We often minimize job dissatisfaction as if it is a routine inconvenience—something to be brushed off with a complaint at happy hour or a sigh over morning coffee. However, what if we recognized that, for many people, the workplace is not just a source of stress—it is a site of chronic harm? What if the subtle dread, persistent exhaustion, and emotional deadening we normalize were signs of a deeper threat to psychological and physiological health?

Emerging research in occupational health psychology, trauma studies, and neurobiology now affirms what many have felt intuitively: that chronic exposure to psychologically unsafe work environments can fundamentally dysregulate the nervous system, impair immune and hormonal functioning, and erode the capacity for emotional regulation and cognitive clarity (McEwen & Gianaros, 2010; Maslach & Leiter, 2016). These impacts are not theoretical—they are embodied. The mind may try to rationalize or adapt, but the body keeps score (van der Kolk, 2014). Over time, the cost accumulates and becomes profound.

In my clinical practice, I have supported individuals whose workplaces slowly dismantled their confidence, sense of agency, and capacity for connection. These clients often arrive with symptoms that resemble trauma: sleep disturbances, hypervigilance, emotional numbing, and a persistent belief that something is wrong with them for not being able to “handle it.” They describe themselves as broken, depleted, or numb. However, what often becomes clear in the therapeutic process is this: they are not broken—they are responding appropriately to environments that have been consistently misattuned, extractive, or emotionally unsafe.

For some, the decision to leave such a job is not simply about improving work-life balance—it is a pivotal act of self-preservation. Walking away becomes a declaration of worth, a way to reassert control over one’s life and nervous system. Quitting under these conditions is not weakness or impulsivity—it is often the first step toward recovery.

This is not an endorsement of recklessness or a romanticization of quitting. It is an invitation to recognize the deep psychological toll of toxic work environments, and to validate the inner voice—often buried under guilt, fear, or economic pressure—that says, “This is no longer sustainable.” It is about naming a truth that many people feel but struggle to articulate: sometimes, the most courageous and life-affirming act is to walk away from what is killing you slowly.

The Neuroscience of Chronic Workplace Stress

When the workplace becomes a source of ongoing psychological threat—whether due to toxic leadership, excessive workload, values misalignment, or chronic invalidation—it initiates a physiological stress response that is both immediate and, if unrelenting, deeply damaging. At the center of this response is the hypothalamic-pituitary-adrenal (HPA) axis, a complex system that governs the body's reaction to stress. The HPA axis is designed to mobilize the body in the face of acute danger by releasing cortisol and adrenaline, hormones that increase alertness, focus, and energy reserves. While this fight-or-flight response is adaptive in short bursts, it becomes maladaptive when activated chronically, as it often is in harmful work environments.

Overactivation of the HPA axis leads to widespread physiological and neurological dysregulation. On a cognitive level, chronic cortisol exposure impairs memory consolidation, attention regulation, and executive function, resulting in forgetfulness, poor concentration, and decision fatigue (Lupien et al., 2009). These changes can mimic symptoms of ADHD or mild cognitive impairment, and many individuals report feeling mentally "foggy" or unable to keep up with demands they previously managed with ease. From a mood perspective, prolonged stress exposure increases vulnerability to anxiety, depression, emotional numbing, and affective instability, disrupting one’s ability to regulate emotions or experience pleasure (McEwen & Gianaros, 2010). Over time, the nervous system may become locked into a state of hyperarousal or learned helplessness, alternating between agitation and shutdown.

Physiologically, chronic HPA axis activation suppresses immune function, heightens systemic inflammation, and places strain on the cardiovascular system—factors linked to increased risk of heart disease, autoimmune disorders, and metabolic dysfunction (Sapolsky, 2004). These effects are not “just stress.” They represent a full-body response to a perceived threat that never ends, often exacerbated by the societal expectation to suppress emotional signals and maintain productivity despite suffering. Moreover, the endocrine system, which regulates circadian rhythms, hunger, libido, and metabolic health, becomes disrupted under prolonged cortisol exposure. Individuals frequently report insomnia, weight fluctuations, fatigue, and reduced sexual functioning, all of which can compound emotional distress and further reduce resilience.

Clinically, these experiences are often articulated in language such as, “I no longer recognize myself,” “I used to be sharp, but now I struggle to think straight,” or “I’m just getting by each day.” These are not exaggerations. They are accurate accounts of what happens when the human body is repeatedly forced to adapt to an environment that is misattuned to its needs. The brain and body do not distinguish between a toxic job and a life-threatening scenario—both are interpreted as a chronic threat. Over time, the system breaks down in order to survive.

