The CEO burn-out clinic

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0:41We look forward to seeing you there. Well, it's got a pretty, pretty view, amazing view of the lake in Zurich and all the boats. It's a very relaxing atmosphere. But what would happen in this room? So two things. Our clients come here for medical checks and assessments. So from taking lab samples to echocardiography. cardiography we have everything here checking vitals and so on and then I would also regularly come here throughout the course of the treatments to receive medical treatments one of the main ones being IVs infusion therapy of you know vitamins minerals everything that seems to be or appears to be lacking from the lab results.

1:20That's Jan Gerber the CEO of Paracelsus Recovery in Zurich showing me around his clinic where wealthy individuals including many founders and CEOs come to receive treatment when they have experienced mental health burnout. When they first arrive after a check-in here, this is where they would come before going on to their personal apartments nearby? They would first, we would let them settle in to the apartment. And then it depends, either they come right here for the medical checks or they would first see the psychiatrist in the apartment before they come here. But on the first day, normally clients would see this room, yes.

1:56and this big room is i think what you call the board room what kind of meetings would you hold here it's a multi-purpose room really clients would rarely see it because they have their own therapy rooms in in the residences but potential clients or families who come visit us to kind of check us out first we would receive them here then we have all the team meetings case meetings receiving journalists and so on so a lot of the meetings will do here the clients are having individual personalized one-on-one care but that doesn't mean perhaps their families might be coming for meetings checking on their progress that sort of thing that's right so we would have family members visiting ideally actually a couple of weeks into the treatment but again more often than not they would visit the client in the residence there's plenty of space there to sit down and have discussion so the boardroom is mostly used internally

2:51Welcome to the Business Leader Podcast. I'm Dougal Shaw and my guest today is Jan Gerber, CEO of the Paracelsus Recovery Clinic in Zurich. It costs£85 ,000 a week to be treated here. It's an exclusive facility designed for those used to the finer things in life. The Paracelsus Recovery Clinic has been treating high net worth individuals in Zurich since 2013. It is known for the single-client rehab technique. Patients are assigned therapists who live with them during their stay and are on call 24-7. A team of 15 people, including psychiatrists, nurses, nutritionists and personal chefs, is responsible for each patient.

3:32The clinic owns three apartments on the lakefront in the city centre where patients are treated in isolation. Clients may stay for up to two months at a time. I spoke with Jan Gerber in his study overlooking Lake Zurich to learn more about what kind of people come here, what kind of problems they have and how they are treated. But I also wanted to find out what he can advise about avoiding burnout in the first place. I began by asking him how the clinic first came about.

4:04As many, I would say, business opportunities as one came, more or less by accident, and it was just about spotting the opportunity. What basically happened, I think 15 years plus ago, was a friend of a friend of the family, top executive of a listed company who struggled with an alcohol addiction issue. And my mom's a clinical nurse specialist who worked in mental health for quite a while. And my stepdad at the time was an addiction counselor. My dad's a psychiatrist. So what happened was basically my family was asked, you know, can you help this person very discreetly because he couldn't check into any traditional rehab.

4:40for confidentiality reasons. So he moved into the guest room at my parents' place. And from there, I was doing other businesses at the time. I'm a serial entrepreneur. I kind of realized that's both a need and an opportunity. So it kind of naturally started here in the Zurich area because that was our home. And Zurich's a good place. Switzerland's a good place for mostly confidentiality reasons originally. But also we have obviously a state-of-the-art medical system. And a lot of the state-of-the-art research in mental health comes from here. Carl Jung lived here. So I think there's a lot of good reasons why Zurich is a good place.

5:18And if there's something that makes the Zurich approach different, and you certainly follow it, is that the therapy is one-on-one and the therapist lives in with the patient. How important is that? Given that we treat only very few clients at any given time, with every client's project. And the fees are quite high. So we want to make the most of their stay. So, and there's a lot of therapeutic opportunity any time, you know, throughout the day. It can be over dinner. It can be in the morning before breakfast when somebody just wakes up and has to process a bad dream or sleep. So the idea of the live-in therapist is it's a qualified therapist.

