In The Trenches: Interview with Dr. Eliana Cohen
4:51PM Jul 20, 2021
Dr. Cohen, welcome to the show.
Very nice to have you, we've got a lot of stuff to get into today. And I'm particularly interested to talk to you because this, in my opinion, is an aspect of entrepreneurship and leadership that is not talked about frequently enough, despite how many CEOs and entrepreneurs I know that that deal with some of the issues that we'll talk about today. So where I want to start is any commonalities that you see across entrepreneurs and CEOs. So you work with a large number of entrepreneurs and CEOs in a clinical setting. I'm curious if we as a group tend to present any similarities. So what I mean by that, you know, similarities in personalities, maybe the worries that we have, the burdens that we bear, some of the self talk that we have. Any similarities across entrepreneurs and CEOs that you see at kind of a general level?
Yes, absolutely. And I mean, it's not just me, but there's been research that Gallup did. I don't know if you're familiar with it, but Gallup has a whole study where they look specifically at the personalities, strengths and weaknesses of entrepreneurs and CEOs. And they're exactly the same. Right? So what makes a successful CEO is what makes a successful entrepreneur and vice versa. Right, just as like, you know, what makes it you know, if you have a weakness in any one of those areas, but they have identified, I think, nine personality traits that are common to (I think there are nine), but it's Gallup Strengths Finder, if anyone's interested. And so there is definitely lots of evidence that it's the same personality style and the same concerns.
I mean, we don't have to get into all nine, but what are some of the more common ones that you've seen in your practice?
Well, I mean, it ranges right. So for instance, they look at, if I'm just going with a Gallup study, you know, they look at things like, you know, emphasis on the bottom line, right, so let's say, you know, being financially focused, and, you know, most successful entrepreneurs are and most CEOs are, right? They also look at how much you delegate, for instance. And so again, any of those strengths can be strengths or weaknesses, right? But typically, you want to look at someone who is aware of the bottom line, who's creative, who thinks large scale, but can also look at details who can also delegate. And you know, there can be strengths or weaknesses, any one of those, right, so let's say you find an entrepreneur or CEO who's not so good at delegating, then, you know, they run into some sets of problems right there. And then you see the other extreme, you know, like, pretty much was my case, like delegating too much. And that can happen as well. Right? So those are some of the things that you see, like, just in terms of how it's, but that part is very much focused on the work piece, right. In terms of their personal lives, if you're asking me what the similarities are, well, it's usually people who are very focused on work. And then, you know, there's some of the pathology that emerges, or the symptoms that emerge emerge as a result of that.
What are some of those symptoms?
Well, it's just kind of people who are one pointed attention to their businesses, right, or to their careers. And, you know, inevitably, if you focus on one thing, the other things do go right. So you find that there's more social isolation, more difficulties in the relationship lives, more substance abuse, it just any of the symptoms of lack of balance that you could imagine, right?
Because it requires it, you know, like anything, a project like that a position of CEO or position or having your own business requires like that you could have focus on that. And that alone, at the moment comes at the expense of a lot of other things.
When you talk about those other things that kind of fall by the wayside. You mentioned their relationships, social isolation. What are some of the most common ones that you've seen with with your clients? Are those the ones or are there others?
Those are the ones. So, marital issues, parenting issues, substance abuse, social isolation is huge. The more successful you are, the more likely you are to be quite socially isolated.
In your experience, what you know roughly what percentage doesn't have to be a numerical answer necessarily, but what percentage of entrepreneurs and CEOs experience any one of either burnout or anxiety or depression?
I think I think the right answer to that. And of course, I don't have numbers, but I think that everyone experiences at one point or experiences at one point or another right? And of their careers. So that's likely to happen at any point, like, I just don't know that there is anyone that does have a business, or is the CEO and has gone through no periods of that, sometimes their extended periods, entire decades. Right. So I think it's just inherent to the role to tell you the truth. And yeah, there is a difference between depression and burnout, or anxiety and burnout, those two things are different, but they're not that easy to distinguish outside the clinical setting.
So one of the things that that I want to get into is anxiety as a clinical diagnosis versus anxiety as a kind of normal everyday human emotion that's just part of the human condition. So if a CEO or a business owner is in a place where he or she is feeling anxious, how do they know whether this is regula anxiety, that's just part of being human being versus anxiety that requires some sort of treatment? Be it inpatient treatment with a therapist? And or, you know, some sort of further medical treatment? How do you know kind of where on that anxiety spectrum you reside?
I think you know, in one of the criteria in psychiatric categories is really how much of your life is interfered by it? Right. So how much of your life is impaired? So if there is any, the wording we use is any clinical or significant impairment in personal or career life? Right? So it really is, you know, it seems really, it's really simple in a way, like, it's depends on the level of discomfort that you're experiencing, and whether or not that's running interference in your ability to work, your ability to think clearly or in your ability to relate to people. Right. So because as you say, very well, like, you know, now, it's a funny thing, you know, there's more of an openness to having a quote unquote, mental health issue. Right. And so people will immediately label themselves with anxiety as if it's a condition, it's not always a condition, it's, as you say, very frequently just part of life. Right. But if the person is already experiencing a level of anxiety that interferes with their ability to show up at work, or to make decisions, or they start to panic at every decision, or they have trouble with decision making, that's a good one, you know, that's a very good, very important one. Like, if you get so anxious that your decision making starts to be impaired, or your sleep starts to be impaired, or you just are not deriving any joy from life, then you start to wonder what's going on. Right? So a good time to seek help is when you start to feel all those any and all of those symptoms, or just even the perception of chaos. Right? The reality is that happiness and a good quality of life does depend on a sense of calm. And when you have that many balls in the air, you could enter into a state of feeling like everything's chaotic. Right, so I got a feeling of I can run my life, my life is much bigger than me.
I mean, one thing that you said that was, I think, really important to underline is that of the entrepreneurs and CEOs that you've dealt with, over your many years in the field, you know, essentially 100% of them at some point in their career do deal with something to the effect of anxiety, burnout or depression. And I think that's, that's something that I want to underline only to, you know, normalize it and help entrepreneurs and CEOs out there that might be going through something like that, know, that there's something inherently wrong with them or something is, you know, they're experiencing something particularly unique. I think the fact that, you know, nearly 100% of folks in this group who have decided to take their career in this direction will experience that at some point. I just think it's, that's, that's a fascinating point.
