What Trauma-Informed Executive Coaching Actually Looks Like: A Case Study
LAST UPDATED: APRIL 2026
It’s one thing to understand the theory of trauma-informed executive coaching; it’s another to see it in practice. This case study follows “Jessica,” a driven tech executive, through a six-month coaching engagement — mapping the nervous system, identifying the relational trauma block, and using somatic tools to achieve a concrete professional breakthrough. This is what the work actually looks like.
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.
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Take the Free QuizQ: Is what I’m experiencing burnout or depression?
A: They can look similar but have different mechanisms. Burnout tends to be context-specific — you feel depleted at work but can still enjoy other areas of life, at least initially. Depression is more pervasive and colors everything. Key indicators of burnout include emotional exhaustion, depersonalization (feeling detached from work that used to matter), and a reduced sense of accomplishment. If the depletion extends beyond work into every domain, depression warrants clinical evaluation.
Q: Can I recover from burnout without leaving my job?
A: Yes — in many cases. But recovery requires changes, not just endurance. In my work with burned-out professionals, recovery typically involves three threads: nervous system regulation, boundary restructuring, and meaning reconnection. Some women do ultimately leave their positions, but many find that healing their relationship to work — rather than just the workload — makes their current role sustainable again.
Q: How do I set boundaries at work when the culture doesn’t support them?
A: Carefully, strategically, and with the understanding that the first boundary is always the hardest. Start with one non-negotiable — a time you leave by, a meeting you don’t attend, a weekend you protect. Observe what happens. In my clinical experience, driven women consistently overestimate the professional consequences of boundaries and underestimate their personal cost of not having them.
Q: My burnout feels physical — not just emotional. Is that normal?
A: Yes. Burnout is a nervous system state, not just an emotional one. Chronic stress dysregulates your hypothalamic-pituitary-adrenal axis, which manifests as fatigue, insomnia, digestive issues, chronic pain, weakened immunity, and hormonal disruption. When driven women report that their bodies are ‘falling apart,’ they’re describing the physiological consequences of sustained sympathetic activation. Your body isn’t being dramatic. It’s been keeping score.
Q: Will taking time off actually fix my burnout?
A: Time off can help — but it’s rarely sufficient on its own. If you return to the same conditions that burned you out, the relief will be temporary. In my experience, sustainable recovery requires both restoration (rest, reconnection, joy) and restructuring (changing the conditions that created the burnout). Vacation treats the symptom. Structural change treats the cause.
Both/And: Professional Success and Personal Depletion Are Not Contradictions
When driven women experience burnout, they often feel disqualified from naming it. They chose this career. They fought for these opportunities. They’re paid well, respected, and doing meaningful work. How can they be burned out when they have what so many people want? This logic is airtight — and completely irrelevant to what their nervous system is telling them.
Camille is a partner at a consulting firm who told me she wakes up at 4 a.m. with her heart racing and doesn’t know why. She loves strategy, loves her clients, loves the intellectual challenge. What she doesn’t love — what she can barely articulate — is the cost: the missed bedtimes, the body that holds tension like a fist, the creeping suspicion that she’s become a function rather than a person. “I should be grateful,” she said. I told her gratitude and exhaustion aren’t mutually exclusive.
Both/And means Camille can be genuinely passionate about her career and genuinely depleted by it. She can appreciate her privilege and still acknowledge that the pace is unsustainable. She can want to stay and need things to change. Burnout in driven women isn’t a failure of gratitude. It’s the predictable consequence of a nervous system that was wired for vigilance being asked to sustain peak performance indefinitely without rest.
The Systemic Lens: Why Self-Care Can’t Fix What Workplaces Broke
When a driven woman burns out, the cultural response is almost universally individual: take a vacation, set better boundaries, practice mindfulness, learn to delegate. These suggestions aren’t wrong — but they’re woefully insufficient, because they locate the problem inside the woman rather than inside the system that burned her out. Self-care cannot compensate for structural exploitation, no matter how consistently you practice it.
