In a dimly lit Manhattan hotel ballroom earlier this year, a panel of leading psychiatrists gathered for a keynote Q&A. The audience was a sea of grays and navys, conference lanyards slung over shoulders like ID tags on soldiers. The moderator, himself a therapist turned executive coach, posed a quiet, disarming question:
“How many of your patients would you say you’ve healed?”
There was a pause. The kind that leaks discomfort. One doctor chuckled nervously. Another shifted in her seat. No one raised a hand. This wasn’t a gotcha moment. It was a mirror.
Psychiatry, born in Freud’s study and institutionalized in America’s medical-industrial complex, was never promised as a cure. Its goal has long been containment. Stabilization. Some relief. It gives language to the things we can’t say to our spouses, our shareholders, or ourselves. But healing? That word belongs to shamans and saints.
And yet, the question stuck with me. Not because it indicted psychiatry. But because it exposed a hidden ceiling: a profession capable of so much more than mere damage control.
In the show Billions, this ceiling is shattered by Wendy Rhoades, the steely, Ivy League-educated in-house performance coach at Axe Capital. She’s not a therapist in the conventional sense. She doesn’t coddle. She reprograms. She weaponizes. She engineers winners.
Wendy’s role is fictional, but her impact on real-world professionals is very real. For years, CEOs, fund managers, elite athletes, and elite operators have relied on “advisors” and “coaches” who were, at their core, trained in psychiatry or psychology. They simply moved beyond the couch and into the command room.
And maybe that’s exactly where psychiatry belongs now.
Not in the shadows of clinical diagnosis, but in the sunlight of corporate performance.
Mental health is no longer taboo. That battle, thankfully, has been fought and won. Today, it’s common, admirable, even, for founders and executives to speak openly about their therapy journeys, their depression, their burnout.
And yet, despite this cultural enlightenment, the statistics are damning. According to the World Health Organization, depression is now the leading cause of disability worldwide. Anxiety disorders are surging, particularly among high-achieving millennials and Gen Z leaders. Prescription medication use has never been higher.
Some argue this means we’re finally addressing long-ignored issues. Others quietly wonder: if so many people are in therapy, why does everyone still feel so broken?
But here’s a less cynical take:
Maybe most of us aren’t broken at all.
Maybe most of us are high-functioning but misaligned. And what we actually need is a system that doesn’t just treat dysfunction, but cultivates optimization.
Imagine this: every high-performance organization, hedge funds, tech startups, elite law firms, has an on-site psychiatrist. Not a therapist you’re referred to after a breakdown, but a performance partner you see weekly, by design.
Not because you're struggling. But because you're striving.
Here’s how it works: