Therapy for Female Tech Founders

For tech founders hoping to rest without feeling as though they’re falling behind.

Lunch on the roof, one email at a time

Soo is an illustrative composite, not a real client or a real founder. She’s 44, and she’s the founder and CEO of a software company that helps regional utilities track equipment maintenance. The company is six years old, it has forty people on payroll, and she’s in the middle of raising its next round.

It’s a bright, windy afternoon in early fall, and she’s on the roof terrace of her office building for the first time in weeks. She made herself a promise this morning: lunch outside, away from her desk, phone face down. There’s a turkey sandwich on the table in front of her, still half in its paper, and a bottle of sparkling water sweating in the sun. A potted olive tree rattles in the wind behind her.

She’s taken three bites. Between each one, the phone has turned face up again. A partner at one firm wants the updated retention numbers before their call on Thursday. Someone at another firm has forwarded the deck to a colleague and wants to find time next week. Her head of finance has flagged a question in the data room that she knows only she can answer well.

None of it is urgent in the sense of needing an answer in the next ten minutes. All of it feels urgent anyway. If I answer now, it’s one less thing tonight, she thinks. If I don’t, they’ll think we’re slow. She wraps the sandwich back up, sets it next to the water bottle, and starts typing with both thumbs.

A few minutes later she stops and looks at the sandwich. She isn’t hungry anymore, exactly. She’s something else, and she doesn’t have a word for it. She opens the next email.

If some of that feels close to home, this guide is for you. It’s for women who are building technology companies and who’ve noticed that rest has started to feel like falling behind. It looks at what that feeling can look like in a building week, what burnout does and doesn’t mean, what therapy can work on while the company keeps moving, and what it can’t do for you.

A quick note on where I’m coming from. I’m a licensed therapist, and I also coach executives. This article is general education. It isn’t therapy, coaching, or business, legal or financial advice, and it can’t tell you what’s going on for you personally. Soo and the other founder in this guide are illustrations, not people.

When rest feels like falling behind

If you’ve felt this, you may have felt it before you had a name for it. You sit down to eat, or you close the laptop at a reasonable hour, or you take a Saturday off, and something in you starts keeping score. The inbox is filling. A competitor is shipping. The runway is shorter than it was last month. Rest stops feeling like rest and starts feeling like a debt you’ll have to pay back with interest.

Here are some of the ways it can show up. These are descriptions, not symptoms on a checklist, and none of them tells you whether anything clinical is going on.

• Breaks turn into catch-up time. Lunch, a walk or a weekend morning quietly becomes the hour you finally clear email, so it never counts as time off.
• The company’s calendar sets yours. A fundraise, a launch or a customer escalation decides when you eat, when you sleep and whether you make it to your kid’s game.
• Stopping feels risky, not restful. When you do stop, the quiet fills up with what you haven’t done yet.
• You’re responsive by reflex. You answer investors, customers and your team quickly because speed feels like proof that the company is healthy, and that you are.
• The people closest to you get what’s left. Your partner, your friends or your kids get the tired version of you, and you notice it, and you feel bad about it, and you keep going.

Some of this is part of building something hard. A fundraise can compress your calendar. An outage may require a response in the middle of the night. The question this guide is interested in isn’t whether you should ever work hard. It’s what happens when the urgency stops being about particular weeks and starts running every week, including the ones where nothing is actually on fire.

If you’ve started to feel that the company has taken over more of your identity than you meant to give it, my piece on role engulfment looks at that pattern while you’re still running the company.

What burnout means, and what it doesn’t

When rest keeps feeling like falling behind, it’s natural to wonder whether you’re burned out. It helps to know what the term actually refers to, because it’s used loosely, and it isn’t a catch-all for being tired or feeling guilty about resting.

A few things follow from that definition, and they matter if you’re trying to make sense of your own experience.

First, the WHO says burn-out is not classified as a medical condition. It’s listed among factors that influence health or lead people to contact health services. So even if the description fits, it doesn’t tell you what, if anything, a clinician would diagnose.

Second, the WHO says the term refers specifically to the occupational context and shouldn’t be applied to other areas of life. Guilt about resting, a low mood that’s spreading beyond work, grief, or a sense that something from further back is being stirred up aren’t what the term describes. That doesn’t mean they can’t show up alongside work stress in the same week, or have causes of their own. This article can’t sort out that overlap for you, and if you’re unsure what’s going on, an assessment may be appropriate.

Third, a definition can’t sort out your particular situation. Please don’t use this article, or any article, to diagnose yourself. If you’re worried about how you’re sleeping, eating, feeling or functioning, a primary care provider or a licensed mental health professional can assess what’s going on. The National Institute of Mental Health notes that first being examined by a health care provider can help rule out a physical health issue, because symptoms like a change in mood or trouble concentrating are sometimes due to a medical condition.

What therapy can work on while you’re still building

If you’ve been thinking of therapy as something for after the company is stable, or after the exit, or once there’s time, it doesn’t have to wait for any of those. It also isn’t a productivity program.

