Duke UniversityPsychiatry Residency
Brigham & Women'sCL Fellowship
Harvard Medical SchoolFaculty
McLean HospitalDirector of Education, Division of Geriatric Psychiatry
Harvard T.H. Chan School of Public HealthM.P.H.
📖 The Journal

Insights on Leadership and the Mind

Essays on the psychology of senior leadership, from a board-certified psychiatrist and executive coach. Written for the executives who carry weight they rarely get to set down.

Coaching · Latest

What Executive Coaching Costs, and What Actually Determines the Price

Executive coaching rates range from a few hundred dollars an hour to several thousand. Here is what sits behind those numbers and how a senior leader should evaluate the spend.

By Dr. Stephanie Collier · August 13, 2026 · 9 min read
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Coaching

Does Executive Coaching Work? What the Evidence Actually Shows

The research on executive coaching is more encouraging than skeptics assume and weaker than the industry implies. What matters most is what predicts a good outcome.

Aug 7, 2026 · 8 min read
Governance

What Boards Miss When They Assess a Chief Executive

Directors are trained to read results. Very few are trained to read the person producing them, and the gap between the two is where most leadership failures incubate.

Aug 1, 2026 · 8 min read
Leadership

When the Company Is You: Founder Identity and the Cost of Fusion

The fusion of founder and company produces the conviction that builds something from nothing. It also produces a specific and predictable set of failures.

Jul 27, 2026 · 8 min read
Performance

Perfectionism in Senior Leaders: The Strength That Becomes a Constraint

High standards and perfectionism look identical from the outside and function completely differently from the inside. The distinction determines whether the trait builds a career or slowly dismantles one.

Jul 21, 2026 · 8 min read
Leadership

The Psychological Toll of Leading a Layoff

Organizations prepare leaders for the mechanics of a workforce reduction and almost never for what conducting one does to the person who has to do it.

Jul 15, 2026 · 8 min read
Mental Health

Alcohol and Executive Performance: An Honest Clinical Look

Most executives who drink are not in trouble. Almost all of them are paying a performance cost they have not measured, because the mechanism is invisible from the inside.

Jul 9, 2026 · 8 min read
Mental Health

Attention Without Deficit: Recognizing ADHD in Senior Leaders

Many senior leaders reach the C-suite with undiagnosed ADHD, carried there by intelligence and compensation. The scaffolding usually fails at a predictable point.

Jul 3, 2026 · 8 min read
Leadership

Leading Through Personal Loss: Grief in the Executive Chair

Grief is a physiological event with measurable effects on cognition, and organizations schedule three days for it. What senior leaders need to know about leading through loss.

Jun 29, 2026 · 8 min read
Coaching

What Actually Stays Private in Executive Coaching

Coaching confidentiality is a professional commitment, not a legal privilege. The difference matters most in exactly the situations where a leader most needs to speak freely.

Jun 24, 2026 · 8 min read
Burnout & Recovery

The Warning Signs of Executive Burnout (From a Psychiatrist's Perspective)

What executive burnout looks like beneath the surface, and why the earliest signs are physiological and cognitive long before they become behavioral.

Jun 18, 2026 · 7 min read
Leadership

The Loneliness of the CEO: Why Isolation at the Top Is a Clinical Risk

Why the isolation that comes with the top job is not a personality issue but a structural and clinical risk with real consequences for judgment and health.

Jun 11, 2026 · 8 min read
Coaching

Executive Coaching vs. Therapy: What's the Difference, and Which Do You Need?

An honest account of how executive coaching and therapy differ, where they overlap, and how to tell which one your situation actually calls for.

Jun 4, 2026 · 8 min read
Performance

Decision Fatigue in Senior Leaders: The Hidden Tax on Judgment

The neuroscience of why a leader's tenth good decision is harder than their first, and what senior leaders can do to protect the quality of their judgment.

May 28, 2026 · 7 min read
Performance

Sleep and Executive Performance: The Most Underrated Leadership Edge

Why the sleep most executives treat as expendable is, clinically, the single most reliable lever for sharper judgment and steadier leadership.

May 21, 2026 · 7 min read
Leadership

The Resilience Myth: Why "Toughing It Out" Fails Senior Leaders

Resilience is not the ability to absorb unlimited strain without complaint. The leaders who treat it that way are the ones most likely to break.

May 14, 2026 · 7 min read
Leadership

Imposter Syndrome in the C-Suite: A Clinician's Field Guide

Imposter feelings rarely disappear with success; they often sharpen. A clinician's guide to understanding and working with them at the highest levels.

May 7, 2026 · 8 min read
Transitions

The First 90 Days: A Clinical Approach to Executive Transitions

The first 90 days of an executive role reward structured observation over early action, and a clinical lens shows leaders how to read the system before changing it.

Apr 30, 2026 · 8 min read
Mental Health

High-Functioning Anxiety in Leaders: The Performance Trap

High-functioning anxiety drives the behaviors organizations reward, which is exactly why it goes unrecognized and unaddressed in senior leaders.

Apr 23, 2026 · 8 min read
Coaching

How to Choose an Executive Coach: A Buyer's Guide for Senior Leaders

A framework for senior leaders evaluating executive coaches, covering credentials, clinical depth, confidentiality, and the questions that reveal real competence.

Apr 16, 2026 · 9 min read

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