Dr Suzan Song, a Harvard and Stanford-trained psychiatrist based in Washington DC, sees a lot of CEOs in her practice. These high-performers have a shiny track record of withstanding unrelenting pressure, yet in midlife many of them crumble.
Successfully coping with hard times is not about toughness and teeth-gritting, according to Song, 47, who is also a researcher and humanitarian adviser working with survivors of atrocities, from former child soldiers to those exploited in human trafficking. So-called resilience, she says, is about having flexibility and the ability to “embrace instability”, a phrase she hesitated to use in her profound and powerful book How We Suffer and Why We Heal. “It’s something that feels so uncomfortable, on a primal level, and yet it’s like a psychosocial vaccine,” she says.
Few are inoculated. “We live in a very performative culture,” she says. “The expectation and the norm is that we will all be doing well at all points and at maximum capacity.” Many high-flyers have been groomed to be highly competent and productive since childhood. “And that competence, I think there’s pros and cons to it.”
High-performers are used to “over-functioning”, which society rewards. Then, when they reach a point where they’ve attained every goal, “they fall apart — because they have no internal sense of ‘why am I doing all of this? What is this for?’”
As well as realising they lack a firm grasp of what genuinely matters to them, many of her clients suffer when life goes awry in an unexpected way and they discover they are not in charge. At work high-performers have personal agency, skills, resources, contacts and experience.
“They can draw on all of those and have control over outcomes,” Song says. “But many of our instabilities, some are of our own doing but some just happen. It’s very upending for most people because we haven’t learnt how to manage it. We don’t learn these skills of ‘what do we do when our worlds fall apart?’ We’re basically told, ‘You get back on track, you work hard, you just do it, you just barrel through it.’”
Until one day you find you can’t. Here’s how Song helps high-performers get back on track.
Identify your missing emotions
Song’s approach to therapy is informed by her own traumatic experiences. When she was 15 her father, who ran a liquor store, was robbed, stabbed and kidnapped. His attackers planned to dump his body but he threw himself from their moving van and crawled for half a mile in search of help. He died in a hospice bed nearly 13 months later.
“I really did think I was OK and I still did well in school, college, medical school, residency,” Song says. She numbed the pain. Only 15 years later, receiving a death threat in Burundi — “I find myself in hiding from former child soldiers, for my life” — did she realise that she was putting herself in terrifying situations to replay the horror of her adolescent loss, “because I still held my father’s shocking death in silence”.
We dodge certain emotions because they’re scary, she says. “We want to get rid of the feeling and just keep on moving.” But long-term avoidance means “it comes out in some other shape”.
This is a common coping style in high-flyers: “I’m OK, I don’t need anything or anyone.” But in midlife, when we often need help or are yearning to change, it no longer serves. Song suggests identifying your “porcupine quills” — behaviours such as sarcasm, acting out or rationalising that drive others away. Ask yourself: “What emotions are they protecting?”
The power of being adaptable
More recently Song has again endured a tumultuous and difficult few years. “I had divorce, I had a house fire, I had displacement,” she says. As friends reassured her, she reflected that there is never a guarantee of stability. “People who are able to flourish and find grounding are those who are more adaptable,” she says. “They don’t have a notion that stability is the ultimate success or life goal. They say, ‘OK, this is our intention, we will work towards it, we will pivot as needed.’ And they’ve built that muscle over time.”
During the pandemic she worried that children and adults she worked with — survivors of torture, refugees, former hostages, many of whom have high anxiety — would be retraumatised. “But they actually were thriving during the shutdowns,” she says. They had developed ways of coping. “‘I’ve been here before. I know how to do this. And I know we’ll be OK.’ They’d internalised the sense that we embrace the world as unknown.”
Build identity through purpose, not performance
“Many high-achievers — I’ll put myself in that bucket — organise their identity tightly around one trajectory,” Song says. “The habits that make someone successful at that level — overriding fear, compartmentalising, sustaining performance under pressure — are adaptive and rewarded, but they can also create a fairly rigid sense of self. If the plan fractures with a job loss, public failure, a health crisis, a struggling child, it can feel like a threat not just to their work but to who they are.”
Song experienced this herself when the death threat forced her to abandon her work. “I was on a very clear academic path with multiple degrees, awards, a PhD under way in Burundi with the goal of eventually directing a major global health programme,” she says, adding that she felt she’d dismantled the career and professional identity she’d spent nearly two decades building. “What stands out isn’t the trauma of the event but what it revealed when I could no longer stay on course.”
Her response was high-performer typical: “Doubling down cognitively with more analysis and attempts to regain control through understanding.” However, she realised: “That strategy works professionally but not so much existentially. You can be exceptionally capable and still discover that your sense of self is vulnerable if it rests entirely on being exceptional.”
Purpose is key to fulfilment
“Endurance and accomplishments — that’s not purpose,” Song says. “Purpose is something of meaning that’s larger than ourselves.” Finding yours means shifting away from needing to control everything, especially at work, towards re-evaluating yourself and what’s important to you. It doesn’t always mean “blowing up your life”, quitting the C-suite to be a padel instructor. It does mean maintaining your moral compass. “Check to see if your values, identities and behaviours are aligned,” she says. “Purpose emerges from coherence, when what you do reflects who you are and what you care about.”
Shift your inner narrative
Our inner narrative, especially if we’re unaware of it, controls how we understand the world. A narrative Song sees often in high-flyers is “I’m not loveable unless I’m achieving”. “When that’s the message one learns” — usually from parents — “of course they’re going to achieve. The alternative is, ‘you’re not loveable’,” she says. (Yet, she adds, even if they do reach a goal, “maybe they’ll feel good for an hour”.) “Many people walk around completely oblivious to their narratives. And these narratives are running their perceptions of how they engage with people, how they perceive events at work.” These narratives can be “identity scripts”, written for us by others.
One such is, what should a mother be? Across cultures, it’s essentially “a martyr”. Song, whose children are eight and ten — “I’m very involved in their lives” — recently challenged her “mother narrative”. She’d volunteered for three school events in one week yet felt guilty for cancelling a fourth. Identify your narratives. Ask whether this belief is helping you or holding you back. Song reflected: “What am I telling myself about what a good mum should be?” If someone else wrote your script, you can change it. “We can rewrite that to what we think is healthier, more aligned and more resonant with who we are or want to be,” she says.
Why We Suffer and How We Heal by Dr Suzan Song (Ebury, £18.99). To order a copy go to timesbookshop.co.uk. Free UK standard P&P on orders over £25. Special discount available for Times+ members