Importantly, this breakdown is not a reflection of personal inadequacy. It is a predictable neurobiological outcome when human beings are placed in inhuman systems. Understanding the science behind these symptoms can offer not only validation but also the first step toward self-compassion, recovery, and the restoration of agency.

Burnout Is Not Just Fatigue—It is a Syndrome

Burnout is frequently misunderstood as mere tiredness or low motivation. In casual discourse, it is often used interchangeably with stress or exhaustion. However, burnout is not simply a passing state of fatigue—it is a clinically recognized occupational syndrome with psychological, relational, and physiological consequences. As defined by Christina Maslach and Michael Leiter (2016), burnout is a multi-dimensional condition that develops in response to chronic interpersonal and institutional stressors at work, particularly when there is a mismatch between a person’s values and the demands or structure of the workplace.

Burnout consists of three interrelated dimensions. The first is emotional exhaustion, which refers to feelings of being emotionally drained, overwhelmed, or depleted by one’s work. This often results in reduced empathy, affective flatness, or an inability to recover during non-work hours. The second component is depersonalization, which involves psychological distancing from the work itself or from the people one is meant to serve. Individuals may become cynical, irritable, or emotionally detached—not out of malice, but as a protective mechanism against ongoing stress. The third dimension is reduced personal accomplishment, a state in which individuals begin to doubt their competence, feel ineffective, and lose their sense of efficacy or meaning in the work they do (Maslach & Leiter, 2016). When these three dimensions converge, the result is not only emotional erosion but a rupture in professional identity and vocational vitality.

The consequences of burnout are profound and far-reaching. Studies have linked burnout to clinical depression, anxiety disorders, insomnia, and even suicidality (West et al., 2018). The World Health Organization (2019) now formally recognizes burnout as an “occupational phenomenon,” emphasizing that it results from chronic workplace stress that has not been successfully managed. Importantly, burnout is not considered a problem of the individual, but a systemic failure that arises when organizational conditions become incompatible with human psychological limits.

Despite this growing recognition, many institutional and corporate cultures continue to minimize burnout or even valorize it. Over-functioning is often rewarded through promotions or praise, while those who attempt to set boundaries or request support may be labeled as unmotivated or resistant. These environments breed conditions in which employees are pushed past their psychological capacities and then blamed when they collapse. This is a form of organizational gaslighting that conceals systemic dysfunction by pathologizing individual responses to chronic stress.

In reality, burnout is not a sign that someone is flawed—it is a sign that the system has failed to care for the human beings within it. As such, interventions aimed solely at helping individuals "manage" their burnout without addressing the broader institutional context are incomplete at best, and ethically negligent at worst. Sustainable recovery from burnout must include a re-examination of workload, power dynamics, values alignment, and organizational culture. Anything less merely reinforces the cycle of harm.

Toxic Jobs Create Trauma, Not Just Stress

Not every job that leads to burnout is inherently toxic, but when toxicity is present, the psychological and physiological consequences can resemble those of complex trauma. Toxic workplaces—those that are chronically hostile, exploitative, gaslighting, discriminatory, or fundamentally misaligned with basic human dignity—can create conditions in which employees experience ongoing emotional harm. These environments may include persistent microaggressions, manipulative leadership dynamics, surveillance cultures, inequitable policies, or cultures of fear where retaliation is a constant threat. For individuals who are marginalized due to race, gender, sexual orientation, disability, or neurodivergence, these dynamics are often intensified, as structural oppression and workplace toxicity intersect (Sue et al., 2007; Nadal et al., 2014).

Judith Herman (1992), in her foundational work on psychological trauma, highlighted that trauma does not only result from acute catastrophic events, such as violence or disaster. Trauma can also occur in chronic situations of entrapment, particularly when a person is subject to ongoing subjugation without the power to resist or escape. This concept is especially relevant to toxic work environments, where financial dependency, professional identity, health benefits, or visa status can create a sense of entrapment. In these conditions, the workplace becomes not just a source of stress but a site of systemic threat to autonomy, identity, and psychological safety.

