Both the EMH and Chakotay — hell, even Tom on occasion — have tried to address some of those psychological points to her to varying degrees of success. It's not that she doesn't absorb what they say or is unwilling to hear them out so much as she cannot afford to. Her armor has to remain in place; it can't crack or weaken, can't warp around the edges. She's well aware that regular sessions with a counselor would do her a lot of good, but that's one of the many things that Voyager left Deep Space 9 without.

She knows what her faults are, knows what labeling would likely be applied. She knows her coping methods aren't always the best, and that she's far from being a picture image of the ideal captaining model. Quite frankly, she doesn't much care at this point. If Starfleet wants to take her to task for keeping Voyager a Starfleet vessel with a crew that was alive and thriving, who hasn't had to outright break the Prime Directive in order to survive, then so be it.

"Shouldn't I be the one thanking you for listening?"