The Psychological Needs of the Extremely Ambitious

Why we should all care more about founders than we do

The Pantheon ceiling in Rome. Credit: Matt Bateman

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 newwould 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.

Take, for example, the ambition to “make your venture-backed startup profitable”: to develop, market, and distribute a product or service that’s never existed before, in a form that’s valuable and accessible enough for large numbers of people to want to pay you for it, in sufficient quantity that your revenue consistently exceeds your costs. 

If you’ve never tried to do this, you probably under-appreciate just how psychologically demanding it is—in particular, how much fresh and unfettered thinking, win-win relationship building, emotional self-management, authentic conviction, earned self-trust, intellectual ambitiousness, and disciplined focus it requires. 

If you’re among the few who have, then you have some idea of what it takes—and you may now be facing the challenge of maintaining a strong company culture at scale, or deciding how to hand over the reins so you can move on without undoing everything you’ve done, or grappling with what to do next. 

You may also be dealing with one of the distinct (or at least distinct-looking) psychological problems that can afflict the extremely ambitious. Maybe it’s an over-reliance on gut hunches in contexts where they may be miscalibrated, or a mix of cynicism and insecurity about your ability to “get through” to others. 

This isn’t uncommon: Steve Jobs is one example of an ambitious builder who seemed to grapple with both problems. As I’ve described elsewhere:

“In the Becoming Jobs biography, for example, we see multiple instances in which the young Jobs gets frustrated with his team members’ performance and responds by shortchanging them the very resources and support they would need to improve their performance, thus further fueling his frustration and perpetuating the cycle. The underlying mindset, if I had to speculate based on similar patterns I’ve observed in my clients, might have amounted to something like 'people either get it or they don’t'—a kind of fixed mindset applied to the talents and capabilities of others.” 

Even if you don’t struggle with typical “pathologies of the ambitious,” you’ll need to pave new psychological trails to fit the technological, cultural, scientific, or artistic trails you’re blazing. I wrote about some of the distinct psychological needs I’ve observed in my most ambitious clients:

  • Beyond “setting more realistic goals,” my clients need help balancing wildly ambitious goals with honesty about the low probability of success.
  • Beyond “reappraising their catastrophic thoughts,” they need help recognizing when their “reappraisal” is just a rationalization of what is in fact a looming catastrophe that needs to be solved.
  • Beyond “taking other people’s perspectives,” they need help disconnecting long enough to work out their own.
  • Beyond “asserting themselves,” they need help seeking out relationships and communities that offer them closeness without assimilation.
  • Beyond “learning mindfulness skills to manage their stress,” they need help recognizing when they're using these skills as a procrastination tool.
  • Beyond “scheduling self care,” they need help powering through a week without rest for the sake of a valued endeavor.
  • Beyond identifying generic values to guide their choices, they may need help articulating a mission statement that captures their aspirations, while still allowing flexibility in execution.
  • Most of all, they need help developing the self-awareness and self-honesty to determine which skills they need when

There aren’t many psychological resources available for these needs. But this doesn’t mean you have to settle for misery and burnout or lower your ambitions. Rather, it means you need to articulate and advocate for your needs well, as well as be entrepreneurial (or, as Paul Graham would put it, relentlessly resourceful) about hunting down and bootstrapping the right resources. In addition to my own founder coaching practice and my newsletter, I also recommend Dr. Julie Gurner, Amy Buechler, and others working at the intersection of psychology and executive coaching.

A difference in emphasis: raising the floor versus raising the ceiling

Matt Clifford has written about how building a world-changing technology company has never been easier than it is today. But for all of the technical, commercial, and industry-specific knowledge that founders can readily access, psychological knowledge still lags behind. (In fact, Matt hired me to coach and consult founders at his organization Entrepreneur First; we've discussed it together.) Perhaps this is why the number of tech founders remains small, and the number who actually gain some traction—much less turn a profit—is even smaller

Most of my field (along with most of our social and ethical systems and institutions) is focused on “raising the floor” of human functioning: lifting more people out of depression, anxiety, and trauma, and up to the mean level of wellbeing, resilience, self-efficacy, or whatever outcomes we’re trying to optimize. The methods and metrics used by the vast majority of psychology research reflect this focus. 

These problems definitely need solving. But I believe “ceiling-raising” problems are just as important, far more likely to be neglected, and potentially the more fundamental of the two. 

Imagine how much more, better, and cheaper technology—including mental health and wellbeing-enhancing technology—would we all be enjoying today if more people had the psychological wherewithal to conceive and execute on ambitious ideas, and if they grew progressively happier, wiser, and more skillful at doing so?

How much more uplifting would our news cycles and social media feeds be if the world’s most influential builders—like Elon Musk, Peter Thiel, and Mark Zuckerberg—had the tools to up their psychological game? 

These are the kinds of problems I’m most excited to solve. As I wrote about in my piece about "psychological perfection," some founders are already there. But even these founders can’t always articulate what they’re doing differently.

I want to work with those people to understand what they’re doing and help them do it even better. And I want to work with the people who aren’t quite there but are aspiring to be (much like myself) to help them figure out how to climb to that higher level. As I work with both sets of people, I want to distill the principles that power that climb, and to ultimately use those principles to inspire and empower new heights of human thriving at scale. 

To the ambitious founders and innovators reading this: your psychological needs are formidable and real. You deserve better support than you’re likely getting, which is all the more reason to go and seek it out.

As for the rest of us: let’s not be too quick to deride or dismiss ambitious founders, especially when they act out or appear to be going off the rails. Let’s thank them for the trails they’re blazing, however unevenly, and recall that their endeavors raise the ceilings for our own.


Dr. Gena Gorlin is a Clinical Associate Professor of Psychology at the University of Texas at Austin. She is a licensed psychologist and founder coach specializing in the needs of ambitious people looking to build. This piece was originally published in her newsletter.



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Pedro Martins Dusso 3 months ago

WOW, just wow!

Georgia Patrick 3 months ago

Fascinating. Glad to see this level of awareness. Does your interest and practice stay in the lane for founders, who chose technology as business and achieved venture backing? Do you swim in other lanes, such as founders in other industries? Or founders with financial backing other than venture capital?

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