Dear CEO, go see a therapist. Please.

At a certain point in a successful executive’s career, almost every important part of his life has a professional adviser. Someone examines the company’s accounts, someone structures his wealth, someone optimises his tax exposure, someone scrutinises his health, and, increasingly, someone tells him how much deep sleep he managed last Tuesday.

Yet, the machinery through which he interprets criticism, handles rejection, exercises control, responds to uncertainty, and decides whom to trust often escapes anything resembling the same rigorous examination.

Dear CEO, go see a therapist. Please.

This is not a suggestion that you are secretly unwell, nor an attempt to diagnose an entire class of people whose principal shared characteristic is occupying the largest office. The argument is simpler: when you hold disproportionate power in an organisation, your psychological habits stop being entirely personal.

They acquire budgets, reporting lines, performance reviews, hiring decisions, and, occasionally, several thousand employees who become exquisitely skilled at accommodating them.

A manager who cannot tolerate disagreement might make his immediate team miserable. A chief executive with the same problem can slowly build a company in which disagreement becomes professionally hazardous. A founder whose self-worth depends too heavily on being indispensable may sincerely believe he has a delegation problem, when what he has actually built is an organisation designed to confirm his indispensability.

Business vocabulary makes these tendencies remarkably easy to dignify. Anxiety can masquerade as urgency; excessive control can look like exacting standards; an inability to change one’s mind can enjoy a long and profitable career under the name “conviction”.

Power blind spots

This would matter less if senior leadership made people unusually resistant to stress. The evidence suggests precisely the opposite. DDI’s 2025 Global Leadership Forecast, based on 10,796 leaders across more than 50 countries, found that 71 per cent said their stress had increased significantly after taking on their current roles.

Nearly one in six reported burnout, while 40 per cent of stressed leaders had considered leaving leadership altogether in order to improve their well-being. The World Health Organization, meanwhile, estimates that depression and anxiety cost the global economy around 12 billion working days and US$1 trillion ($1.28 trillion) in lost productivity each year.

None of this proves that 71 per cent of leaders belong on a therapist’s couch, and it would be intellectually lazy to pretend that it does. It does, however, make the heroic mythology surrounding senior leadership increasingly difficult to defend.

We still behave as though elevation through a corporate hierarchy produces, alongside the salary increase, some mysterious improvement in emotional self-knowledge. Often, it merely gives a person fewer people willing to tell him when he is being unreasonable.

Power is particularly good at corrupting feedback long before it corrupts anything more dramatic. The further someone rises, the more information reaches him after passing through calculations of consequence: how will he react, how much should I say, is this the right moment, and will honesty cost me later?

A CEO may therefore regard himself as unusually receptive to criticism while presiding over an organisation that has quietly learned which criticisms he enjoys receiving. The tragedy is that everybody else can sometimes see the pattern more clearly than the person around whom it has formed.

This is where therapy becomes interesting as a leadership proposition, rather than merely a mental-health intervention. Executive coaching tends, understandably, to focus on performance: how to communicate better, delegate more effectively, manage conflict, or become a more persuasive leader. Therapy can go somewhere less comfortable.

It can ask why delegation feels threatening in the first place, why a particular kind of criticism provokes disproportionate anger, why achievement brings relief rather than satisfaction, or why a leader repeatedly hires people he later claims have “disappointed” him in almost identical ways.

When psychology scales

Those questions can sound indulgent until you consider their organisational cost.

Gallup has repeatedly found that managers account for 70 per cent of the variance in employee engagement across teams. Its 2026 Singapore workplace research also found that leaders rated their organisations’ managers’ effectiveness at developing and engaging people at only 3.32 out of five.

Companies spend extraordinary amounts measuring engagement, studying retention, hiring culture consultants, and investigating why employees have stopped speaking up. Sometimes the investigation might profitably travel one floor higher.

The point is not that every dysfunctional organisation can trace its problems to its chief executive’s childhood. Companies have structural problems, incentives matter, bad strategies exist, and some workplaces simply ask too much of too few people.

Therapy should not become the newest way to individualise what are fundamentally institutional failures. But institutions do not float above human behaviour either, and corporate culture often consists of personal habits that became powerful enough to acquire policy.

An asymmetry at the top also makes this worth taking seriously. The more senior you become, the more people around you have reasons to manage your perception of them. Colleagues want your confidence, employees want advancement, advisers want to retain their mandate, investors want access, and even friends may grow reluctant to challenge someone whose life increasingly rewards certainty.

A therapeutic relationship offers something unusual in that ecosystem: a sustained conversation with someone who has little interest in being promoted by you, funded by you, invited onto your board, or impressed by the size of your last transaction.

That matters because self-awareness becomes harder, rather than easier, when the world begins adjusting itself around you. 

The unaudited asset

Substantial evidence already shows that psychotherapy can improve functioning across relationships, work, and everyday life, although no responsible clinician would claim that therapy can manufacture wisdom, morality, or good judgment on demand.

A CEO can spend years in therapy and remain a terrible CEO. He may simply understand, with unprecedented clarity, why he is terrible. Still, even that is arguably an advance on the executive who mistakes every recurring interpersonal disaster for an inexplicable run of bad hires.

More importantly, therapy need not begin when something has gone wrong. We accept preventive logic everywhere else in corporate life without requiring catastrophe first. Boards conduct audits before the money disappears; companies run cybersecurity tests before the breach; executives undergo medical screenings before they collapse in a meeting.

Yet psychological examination retains the strange implication that one must first demonstrate damage. “I don’t need therapy; I’m fine” is an oddly low threshold for someone whose decisions can alter thousands of livelihoods.

Perhaps the better question is not whether you are coping with the job, but what the job lets you avoid examining. You can be highly functional and profoundly unreflective, build an enormous company while repeatedly failing at intimacy, command a room while being incapable of tolerating vulnerability, or read a balance sheet with forensic precision while remaining almost comically incurious about your own behaviour.

Success does not falsify these contradictions. Sometimes it subsidises them.

There is a final reason CEOs should consider therapy, and it has less to do with pathology than credibility. Corporate leaders now routinely encourage employees to discuss mental health, use counselling benefits, establish boundaries, and seek help before reaching crisis. 

Those messages become rather hollow when senior leadership continues to treat therapy as something for people who have failed to cope. Nothing requires the CEO to announce his sessions on LinkedIn or convert private vulnerability into another piece of personal branding. In fact, please do not.

Just go. Go because you occupy a position where your strengths are amplified, your weaknesses are insulated, and ordinary quirks can have extraordinary consequences. Go because companies already subject almost every valuable asset to periodic examination, and because there is something faintly absurd about auditing the organisation from top to bottom while leaving the person at the top entirely unaudited.

A good therapist will not tell you how to run your company. With some luck, however, they may help you understand the person who does.