produce women who are maximally productive and minimally inconvenient.

The driven women I work with have often been overriding their nervous system for so long that they’ve lost the ability to identify what they’re feeling until it becomes a crisis. They don’t notice stress until it becomes a panic attack. They don’t notice exhaustion until they collapse. They don’t notice anger until it erupts. This isn’t a failure of self-awareness — it’s the predictable result of a culture that punishes women for having bodies with needs.

In my clinical practice, I help women reconnect with their nervous system’s signals — not as problems to manage but as information to heed. This requires naming the systemic forces that taught them to disconnect in the first place. When we understand that body disconnection in driven women isn’t a personal limitation but a cultural conditioning, the work shifts from “fixing what’s wrong with me” to “reclaiming what was taken from me.” That reframe is clinically significant — and for many of my clients, it’s the beginning of real change.

There’s also a workplace dimension that’s worth naming directly. Modern professional environments — particularly in tech, finance, and medicine — are structured in ways that actively dysregulate nervous systems. Open-plan offices, always-on communication, unpredictable deadlines, the ambient threat of layoffs or restructuring: these aren’t incidental features of workplace design. They’re the conditions under which many driven women are expected not only to perform but to thrive. The driven women who appear to thrive in these conditions are often the ones whose nervous systems have become so habituated to hyperactivation that they no longer recognize the dysregulation as dysregulation. They call it “staying sharp.” They call it “high-performance culture.” What they’re actually describing is a chronic stress state that the body can sustain for a surprising amount of time — until, suddenly, it can’t.

Resmaa Menakem, MSW, therapist and trauma specialist and author of My Grandmother’s Hands, writes about the way bodies carry not only individual history but intergenerational and cultural history. The nervous system patterns we inherit — through epigenetic transmission, through early relational experience, through the conditioning of our cultural context — don’t disappear because we’ve achieved success. They show up in the boardroom, in the way you hold yourself when criticized, in the speed with which your body braces for threat even in nominally safe environments. Naming this isn’t about assigning blame. It’s about accuracy — and accuracy is what makes healing possible.

“I’m Fine. Just Busy.” — And Why That Answer Isn’t Enough Anymore

If you ask a driven woman if she is stressed, she will likely say, “I’m fine. Just busy.”

She says this because she is still functioning. She is still hitting her KPIs. She is still showing up to the meetings. In our culture, we equate functioning with health.

But functioning is not the same as health. You can function in a state of severe biological distress. In fact, if you have a history of childhood adversity, your nervous system is likely highly adapted to functioning in a state of crisis. You’ve been running on adrenaline for so long that dysregulation feels normal.

This assessment is not about your performance metrics. It is about your biological reality. It is designed to help you identify the subtle, often invisible ways that a dysregulated nervous system is driving your career — AND what it’s costing you in sleep, health, marriage, and the simple capacity to enjoy the life you’ve worked so hard to build.

If you’re ready to do something about what you discover here, trauma-informed executive coaching is designed for exactly this. You can also connect with Annie’s team to explore what that support might look like for you.

Assessment Instructions

Read each statement below and rate how frequently you experience it on a scale of 1 to 5:

• 1 = Rarely or Never
• 2 = Occasionally
• 3 = Sometimes
• 4 = Frequently
• 5 = Almost Always

Be ruthlessly honest. Do not answer based on how you want to feel, or how you present yourself to your team. Answer based on your internal, private experience.

Section 1: The Fawn Response in Leadership

The fawn response is a trauma adaptation where you attempt to avoid conflict and ensure safety by appeasing others, abandoning your own boundaries, and absorbing the emotional labor of the room.

1. I find it physically uncomfortable (tight chest, racing heart) to deliver critical feedback to a direct report, even when it is necessary.
2. I frequently say “yes” to taking on additional projects in meetings, only to feel a wave of resentment and exhaustion immediately afterward.
3. I spend an excessive amount of time drafting and re-drafting emails to ensure the tone is perfectly “soft” and cannot be misinterpreted as aggressive.
4. If a senior leader or board member is in a bad mood, I subconsciously feel that it is my responsibility to fix it or manage the energy in the room.
5. I frequently apologize for things that are not my fault, or use minimizing language (“Just checking in,” “Does that make sense?”) to soften my authority.

Section 1 Score: _____

What I see consistently in my work with driven, ambitious women is that the body holds the truth long before the mind catches up. By the time a client lands in my office describing what isn’t working, her nervous system has been signaling for months — sometimes years. The tightness in her jaw at 3 a.m., the way her shoulders climb toward her ears during certain conversations, the unexplained fatigue that no amount of sleep seems to touch. These aren’t separate problems. They’re a single integrated story the body is telling about an emotional terrain the conscious mind hasn’t been able to face yet.

References

Peer-Reviewed Research (Vancouver)

1. van der Kolk BA, Wang JB, Yehuda R, Bedrosian L, Coker AR, Harrison C, et al. Effects of MDMA-assisted therapy for PTSD on self-experience. PLoS One. 2024;19(1):e0295926. doi:10.1371/journal.pone.0295926. PMID: 38198456.
2. Porges SW. Polyvagal Theory: Current Status, Clinical Applications, and Future Directions. Clin Neuropsychiatry. 2025;22(3):169-184. doi:10.36131/cnfioritieditore20250301. PMID: 40735382.

Books & Cultural Sources (Chicago Author-Date)

• Maté, Gabor. When the Body Says No. A.A. Knopf Canada, 2003.
• Menakem, Resmaa. My grandmother's hands. Penguin Books, Limited, 2017.

Medical Disclaimer

Medical Disclaimer