Sometimes You Need the Damn Box

Some jobs require people to put emotion aside long enough to perform. Resilience also means knowing when to pick it back up.

There are jobs where the normal human reaction and the necessary professional reaction cannot happen at the same time. A medic can be horrified by what is in front of him and still need steady hands. A surgeon can care very much about the person bleeding on the table while thinking about anatomy instead of tragedy. A platoon leader can lose somebody he loves and still have living people waiting for a decision.

The fear, grief, anger, or disgust may be entirely appropriate, but that does not mean this is the moment to give it your full attention. Sometimes the job gets the next twenty minutes. That ought to be fairly obvious to anyone who has worked around emergencies, yet the language we use around emotional health has become muddled enough that it is worth saying plainly.

For a long time, certain professions handled psychological stress with some variation of “suck it up.” Do the job, keep your mouth shut, go home, and repeat until retirement. A lot of people became very good at functioning that way. Some also discovered years later that being able to lock something away and being able to deal with it are not the same skill.

Correcting that culture was necessary, but I am less convinced that everything said during the correction has been useful. Popular mental-health language now gives us phrases like “feel your feelings,” “sit with it,” “honor what you’re feeling,” and “give yourself space.” There is nothing inherently wrong with any of that, and good therapy is far more sophisticated than its social-media translation. Good clinicians routinely teach people to tolerate distress, regulate emotion, reconsider the meaning they assign to an event, and choose what they do rather than simply react.

The trouble starts when recognizing an emotion gets confused with obeying it. A frightened person can have a completely understandable fear and still make a terrible decision because of it. Someone can be justifiably angry and still need to keep his mouth shut for five minutes. Grief may deserve all the room in the world, just not while someone else is bleeding.

People in high-stress professions need a way to talk about this without pretending they are either emotionally enlightened or emotionally defective. What they need is a measure of professional detachment, used deliberately rather than lived in permanently.

We Already Train It

The military understands this better when it talks about performance than when it talks about wellness. Defense Health Agency guidance on high-stress operations describes stress inoculation training as a way to help service members remain effective when stress is working against them. The techniques include controlling emotion so fear and negative thoughts do not become distractions, reducing the body’s physical stress response, rehearsing tasks until they become automatic, visualizing successful performance, prioritizing during information overload, and maintaining communication with the team.

Nobody needs to call that “detachment” for the principle to be obvious. The person is learning to keep an internal reaction from taking over the task, and there is some evidence that this can be trained.

A randomized study published in Scientific Reports in 2026 involved 66 soldiers in an elite military setting. Thirty-five received 15 hours of emotional-intelligence training focused on recognizing, understanding, and regulating emotions; 31 received control training. Researchers then exposed them to simulated combat stress.

The trained group showed lower biological stress responses and better performance on several measures. Shooting accuracy was 94.1% in the trained group and 51.6% among controls. The trained soldiers also remembered more mission-critical information, performed better on complex calculations under pressure, and tolerated cold-water immersion longer.

Those are striking numbers from a very small study, interesting enough to deserve attention but nowhere near sufficient to declare the question settled. A 2025 systematic review makes that caution necessary. Researchers found 46 relevant studies examining emotion regulation and coping among active military personnel, but only three examined performance variables and six examined military variables. Half of the performance and military variables assessed came from studies judged to have a high risk of bias.

The review concluded that emotion regulation appears related to military performance and outcomes, while also showing how little good research exists on something plainly central to functioning under stress. We have spent generations learning how to make people perform while exhausted, overloaded, cold, frightened, confused, and responsible for somebody else’s life. The military can measure sleep, hydration, heart rate, ammunition expenditure, aircraft hours, and an impressive number of other things. What somebody does with fear while making a consequential decision deserves the same serious attention.

Medicine Has the Same Problem

A surgeon does not get to stop halfway through a procedure because the situation has become emotionally upsetting, and nobody would want one who did. That does not make the surgeon inhuman. It is part of what the patient is relying on.

A systematic review in Surgical Endoscopy examined 19 studies involving acute stress during real and simulated surgical procedures. Under stress, surgeons showed more procedural errors, longer task-completion times, poorer instrument handling, and worse nontechnical performance, including teamwork and communication. The authors did not find evidence establishing a causal relationship between surgeon stress and patient outcomes, which is worth preserving rather than embellishing. What they did find was simpler: excessive acute stress can interfere with the surgeon’s ability to perform.

Medicine has wrestled with the emotional side of that problem for decades. One of the older terms is detached concern, an unfortunate phrase because “detached” sounds like we are training physicians to look at terrified patients the way accountants look at invoices.

The useful version of the idea was never that cold. The physician has to care about the person in the bed and retain enough distance to remain the physician. Too little concern and the patient becomes a diagnosis attached to a room number. Too little distance and the clinician risks being pulled so deeply into the patient’s distress that clear judgment becomes harder.

A small longitudinal study provides an interesting example. Researchers followed 108 professionals working in health care, education, and social services across eight months and identified different combinations of empathic concern and detachment. The group with both high concern and high detachment, described by the researchers as “balanced,” showed the lowest emotional exhaustion over time.