The data is clear: women in professional environments face systemic conditions that make burnout not just likely but almost inevitable. The gender pay gap means women work harder for less. The “prove it again” bias documented by Joan C. Williams, JD, professor and workplace researcher, means women’s competence is constantly questioned in ways men’s isn’t. The motherhood penalty is well-documented. And the “office housework” — organizing, mentoring, emotional labor — disproportionately falls to women while being systematically undervalued in performance reviews.
In my clinical work, I find it essential to name these forces. When a driven woman tells me she’s burned out, I don’t just ask about her sleep hygiene and coping skills. I ask about her workload, her workplace culture, the expectations placed on her versus her male colleagues, and the structural supports — or lack thereof — she’s working within. Because treating burnout as a personal wellness problem when it’s actually a systemic justice problem isn’t just clinically incomplete. It’s gaslighting by another name.
The Presenting Problem: She Knew Her Strategy Was Right. She Just Couldn’t Say It Out Loud.
Jessica, forty-one, was the Chief Marketing Officer at a rapidly growing SaaS company in the Bay Area. She was brilliant, highly compensated, and universally liked by her team.
She was also on the verge of quitting.
“I’m exhausted,” she told me in our initial consultation. “My CEO is a visionary, but he’s incredibly aggressive. In executive meetings, if he doesn’t like an idea, he tears it apart. He raises his voice. He interrupts.”
I asked Jessica how she responded in those moments.
“I go completely blank,” she said, looking ashamed. “I know my data is solid. I know my strategy is right. But when he starts yelling, I just agree with him. I apologize. I back down. And then I spend the next three days furious at myself, working until midnight to redo the strategy his way.”
*(Note: Jessica is a composite of many clients I’ve worked with over the years. Her name and identifying details have been changed for confidentiality.)*
Jessica had tried traditional executive coaching. Her previous coach had given her communication scripts and told her to “stand her ground.” But the scripts didn’t work. When the CEO raised his voice, Jessica’s brain simply wouldn’t let her speak the words.
She didn’t have a communication problem. She had a nervous system block.
DORSAL VAGAL FREEZE
Dorsal vagal freeze is a biological survival state triggered by extreme or inescapable threat. The nervous system determines that fighting or fleeing is impossible, so it shuts the body down to conserve energy and minimize pain. Symptoms include brain fog, physical heaviness, dissociation, and an inability to speak. In plain language: when Jessica went “blank” in those meetings, her brain was doing what it was trained to do in situations of severe threat — go offline. It had nothing to do with her intelligence or competence. It was pure biology.
Month 1: Mapping the Nervous System
In trauma-informed executive coaching, we do not start by trying to change the behavior. We start by understanding the biology driving the behavior.
During the first month, the focus was entirely on mapping Jessica’s nervous system. She tracked exactly what happened in her body during those executive meetings.
“When he starts to raise his voice,” she reported in week three, “the first thing that happens is my vision gets blurry. Then my throat gets tight, like I can’t swallow. And then I feel this intense, buzzing energy in my chest, but my arms and legs feel heavy, like they’re filled with lead.”
Jessica was experiencing a classic dorsal vagal freeze response, mixed with a fawn response — appeasing the threat to survive. Her previous coach had told her to “fight” (stand her ground). But you cannot ask a nervous system that is in a deep freeze to suddenly jump into a fight response. It is biologically impossible.
“When you decide, finally, to stop running on the fuel of anxiety, desire to prove, fear, shame, deep inadequacy — when you decide to walk away from that fuel for a while, there’s nothing but confusion and silence. You’re on the side of the road, empty tank, no idea what will propel you forward. It’s disorienting, freeing, terrifying. For a while, you just sit, contentedly, and contentment is the most foreign concept you know.”
