Executives Wait 21 Months Before Their First Therapy Session: Martha Fernandez of CEREVITY on Shortening the Wait

Most founders do not ignore the warning signs. They see them, name them privately, and keep going. In a CEREVITY review of 307 executives who sought therapy, the median gap between recognizing serious strain and a first session was 21 months, and 58% waited until a crisis forced the decision.

Martha Fernandez, LCSW, saw that pattern repeatedly in her clinical work with founders, executives and physicians, and it led her to co-found CEREVITY, a private-pay concierge network of independent licensed clinicians offering confidential online therapy in all 50 states. What kept her clients away from support was rarely doubt about therapy itself. It was the fear of who might find out, and care that did not fit a life run by a board, a calendar and a team that needed them steady.

In this Q&A, Martha explains what it looks like when founders hide strain from investors and boards (64% of the 318 founders in one CEREVITY review said they had), what that silence costs their decision-making, and the one relationship every woman founder who is "the steady one" should build before she needs it.

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Q: What led you to co-found CEREVITY, and how did your clinical work with founders and executives shape the idea behind it?

For years I kept meeting the same kind of client at the worst possible moment: a founder, an executive or a physician who had known for a year or more that something was wrong and had kept going anyway, until a crisis or a near-miss made the decision for them. When CEREVITY reviewed 307 executives who sought therapy through the network, the median time between first recognizing serious strain and a first session was 21 months, and 58% waited until a crisis forced the issue. That matched what I had seen in my own work. These clients believed in therapy. What stopped them was who might find out, and care that did not fit a life run by a board, a calendar and a team that needed them steady. We built CEREVITY to shorten that wait. CEREVITY is a private-pay concierge network of independent licensed clinicians built for high achievers: executives, founders, physicians, attorneys and finance leaders, offering confidential online therapy in all 50 states.

Q: You've written about founders hiding strain from their investors or boards. Can you share an example of what that pattern tends to look like, and what it costs them?

It usually looks like competence. The founder walks into the board meeting with a clean deck and a strong quarter, answers every question, and goes home to another night of four hours' sleep. In a CEREVITY review of 318 founders who sought therapy, 64% said they had hidden strain from their investors or boards. Here is a composite drawn from several founders, not any one person: a CEO in the middle of a raise who told no one, including her co-founder, that she had stopped sleeping and was second-guessing every decision. The cost was not the strain itself. It was that she made the biggest decisions of the company's life alone, put off a hard conversation with her co-founder for months, and spent the energy she needed for the raise on keeping the secret. Hiding strain also changes judgment. In a separate CEREVITY review of 261 high achievers, 62% said they made worse decisions while hiding how they were doing.

Q: What's one piece of advice you'd give other women founders who feel like they have to be "the steady one" for everyone around them?

Have one relationship where you are not the steady one, and set it up before you need it. That can be a co-founder, a board chair, a friend outside the company or a clinician, but it has to be someone you do not have to manage. It also helps to agree on a signal in advance, a plain sentence like "I'm running low" that tells your co-founder or chair to take something off your plate without a long explanation. And if you are heading into a fundraise, a launch or a hard year, get confidential support before it starts, not after. Being steady for everyone else is a real strength. It only becomes a liability when there is nowhere you get to put it down.

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