6:03They're basically 24 hours. They stay at the same residence. and they're scheduled sessions but mostly they they can just therefore support spontaneous processing of emotions and thoughts that come up and what when somebody comes here for the first time what's the first thing that happens we would normally immediately kind of well hit the ground running as it speaks so somebody arrives here obviously we let them settle in their residence on the same day there would already be an array of of assessments we always have to start with a psychiatric assessment also just to ensure the safety of the person some clients come to us in a not very stable condition and then also lots of lab tests and kind of initial medical checks already so we have as much information as quickly as possible i mean i've been lucky enough to experience through your hospitality something of what the person goes through when they arrive here and it is a kind of vip treatment you come straight off the plane and you're met at the door you're taken to your own personal special passport control you go to the ip lounge there's a bentley car that brings you to the residence you have a personal chef here making your favorite meals and collaboration of a nutritionist are these things because your wealthy ceo clients kind of expect that or is that part of the treatment to have this kind of environment centered around them?

7:25It's both. So first of all, you have to be aware that going to treatment for anybody, not just, you know, a founder, manager, a CEO, is initially scary. You're in a very fragile state. You don't know exactly who you'll meet. Can I trust these people? Will I be in good hands? And so on. So a very smooth arrival, in a way is key. So we just try to mitigate any stress or triggers. So what you described is about that your luggage will be picked up for you just sit in a, you know, in a lounge have tea until everything's ready off the plane and then it'll be brought straight to your car. You don't have to queue.

8:03There's a therapeutic element to that. And the other thing is, you know, let's call it the luxuries or the amenities and then the service that we provide, you could call it five star or high-end or luxury in the end it's most of her clients you know they kind of live that lifestyle and us replicating that is just about having them feel as comfortable as possible and not adding additional stresses but trying to take away as many stresses as possible so they can really focus on therapy and what are the problems that people typically present with originally cause them to get into this state at work, presumably mostly?

8:42We probably see as many problems, a combination of problems, as we see individual people. But kind of an overarching theme is, of course, kind of the burnout and at the end with my energy type topic. How that presents itself can really vary. So, you know, most managers or founder managers who have very intense jobs and do that often for years and decades, it's kind of a slippery slope. It's not suddenly one day that they run out of energy and hit the wall. So normally the first thing that goes is sleep quality. What do you normally do if, you know, over a longer period of time you don't sleep well is either your GP prescribes, so you find your own ways to get your hands on remedies.

9:26So this self-medication of symptoms that can lead to addiction issues at some point. I mean, some people just drink a bottle before going to sleep to kind of induce that sleep, because otherwise the brain would just go on because it's triggered all day. It can also be symptoms of depression or anxiety, which are natural, let's say, symptoms or side effects of, you know, kind of working, grounding yourself to the ground with work. And obviously, you can't speak about specific cases and patients. But in terms of the kind of issues that are causing this in business, is it things like the stress of responsibility for employees?

10:08You had to worry about shareholder expectations. Is it business things like that? There are two reasons. I took, in a way, separate pathways. ways. One is that people who are drawn to this kind of job and also excel at this kind of career often also have already certain personality traits or often even diagnosable disorders that make them exactly good at that. So there's a self-selection mechanism there. So ADHD, for instance, you see a much higher incidence amongst founder managers with ADHD. I mean, I think it's fivefold, tenfold, something like that. But it's also five to eightfold in alcoholics.

10:51So there is that correlation, right? So there's the self-selection bit. And then obviously it is stressful. And the stress of, you know, it's not only during economic downturn or when the business struggles, but obviously then it really compounds. So often, you know, the kind of the burnout crashes, they happen around that time. Or just when, you know, things have turned around and they recover and the kind of nervous system can relax a bit after, you know, a few months or a couple of years. of that neurological stress. And then the system just folds. It's interesting that people with ADHD or tendency towards alcoholism are the successful founders.

11:28Is the positive side of that that you have this compulsive behavior, a kind of obsessive personality, which allows you to get things done, like build a business? That's exactly it. So traits associated with ADHD or other personality disorders in a way, excessive risk taking or high risk appetite, let's call it that way. Impulsivity, you're able to make on the spot decisions and sometimes very high stakes decisions that others just need longer with or don't even dare to do. But it's also a certain confidence, at least outwardly portrayed, and resistance to criticisms. When everybody else says that this doesn't make sense, it's kind of the out of the box thinkers that often are proven right in hindsight.

12:10So it's a mix of these traits, exactly.

12:19With many people it's distinguishing who you are as a human being, as a person and the role you play at your work is kind of blurry. When you ask somebody you just met, who are you, or the way you introduce yourself is like, I'm a doctor, I'm a manager, I'm an accountant. So kind of a role in a way is the first thing that we mention. And obviously with more and more senior managers of bigger and bigger companies, that line is more and more blurred. And at some point it's in a way a singularity. And a top executive of an international corporation is just that to anybody around them, public as well as private.

12:59And even their kids and their spouse kind of live with that reality. So the fear of that failing is portrayed as a very, very personal failure. And we also have to consider that even a lot of successful, high-flying, almost glamorous people suffer from imposter syndrome. So there is this self-esteem issue somewhere deep buried inside, often covered by the glamour and what's portrayed to the outside. But that constant fear of, you know, this is too good to be true. I'm more successful than I ever thought I would be. So there's this fear that goes often along with it. I might be found out at any moment that I'm actually not that person that everybody admires and looks up to.

13:52And obviously, when that fear gets more real, again, with numbers deteriorating, layoffs having to happen, etc., that can really trigger a mental health issue. I mean, it's one of the reasons that it's good to have this very personalized private care, because there is some stigma around having therapy and admitting to a mental health burnout. and do people typically when they come to you do their do other people in the organization know about it or do they want to keep it a bit secret um that really depends we've we've had everything um we've had boards referring the ceo um we've had uh a kind of you know private partnership type organizations the partners doing an intervention on the on one of their partners um so they want them to recover so the business does well again they're kind of showing faith in the person that's exactly that well it's faith in the person or just a realization that's you know it's that person has to somehow function and get well because there's too much at stake at that moment and then we also see many many cases the opposite where it's really just the person themselves and or you know kind of their spouse or close family knowing and confidentiality is key.

15:07And there is ways to do justice to all of that. The advantage of our setup where we can treat every client very separately, kind of one client at a time as they approach a whole team for one patient in a separate residence, we can be very flexible in terms of work meetings they have to hold online, or they can even commute back and forward internationally to attend to investor meetings or board meetings or key things. Therapists can go along with them, then they come back. This is something that kind of a traditional clinic cannot provide. I didn't realise that. So you can carry on working while receiving the therapy?

15:43It's not ideal, but in many cases, that's the only option because the alternative is for them losing their job or their reputation. And again, if that's so enmeshed with their own identity, that's therapeutically not advisable either. So if you have the time, devote it to therapy and treatment and recovery, but more often they're not with professional managers. They cannot just step away for a few weeks. Do you think these people have quite specific problems or would it be a very similar phenomenon that come up when some of your therapists, because they also work in the public health system, are they encountering the same problems there?

16:24It's just on a bigger scale here or is it something uniquely different with the CEOs? Again, I think it's both. I mean, CEOs are human beings. So again, they come with their personality traits and their quirks and fears and shames and abandonment issues and personality disorder and whatnot that anybody could have. I think that the pressure of the responsibility and often also wealth that is built and comes into play in a way it just it kind of throws fuel into the fire of normal life problems. So if you have a relationship with a problem at home that can get much worse if with such a high strung job for example or midlife crisis or a question of identity crisis things like that.

17:15Is there a difference between the kind of problem that men and women present themselves with as CEOs and if so do you have to treat them differently? It's very hard to generalize. Obviously you know that the pressures, the burnouts topic, the stress topic kind of affects everybody in a way equally. All things equal I would say women CEOs seek help earlier. They're more aware or dare more possibly to seek therapeutic support before hitting a wall whereas men tend to just kind of grind on I think that's still kind of how we are culturally conditioned to a degree until it's just not physically and neurologically possible anymore.