NIMH lists several reasons people seek psychotherapy. One of them is dealing with severe or long-term stress from a job or family situation. Another is having symptoms with no physical explanation, such as changes in sleep or appetite or low energy. NIMH also describes the general goals as relief from symptoms, maintaining or improving daily functioning, and a better quality of life.

For a founder who’s still building, that can include things like:

• The pull toward answering everything right away. What happens in you when you don’t respond, and whether that reaction fits the actual stakes.
• What rest means to you. Whether stopping feels safe, earned, lazy or dangerous, and where those meanings might come from. That could be recent history, older history, or simply the norms of the startup world you’ve been living in.
• How you talk to yourself in a hard week. The running commentary after a tough investor call or a missed target.
• Your relationships outside the company. How the work is landing on the people you live with, and what you want those relationships to be.
• Sleep, appetite and energy. What’s been changing, and whether you need a medical check alongside therapy.

You don’t need to assume your drive comes from an old wound. You can ask a therapist how they would assess what’s happening rather than start with that explanation. For some people, history is part of the picture. For others, the main thing may be a hard stretch at work plus habits that made sense for a while and don’t anymore. An assessment, and your own sense of what matters, can help decide what to focus on.

It’s just as important to be honest about what therapy can’t do. It can’t extend your runway, close your round, fix your board or guarantee that the company succeeds. It can’t promise that you’ll be more productive, make better calls or keep your momentum. Those depend on many things outside the therapy room. What therapy can offer is a place to look at your own patterns and choices with a professional. One question you might bring is how to keep the company from being the only thing that decides how you live.

NIMH also notes that choosing a treatment plan is based on a person’s individual needs and medical situation and should happen under the guidance of a mental health professional. That applies here too. The founder label doesn’t point to one approach.

The free hour she agreed to

Keri is an illustrative composite too, not a real client or a real founder. She’s 49, and she’s the technical cofounder and CEO of a company that builds security software for mid-sized hospitals. She wrote a lot of the first version of the product herself. These days she mostly writes emails, board updates and hiring plans.

It’s a gray Saturday afternoon, and she’s standing in the fiction section of an independent bookstore a few blocks from her apartment. She made a deal with herself on the walk over: one free hour. No laptop. Phone in her coat pocket. She’s holding a paperback novel she’s meant to read for two years, running her thumb along the edge of the pages. The store smells like paper and someone’s wet umbrella.

Twenty minutes in, her phone buzzes against her hip. Without looking, she guesses it’s the on-call channel, or her head of engineering, or maybe the investor who likes to send notes on weekends. It’s probably nothing, she thinks. And if it isn’t nothing, I’m the one who should know.

She doesn’t take the phone out. She doesn’t put the book down, either. She reads the first page twice without taking in a word of it, and she can’t decide whether she’s resting or just standing still while the guilt catches up.

Keri’s version of the pattern looks different from Soo’s. Soo can’t stop answering. Keri can stop answering, at least for a while, but she can’t stop being on alert. Both of them are doing the thing they set out to do, taking a break, and neither of them is getting what a break is supposed to give.

If you recognize either version, it could be worth bringing to a therapist. The point wouldn’t be to scold yourself for checking your phone. It would be to understand what the checking does for you, and what it costs.

Sleep and the pull of urgency

If work keeps displacing your sleep, during a fundraise, a launch or just an ordinary busy stretch, it may be worth looking at on its own. Sleep isn’t the whole of rest, but it’s one concrete place to start.

The Centers for Disease Control and Prevention offers general guidance on sleep. It notes that the amount of sleep you need changes as you age, and it recommends talking to your healthcare provider if you have problems sleeping. The habits it lists include going to bed and getting up at the same time every day, keeping your bedroom quiet, relaxing and cool, and turning off electronic devices at least 30 minutes before bedtime.

That’s general public health guidance, not a treatment plan for founders, and it isn’t a rule you’ve failed if a launch week wrecks it. It can still be a helpful baseline to hold your weeks against. If your sleep has been short or broken for a long time, or you’ve noticed changes in your mood, energy or appetite along with it, that’s worth raising with a primary care provider, and it’s something a therapist will want to know about too.

Some questions you might sit with, on your own or with a therapist:

• When did the company’s schedule start setting my sleep, and is that still necessary?
• Which late-night emails actually need me, and which am I sending because not sending them feels worse?
• What would a realistic sleep window look like during a fundraise, not an ideal one?
• Who could cover the first response to an overnight issue, even some of the time?

None of these have one right answer.

What to bring to a first conversation

If you’re thinking about starting therapy while the company is moving fast, it can help to walk into the first conversation with a few things in mind. The goal isn’t to arrive with a perfect summary. It’s to give the therapist a real picture of your life, and to find out whether the way they work can fit it.

Things you might describe:

• What a typical week looks like right now, including the parts you’re not proud of.
• What rest looks like for you these days, and what happens when you try it.
• What’s changed in your sleep, appetite, energy or mood, and for how long.
• What you’re hoping will be different, in your own words, even if it’s vague.
• Anything that’s made it hard to start therapy before, including time.