It was a small observational study, not an experiment proving that detachment prevents burnout. Even so, it challenges the assumption that caring and distance must move in opposite directions. People may be capable of a great deal of both.

Suppression Is Something Else

Professional detachment becomes dangerous when the word is used as a respectable substitute for avoidance. Pretending nothing bothers you is not emotional control. Neither is hiding every symptom, drinking yourself to sleep, refusing to discuss anything difficult, or answering “fine” for twenty years because it ends the conversation efficiently.

A study of 105 medical residents helps separate these ideas. Researchers looked at emotional suppression and cognitive reevaluation, which involves reconsidering how one interprets an emotional situation. Greater suppression was associated with higher depersonalization, while cognitive reevaluation was associated with greater feelings of personal accomplishment. The study was cross-sectional, so it cannot tell us that suppression caused burnout or reevaluation prevented it, but it does tell us those approaches to emotion are not interchangeable.

There is a practical difference between convincing yourself that you do not feel something and knowing that you feel it but cannot deal with it right now. The medic treating a casualty does not need to believe the situation is less horrible than it is. He needs enough room between what he feels and what his hands are doing to remember what comes next.

A physician telling parents that their child has died does not have to become emotionally blank. She does need enough control that the parents do not suddenly find themselves managing her grief too. Fear does not have to disappear before someone can act courageously, and anger does not have to disappear before someone can act professionally. The skill is having some say in what happens next.

Caring Without Absorbing It

The medical literature becomes particularly useful here because researchers have tried to separate different parts of empathy instead of treating it as one vague virtue.

A study of 7,584 practicing physicians found that compassion satisfaction was strongly associated with empathic concern, perspective-taking, and altruism. Compassion fatigue was more closely associated with personal distress and difficulty identifying and regulating one’s own emotions. That suggests something more complicated than the familiar claim that caring too much burns people out.

A clinician can understand that a patient is terrified without becoming terrified with him. She can recognize another person’s grief without having to reproduce that grief internally at the same intensity.

A recent review in Annals of Neurology calls the useful version skillful empathy. Its authors describe a trainable combination of emotional resonance and cognitive perspective-taking. They also discuss emotional contagion, where another person’s distress starts becoming the clinician’s own, and argue that clinicians can be taught to preserve empathy while maintaining awareness that the patient’s distress belongs to the patient.

There is also evidence against solving this problem by becoming colder. A 2024 systematic review and meta-analysis included 21 studies and 27,129 medical students. Greater empathy was associated with lower burnout overall, and cognitive empathy showed the clearest favorable relationship with several burnout dimensions. Affective empathy by itself did not show the same consistent associations.

Telling clinicians to care less is therefore not much of an answer, but neither is asking them to absorb every person they treat. If somebody falls through thin ice, caring about him does not require climbing into the hole beside him. Somebody has to stay where the footing is good enough to pull.

That is closer to what professional detachment should mean.

The Box

People around the military have been teaching a rough version of this forever: put it in the box, drive on, handle what is in front of you. There is a reason the box exists. Sometimes you genuinely need the damn thing.

The mistake was never simply having one. The mistake was teaching somebody at 19 how to put things into it, rewarding him for how much he could carry, and never talking much about opening it again.

Temporary compartmentalization can be useful enough to keep somebody alive, but it can also become habitual. You can see what happens when an operational posture follows someone into a place where it is no longer needed. Everything becomes a task. Every delay feels like incompetence. Ordinary complaints sound ridiculous compared with real problems. Sitting still feels irresponsible. Someone who takes too long to explain something becomes an obstacle instead of a person.

Those habits may have been extraordinarily useful somewhere else. They can make a kitchen pretty unpleasant.

Medical professionals bring home their own version. Someone who learns to move from a death to paperwork to another sick patient without losing the ability to function can become very accomplished at emotional distance. That skill becomes less useful when the shift ended three hours ago and the people in the house are still being treated like interruptions.

There is a serious counterargument here, particularly in medicine. An article in Academic Medicine argues that modern clinical training may already encourage too much detachment. The authors contend that excessive emphasis on professional distance can weaken meaningful human connection with patients and contribute to disenchantment with the profession. They propose a much more relational model of physician-patient care.

Their criticism deserves to be taken seriously. They also acknowledge why professional boundaries exist: forms of compassion or closeness can interfere with reasonable clinical judgment, human emotional capacity is finite, and poorly managed attachment can cause harm.

That gets closer to the problem than choosing between detachment and empathy. A professional has to be able to move between them.

Getting Back Out

We spend a lot of training time preparing people to enter stressful situations. Military training deliberately introduces fatigue, uncertainty, noise, time pressure, information overload, and fear. Medical simulation creates deteriorating patients, failed equipment, hemorrhage, competing priorities, and difficult decisions. The point is to make performance survive conditions that interfere with it.

We are less explicit about what happens when those conditions end, partly because there probably is not one correct way to come down from a terrible event. Some people want to talk immediately. Others want a meal, a shower, and sleep before they are interested in discussing anything deeper than where somebody left the car keys. Some prefer the people who were there. Others would rather talk with someone who was not.

