CEOs on the Couch: The Importance of the Therapeutic Alliance When Working With Executives

The formation of the therapeutic alliance in clinical work is central to psychoanalytic theory and psychoanalysis, and can inform the analytic consultant about the importance and nature of the therapeutic alliance. Because CEOs tend to be narcissistically oriented (as noted by Manfred Kets de Vries and Michael Maccoby), they present important considerations and challenges to the analytic consultant relative to forming and maintaining the therapeutic alliance. The theoretical work of Heinz Kohut is particularly useful in guiding the critical task of forming a successful therapeutic alliance.

This article is taken from my doctoral dissertation that included a study of six CEOs who voluntarily sought a therapeutic intervention to enhance job performance and interpersonal work relationships. In the two cases presented in this article, the research methodology is a retrospective case narrative. Each case narrative was cocreated by both the CEO and me as the analytic consultant. My summary of the therapeutic relationship focuses on the CEO's presenting problem(s), the development of the therapeutic alliance, transference phenomenon and interpretation, and the integration of growth. The CEOs' summary is data taken from an interview conducted 1+ year(s) after the conclusion of the therapy. CEOs were asked to reflect on their experience of the therapy to get at how they described and understood the therapeutic alliance—and its impact on the treatment and their capacity to implement satisfying changes in their professional lives.