I decide in these cases what my character will put on the line, and so there is always that layer of safety, even if it seems my character has losses, and is struggling with angst. ( I have done my share of WOD). When I play in games with role playing mechanics that really puts on the pressure, it is different. It's actually more immersive, despite the initial reaction that role playing mechanics should destroy the player's autonomy. Everything has a more immediate feel, a greater intensity.
This earned a lot of xp, but the take-home needs to be emphasized.
In real life we aren't characterizing ourselves. In real life we don't have nearly the expression of autonomy or internal locus of control that one characterizes their PC with in a game of AD&D, 3.x, and 5e D&D.
In real life, our behavioral outputs are a collage of external inputs (from emotional provocateurs to those that turn genes off and on), irrational compulsions, irrational biological imperatives, divorced-from-conscious-mind-neurological-subroutines, crappy heuristics, erudition, practice, and well-considered mindfulness.
So that very pressure (that you cite) is fundamental to our daily lives, and shapes the most visceral moments of our lives in key ways...ways that transcend that moment and feed back onto the rest of our days. Mechanics that push/pull/provoke/demand (often with the seduction of immediate return at the cost of "the long game") are the best way I know of to model the fundamental role of those many externalities (like a drug addict battling their addiction, or an enabler battling their conscience, or a workaholic battling their zeal/anxiety, or someone who is more comfortable sad than happy battling their damaging comfort with melancholy, or someone who lacks discipline trying to control their disorderly compulsions, or someone who is being leaned on by the police for 36 hours who confesses to a crime they didn't commit, etc etc).
A man arrives 5 minutes too late from a 2 hour journey that was meant to save his sister from suicide. Her body rests on cold white tile, laying in a pool of thick red, blood and gore on the wall next to her. He stoops down over her. The world is complete silence as they share this moment. This is the last time he will ever see her and he probably knows this will haunt him the rest of his life. Dilated pupils in her dead eyes. Frothing mouth. Wet hair from the blood and gore. Skull fragments everywhere. He just stares into her dead eyes. For who knows how long.
Why does he do this? Is it because this moment he has waited on for so long is finally upon him and he doesn't want to consider the philosophical implications? He doesn't want to hear the sound of his mother's heart breaking when he calls her to tell her what has happened? Because she has left 3 children behind and they're likely to all be ruined by this? If he just stays in this moment, his sister won't truly be reduced to this broken biological state and he won't have to confront all of those things. As he is staring, he knows this is a terrible image to imprint upon himself...it will have lasting effects for certain. But he can't tear his eyes away from hers nonetheless.
That is life.
Its marked by visceral events that aren't "full-agency characterization" (such as the case is when there is no active machinery or feedback loop putting pressure on you) that are completely transformative. You're not struggling with contrived angst in real life that is all bark (mere performance) and no bite (actual emotional, physical, or philosophical phase-change). There is real pressure brought to bear against you from several different directions (some internal, some external). And the misbegotten idea of a singularly unified consciousness (rather than overwhelmingly an amalgamation of entangled inputs wholly divorced from the "you" that you identify with) that is cooley in control of your behavioral outputs is quickly put to rest.