Yeah, that is absolutely of great importance. Because, you know, in a way, you know, we all live within the same 24 hours, right? And so if you think about it, as you know, there's certain roles in life that require all to almost all 24 hours of it, you are going to throw something out of balance, right? And it's, that level of responsibility doesn't come easy. You're a human being and as such you will have anxiety and some trouble kind of keeping yourself centered if you're taking on that much right. So that's just part of being human, and it is smart to seek help, of course, right? Because that's the first thing I tend to explain to this population is that your career and your mental health are not two separate things, your business and your mental health are not two separate things. They're the same exact thing. Because if you go down, the entire business tends to go down. Frequently, you know, of course, there's all kinds of good biggest business practices that you can put in place to make sure that your business can run without you. But, you know, frequently they don't, you know, many entrepreneurs and many CEOs tend to carry a lot of it themselves.
Do you see any common habits or self talk, or mental models that are ultimately unhealthy for entrepreneurs and CEOs? So I'll give you a couple examples. What I mean, so for me, my ambition led to not enough work-life balance, my focus on achievement manifested in such a way that when I went through a week or a month, where I didn't achieve something, I really felt quite upset about it at either conscious or subconscious level. You know, the fact that I was leading an organization, I thought I had to be strong for everybody. So it's very unwilling to appear vulnerable, things like that, like, yeah, are there any kind of self imposed ideals or self talk or practices that entrepreneurs tend to possess that are ultimately unhealthy or counterproductive?
Yes, and that's exactly you just pointed out, one of the bigger ones they can sense of having to be absolutely perfect, and not show any vulnerability that's very common as people go up in their career, right. So the more the more visible you are, in your leadership, the more people will get into a type of perfectionism that doesn't let them breathe, right? So let's say, think about it this way, in performance psychology, we tend to say, learn to fail or fail to learn, right. That if you think of a good life, being a life where you're allowed to fail, in hopefully minor ways, but as you learn, right, and you taking risks, strategic risks that teach you lots, right, and what happens is as you go up, in let's say, the corporate ladder, the less risk you tend to take, because then you become, you know, just very aware of how visible you are. And so, that's the formula for stagnation. And, you know, people that aspire to these positions aspire to these positions, because they're typically very, very bright and capable of these things. And it's a shame to think that sometimes, just because they become very visible and very self conscious around that visibility, they're not going to have the freedom to think as freely. And make decisions that are maybe less popular for instance, right. So there is definitely a self consciousness that can occur. And call it self consciousness or image management or call it perfectionism, which, of course, coincides with tremendous levels of anxiety. Right? So that personality trait, which perfectionism is the inability to tolerate failure, or the risk of failure. That's what that is, right? So people don't know, really, they think that perfectionism is to have everything perfect, but it's not really the real issue of perfectionism is a real dread of any failure.
Yeah, that's so important. Because right before I became an entrepreneur, you know, over a decade ago now, I would absolutely describe myself as a perfectionist. And what I didn't realize, before I'd ever run a business and led groups of people is that running a business is effectively a never ending set of problems that you're tasked with solving. And with someone, you know, one of the things that I blogged about a while ago was, as somebody who had, you know, kind of quite objectively never really experienced a material professional failure in my life, I found that my fear of failure was much, much higher than I think it otherwise would have been. So I think it's interesting to contrast the idea that entrepreneurs and CEOs tend to be perfectionists, and yet their role is such that they are in completely imperfect environments. That's what running a business is.
Right. Like running a family, you know, like it's a it's a live thing. Right? So it's always going to be glitching. Right, like it's a it's a human, you know, I mean, it's a live organism, business, in a way right? Absolutely. And, and you know, there's a great book, if your audience is interested, on the lack of development that occurs as people move up the corporate ladder, and you know, that applies again to CEOs, but it also applies to entrepreneurs. The book is called Black Box Thinking. And it really looks at how people start to stagnate because of this fear of making a mistake, right? And it's so limiting, not to mention, the anxiety that it creates. And many, like you, will have been a perfectionist and been successful at avoiding failure, right? So sometimes they actually believe and frequently if you're asking me about what is the common theme, most people once they get up to a certain level of success, they believe that their perfectionism is what got them there. And it becomes really quite dysfunctional, because it's not the perfectionism that got them there. And it is, in fact, the perfectionism that is interfering with their ability to carry that responsibility with some grace.
You mentioned earlier, the likelihood or propensity of CEOs and entrepreneurs to experience burnout or anxiety at some point in their in their careers. So I was diagnosed with burnout a number of years ago, and when I shared it with my family and friends, that their response was "Oh, so that means you're tired, right?". And what I had to explain to them is that burnout is different from simply being tired. So how does an entrepreneur CEO know whether they're simply tired, which of course is naturally part of the job, or whether they are actually burnt out? Like how do you? How does one know if they're burnt out, versus, again, just experiencing a normal human emotion of fatigue?
It's not easy, right? Like, it's really not a very easy differentiation. But I usually tend to lean on the side of burnout when the primary feature tends to be a lack of interest in your own stuff, right. So we're the one thing that made you feel really passionate and engaged, suddenly starts to feel really dull, right? Like it's, it's lacking its luster, you're not excited, you're not looking forward to the next stage, you're not invested in the same way, you're going on automatic pilot. It's that kind of disengagement, like a flatness that occurs, if you're depressed, and you're looking at slightly different symptoms, because you might also not have a sense of passion and enjoyment, but you would have other symptoms like sleep deprivation, like insomnia, changes in your appetite, hopelessness, helplessness, it has like a different quality. Whether or not you'll end up in burnout or in depression really depends on your nervous system, like, there's nothing you can do it just your body will pick itself, right? Like, it's, it's not, it doesn't depend on how strong you are, it doesn't depend on anything, it's just your nervous system might be more wired to produce a depression, or to go towards burnout.
So, knowing that entrepreneurs and CEOs have, in many ways, kind of the weight of the world on their shoulders, what are some practical strategies, practices, or tools that they can use either to prevent burnout from happening? Or let's say, if they're burnt out, to maybe mitigate its effects? What would you recommend to someone trying to prevent burnout or someone who has burnout and wants to address it in a healthy way?
Right, so you've touched on the the fact that this is a mental health issue. So I think the very first thing is to have a space to really look at what's going on with you. So, I'm not advertising at all, but the reality is that you should get a therapist who's knowledgeable. Who knows what, what they're doing in this area. Because, you know, part of the problem is that when you're carrying all that responsibility, you can't really see things objectively. And, you know, none of us really see ourselves as clearly as we could, right so it's really important to lean on someone. And the therapist isn't going to fix everything, but the therapist can act as a good mirror, like an accurate mirror as to where you're standing in that entire range. So as you said, you know, you don't frequently you won't even know how far gone you are. So it's a good idea to have someone who sees this every day. Tell you, well, you look like you're at this stage. And this stage is a matter of speaking, it's just the language thing, but you know, if I'm standing in front of someone after all these years, especially now on Zoom, it's interesting, I'm really not looking at the person, I'm looking at their nervous system. And if I see a level of agitation that even if the person doesn't report feeling anxious, it's really easy to tell from outside, how far gone they are. Like, are they enduring a level of stress that they shouldn't be enduring? And so then we're looking at solutions that range the entire thing, right? Like you're looking at how is their business structured? So there is an element of strategy. What is going on in the business that is driving them, creating the lack of balance? So in one case, I recall one of the women I worked with, I think I might have mentioned her at one point, but she had a tremendously successful business. She's a woman who was probably early 60s, late 50s. But her business had been so successful that all her kids had developed businesses around hers. And it was a family business was just incredibly successful. And, you know, she had no one to lean on. She had raised her kids to enter the business and help, and this kind of belongs to the family. Very common in family businesses. Right? Doesn't matter how big or small, right? Because there's, you know, there's huge businesses, that are family businesses. And there's was no succession plan, right, there was the kids had invested themselves in other things. There were interpersonal problems with the Father, her husband was not very helpful at the business, the kids avoided working with the Dad. So basically an issue around the logistics of the business where everything kept falling back on her shoulders. The nature of the business was such that she really couldn't involve people from outside her family, because...Well, I just can't tell so much, because I have to be careful about not disclosing, you know, I mean, but it was the type of business, I guess you'll have to take my word for it. But it's the type of business where you don't want to involve anyone, that is not family, right? Because it's very hard to monitor what will happen, right? She could lose 1000s and 1000s of dollars. Anyway. So that would be a situation where first we had to look at what was going on in the family dynamics, and what she would need to put in place so that she could take a holiday. Or she could take, you know, a year off when she wanted. So first we were looking at that. But then that led to looking at what were the family dynamics and the trouble in relating with the kids and the trouble in the marriage that was embedded in the entire business. And so how does that happen, it is interesting to look at that. Entrepreneurs will typically be people who can take on a lot. Inevitably they keep growing and growing and growing. And if there's someone who's not that confident, they take it on themselves, right? They they know they can do 10 times the work of other people. And they end up doing it if they're not careful. So you're looking at the entire thing. So you're looking at relationships, and what needs to change there, you're looking in the cases of businesses, succession planning, you're looking at the family dynamics, and you're also looking at their personality traits as to whether or not they're capable of giving themselves a break. So those are all part of the treatment process. So both diagnostics, where are you at? Are you enjoying your life, and what is interfering with your ability to set up the business in such a way that it can run a little bit without you.
So in each blog post that I've posted thus far, there's there's typically links to a bunch of external resources. And one of the things that I found incredibly interesting is of the dozens of links that I've posted, by far the most clicked on link by a factor of 5x is an article that I posted entitled "Overcoming Imposter Syndrome". So clearly, people are interested in this thing called imposter syndrome. So can you tell us what is impostor syndrome? And why do you think it's so common among entrepreneurs and CEOs?
You know, it's not really a diagnostic category, but I know what you're talking about.
The way that it was described to me was, you know, feelings of self doubt, despite external evidence of success, right? Even though you're successful, you still doubt yourself and you feel like an imposter, right? Almost as name implies. Why do you think entrepreneurs feel that so frequently?
I just think that typically their personalities are perfectionistic. Right. So we go back to that their personalities don't tolerate their own flaws very well. Right. So there's always like a bit of, there's a huge gap between the role they inhabit in the world, right, with those around them, and their own sense of self. Right. And that's, you know, probably imposter syndrome, if you, you know, looked at it scientifically, would be a big gap between the social image that they're projecting, and how they feel within themselves. And so that brings us to the other topic of things that, you know, we do a lot in, in therapy is, you know, I teach people to meditate, right? So, you know, meditation is about learning to not have, it's not so much about having a better self image, it's about not having one. Not being restricted by "I am this person", right, just being a little bit more in flow, if you think about it, the times that you're most happy are the times that you don't think of yourself as anything. Not good, not bad, you're just not there in flow when you're in flow. So it's a little bit of this kind of undoing, just getting first the self image to catch up to what's going on, the reality outside, which is, you know, good news altogether. And then learning to not really care so much about how you're perceived.
I've found that the the higher that one goes, whether it be academically, professionally, whatever the case may be. I can't say this clinically, because this is not my area of expertise. But anecdotally, I can at least say that the higher one goes, the more likely it is that not just you're going to feel imposter syndrome, but everyone around you is probably going to feel it. And anecdotally, you know, I point to my years at Harvard, where we would have a joke among, you know, almost all the students, we would all joke that we thought that we were the admissions mistake, right. So when the admissions committee read our application, somehow, some way we snuck in, because none of us felt like we deserved to go there. And at the time, you know, we said it in kind of a humorous way. But what we were really admitting to each other is we were all experiencing imposter syndrome. Because when you get to a certain point, you know, certain levels just become unfathomable. And they're not necessarily consistent with the way that you think of yourself, right? Everyone thought that they were the dumbest person in the class, right? And that that, of course, can't be true. So it's the same thing when you become a CEO, and you are responsible for you know, 10, 20, 50, 100 people. And so one of the one of the practical tools that that I was told, I can't remember by whom, but they said, If you find yourself in an environment where you feel imposter syndrome, just know that it is very likely that all of your peers in that room are feeling the exact same thing. And just just reminding myself of that, when I go to conferences, or CEO events, I find that very comforting.