Over time, individuals exposed to these conditions often exhibit hallmark features of trauma-related distress. Common responses include hypervigilance, where the nervous system remains in a state of heightened alert, constantly scanning for interpersonal danger or unpredictable reprimand. Emotional blunting or dissociation may also occur as a protective strategy, where the psyche numbs itself to avoid overwhelm or internal collapse. Many individuals begin to experience profound interpersonal difficulties, especially around trust and boundary formation, as workplace betrayals generalize to other areas of life. In addition, somatic symptoms often emerge—chronic migraines, gastrointestinal distress, muscle tension, fatigue, or autoimmune responses—manifestations of the body absorbing and expressing unresolved threat (Scaer, 2005; van der Kolk, 2014).

The cumulative toll of these conditions may mirror what trauma researchers describe as complex PTSD—a form of post-traumatic distress that results from sustained exposure to emotionally harmful environments, particularly in relational or institutional contexts (Courtois & Ford, 2009). Unlike single-incident trauma, complex trauma is often more challenging to recognize because its source is normalized, chronic, and embedded within everyday systems like the workplace. It is not uncommon for individuals to leave such jobs with deep mistrust, identity fragmentation, and a loss of confidence that can persist long after the exit.

As van der Kolk (2014) writes, “The body keeps the score.” When the workplace becomes the site of repeated psychological injury, the impact is not only emotional but also embodied. Healing from workplace trauma often requires a comprehensive approach that addresses the physiological stress load, unprocessed emotions, and disrupted internal working models of safety, trust, and self-worth. Recognition is the first step—naming that what happened was not "just stress," but something more insidious and long-lasting. Moreover, from that recognition comes the possibility of liberation, repair, and reintegration.

Mental Health Outcomes After Leaving a Harmful Job

While the decision to leave a toxic job can be frightening, research and clinical evidence consistently affirm that doing so can lead to substantial and often rapid improvements in mental and physical health. In environments characterized by psychological harm, such as chronic invalidation, overwork, lack of autonomy, or values misalignment, the nervous system becomes trapped in a sustained survival response. Exiting such environments often results in what many clients describe as a sense of "coming back online."

A longitudinal study by Harms et al. (2021) found that individuals who voluntarily left toxic or psychologically unsafe work environments experienced significant improvements in emotional functioning, physiological symptoms, and overall well-being within a relatively short period. Specifically, participants reported increased emotional clarity within four to six weeks, improved sleep, and a decrease in somatic complaints such as headaches and gastrointestinal issues by three months, and a progressive rebound in self-efficacy and optimism over time. These outcomes suggest that removal from a chronically activating environment allows the body and mind to recalibrate, restoring access to affective states, cognitive flexibility, and internal motivation.

From a neurobiological perspective, this change is consistent with models of stress recovery. When the environment no longer triggers the sympathetic nervous system into fight, flight, or freeze states, the parasympathetic system can re-engage, facilitating emotional regulation, physical rest, and cognitive processing (Porges, 2011). In simpler terms, once the threat is removed, healing begins—not only psychologically but somatically.

Clients frequently describe this shift as profound. One shared, “I did not know how numb I had become until I started to feel again.” Another noted, “It was like I had to leave to remember who I was.” These statements reflect the disconnection from self that can occur in toxic work environments and the powerful restoration of identity and emotional access once the source of chronic stress is removed.

In psychotherapy, this transition period is often where the real work begins—not because the pain has ended, but because psychological space has opened up. In systems theory and trauma recovery models alike, healing and reflection require room to breathe, grieve, process, and reorient. According to Herman (1992), recovery from trauma begins only when the survivor is removed from the source of danger. The same is true for work-induced stress injuries: as long as the environment remains harmful, it is tough to engage in meaningful healing.

Leaving a toxic job does not guarantee instant clarity or immediate joy. However, what it does create is the precondition for reintegration—a chance to reconnect with one’s body, values, and deeper sense of self. As internal resources replenish, individuals often experience increased vitality, agency, and emotional depth. What begins as an act of leaving usually becomes a profound process of returning to oneself.

You are Not Lazy. You are Traumatized. Or Burned Out. Or Both.

In chronically toxic work environments, employees often internalize harmful narratives that blame them for their distress. These environments frequently pathologize valid emotional responses by labeling individuals as “too sensitive,” “not resilient enough,” “overreacting,” or “difficult to work with.” Such narratives are a form of organizational gaslighting—a defense mechanism used by dysfunctional systems to deflect accountability by shifting the burden of responsibility onto the individual. The result is a deeply corrosive dynamic in which suffering becomes privatized and invisible, while the source of harm remains unaddressed.

