Work-Related Anxiety and Trauma in Physicians: How It Shows Up and How Accelerated Resolution Therapy Can Help
You walk into the same procedure you've done hundreds of times, and your heart starts pounding. Your hands feel unsteady. A case from months ago flashes through your mind, and for a moment you're not here, you're back there.
You get through it. You always do. But afterward, you sit in your car a little longer than you need to. And that night, the images come back as soon as you close your eyes.
If this sounds familiar, please know that nothing is wrong with your competence, and you're far from alone. What you're experiencing is a very human response to the extraordinary things medicine asks you to witness and carry. And it can be resolved, often more quickly than you might expect.
How Common Is Work-Related Trauma Among Physicians?
Much more common than most people realize. A 2025 meta-analysis found a pooled PTSD prevalence of about 15 percent among physicians, compared with about 4 percent in the general adult population. Rates can be even higher in some settings: one study found that 15.8 percent of emergency physicians met criteria for PTSD. And among emergency medicine residents in another study, nearly 12 percent met criteria, while 30 percent had symptoms that didn't reach a diagnosis.
Those numbers don't include the many physicians whose anxiety never reaches a formal diagnosis, but who still feel its effects every day at work.
How Work-Related Anxiety and Trauma Show Up for Physicians
Work-related trauma doesn't always look like what people expect. In physicians, it often shows up quietly, in ways that are easy to dismiss or hide.
At work
Hesitation or second-guessing before procedures or decisions that used to feel routine
Dread of a particular unit, type of case, or patient presentation
Strong reactions to certain alarms, overhead pages, or sounds
Over-checking, over-ordering tests, or difficulty trusting your own judgment
Avoiding certain procedures, shifts, or responsibilities
At night
Replaying a difficult case or outcome over and over
Images that appear as soon as you try to sleep
Nightmares or waking in the middle of the night with your heart racing
In your body
Racing heart, shaking hands, tight chest, or stomach distress in certain situations
Feeling constantly on guard, even on days off
Exhaustion that rest doesn't seem to fix
At home
Irritability, emotional numbness, or withdrawal from your partner and family
Difficulty being present, because part of your mind is still at work
Avoiding conversations about your day altogether
Dreading the end of your time off because you have to go back to work
Why It Doesn't Go Away on Its Own, Even When You Know It Wasn't Your Fault
Physicians are exceptionally good at understanding problems logically. But you can know, completely, that an outcome wasn't your fault and still feel your body react the next time you're in a similar situation.
That's because traumatic and highly stressful memories are often stored with the original images, sensations, and alarm response still attached. Each time the memory is triggered, the brain fires the same stress response, which can strengthen the pattern over time. Insight alone often can't reach it. That's why many physicians try talk therapy, understand exactly what's happening, and still find the reaction hasn't changed.
What Is Accelerated Resolution Therapy?
Accelerated Resolution Therapy (ART) is a brief psychotherapy that helps people resolve distressing memories, images, and anxiety, typically in one to five sessions. It combines guided eye movements with a technique called voluntary image replacement, in which the distressing images connected to a memory are changed so they no longer trigger the same physical and emotional reaction. ART was developed in 2008 and has a growing body of research, particularly for trauma and PTSD.
The facts of what happened stay intact. What changes is the automatic response your body and brain have attached to the memory. You can still remember the case. It simply stops pulling you back into it.
Why ART Is Well Suited to Physicians
It's short-term and targeted. ART typically takes one to five sessions. For physicians with demanding schedules, a focused approach with a clear endpoint is often far more realistic than months of weekly therapy.
You don't have to talk about what happened. ART allows you to work with a memory privately in your own mind while the therapist guides the process. You don't need to describe a difficult case, a bad outcome, or details you can't or don't want to share.
It works on the reaction, not just the understanding. ART is designed to change the automatic physical and emotional response tied to a memory, which is often exactly what insight-based approaches can't reach.
It supports confidence at work. When distressing memories lose their charge, many people find they can approach situations that once triggered anxiety with more calm and clarity, which can help restore the confidence they bring to their work.
What Can ART Help Physicians With?
Hesitation or lost confidence after an adverse event, complication, or medical error
Procedural or performance anxiety
Intrusive memories or images from difficult cases
Board, licensing, or recertification exam anxiety
Strong aversions to a particular procedure, unit, type of case, or alarm after a difficult experience
Sleep disrupted by work-related memories
Distress after a lawsuit, complaint, or workplace violence
General work-related anxiety
What Happens in an ART Session?
Identifying the target. You and your therapist identify a specific memory, image, or situation that's causing distress, without needing to describe it in detail.
Noticing the body's response. You notice what you feel physically as you bring the memory to mind.
Guided eye movements. The therapist guides you through sets of eye movements while you hold the memory and sensations in mind, which helps the distress ease.
Voluntary image replacement. You replace the distressing images with new ones of your choosing, so the memory no longer carries the same charge.
Checking the result. You revisit the memory to notice how it feels now. Many people describe it as feeling distant, neutral, or simply in the past.
Is ART Right for You?
ART may be a strong fit if a specific memory, image, or type of situation keeps affecting your work, sleep, or confidence; if you'd rather not describe what happened; or if you understand the problem but the reaction hasn't changed. If more is going on, ART can be one part of a broader plan. And because ART sessions can be done virtually, they can fit around even the most unpredictable schedule.
You Can Feel Like Yourself at Work Again
The anxiety and memories you're carrying are a natural response to the weight of your work, not a sign of weakness or failing skill. You don't have to keep pushing through them alone. With a short-term, targeted approach like ART, many physicians find that what once hijacked their confidence becomes simply a memory, and they return to their work with steadier hands and a quieter mind.
If you are in crisis or having thoughts of harming yourself, please call or text 988 to reach the Suicide and Crisis Lifeline, or call the free, confidential Physician Support Line at 1-888-409-0141.
Frequently Asked Questions
How common is PTSD among physicians?
Research suggests about 15 percent of physicians experience PTSD, compared with about 4 percent of the general adult population, with higher rates in some settings such as emergency medicine.
How does work-related trauma affect physician performance?
It can show up as hesitation, second-guessing, dread of certain situations, intrusive memories, and difficulty sleeping, all of which can erode confidence even in highly skilled physicians.
How many sessions of Accelerated Resolution Therapy do physicians need?
ART typically takes one to five sessions, depending on what you're working on but individual results may vary.
Do I have to talk about what happened in ART?
No. ART allows you to work with a memory privately in your own mind while the therapist guides the process, so you don't need to share case details.
Can ART be done virtually?
Yes. ART can be delivered through secure video sessions, as long as the therapist is licensed in the state where you're located.
If you're curious how ART compares with EMDR, you may also find it helpful to read Accelerated Resolution Therapy for Physicians: A Faster Alternative to EMDR.
You don't have to keep carrying this. If work-related anxiety or difficult memories are affecting your work, sleep, or confidence, I'd be glad to talk. I offer a free, confidential 15-minute consultation where you can ask questions about ART and whether it might be a good fit, without needing to share any details you're not ready to share.
[Schedule your free 15-minute consultation]
Noël López-Freeman, LMFT, has been a Licensed Marriage and Family Therapist since 2006 and has been married to a physician for more than two decades. She works virtually with physicians, physician spouses, and physician couples in California, Utah, Idaho, Iowa, Indiana, Texas, Florida, and South Carolina drawing on training in Accelerated Resolution Therapy, the Gottman Method, Emotionally Focused Therapy, Discernment Counseling and other evidence-based approaches.