Nice, nice. There's that of course, you know, Misery does love company. Yeah, no, for sure. So first of all, you reach a level of success that you could have never imagined. Right. And so that throws you off. And so I do think at some level, that there's a self consciousness that we're discussing, right, which is the imposter syndrome. And when, if you think about it, the imposter syndrome is always when you're looking at yourself from outside. Right? You're looking at yourself from the eyes of others. Right? So also, you know, kind of learning to not watch yourself from outside to not compare yourself to not engage in social comparisons. In a way, what I'm saying is that your once you achieve a level of success, it's important to retain a sense of not taking yourself so seriously. Because if you do, then you're really going to get yourself really self conscious. And that's where the imposter syndrome is most active.
Let's let's talk about loneliness. Because I can say from firsthand experience, that being a CEO is a very lonely position. So for me, you know, if I had worries, I wouldn't share them with my employees because I thought that I would scare them off. I wouldn't share my worries with my board of directors because I didn't want to appear incompetent, right? They were my boss. If I tried to share feelings with my spouse, you know, I'd worry that maybe she just wouldn't understand because she's never been a CEO. So what advice do you have for entrepreneurs and CEOs who feel lonely, who feel like, you know, they don't really have an audience who can understand what they're going through for some of the reasons that I just said.
I think that, you know, there's two things one, and I think Ray Dalio mentions a version of this, but one is unrelated, slightly unrelated to what you're saying. And it's about having relationships that are not related to your business, right? So having relationships outside work, where you're not a CEO, right? I that's I think of our utmost importance, you know, to keep yourself healthy, that you're not always in a position of authority. And you're with people who really don't really care that you're a CEO, right. So that's, you know, to keep you real, right. That would be the first thing like to and also not to mention that, you know, we know that the more exposure, you have to different ways of thinking, you get out of the office where everybody says yes to you, right, and you get a much clearer sense of who you are, right? Like, you come back to some relationship dynamics, that might be more helpful. So that's one angle. And of course, you know, the next step is to really kind of create space for yourself first, right? So it's ironic, but you're lonely, in part, because you're not in touch with yourself. So I would say, first is the work to really be in touch with yourself and to be better company to yourself, right, to be able to be at ease within yourself. And then of course, you know, part of it is to plug into the wider world, whether it's through a cause, or if it's, you know, to do with your family, or as I said, you know, exploring friendships and relationships, where you're not in the role of being the boss. Right. But that only happens once you really are ready to like Lift your head and change things.
Well, that's exactly right. One of the mistakes that I made that ultimately led to my my diagnosis of depression at the time, was I realized, and I'm sure many CEOs can can empathize with this, I realized that I'd spent upwards of 10 years putting everybody's interests above my own. My employees, my shareholders, my investors, my family. Everybody, except me, always won the battle for my attention, and my awareness and my sincerity. And when I talk to CEOs about it now, and I talk to them about rituals that work for me things like exercising, meditation, journaling, they often say to me, Well, I don't have time to do that, or I can't afford to do that. And my response to them is you can't afford not to, because at some point that's going to come bite you.
Of course. Exactly. Exactly. Exactly. And you know, it's the sad state of affairs, if you've designed a life for yourself, where you can take one or two hours for yourself.
So let's talk about that a little bit more. Because what I found, I guess, part of the natural human condition is, people tend to be harder on themselves than they would be on other people in the exact same situation. So for example, if I made a bad decision at work, but it was a complicated decision, you know, I'd beat myself up, I'd say I'm, you know, I'm an idiot, I don't know what I'm doing. And yet, if my wife were in the exact same situation, I would be more understanding, I would say, Hey, this is really complicated. I'd say, Hey, this is how you learn. So why are we so much harder on ourselves than we would be on others? And is there anything that we can do to kind of, you know, prevent this? Prevent ourselves from doing that?
Yeah, I mean, that's part of the coaching, right? That I was referring to, in therapy that you really kind of examine your relationship to failure. Right? Right. So you It takes it takes some training, there's no doubt to realize that you to really, really give yourself permission to not do things perfectly. Right? So to really kind of treat yourself the way you would treat others. That takes lots of training, but it is absolutely important to be able to see objectively, do I deserve that level of punishment because that's what happens is that you're punishing yourself. And frequently people just depending on how bad they are at it, this kind of self critical voice, They really can put themselves through all kinds of terror. Right? So, you know, I'm thinking about, I know that guy who has to do a big presentation in front of the entire company, and they make a slight mistake, or their words don't come out just perfect. And then they spend an entire week beating themselves up. Right and there is such inefficiency in that if you think about it, right.
Yeah, I think we I mean, as you correctly point out, this isn't something that you can change overnight, it takes a lot of practice
Yeah. Because it's, it's intrinsic to your personality, right. And as I was saying, some people really even think they credit that kind of attitude, the self criticalness, with their achievements. So it takes a lot of examining, and a lot of resistance that comes in at that point, because some people are like, Yeah, I know, I could let go of the self criticism. But this is what got me here.
Right, right, right. Something that I've come to realize is that absolutely everything has a price, whether perfectionism or a high degree of focus on achievement. If you think that's what got you to where it is, where you currently are, in part, maybe it did. But you have to ask yourself, what is the price of that over focus on achievement? What is the price of perfectionism, what is the price of no work life balance, and in my experience, simply being aware, or at least more aware of what the price of those things are, at least in my case, opened my eyes to the fact that, hey, you know, achievement is not free. Working hard is not free, perfectionism is not free,
And that in that not every category in life, the thing is, requires to be exceptional, you know, like, so in some things in psychology, we want to be average, you want to have average levels of anxiety, average levels of depression, a relatively average marriage, you know, that's already an achievement. That's really, you know, I mean, like, is not a bad thing, when it comes to mental health, you don't want to be when it comes to any physical feature, you don't want to have really high cholesterol or really low cholesterol. And so in some areas of life, the same framework that you've used, that we use for achievement is no longer valid. You know, having kids that are sort of average in their mental health, you know, average in terms of their level of attachment to you, is probably very healthy. You don't want a kid who's so attached, and you don't want a kid who's so detached. So do you know what I mean? So that kind of, there's also a phobia of being average that happens in high achievers,
If we get more tactical, let's talk about, you know, rituals, or practices or tools that you find helpful. So for me, some of the things that I've done that I found very helpful daily meditation, journaling, vigorous physical exercise. These are, for example, these are the kind of three tools if you will, that I've used that have really helped me work through my anxiety, when you deal with entrepreneurs and CEOs who are dealing with burnout or anxiety or anything like that, are there any kind of practical tools like that, that you tend to recommend more often than not?
