If Part of You Feels Like You Don’t Deserve Peace, You’re Not Alone

Survivor Guilt + Imposter Phenomenon in Veterans, First Responders, and High-ACE Histories

Brain Treatment Center NoVA | Northern Virginia • Washington, DC

Some of the strongest people you’ll ever meet carry a quiet, relentless thought:

“I don’t feel like I deserve peace.”

It can show up as survivor's guilt after loss, imposter feelings after transition or injury, or a constant drive to “earn” rest through overwork. In veterans and first responders, this isn’t rare; it’s often a predictable outcome of repeated exposure to responsibility, danger, moral conflict, and grief. It’s also frequently amplified by adverse childhood experiences (ACEs) that shaped the nervous system long before adulthood. 

This article breaks down what survivor guilt and the impostor phenomenon are, why they’re so common in high-responsibility service roles, how ACEs can “prime” stress and threat systems, and what recovery can look like, without minimizing meaning, sacrifice, or identity.

Survivor Guilt vs. Impostor Phenomenon

Survivor guilt

Survivor's guilt is a form of distress that can follow traumatic events where others died or suffered while you lived, escaped, or later began to function again. It can involve painful “if only” thinking, perceived responsibility, and self-punishment, sometimes even when responsibility isn’t realistic. Contemporary clinical writing notes that survivor's guilt is common after trauma and can be addressed using cognitive models that target responsibility, threat, and moral meaning. 

In military and veteran communities, guilt and shame can also overlap with moral injury, a pattern of distress after experiences that violate deeply held moral beliefs (e.g., perceived betrayal, commission/omission, witnessing). 

Imposter phenomenon

The impostor phenomenon describes persistent self-doubt and a fear of being “exposed” as not truly competent, despite evidence of performance and achievement. It was originally described by Clance and Imes and remains widely recognized as a real, measurable experience (not a formal DSM diagnosis). 

How This Looks in Real Life

Survivor's guilt often sounds like:

• “I should have done more.”

• “It should’ve been me.”

• “I don’t get to be okay if they aren’t.”

• “If I’m happy, I’m dishonoring them.”

Impostor feelings often look like:

• Over-preparing, overworking, or never feeling “ready”

• Minimizing earned competence (“I just got lucky”)

• Fear of evaluation or being watched

• Feeling “less than” outside an operational identity

Both patterns can drive high functioning on the outside while the inside stays tight, watchful, and exhausted.

Why This Is So Common in Veterans and First Responders

Veterans and first responders are repeatedly exposed to situations that load the brain with:

• High responsibility

• High consequence

• Unpredictable threat

• Loss and grief

• Moral complexity 

When that becomes the baseline, the nervous system can learn a painful rule:

Peace is unsafe. Rest is undeserved.

And when service members transition, promote, get injured, retire, or shift out of an operational role, identity can destabilize, making impostor feelings and survivor's guilt louder.

The ACE Connection: Why Some Nervous Systems “Carry More”

The original ACE study demonstrated a strong graded relationship between childhood adversity and later health risks.  The CDC summarizes ACEs as childhood experiences of abuse, neglect, and household challenges that can affect health and wellbeing across the lifespan. 

Research on toxic stress and early adversity explains how this happens: chronic activation of stress-response systems in childhood can leave lasting effects on brain development and physiology across the lifespan. 

In public safety populations, studies have begun to directly examine this link. For example, ACEs have been associated with mental health outcomes among police officers.  Broader public safety research has also examined how childhood adversity can relate to later adult mental health symptoms and vulnerability pathways. 

A helpful way to say it clinically (and compassionately)

Higher ACE exposure can “train” the brain early to:

• scan for threat

• brace for loss

• over-function to prevent chaos

• suppress needs to stay safe

That can create high competence and high compartmentalization, but often at a cost: chronic tension, self-criticism, and difficulty receiving safety or peace. (And importantly: this is not universal, people vary widely, and protective childhood experiences and supportive adult relationships can buffer risk.) 

The Neurobiology Behind “I Don’t Deserve Peace”

This isn’t just a mindset. It can be a state.

• Survivor's guilt can hook into responsibility and threat networks: If I stop blaming myself, something bad will happen again. 

• Impostor feelings can be reinforced by nervous-system hyperarousal: increased monitoring, rumination, perfectionism, and avoidance. 

• In trauma-exposed groups, guilt and shame have documented relationships with PTSD severity and treatment outcomes, which is why guilt-focused interventions exist. 

The goal isn’t to erase meaning or loyalty. The goal is to help the brain stop using self-punishment as a method of staying connected, staying vigilant, or staying “worthy.”

What Actually Helps

1) Treat guilt as clinically relevant, not “just feelings.”

There are evidence-based approaches designed specifically to reduce trauma-related guilt (including structured models used with combat veterans). 

2) Restore regulation before demanding “insight.”

Many people can intellectually understand “it wasn’t my fault” while their body still reacts like it was. Stabilizing sleep, arousal, and stress physiology makes cognitive and trauma therapies far more effective. 

3) Address the full load (brain + body)

For many high-performing trauma-exposed individuals, recovery is strongest when it’s multidisciplinary: brain regulation, psychotherapy, and physiologic stabilization (metabolic health, inflammation, nutrients, autonomic balance) work together.

How Brain Treatment Center NoVA Can Help

At Brain Treatment Center NoVA (serving Northern Virginia and Washington, DC), we often see veterans and first responders who are “doing life” but can’t access peace. Survivor guilt and impostor feelings may be part of the picture, especially with trauma, moral injury, TBI exposure, or high ACE history.

Our approach is built around restoring function and regulation, not just managing symptoms.

Depending on clinical need and appropriateness, care may include:

• Neuromodulation options (including rTMS/MeRT when indicated)

• Occupational therapy for regulation, executive function, and real-world performance

• Trauma-focused therapy (skills + processing when the system is ready)

• Integrative psychiatry (when medications are needed, with a regulation-first lens)

• Functional health support for cellular stability (sleep physiology, nutrient depletion, inflammation/metabolic strain, mitochondrial support strategies)

• HBOT as part of a broader recovery plan when appropriate

If your internal narrative says, “I don’t deserve peace,” we’ll take that seriously, without pathologizing you. Peace doesn’t erase sacrifice. It restores your capacity to live.

References

Bistas, K., et al. (2023). The intricacies of survivor’s guilt: Exploring its causes and impact. Cureus. 

Blosnich, J. R., Dichter, M. E., Cerulli, C., Batten, S. V., & Bossarte, R. M. (2014). Adverse childhood experiences and military service: Prevalence and associations with adult health outcomes. JAMA Psychiatry. 

Centers for Disease Control and Prevention. (n.d.). About the CDC-Kaiser ACE Study. 

Clance, P. R., & Imes, S. A. (1978). The impostor phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241–247. 

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. 

Huecker, M. R., Shreffler, J., & Diaz, F. (2023). Imposter phenomenon. In StatPearls. StatPearls Publishing. 

Murray, H., & Ehlers, A. (2021). Survivor guilt: A cognitive approach. Behaviour Research and Therapy. 

Norman, S. B., et al. (2014). Trauma informed guilt reduction therapy with combat veterans. Cognitive and Behavioral Practice. 

Roth, S. L., et al. (2022). Mental health symptoms in public safety personnel: Associations with adverse childhood experiences and related factors. [Journal article—ScienceDirect]. 

Shonkoff, J. P., et al. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. 

U.S. Department of Veterans Affairs, National Center for PTSD. (n.d.). Spirituality and guilt (professional resources). 

Violanti, J. M., et al. (2021). Adverse childhood experiences and police mental health. Policing: An International Journal.