In this episode: There’s still a stigma around therapy for entrepreneurs and executives, who feel they have to stay unbreakable for their families and their companies. Jon Peyton talks with Dr. Ryan Carboneau of Northern Virginia Therapeutic Services, a licensed therapist and fellow entrepreneur, about why it can be lonely at the top, how blind spots show up at work and at home, and when to consider talking to a therapist.
Key insights
- It’s lonely at the top. Leaders often have no one inside the company to talk to, and a therapist offers a confidential, judgment-free space.
- Many entrepreneurs are wired for the rush of the next sale or idea and may undervalue time spent on relationships.
- What looks like complacency may be boredom, or a sign that the next stage needs someone with different strengths.
- Lead by listening: find out what your family and employees need instead of giving them what you needed.
- Don’t wait until things break. Repeating the same problems across businesses or relationships is a good reason to talk to someone.
Episode timeline
- 0:47 Removing the stigma
- 3:17 Dr. Ryan’s story
- 8:16 Lonely at the top
- 10:09 “Gripes go up”
- 12:44 Chasing the next hit
- 17:14 Boredom, not complacency
- 21:56 When to see a therapist instead of a coach
- 24:05 How the past shapes how you lead
- 30:08 Start by listening
- 35:42 What therapy adds that a coach doesn’t
- 41:47 Cognitive distortions
- 50:10 There’s no right time, but there is a wrong one
- 53:09 Friends say yes; a therapist tells you the truth
- 1:02:11 How to find the right therapist
The episode in brief
Removing the stigma. Therapy, Dr. Ryan says, is a place to get things off your chest without being judged and to better understand where you stand and how to communicate with the people around you. Jon frames it as one more resource to delegate to, like hiring an HR manager or a financial analyst.
Lonely at the top. Many entrepreneurs keep a small inner circle because they don’t want employees who rely on them to see vulnerability. Dr. Ryan quotes Saving Private Ryan: “Gripes go up.” Managers take concerns to the people above them, but a CEO has nowhere further up to go. A therapist can be that person, without condemning you or labeling you for how you feel about people or situations.
Chasing the next hit. Jon revisits a Season 1 idea: many entrepreneurs chase the reward of the next sale, check or idea and get less of that rush from relationships. Dr. Ryan says that wiring is fine to accept, but it can create blind spots with a partner, kids or employees. He also reframes complacency as boredom. Sometimes you’re bored because the business has reached a stage that needs different skills, and bringing in someone who has them lets you focus on what you do best.
How the past shows up. Dr. Ryan explains how childhood experiences can shape how we lead. A child whose parent always pointed out what could have been better may grow up driven by never feeling good enough, and may pass that pressure on to their own kids or employees. The fix starts with listening: notice what each person actually needs instead of giving them what you needed. As Dr. Ryan puts it, leaders can only bring people to about the level they’ve reached themselves.
Coach or therapist? A performance coach helps you reach the next level in business. A therapist helps when you keep running into the same problems in yourself, your businesses or your relationships. Dr. Ryan introduces cognitive distortions, common thinking traps like catastrophizing, and asks new clients to identify the ones they struggle with, with help from a spouse or friend if needed. Friends and successful peers may tell you what you want to hear. A therapist is someone you pay to tell you the hard thing.
When to go. There’s no perfect time, but there is a wrong one: waiting until the wheels fall off, when a spouse wants out or employees keep quitting. Even a session a month can help. Look for a therapist you connect with. Bios only tell you so much, so a first conversation can help.
Key action items
- Notice your patterns. Write down problems that keep showing up across your businesses or relationships.
- Ask the people closest to you. Ask your spouse or a trusted friend where they’d like more of your time and attention.
- Listen before you advise. In your next conversation with an employee or family member, ask what they need before offering what you’d want.
- Learn the common thinking traps. Read about cognitive distortions and note which ones sound familiar.
- Book a first conversation. If you’re curious, find a licensed therapist and schedule an initial consultation.
Listen next: Episode 43: The Entrepreneur’s B.H.A.G.
Guest details reflect the time of recording.
This episode is educational and isn’t medical, mental health, legal, tax or financial advice. Speak with a licensed professional and your own advisers about your situation. If you’re in crisis in the U.S., call or text 988.