Absolutely. So the meditation becomes a very big one, right? I don't know that there's any athletes who's a high achieving and, or any CEO, really, that is healthy, that is not meditating, you know, there's just no other angle, given the lifestyles that we lead. And with meditation, there's something really important in that is that there is a dose response. So if you meditate 10 minutes is not the same that if you meditate 15 minutes or 20 minutes or half an hour, right? So I would imagine, I don't know what Steve Jobs was doing, but I think the likes of Steve Jobs, who, for instance, took that very seriously. They're probably meditating an hour an hour, or an hour and 15 minutes a day. Right? So it's a lifelong journey. So something you sort of track you pick up. So if you're serious about meditation, I would always tell people, you know, it's great that you're doing calm and you're doing all these apps, that's fabulous. But more formal training and getting a therapist or a meditation coach, to make sure that you actually getting as much of it as you as much benefit from it as you can is really essential, because it's a wonderful tool, but it's a tool that requires a real investment. And that's when it starts to really shine and you know, you start getting rid of your ego, which is a way of getting rid of imposter syndrome in a way, you know, because it's not about having a, you know, imposter syndrome, it really is an ego thing. So you started transcending some of the nonsense, the difficulties with failure, all that. So you can, I tend to do that in conjunction with therapy. And then in therapy, you know, it's usually people that come to see me every two weeks, every three weeks, more as a consultant, so when it comes to performance psychology, we're more consultants than we are therapists. Right. So that would be part of it, of course, physical activity is important, but I think the the act of creating space for yourself, right. So I don't know if that was the case with you. But for me, for instance, once I started making room with my practice, I have room, I just, you know, I couldn't get enough of it, you know, sort of like, now I made room for meditation, and I made room for workouts, and so, you know, then you naturally start to make room for classes that you want to take on meditation or hobbies. And so you start to kind of notice the worlds and and come to an end, if I devote some time to myself. And so when you get a taste for that, and it's not a chore, it's not a, I meditate, because everybody else meditates, I meditate because I truly enjoy being in touch with myself. You know, it takes, of course, a little bit of time to get there. But then it just, I think what ends up happening is that things start to flow a lot easier, and you stop doing things that violate, you know, your balance. So it is a very significant tool, but only when taken all the way to a real, you know, that, you know only will use full depth and not as something that you pick up casually.
So my, my observation of entrepreneurs and CEOs is that there's an interesting kind of paradox. And I know I fell victim to this. So it's this concept of, if you were to ask the average CEO, what her values are, she would say, most likely Family First, you know, health second, work third. And yet, if you were to observe that person, chances are her behaviors would suggest she values work first. You know, money second, and then family and health tied for third. So why do you think that, you know, high achievers, like entrepreneurs and CEOs, why do we tend to live in a way that is not in accordance with our stated values? And is there any way, any tools or strategies or moments of awareness that we should familiarize ourselves with to kind of get us closer to living in accordance with at least our stated values?
I mean, I think that some of it is developmental, right, like, so it's not unusual for like, as you're starting your career to have only the value of achievement be the primary thing, right? And then once you do achieve a bit, or you're achieving enough, then usually what happens is that people transition into opening that up. And yes, frequently in entrepreneurs who've kept growing and growing, they've only valued growth. So I think that, you know, it stands a better chance, I don't know, like, Is there any method to do it? Well, it's the method of becoming more human and more mature, right? But that requires that you be as shown developmental stage where you have to lift your gaze and notice what else is going on. And often do I get entrepreneurs coming to ask me are CEOs coming to ask me about this? No, usually they come to me once the wife, let's say, if it's the wife, or the husband puts their foot down and says, You know, I am done. Yeah. Right. So it's really rare for someone to really say, you know, listen, I'm obsessed with achievements, I have lived my entire life, and that my entire self esteem depends on what I achieve and what I get done. And I'm starting to notice that, you know, in order to have a deeper and more meaningful life, I should probably look at other things, right? Like, but that happens. I occasionally get someone one or two people asking me this upfront. But frequently, it's the wife who says, you know, I'm actually done. You haven't seen your kids in the last 15 years.
You know what, that's really interesting. I think it goes back to your earlier point of, you know, as human beings, it's simply harder to evaluate ourselves in a lot of ways. So one practical tool that, I haven't done this, I should disclose, but I do know another fellow CEO who does do this, him and his wife, once, with a regular cadence, let's just say it's once a month, his wife gives him a kind of proverbial report card on, am I living in accordance with my stated values. So he's going as far as writing down his his core values. Every month, he asks his wife to evaluate him on the extent to which he's living his values. And I thought that was really interesting, because, you know, if someone's going to have a view into this, you know, your spouse who sees you every day, probably a reasonable person to have a more objective view on that than yourself. Because I think it's to your point, it's, it's very hard to evaluate yourself along these, these bases.
Absolutely, absolutely. And it's just, I don't know who it was. But I think that I read somewhere. And I always think about this, because of the fact that, you know, the most successful CEOs are the ones that actually take their marriage with the same level of attention and strategic attention as they would with with a business. Right, right. Because they know that if they don't devote that kind of attention to their marriage, the marriage is done.
The other thing that's interesting is, if you don't have a set of values, either written down on paper, or at least at the very least in your head, then how are you ever going to know if you're living in accordance with them? One of the things that I've learned through working through depression and anxiety as a CEO and entrepreneur is this concept of being deliberate, which is if you just let life happen to you, you're not really in the driver's seat, you're just kind of in the passenger seat, and you become a victim to just the set of circumstances that happen to present themselves in your life at any given moment. But if you're, if you're deliberate enough to say, Hey, here's what I value. And I'm going to kind of have regular check ins to see if I'm living in accordance with those values, then all of a sudden, you know, you're not a passenger anymore, you're in the driver's seat. And you can you can make changes if you need to. So I think what's important there is for people who might be kind of either consciously or subconsciously wrestling with this idea of Well, hey, am I am I living the way that I really want to live? You know, if you if you don't have your values written down, you're you're driving without a map.