It is crucial to understand that when a person experiences emotional exhaustion, reduced performance, or physiological breakdown within an unhealthy work setting, these are not indicators of personal failure. Instead, they are evidence of a well-functioning nervous system responding to a prolonged threat. According to Maslach and Leiter (2016), burnout is not caused by a lack of resilience, but by persistent mismatches between a person and their work in domains such as values, workload, control, fairness, and recognition. Similarly, trauma experts such as van der Kolk (2014) have demonstrated that the body has adaptive mechanisms that respond to chronic threat and emotional unsafety—even when those threats come in the form of verbal invalidation, high-pressure performance demands, or the erosion of dignity over time.

In this context, symptoms like fatigue, dissociation, cynicism, or shutdown are not moral failings. They are survival responses. When your body and mind begin to resist an environment through emotional numbing, physical illness, or a collapse in motivation, this is not laziness. It is a form of embodied wisdom. It is your system’s way of saying, “This is unsustainable.”

Self-blame is often reinforced by performance-centric cultures that reward over-functioning while punishing emotional authenticity. These systems make no room for human limitations, rest, or repair. Over time, individuals may internalize these conditions as personal inadequacy. The psychological toll of this process has been well-documented. Chronic exposure to invalidation and misattunement in adult environments, especially those resembling abusive relational dynamics, has been associated with symptoms of complex PTSD, anxiety, and learned helplessness (Herman, 1992; Seligman, 1975). This erosion of agency and identity can be profound, and it is not “overreacting” to feel broken down by it.

Let us be clear: there is nothing wrong with you if your body and mind are rejecting a system that is fundamentally misaligned with your values, boundaries, or psychological needs. That rejection is not weakness. It is intelligence, self-preservation, and—if allowed to be honored—the beginning of healing. Pathologizing yourself in response to organizational dysfunction only furthers the injury. The more accurate framing is this: your symptoms are a reasonable response to an unreasonable situation.

Strategic Exits: Quitting with Integrity and Intention

Here are some validated psychological and physiological signals that it may be time to plan your exit:

If you are checking multiple boxes, your body might be saying what your mind is not ready to admit: it is time to go.

Quitting your job does not have to be a reactive or chaotic decision. When done intentionally, it becomes an act of alignment—an expression of integrity rather than avoidance. This is what psychological literature refers to as values-based behavior, wherein individuals make choices rooted in their core beliefs and long-term wellness goals, even in the presence of emotional discomfort (Hayes, Strosahl, & Wilson, 2012). Strategic exits are not about burning bridges or acting out of frustration. Instead, they represent a thoughtful commitment to self-preservation, dignity, and psychological recovery.

A critical aspect of a successful and sustainable exit involves financial preparation. One of the primary barriers to leaving harmful work environments is the fear of economic instability. Research has shown that financial strain significantly exacerbates the psychological toll of workplace stress, leading to heightened anxiety, depression, and impaired decision-making (Sinclair & Cheung, 2016). Developing a three- to six-month financial cushion, where feasible, can provide the stability needed to process, reflect, and rebuild. This kind of planning helps shift the nervous system out of chronic threat response and opens up space for clarity.

Support during this process is equally vital. Consulting with a therapist, coach, or trusted advisor can offer containment, perspective, and emotional regulation during what is often a turbulent time. The therapeutic relationship, in particular, is a powerful tool for restoring self-trust and processing disempowering narratives that usually arise in toxic work environments (Bohart & Tallman, 2010). These consultations provide an anchoring experience—what early theorists like Alexander and French (1946) described as a “corrective emotional experience”—where individuals can begin to separate their internalized sense of failure from the external dysfunction they have endured.

Another critical strategy is setting a clear and bounded exit timeline. Without a structured plan, individuals often remain stuck in cycles of indecision that fuel helplessness and emotional exhaustion. Cognitive science research on executive functioning supports the use of temporal anchors—specific decision deadlines—to reduce cognitive load and restore a sense of agency (Barkley, 2012). Whether that means choosing to leave after a bonus cycle, project completion, or a predetermined date, what matters most is clarity and follow-through. A well-articulated timeline serves as a container for emotional ambiguity and transforms avoidance into purposeful action.

Emotional processing is also essential in the exit journey. Leaving a job, even a harmful one, often triggers grief. People may mourn lost time, neglected aspirations, fractured professional relationships, or an idealized version of what they hoped the job could be. Worden’s (2009) model of grief suggests that healthy transitions involve recognizing and working through these emotional losses rather than suppressing them. Individuals may experience a mix of fear, shame, sadness, and anger—all of which are valid. Suppression of these responses often leads to delayed burnout relapse, especially if one enters a new role without having metabolized the trauma of the previous one. As van der Kolk (2014) has emphasized, the body insists on acknowledgment—what is not processed emotionally will often be expressed physiologically.