17:59I think the conversation over the last years around mental health has really exponentially taken hold in the social media and in the media as well. So it's become more and more okay for a CEO to say, you know, I need to step back for a moment and take care of my own mental health.

18:18trying to draw some positive things for people to do so they don't get to burnout from all the therapy you've done here can you make any recommendations for people that would protect them so it's less likely they reach mental burnout as in any health topic and also physical somatic health as well as mental health prevention is key and prevention obviously starts with awareness i have for a while been actually an advocate for including top management mental health into a risk management framework of a company kind of you know kind of rigid assessments and then would have to see you know a coach or a therapist on a regular basis kind of on a kind of supervision type setup and that would all help kind of to detect early warning signs or red flags before actually you know kind of the the flames, it already goes up in flames.

19:16But if a company doesn't have that setup, and very few do, just for the person themselves, it's, you know, be aware, be honest with yourself if you feel that there is a trend. And the early morning signs, again, are sleep goes first. Then episodes of anxiety that, you know, are more than founder managers or CEOs, they know anxiety, right? it's a normal part of that existence. But if that just, you know, becomes more frequent or more severe. How could that manifest itself? Would it be like close to a panic attack? Yeah, I mean, a panic attack or close panic attack is already a certain escalation level.

19:55So it's really about monitoring. If it's more frequent, kind of you get up in the morning and you get that kind of feeling of, you know, everything's going to crash and burn. It doesn't have to be an anxiety attack in a clinical sense yet. But if that starts happening more often, again, it's part of normal experience for a CEO. But if that starts happening more often over a longer period of time, that's probably a warning sign. Relationships deteriorating can be a warning sign as well with your kids or spouse or friends. Loss of appetite or mood swings, things like that. Mood swings or irritability is one sign, exactly.

20:33Appetite is probably more the change in nutrition. So, you know, more caffeine, more sugar. Again, if that's a trend that reaches a certain level, that can be an indication. Often it's a mix of that. But it's also kind of just if you reflect your energy level, where are they? And with age, and that's another thing, it's normal for energy levels and stamina to go down and cognitive function, concentration, memory to kind of diminish a little bit over time. But if that goes very quickly within a few weeks or, you know, over the course of a few months, that can be a strong warning sign as well. So it's about detecting those, being honest with yourself and then ideally get professional help, a coach or a therapist who can advise you what to do.

21:22And obviously on the prevention side, it is, none of that is there yet. But to prevent it going in the direction if you have that kind of high strung job is the best prevention is foster healthy relationships. that's both romantic family and uh and friends and exercise regularly you know eat healthy uh pay attention to your sleep hygiene take those non-negotiable times out from your job and that's tough you know it's often a 24-hour commitment but i had to learn that too at some points a certain time in the evening i just turn off my phone um and i didn't used to dare to do that because like yeah something could happen late night you don't know um but uh for me it was just a game changer in terms of my stress levels and mental well-being.

22:06One CEO I met recently in London told me that he found that journaling was very powerful and built resilience because he would write down the positive things he achieved. And then when he hit a bad patch, that would kind of, that would help him. And he was so impressed by that, that he's basically taught his whole company to do that. Is that something useful? Is there any other little things that people in general throughout the workforce can do? 100%. and I mean this is widely recognized and known and I would like to add here because a lot of people don't journal because it seems daunting to kind of you know take that time out of the day and you know and it's like with going to the gym or any other exercise you know start small but it's about consistency you can write five lines a day and that might be enough for a few weeks and as you say that can really help because it's a different cognitive function and reflection if you write something down than if you just, you know, think about it five minutes on the way to get coffee.

23:07You've been listening to me, Dougal Shaw, speaking to Jan Gerber, CEO of the Paracelsus Recovery Clinic in Zurich for the Business Leader podcast. Please do rate and subscribe to us wherever you get your podcasts. We do two episodes every week.

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