Absolutely, yeah. No, I'm with you. Absolutely. And the people that can remind you, most clearly are the people that are not on your payroll, you know, ask your children, your kids will tell you. Yeah, you know, I'm I have I have been more patient, am I more present? Have I been more fun? Or am I again, in that kind of, because you know, that what happens is that they show up, you know, they're most people are depleted at the level of when they're working that many hours, right? So they show up at home. And what they're bringing home isn't that great energy, or they are moody or so the kids or kids are perfect to tell you kids and pets will tell you what kind of energy you're bringing.
Let's get to this issue, because I know I certainly suffered from this. And I know a lot of others do, too. A lot of entrepreneurs and CEOs find that their own level of happiness is tied very closely to how the business is doing. So for example, if the business is having a good quarter, then they'll be happy. If the business is having a bad quarter, or is experiencing some sort of crisis, they'll be unhappy. And almost every entrepreneur I know, says, I want to find a way to separate my own personal sense of happiness and self worth from how my business is doing. How does one even go about starting to do that? Or is that even possible?
I think it is possible, actually. But I think it's possible along the lines of what I was saying to you that it's a very long journey to get to the point where your ego is not involved, and you're not walking around being a CEO all the time. Right. So if you have a very well developed sense of yourself outside of that social identity, and you're living from there, then your job is just one more role. And it's a job, you know what I mean? And so it's like, like I was saying, you know, not taking yourself so seriously, right so that you do have a very clear sense of what, maybe put it this way, a definition of success. That is that required that includes How am I living my life, whatever is designed for life for myself, right? And so you're if you're invested in all other aspects of your life, then you know, the the stuff that happens at work can go up and down and doesn't define every piece of you. And so that's what I mean by like this, you can turn you can put on your social role, and then take it off at the end of the day. Right? Right. Like, you know, I follow this Yogi who says, you know, if you shouldn't have an identity, when you're sitting in the sofa in your house, you know, identity, you should check it at the door, right? So when, when you're living from that place, it's much easier to, to have that kind of balance, where, you know, you're not defined by not just a few things going bad at work, but you're just not defined by things going good or bad. More of a time, of course. So is it easy? No. Is it possible? Yes. But it does require that kind of psychosocial development of your personality, where you really have gotten much more mature, you know,
One thing that I also struggled with, so it's interesting that you mentioned the Strengths Finder tool, I'll post a link in the show notes for for people who are interested, I did that and I actually made my whole management team do that, which was a great exercise. My, my dominant personality trait was an achiever. And I mentioned that only because I suspect many other entrepreneurs and CEOs are also achievers as their dominant personality trait. When running a business, the challenge that that creates, is sometimes there are days or weeks, sometimes even months, where you as the CEO, you don't feel like you've achieved anything. In fact, sometimes there are days, weeks or months where you feel like you're moving backwards. And though that might not sound like a big deal to some people, for achievers, that's a huge problem. Because, you know, we, I think I read that, consciously or otherwise, you need to feel a sense of achievement every day to feel happy. So what would you say to achievers like entrepreneurs and CEOs, when, you know, they go weeks or days or months without any meaningful achievements? How do we still kind of get the satisfaction and the chemicals that our brains need to maintain our sense of kind of balance and happiness?
You know, so it's interesting, because that touches on another topic that we haven't discussed yet. But I mean, the reality is that there's an element of addiction, right? Because being a workaholic, even if you're not successful, but being a workaholic, at any level, or and then by workaholic, I don't mean to be judgmental, it's just how much time let's just say working that hard, sort of labeling it as a negative thing. But there is an element of getting addicted to the achievement because that as you say, you know, you get a dopamine release from it. Right. So just like somebody else might be addicted to a substance, you know, you could be addicted to achieving. Yes, yeah. And so what you're saying to me is like, how do I if I don't get it here? Where do I get my drug? What I would say, Well, actually, you know, we need to look at not needing the drug. Right? It's not like, Where else can I find it? Because of course, you'll see this right, like, take a break from the business, and then you become the top marathon runner. Yes, and that's fine. You know, there's nothing wrong with that with getting some athletic achievements under your belts. But if the only thing that brings you happiness is achievement, by the time you hit your 50s or 60s, that game is done. Right or should be done. And there should be something else emerging, you know. So it's, it's about learning to find joy in different ways, and getting unhooked from that kind of addictive quality that it can have, right?
And I can already hear kind of the inner achiever in me saying, Okay, well, how do I get there?
Yeah, exactly. You're doing the same thing as my patients do. They're like, yeah, that's really interesting Dr. Coehn, and like, the analysis is great. But give me the action. It's like, wait a minute, the action is self discovery. That's the action. So there is that thing, so it's not about substituting but about diversifying. So having other sources of joy so that your only joy isn't all achievement at some point that needs to transition. Just another way of saying it is in performance psychology, we we talk about achieving success, but then sustaining success. And sustaining success requires a different set of skills. But frequently, what happens is if your hooked on achievement, sustaining success is not that interesting,
Well the other interesting thing about achievement is that, by its very nature, it's fleeting. And by that I mean, the second that we achieve our goal, instead of celebrating the achievement of the goal, we just move the goal line forward. So for example, if we've had a goal, I really want to hit $20 million of revenue, the moment you hit $20 million of revenue, you're gonna say, Well, now I want to hit $50 million of revenue. So achievement kind of feels like a bit of a hollow drug in that respect.
It is. Like all drugs, right? Like there is no No, no drug that isn't hollow. But yeah, absolutely. It's hollow, absolutely hollow. And so that's the thing where it doesn't matter what you achieve. If you are completely, you know, you we consider I consider it an addiction, because it's happiness that comes from the outside. And so in some ways, if the person doesn't develop the ability to have an intrinsic sense of self worth, and comfort, and joy in their life that isn't procured by money, success, or external variables, then you're always in that treadmill. So there is a need, I think, you know, the more successful you are to really then turn your attention to how do I design this successful life? Not a successful business. Now, they get in the way. And you know, of course, you know, it makes sense to have it be unbalanced for the first decade or two. But then, at some point, you need to turn your attention to what is the successful life what you call value, right? And can I design a life for myself that makes sense that makes me feel human and makes me feel alive, and purposeful, without necessarily running after just the dopamine high
So let's talk about ambition, because ambition... look, to be a successful entrepreneur or CEO, you as you know, you have to be ambitious, right, sometimes relentlessly ambitious. And I think that's pretty well understood. But as we've talked about, everything has a price. And there is a price to untethered, perhaps unhealthy levels of ambition. So how do people know... and this is borderline an unfair question... How do people know if their ambition is at a healthy level?