Finally, envisioning the next chapter does not require a detailed roadmap. What it does require is the capacity to orient toward a general sense of meaning or direction. According to self-determination theory, people flourish when they experience autonomy, competence, and relatedness in their environments (Deci & Ryan, 2000). If your current job violates one or more of these needs, even beginning to move toward something that restores them, such as pursuing creative projects, further education, or mission-aligned work, can reignite motivation and psychological vitality. Individuals do not need to have everything figured out before leaving; they only need to trust that honoring their psychological needs is not irresponsible, but intelligent and necessary.

Reclaiming Your Life, One Brave Step at a Time

There is no moral victory in enduring suffering for its own sake. Our cultural narratives may glorify perseverance and hustle, but these values become harmful when they are weaponized against well-being. There is no prize for staying the longest in an environment that diminishes your health, agency, and humanity. Quitting a job that undermines your psychological safety, self-worth, or emotional regulation is not an act of weakness—it is an act of maturity and self-respect.

To want safety, dignity, respect, and alignment between your work and your values is not excessive. It is human. If you find yourself seriously considering whether your job is sustainable, know that you are not alone. Many people are quietly navigating these same questions, often without language or permission to validate what their nervous systems already know. The choice to leave can be terrifying, uncertain, and disorienting—but it is also often the beginning of profound healing. It is a step toward reclaiming your voice, your energy, and your life. Quitting your job might not just change your path—it might save your life.

Strategic Exits: Quitting with Integrity and Intention

Quitting your job does not need to be a reactive or chaotic decision. When done intentionally, it becomes an act of alignment—an expression of integrity rather than avoidance. This is what psychological literature refers to as values-based behavior, wherein individuals make choices rooted in their core beliefs and long-term wellness goals, even in the presence of emotional discomfort (Hayes, Strosahl, & Wilson, 2012). Strategic exits are not about burning bridges or acting out of frustration. Instead, they represent a thoughtful commitment to self-preservation, dignity, and psychological recovery.

A critical aspect of a successful and sustainable exit involves financial preparation. One of the primary barriers to leaving harmful work environments is the fear of economic instability. Research has shown that financial strain significantly exacerbates the psychological toll of workplace stress, leading to heightened anxiety, depression, and impaired decision-making (Sinclair & Cheung, 2016). Developing a three- to six-month financial cushion, where feasible, can provide the stability needed to process, reflect, and rebuild. This kind of planning helps shift the nervous system out of chronic threat response and opens up space for clarity.

Support during this process is equally vital. Consulting with a therapist, coach, or trusted advisor can offer containment, perspective, and emotional regulation during what is often a turbulent time. The therapeutic relationship, in particular, is a powerful tool for restoring self-trust and processing disempowering narratives that usually arise in toxic work environments (Bohart & Tallman, 2010). These consultations provide an anchoring experience—what early theorists like Alexander and French (1946) described as a “corrective emotional experience”—where individuals can begin to separate their internalized sense of failure from the external dysfunction they have endured.

Another important strategy is setting a clear and bounded exit timeline. Without a structured plan, individuals often remain stuck in cycles of indecision that fuel helplessness and emotional exhaustion. Cognitive science research on executive functioning supports the use of temporal anchors—specific decision deadlines—to reduce cognitive load and restore a sense of agency (Barkley, 2012). Whether that means choosing to leave after a bonus cycle, project completion, or a predetermined date, what matters most is clarity and follow-through. A well-articulated timeline serves as a container for emotional ambiguity and transforms avoidance into purposeful action.

Emotional processing is also essential in the exit journey. Leaving a job, even a harmful one, often triggers grief. People may mourn lost time, neglected aspirations, fractured professional relationships, or an idealized version of what they hoped the job could be. Worden’s (2009) model of grief suggests that healthy transitions involve recognizing and working through these emotional losses rather than suppressing them. Individuals may experience a mix of fear, shame, sadness, and anger—all of which are valid. Suppression of these responses often leads to delayed burnout relapse, especially if one enters a new role without having metabolized the trauma of the previous one. As van der Kolk (2014) has emphasized, the body insists on acknowledgment—what is not processed emotionally will often be expressed physiologically.