Practical questions to ask, since your calendar may be the first obstacle:

• What session times do you offer, and how far ahead do people usually book?
• Do you offer telehealth, and are you authorized to practice where I’ll be during sessions if I travel?
• What’s your cancellation policy if a fundraise or an outage blows up my week?
• How do you handle times when I need to come less often, or more often?

Every practice answers these differently. If you’d like a fuller set of questions about fit, approach, fees and confidentiality, and help sorting therapy from coaching, my guide to therapy for female founders covers those in more detail.

It also helps to be clear about roles. A therapist can help with how the business is affecting you, and how you’re responding to it. A therapist isn’t the right person to decide your cap table, your term sheet, your legal exposure or your financial plan. Those questions belong with qualified business, legal and financial advisors. Therapy can help you think about how you want to show up in those conversations. It doesn’t replace them.

Both/And: protecting your health and caring about the business

You may feel you have to pick a side. Either the company comes first and your health waits, or you protect your health and accept that the company might suffer. It can feel like a trade, where every hour of rest is taken out of the business.

Both/And means you don’t have to accept that framing as the only one. You can care a great deal about the company and care about your own health. You can want this round to close and want to eat lunch without typing through it. You can take the business seriously and take yourself seriously in the same week.

That doesn’t mean both will always work out. There will be weeks when the company needs more than is comfortable, and weeks when your health needs you to let something slip. Holding both doesn’t guarantee a good outcome for either one. It means you stop treating one of them as the thing that never gets a vote.

For Soo, that might look like answering the retention request in time for Thursday’s call, and letting the other two wait until after lunch. For Keri, it might look like letting herself read the book without solving whether she’s resting correctly. Small choices like these don’t settle the bigger question. They’re a way of practicing it.

If you’ve noticed that the only time you protect your health is when your body forces the issue, that’s worth talking about with someone. So is the opposite, if you’ve started to feel that caring about the company at all is a problem. Neither side of this has to win.

The Systemic Lens: conditions therapy can’t fix

If you’re building a company, you’re doing it inside conditions you didn’t design, and some of the pressure that feels personal may make more sense when you look at the setting.

One example comes from a 2014 paper in the Proceedings of the National Academy of Sciences, led by Alison Wood Brooks of Harvard Business School, titled Investors prefer entrepreneurial ventures pitched by attractive men. It combined different kinds of evidence, and it’s worth being precise about each.

• A field study. The researchers analyzed pitches from three entrepreneurial pitch competitions in the United States, judged by panels of angel investors. These were real pitches, not identical scripts, and in this sample male entrepreneurs were more likely to win.
• Controlled experiments. In an online experiment, participants watched pitch videos that showed images related to the ventures but not the entrepreneurs, while a male or female voice narrated the same script. In this experiment, participants were more likely to choose the male-narrated pitches. The paper also reports a lab experiment that changed the design in other ways, including adding photos that varied how attractive the entrepreneur appeared. The authors describe their experiment participants as nonprofessional evaluators, not professional investors, so the experiments aren’t a measure of how venture capitalists as a group behave.

The authors also named limits. The experiments focused on one industry. Drawing on an existing model of gender bias, the authors also raised the possibility that women may be more persuasive when they pitch ventures seen as female gender-typed. That’s a boundary they suggest, not something this study established. They also didn’t ask investors to explain how they made their decisions. And the paper is from 2014. It isn’t a study of tech founders’ mental health or rest, and it doesn’t tell you what’s happening in any particular pitch, board meeting or funding decision, including yours.

What it does offer is a reason to take the setting seriously. What follows is my own application, not something the paper measured. If a founder works harder to be heard, prepares more to feel credible, or answers faster so no one can call her slow, some of that effort may be a response to the conditions she’s working in, not just a personal habit to fix. The paper doesn’t show that any particular investor is biased, or that this is why any founder works the way she does. Where the setting is part of it, that isn’t her fault. Therapy can’t guarantee funding or remove bias from the funding process.

In therapy, some of this could become questions to explore. Which pressures seem to come from the setting, and which from rules she’s carrying on her own? Which efforts feel protective, and which may have outlasted their use? Therapy can’t determine whether a particular investor was biased, and it can’t fix the funding process. It can be a place to think through how she wants to respond. Some of her answers may point toward her own patterns. Some may point toward peers, mentors, advisors or collective efforts that work on the conditions themselves.

Where they are now

Soo is still on the roof. The wind has picked up, and the paper around her sandwich keeps lifting at one corner. She’s answered two of the emails. She’s looking at the third, the one about the data room, and trying to decide whether it needs her now or whether it can wait until after lunch.

Keri is still in the bookstore. The phone has buzzed once more. She’s on the second page of the novel now, and she hasn’t decided whether she’ll buy it, or whether she’ll check the phone when she gets to the corner.

Neither of them has figured out how to rest without feeling as though she’s falling behind. Neither of them has to figure it out on a Saturday afternoon or over one lunch.

If you recognize yourself somewhere in this, it may be enough for now to notice where the urgency shows up in your own week, and how much of it the week actually requires. If that noticing brings up more than you want to carry alone, a therapist is one place to take it. The business will still matter when you come back to it. So will you.

Warmly,
Annie.