Yeah, I think it's outside, it's always outside, someone outside will tell you, right? If your relationships are suffering, like, again, it's about having a reality check, you know, because often, the more ambitious ones are in a bubble. So I mean, as you say, ambition is a trait in an entrepreneur and a CEO, but there's degrees of how lost you can be in there. And so, you know, the way I sense it in a session is if the person feels really uni-dimensional to me, like the only thing they know how to do. And so that they're, you know, okay, this person has been, like, just like an addiction can eat every other aspect of your personality. Like you just become a shell. In a similar way, the stress and the achievement and the dopamine release can be so so addictive, that you just become that. Right. And that's uni-dimensional. Because I mean, I don't know maybe the cases that come to mind that right now to me are people who just have no awareness. Right? So frequently, when you're that far gone into the ambition spectrum, and there's nothing else left, the person doesn't even have the awareness to know that there's another way to live. Right? Then there's also a bit of arrogance in and I'm doing this and this is what is done and I, you know, it's like I misunderstood no one else understands this. And so they're in a little bit of a bubble of their own world of achievement. Right? If you're only a type A personality, there's nothing else to your personality, something's gone wrong. Right.
So, you know, as human beings, we are wired the way that we are, and another kind of very human tendency is the tendency to compare ourselves to other people. And I find that almost inevitably, when you compare yourself to somebody else, you end up feeling inferior in some sort of way. And CEOs, they can compare themselves to their CEO peers, they can compare their companies, to their competitors. They can compare their employees to the the people that they brought in for interviews that didn't elect to work for them. So there are many sources of comparison. So, you know, why is it so common that we compare ourselves to other people? And is there anything that we can do to kind of mitigate the effects of us kind of constantly comparing ourselves to others? Or perhaps are there ways that we can kind of find ourselves doing it less frequently?
Yeah, I would just keep it as a structured exercise whenever you have to see where your company's placing, you know, and when you're trying to get a scorecard, and there's a purpose to the comparison, because you need to know what your competitors are doing? Fabulous. But if you're doing it as a way of living, no. So, as you say, social comparison is intrinsic to all of us. It's not a CEO thing, only. It's across the board. Why does it happen? It's an evolutionary trait. So what has been found is that within three seconds of standing next to someone else, you've already sized them up. Right? So we are wired to be comparing, I think, probably on an evolutionary basis, it's because of survival, right? Like you're just testing is the guy in the elevator going to kill me? Is he big enough? Right? Are they going to get robbed? Right? So we have that wired in. The reality is that comparing yourself to someone who's doing way better, you get depressed. If you compare yourself to someone who's doing worse than you, you feel guilty, so it really doesn't pay off. Right? So what is the strategy for that? nothing other than having the awareness and trying to very, very hard to disengage from all that. And, and, you know, there's social circles, where that is the norm. And like I said, it's, again, there's a social persona, when you go into those social circles, but having environments and situations and relationships where that doesn't play out. Right, there's that element. The other element is, you know, to get out of social comparison, ironically, a real good cure is to wish well on others. Look at the Buddhist angle, which is basically wishing others to do better and to be strong and to be healthy, and so on. And so we call it sympathetic joy, which is the ability to be happy for other people's successes. And yeah, I get that in the business sense, that's not gonna happen. But in general, exercising a bit of that tool that not your entire psychology is about winning and doing better than the one next to you.
Are there any signs or indicators, whether they're physical or psychological, any signs that people should look out for that might suggest that they're not taking adequate care of their mental health? So for example, in my experience, I found that I got sick a lot. Physically sick. I found, you know, feelings of almost being trapped, which is, you know, the company's doing fine, but am I gonna stay in here forever? I don't really see a way out.
I'm sorry to interrupt you. But that's the best one is when people start to wonder if they're trapped. And what's what's next? And how do I get out of this? Thats a huge transition point never to be ignored. Never. Because I find that either unconsciously or consciously right. But typically, it can even happen unconsciously. You don't listen to that. And they start burning down the company. So I have had a few people who were there had a fleeting thought about selling, didn't pay attention to how burned out they were, and then ended up sinking the company through mistakes because they were unconsciously trying to get out.
What other signs people look out for, physically or otherwise, that might suggest that they're not taking adequate care of their mental health?
But suppose sure that you're for sure if you're getting sick, or your sleep is amazing and telling you where you're at. Although there's some very good sleepers out there, not not many, right? So sleep will tell you if you're, something's off balance, that's the first thing that goes is your sleep will get more difficult. And then, like I said, just relationships and your general sense of joy. Like a good life is like that feels good. Period. There's no other category around that, you know?
Yeah, I found when I was, just before I was diagnosed with depression, sleep was something that was really bad for me. As well as lack of interest in the things that I used to find interesting,
Right, so and adonia, which is an inability to enjoy things that you previously enjoyed. Yeah. Right. So joy, like I was saying, Joy absolutely is a telltale sign, you will have a good life, if you are able to enjoy your life, not on the weekends, not the one time that you go skiing in the Alps, but like, you enjoy your life day in and day out. Right, that you're able to embody your life and feel good about it. So sense of joy, the sleep, as you say, helplessness, hopelessness is a very, very clear sign of depression. Trouble making decisions is a common sign of depression. Feeling down on yourself, like an increase in your self-critical voice, or an increase in worry in general. So those are all things that before you're actually kind of, like visibly symptomatic, should be warning signs. But you know, it's easy to miss them. So that's why I tend to think that the busier you are, the more important it is to have someone like an ally outside your environment that sees you once a month, who knows you and can pick it up, if you need a bit of support,
The other thing I'll just mention only because I'm picturing myself a year ago listening to this. And I would say, Oh, my God, I've gotten sick a couple of times, I must be depressed, and then my mind would start going absolutely crazy. You know, thinking about this self-diagnosis. The one thing I'll say is for for anybody who might be kind of have that strange feeling in the pit of your stomach while you're listening to this, either a mental health professional and/or your GP, you know, there is, you know, essentially correct me if I'm wrong, Dr. Cohen, but a checklist of sorts, criteria against which you can compare so you can get formally diagnosed, and just because you are one of these things, doesn't mean that you're clinically depressed.