Finally, envisioning the next chapter does not require a detailed roadmap. What it does require is the capacity to orient toward a general sense of meaning or direction. According to self-determination theory, people flourish when they experience autonomy, competence, and relatedness in their environments (Deci & Ryan, 2000). If your current job violates one or more of these needs, even beginning to move toward something that restores them, such as pursuing creative projects, further education, or mission-aligned work, can reignite motivation and psychological vitality. Individuals do not need to have everything figured out before leaving; they only need to trust that honoring their psychological needs is not irresponsible, but intelligent and necessary.

Conclusion: Reclaiming Your Life, One Brave Step at a Time

There is no moral victory in enduring suffering for its own sake. Our cultural narratives may glorify perseverance and hustle, but these values become harmful when they are weaponized against well-being. There is no prize for staying the longest in an environment that diminishes your health, agency, and humanity. Quitting a job that undermines your psychological safety, self-worth, or emotional regulation is not an act of weakness—it is an act of maturity and self-respect.

To want safety, dignity, respect, and alignment between your work and your values is not excessive. It is human. If you find yourself seriously considering whether your job is sustainable, know that you are not alone. Many people are quietly navigating these same questions, often without language or permission to validate what their nervous systems already know. The choice to leave can be terrifying, uncertain, and disorienting—but it is also often the beginning of profound healing. It is a step toward reclaiming your voice, your energy, and your life. Quitting your job might not just change your path—it might save your life.

References

Alexander, F. G., & French, T. M. (1946). Psychoanalytic therapy: Principles and application. Ronald Press.

Barkley, R. A. (2012). Executive functions: What they are, how they work, and why they evolved. Guilford Press.

Bohart, A. C., & Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart and soul of change: Delivering what works in therapy (2nd ed., pp. 83–111). American Psychological Association.

Courtois, C. A., & Ford, J. D. (Eds.). (2009). Treating complex traumatic stress disorders: An evidence-based guide. Guilford Press.

Deci, E. L., & Ryan, R. M. (2000). The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/S15327965PLI1104_01

Harms, P. D., Credé, M., Tynan, M., Leon, M., & Jeung, W. (2021). Voluntary turnover following workplace mistreatment: An integrative model and meta-analysis. Occupational Health Science, 5(3), 219–241. https://doi.org/10.1007/s41542-020-00072-2

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.

Herman, J. L. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books.

Lupien, S. J., Maheu, F., Tu, M., Fiocco, A., & Schramek, T. E. (2009). The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition. Brain and Cognition, 65(3), 209–237. https://doi.org/10.1016/j.bandc.2007.02.007

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311

McEwen, B. S., & Gianaros, P. J. (2010). Central role of the brain in stress and adaptation: Links to socioeconomic status, health, and disease. Annals of the New York Academy of Sciences, 1186, 190–222. https://doi.org/10.1111/j.1749-6632.2009.05331.x

Nadal, K. L., Davidoff, K. C., Davis, L. S., & Wong, Y. (2014). Emotional, behavioral, and cognitive reactions to microaggressions: Transgender perspectives. Psychology of Sexual Orientation and Gender Diversity, 1(1), 72–81. https://doi.org/10.1037/sgd0000011

Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78. https://doi.org/10.1037/0003-066X.55.1.68

Sapolsky, R. M. (2004). Why zebras don’t get ulcers (3rd ed.). Holt Paperbacks.

Scaer, R. C. (2005). The trauma spectrum: Hidden wounds and human resiliency. W.W. Norton & Company.

Seligman, M. E. P. (1975). Helplessness: On depression, development, and death. W.H. Freeman.

Sinclair, R. R., & Cheung, J. H. (2016). Money matters: Recommendations for financial stress research in occupational health psychology. Stress and Health, 32(3), 181–193. https://doi.org/10.1002/smi.2698

Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271–286. https://doi.org/10.1037/0003-066X.62.4.271

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

West, C. P., Dyrbye, L. N., Satele, D. V., Sloan, J. A., & Shanafelt, T. D. (2018). Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. Journal of General Internal Medicine, 27(11), 1445–1452. https://doi.org/10.1007/s11606-012-2015-7

Worden, J. W. (2009). Grief counseling and grief therapy: A handbook for the mental health practitioner (4th ed.). Springer Publishing Company.

World Health Organization. (2019). Burn-out an “occupational phenomenon”: International classification of diseases. https://www.who.int/mental_health/evidence/burn-out/en/