— Shauna Niequist, Present Over Perfect
— Shauna Niequist, Present Over Perfect
Month 2: Identifying the Relational Blueprint
Once the physical pattern was understood, the question became: why? Why did her nervous system perceive a loud CEO as a life-or-death threat?
In month two, we gently explored her relational blueprint.
Jessica grew up with a highly critical, emotionally volatile mother. Her mother’s rage was unpredictable. If Jessica argued back, the rage escalated into days of silent treatment — emotional abandonment.
Jessica’s nervous system had learned a very clear lesson: When an authority figure is angry, fighting back leads to abandonment. The only way to survive is to freeze, agree, and appease.
“My God,” Jessica said when we made the connection. “I’m not reacting to my CEO. I’m reacting to my mother.”
This realization was the turning point. The shame she felt about “backing down” evaporated. She realized she wasn’t weak — her biology was simply executing a brilliant, historically successful survival strategy. It just wasn’t serving her anymore.
RELATIONAL BLUEPRINT
A relational blueprint is the template for relationship — what is safe, what is threatening, how authority figures behave, how conflict gets resolved — that the nervous system constructs during childhood based on its primary relationships. In plain language: your childhood relationships literally programmed your nervous system to expect certain things from people in power. Until that blueprint is updated, your nervous system applies it to your CEO exactly as it applied it to your parent — regardless of how clearly your adult mind can see the difference.
RESEARCH EVIDENCE
Peer-reviewed findings that inform this clinical framework:
- Hedges' g = 0.73 for behavioral outcomes (PMID: 37333584)
- Cohen's ds = 0.65-0.69 reduction in burnout dimensions (PMID: 38111868)
- n = 28 healthcare leaders interviewed on trauma-informed leadership (PMID: 38659009)
- more than 100 healthcare leaders experienced trauma-informed leadership (PMID: 34852359)
- 61% women in trauma-informed leadership study sample (PMID: 38659009)
Months 3 & 4: Somatic Regulation in the Boardroom
With the shame removed, the somatic work could begin.
The focus wasn’t on what Jessica should say to the CEO. It was entirely on keeping her prefrontal cortex online when he raised his voice.
A specific, invisible somatic toolkit was developed for use in the boardroom:
1. The Grounding Anchor. When Jessica felt her vision start to blur (her early warning sign), she was instructed to press her feet firmly into the floor and grip the edges of her chair. This physical sensation sent a signal up her spine to her brainstem: I am here. I am an adult. I am physically grounded.
2. The Vagal Brake. When her throat got tight, she practiced lengthening her exhale — breathe in for four counts, out for eight, while the CEO was talking. This stimulated her vagus nerve, applying the biological brakes to the panic response.
3. The Visual Shift. To counter the freeze response, she practiced expanding her peripheral vision, taking in the whole room rather than hyper-focusing on the CEO’s angry face.
For two months, her only goal in executive meetings was to practice these somatic tools. She didn’t have to push back on the CEO yet. She just had to stay present in her body.
- van der Kolk, Bessel. The Body Keeps the Score. Penguin Books, 2014.
- Porges, Stephen. The Polyvagal Theory. W.W. Norton, 2011.
- Dana, Deb. The Polyvagal Theory in Therapy. W.W. Norton, 2018.
Further Reading on Relational Trauma
Explore Annie’s clinical writing on relational trauma recovery. (PMID: 9384857)
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Annie Wright, LMFT
LMFT #95719 · Relational Trauma Specialist · W.W. Norton Author
Helping ambitious women finally feel as good as their résumé looks.
As a licensed psychotherapist (LMFT #95719), trauma-informed executive coach, and relational trauma specialist with over 15,000 clinical hours, she guides ambitious women — including Silicon Valley leaders, physicians, and entrepreneurs — in repairing the psychological foundations beneath their impressive lives. Annie is the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she built, scaled, and successfully exited. A regular contributor to Psychology Today, her expert commentary has appeared in Forbes, Business Insider, Inc., NBC, and The Information. She is currently writing her first book with W.W. Norton.