Exactly. And you can get diagnosed formally. And then the other thing, I think, is that, again, people who tend to achieve at that level tend to be incredibly self reliant, right, and they have a lot of trouble, or we have a lot of trouble leaning on other people. Right? Right. So that's, that's another thing, you know, to really keep in mind, lean on someone outside of you, it's not a sign of weakness. And that person will help determine if there is a diagnosis. If you're off the rails, if you seem, you know, more unhappy than usual, more stress than usual, if your levels of sleep deprivation, or doubt, or self doubt are off the rails, like all those things are things that we are able to assess, of course, objectively with questionnaires, and just with clinical assessments.
So I've written about in a number of different cases, how my therapist who I've been seeing for, you know, three, four years now has been a really important tool in my toolkit as an entrepreneur and CEO. I know, you know, hundreds of entrepreneurs and CEOs, and at least 50% of them are seeing a therapist as a way to be kind of the best versions of themselves. But that means about 50% are not. So for the people that have never used one before. Let's get very tactical, I mean, how do you even find one? How do you go about finding a good one? And how do you know whether you need a therapist versus a psychologist versus a psychiatrist? Can we talk to people who have no experience in this domain?
Yeah, um, I would, I mean, this is, I guess, maybe my own bias, but you know, the levels of training for a psychotherapist, for instance, versus a psychologists are really, really different. Right. So you do want to go in my view, you want to go to a regulated professional, which is either I mean, psychotherapists are regulated at the moment, but they're the you know, the point of entry for psychotherapists is much, much lower. Right. So I would say probably psychologist or psychiatrist and then psychiatrists, usually in, in Canada, don't too much therapy. You know, most of them do mostly medication. All right. So that's more I would say you want to go to a psychologist and then seek the counsel of a psychiatrist if there's a need for meds.
How do you how do you find a good psychologist? Because I know when I was looking for one, rightly or wrongly, I just based off geographic proximity, because I had to narrow down the field somehow, because, you know, if I typed in psychologist and the city that I lived in, I mean, I get hundreds and hundreds of results. How does one differentiate between the hundreds of psychologists out there if you let's say, interview, three or four of them before you choose? Like, what should people look for?
It's funny, it's a, you're reminding me of this story that this Italian therapist talks about what she used to have her practice at the top of a mountain, you know, which was impossible to reach. And her angle was the opposite. It was like, the patient's value, what I can provide that, you know, she would have only very motivated patients and not ones according to location. So, I do think that I mean, its practicality to narrow it down. But I mean, at the moment, the good thing is that you don't need to limited by location, right? Because everybody's online. So I mean, I'm really enjoying that. Occasionally, you have the fantasy of finding a shrink for myself in England or something, you know. But the, you know, so how do you go about it, you know, the person has to sound like someone that you can respect. Like, that's the very first step like first qualifications, of course, you know, to see that they're, they have a PhD and that they're not like... my concern with psychotherapists is there may be some really good ones. But again, you know, may not be, it's not as easy to determine who will be good and who's educated enough. And then I will probably just really like, does this person sound like someone I can learn something from? That simple, you know, that I would. That's the way I would pick a therapist for myself. Like, I always tell people, I look through the eyes of any therapists for myself or for my kids, I can I look at the Yellow Pages, even I don't care because it's more the feel I get from them. And whether or not it feels like I'm learning something. It's like anything else in life right? There, it has to be someone who's ahead of you in some way. Right? Like, not in a power sense. But in the sense that, you know, you're not going to look down on their tools. And you actually think they're a person that has a level of wisdom in this area.
So respect and admiration for the toolkit that they can provide you with, I think, if you interview someone, and you're immediately skeptical, and you say, Oh, this is a bunch of, you know, soft baloney. I mean, I think right there.
Absolutely. And that that admiration that you have for your therapist, and the respect is really part of the healing, right, because, again, we were saying you know, it, these are personalities who don't know when to relax and lean on someone. So if you don't feel that your therapist is way smarter than you in this area, don't go to that therapist. Right, because you're not going to trust and if you don't trust, then the very first thing which was can you relax and let someone take care of you, once in a while, is already bypassed. Right? And, and, and that's already, you know, if you want to take the stress away from someone who's feeling their life is out of control, or has gotten too big for them, the very first thing is to have someone that they go to and just the presence of the other person feels trustworthy. Right? Like it's important, you know, that's what are you paying for, you're paying for someone who really feels like this person can has the shoulders to have, you know, broad enough shoulders to take this on with me. Right? So very much an emotional intellectual kind of compatibility needs to be there. And there's very intelligent therapists and some that you know, or not so much.
So, last question for you today, Dr. Cohen, for anybody who's interested in learning more about some of the topics that we discussed today. Are there any resources that they should check out? Are there books to read? Are there blogs to follow? Are there videos to watch? You know, we mentioned strengthsfinder as one.
Yeah, yeah, I would get I'll give you the two that I consider. We used to joke actually we used to give this away as part of the when people joined our Practice, and which I mean, I still kind of recommended, I just got out of the habit of gifting it. But there's two books that I used to joke that I joke are mandatory reading in my practice. So one is specifically on perfectionism. And it's by Tal Ben Shahar. He's a Harvard prof in psychology. And his course, at the time became so popular that he was sort of the most popular courses in psychology in the last century. Like it became like a rock concert scenario. And so Tal's book is called, it was rebranded and so it's now called being happy. But it really is a book about perfectionism. Right, so that's a great one. And it's a great, it's got practices, it explains perfectionism. He's absolutely fabulous at it, little book, but well worth it. The other one is the black box thinking book that I recommended earlier. And that is S-Y-E-D, the author, I don't even know that I know how to pronounce his last name. And blackbox thinking also, you know, I've had people take it to their companies and gift it all around, you know, because it was so meaningful, in terms of liberating you to think to allow yourself to think without feeling fear, the fear of failure, right? If you think about it, life should be about the adventure of creating and growing and so you really need to be able to wrap your head around failure. If you don't do that, it's much harder. Yeah, I think that would be it. Like I there's other stuff that of course, would be useful, but those are two very solid ways to start.
That's great in getting started is is half the battle. Dr. Cohen, very insightful discussion today. I thank you very much for your time. I really appreciate it and I know our listeners do as well.
Thank you. I had fun