"Internal pressure would be the dissonance between your self-identity and how you present …" — There may also internal pressure from the dissonance between your self-identity and reality. That is, between our idealized self-image and our real selves. I found a lot of help with this kind of pressure in Karen Horney's old book, "Our Inner Conflicts." It's available from the library, and it appears that there are even free downloadable versions online.

When it comes to emotional dissonance, I found Karen Horney's book helped me to look at myself more honestly, and honestly, that's the hardest kind of honesty there is.