The Psychological Needs of the Extremely Ambitious

When I tell ambitious tech founders that I think they are an “underserved population,” I get an intense reaction: a mix of surprise at hearing me say it, and equally strong surprise at how much it resonates. 

Founders are striving to do something more innovative, uncertain, and psychologically demanding than most of us ever try to do—many with potentially large impacts on the world—and yet their distinct psychological needs have gone largely unstudied and unaddressed. And despite the many headlines signaling a “mental health crisis in startups,” with several high-profile suicides bringing attention to the generally high prevalence of mental health issues among entrepreneurs, most founders I speak with are somewhat stoically dismissive about their own struggles, saying things like, “This is my chosen burden,” and, “I’m so privileged, what do I really have to complain about?”

This paradox isn’t coming from nowhere. When mental health advocates speak of “underserved populations,” they usually mean those with socioeconomic or health-related disadvantages that make it difficult for them to access or afford care. To say that entrepreneurs are underserved—simply because they choose to work on something really hard and new—would probably raise some eyebrows. 

Besides, many of the high-performing founders I work with already have pretty good mental health. According to a conventional narrative within my field, these founders would fall squarely under the heading of the “worried well”—most of their needs have already been met. 

Many have access to at least adequate financial and social supports; they’ve developed the interpersonal skills to convince investors to give them money (and family members to give them some degree of patience); they’re able to manage their anxiety and motivation well enough to have worked in a relatively unstructured environment where they are the responsible party if anything goes wrong. They also tend to be resourceful, which means they are already familiar with the tools conferred by gold-standard psychotherapy and positive psychology approaches by the time they come to see me. 

What’s left for me to do other than redirect them to those tools and encourage them to make time for self care? If I wanted a real challenge, wouldn’t I be taking on clients who are struggling to stay alive and make ends meet?

The psychological needs of the ambitious

My experience has been the opposite: founders (and other ambitious, formidable creators) challenge me in ways no one else does. This isn’t because they struggle with a unique share of mental health issues; it’s because their ambitions demand levels of psychological competency beyond what the current gold-standard psychotherapy and positive psychology tools aim for.