Some events will leave marks. Others will not. The useful question is not whether somebody displayed the approved emotional response afterward. It is whether he still has choices.

Can he eventually sleep and be present somewhere that is boring and safe? Can he tolerate ordinary problems without resenting people for having them? Can he discuss what happened if he decides he needs to? Can the people who know him tell him something has changed without every conversation turning into a courtroom? Can he notice when something that was supposed to stay in the box for an hour has been there for six months?

And can he open the box at all?

That is where temporary professional detachment starts separating itself from emotional numbing. We should teach that distinction before people need it. Putting an emotion aside for the task does not mean the emotion was unimportant, and returning to it later does not mean somebody failed to handle it the first time. A coping mechanism can be useful in one environment and costly in another.

We are comfortable telling professionals that different situations require different tactical responses. Their own nervous systems should not be the exception.

A Feeling Can Be Real and Still Wait

One of the better changes in our culture is that people can admit more readily when something affects them. Fear is not automatically cowardice. Grief does not establish weakness. Being troubled by a genuinely terrible event does not mean someone lacks resilience.

We can keep all of that without pretending every sincere feeling comes with instructions.

Fear may accurately tell you that the situation is dangerous. Training and judgment still determine whether the useful response is to move, communicate, fire, wait, breathe, or get somebody else out. Anger may tell you that something is wrong, but it does not tell you whether saying exactly what you are thinking right now will help. Grief tells you that somebody mattered and has never been especially interested in scheduling.

For people who work in combat, medicine, emergency services, law enforcement, and other high-stress professions, emotional health cannot mean arranging life so that difficult feelings always receive immediate attention. Sometimes other people are depending on you to remain useful first.

The other extreme failed too. We should not admire someone for becoming so good at setting emotion aside that he eventually cannot find it, or cannot reach anyone who needs more from him than competence.

That is why detachment belongs in resilience training, but only if we teach the whole skill: how to create enough distance to perform, how to recognize when distance has become avoidance, how to come home without bringing the operating mode into every room, and how to ask for help before “this is just how I am now” becomes the explanation for everything.

That is harder than “suck it up,” and more useful than telling people simply to embrace whatever they feel. It requires judgment, practice, self-awareness, and enough humility to recognize when a coping mechanism that once kept you functional has started costing you something.

High-stress professions already demand enormous amounts of judgment. We should stop assuming people will figure this particular part out by accident.

Sometimes you need the box. The important part is remembering that you are supposed to open it again.

Sources

• Stress Reduction Techniques for High Stress Operations, by the Defense Health Agency, Psychological Health Center of Excellence (Military Health System).
• Emotional Intelligence Training Improves Stress Regulation and Performance in High-Stress Occupations, by Jemma B. King, Yiqiong Li, Nicole A. Gillespie, and Neal M. Ashkanasy (Scientific Reports, 2026).
• Emotion Regulation and Coping in Active Military Personnel: A Systematic Review, by Rebecca Kirkham et al. (Stress and Health, 2025).
• The Effects of Stress on Surgical Performance: A Systematic Review, by Adam Tam et al. (Surgical Endoscopy, 2025; first published online Dec. 3, 2024).
• Exhausted Through Client Interaction: Detached Concern Profiles as an Emotional Resource Over Time?, by Bettina Lampert, Christine Unterrainer, and Christian Thomas Seubert (PLOS ONE, 2019).
• Emotion Regulation Strategies, Workload Conditions, and Burnout in Healthcare Residents, by Ramón Martín-Brufau et al. (International Journal of Environmental Research and Public Health, 2020).
• Empathy in Clinical Practice: How Individual Dispositions, Gender, and Experience Moderate Empathic Concern, Burnout, and Emotional Distress in Physicians, by Ezequiel Gleichgerrcht and Jean Decety (PLOS ONE, 2013).
• From Detached Concern to Love: Reconsidering Physician-Patient Boundaries, by Anjola Onadipe and Farr Curlin (Academic Medicine, 2025; first published online Nov. 13, 2024).
• Harnessing the Neurobiology of Empathy and Compassion to Alleviate Burnout in Neurology, by Fadel Zeidan, Joseph D. Stern, and William C. Mobley (Annals of Neurology, 2026; first published online Nov. 26, 2025).
• The Association Between Empathy and Burnout in Medical Students: A Systematic Review and Meta-Analysis, by P. Cairns, A. E. Isham, and R. Zachariae (BMC Medical Education, 2024).

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Tammy Pondsmith is a satirical contributor to The Havok Journal. Her work uses sharp political and cultural satire to examine media manipulation, institutional cowardice, public-policy failures, elite hypocrisy, and the warped machinery of modern outrage. For The Havok Journal, she writes mainly on politics, media, government dysfunction, and American culture, bringing a biting, absurdist voice to serious public issues.

As the Voice of the Veteran Community, The Havok Journal seeks to publish a variety of perspectives on a number of sensitive subjects. Unless specifically noted otherwise, nothing we publish is an official point of view of The Havok Journal or any part of the U.S. government.