Experiencing trauma in extreme contexts (e.g., areas affected by war, famine, or disease) can undermine professionals’ ability to cope and remain engaged at work. Prior research has highlighted coping strategies, such as detachment from trauma. However, less attention has been given to how professionals cope in demoralizing contexts, where trauma is persistent, detachment is difficult, and hope for impact erodes. Drawing on 73 diaries, 146 interviews, field observations, and archival data from Doctors Without Borders/Médecins Sans Frontières, we show how professionals cope by temporally reframing their experiences—anchoring in the past or future to reinterpret their experience, and reorienting their agency to sustain engagement in the present. Building on Construal Level Theory, we identify three reframing pathways that enable professionals to remain engaged over time. Such temporal reframing influences not only how professionals cope but also whether they return to fieldwork or redirect purpose to broader systemic change and policymaking. We contribute to the literatures on trauma and coping by theorizing temporal reframing as a cognitive-emotional coping approach that reorients disoriented agency and explains divergent pathways of sustained engagement or redirected purpose.
Rauch et al. (2026) studied this question.