On January 17, 2025 Canadian Family Offices and Healthing.ca hosted an expert panel that explored the relatioship between “success,” mental health and stigma.
The panel featured two mental health experts from The Residence at Homewood: Dr. Ben McCutchen, Chief of Psychiatry, who provides assessment and treatment services to adults experiencing a range of difficulties including mood and anxiety disorders, substance use disorders, trauma-related disorders, and psychosis; and Paul Obermeyer, RN (Treatment Consultant), who brings more than 25 years of mental health and addictions experience to the table and works closely with clients at The Residence.
The third panelist was Elke Rubach, President, Rubach Wealth – Holistic Family Advisors, a multi-family office in Toronto. She provided insights into emotional well-being within the family office context.
Here is the full *transcript of the engaging panel discussion:
*This transcript is provided for convenience and is based on the audio recording of the video. While efforts have been made to ensure accuracy, minor errors are possible.
Joe Chidley: Good morning, I’m Joe Chidley, Managing Editor of Canadian Family Offices. And it’s my pleasure to welcome you to today’s panel discussion. This event is a joint product on between Canadian Family Offices and Healthing.ca, an online publication that aims to empower individuals to improve health outcomes through expert insights, patient and caregiver stories, and coverage of cutting-edge medical research. So, I’d like to thank Healthing for their support and input right off the bat. Over the past several years, mental illness has come out of the shadows as healthcare organizations, patient groups, and corporate initiatives like Bell Let’s Talk have worked to reduce the stigma and encourage people to get the help they need. Today’s event is an attempt to add to that conversation by focusing on a group that might sometimes go overlooked. Those that our society deems to be quote unquote successful. They could be high performing executives, heads of wealthy families, accomplished athletes or celebrities. We often view these individuals as quote unquote having it all together, but successful people are not immune to emotional and psychological challenges and their highly visible roles or positions of power might make the barriers to getting treatment even higher.
Our panelists today each bring uniquely informed perspectives to this issue and to this conversation, but first a couple of housekeeping items. On the bottom right-hand corner of your screen, you should notice a help button. If you encounter any technical problems during the presentation, please don’t hesitate to click on that button and get some assistance. And one last note, this is the first in what we here at Canadian Family Offices hope will be a series of online panel discussions throughout the year. So please take time afterwards to let us know what you think. You can send feedback to newsroom at CanadianFamilyOffices.com and it will be very much appreciated.
So, without further ado, I’ll pass the virtual mic over to our moderator, veteran journalist and frequent contributor to both Canadian Family Offices and Healthing.ca, Sarah Moore. Sarah.
Sarah Moore: Thank you, Joe. Thanks very much. And thanks everyone for joining us this morning.
I have the honour of introducing our panelists, so I’ll get right to it. I’ll start with Elke Rubach. Elke is a principal at Rubach Wealth, Holistic Family Advisors in Toronto. She’s a certified financial planner. Earlier in her career, she worked as a lawyer with McCarthy Tétrault before founding Rubach Wealth in 2012.
Elke is a frequent contributor to Canadian Family Offices, commenting on the emotional and psychological challenges that wealthy individuals and families can face.
Turning to Dr. Ben McCutchen, he is Chief of Psychiatry for the residents at Homewood, Raven’s View and Workplace Mental Health. He’s the current academic lead for Homewood Health Centre and an assistant clinical professor in the Department of Psychiatry and Behavioral Neurosciences at McMaster University. Dr. McCutchen provides assessment and treatment services to adults experiencing a range of difficulties, including mood and anxiety disorders, substance use disorders, trauma-related disorders and psychosis.
And last but not least, Paul Obermeyer is a registered nurse and treatment consultant at the Residence at Homewood. In his role as Treatment Consultant, Paul brings over 25 years of mental health and addictions experience with extensive experience in emergency psychiatry. Paul helps assess the individual treatment needs and goals of clients at the residence. So, thank you to all three of you for joining us this morning.
That was a very brief overview of what our panelists do. So, I thought I’d kick off the discussion this morning by giving each of our panelists an opportunity to just talk a little bit more about their work as it relates to today’s topic. So maybe Ben, I’ll start with you to just fill us in on the work that you do.
Ben McCutchen: Great, thanks for that introduction. Yeah, my name is Dr. Ben McCutchen and I’m a psychiatrist at Homewood Health. In my role there, I do both clinical work as well as leadership work, overseeing our teams at the residence and Ravensview.
In my clinical work, I work with patients often at our facility, the residence, which is a nine-bed inpatient unit, as well as with our workplace mental health programs. So, when we’re seeing workers that might have injuries or struggles with mental health in the workplace. So, in that work, I have the opportunity to work with patients on a regular basis, in terms of both the assessment and determinaton of treatment plans, as well as carrying out those treatment plans alongside a skilled interdisciplinary team.
Sarah Moore: Great, thank you so much. Over to you, Paul.
Paul Obermeyer: Thanks, Sarah.
First, I’ll correct something reluctantly and say I’m up to 30 years’ experience now in this field. My role as a treatment consultant. So, I’m the first line at the residence at Homewood to take inquiries from individuals and family. And what I do is provide a bit of a concierge service, helping them navigate what the program is, how it can meet their needs and walk them right through to the admission portion.
Sarah Moore: Awesome, thank you very much. And Elke.
Elke Rubach: Thank you, Sarah. Thanks for having me. At Rubach Wealth, we deal with busy professionals. The range is wide, but something we keep drilling is, let’s get your house in order. Let’s simplify before you add a complexity to your financial life. And when we deal with professionals, the higher they are, the lonelier they get. And that’s where all sorts of very emotional and vulnerable conversations, they don’t have with people they should. And we facilitate those conversations amongst family members and business partners. And we ultimately try to normalize the money conversation while making sure that their overall financial life is taken care of. And those little bricks that could crumble the entire house are in place and solid.
Sarah Moore: Great, okay, thank you very much for that overview, everybody. I wanted to circle back to something or how Joe kind of described off the top, the cohort that we’re looking at today, the sort of, we term them as successful. We’re talking about high performing executives.
Well, the heads of wealthy families, athletes, sometimes celebrities.
And before we delve into the sort of specific mental health challenges this group can encounter, I thought we might kick off the conversation by just talking about some of the personality traits that maybe this group share. I think I’ll start with you, Ben.
Dr. Ben McCutchen: Yeah, yeah, great question.
I think there’s a lot of different personality traits that we see in this cohort of paents.
The same ones that can propel somebody towards great success in business or at home or school are sometimes also the same traits that might make somebody vulnerable to a mental health condition.
Common examples might be something like perfectionism. So that’s sort of fine adherence to details, getting things right, a certain level of exactness, having high expectations. These are things that can really propel somebody forward, but sometimes left unchecked, they can result in different challenges as well. But at the residence, we tend to work with a lot of high performing individuals. And we do see some similarities.
Generally, these are people that have really high levels of self-discipline, right? They are people when they set a goal and they put their mind to it and they stick to it. They’re really good at regulating themselves. At the same time, that can also lead to being really hard on yourself as well, or struggling with things like self-compassion, all of which can be encompassed there. We also tend to see people with really high levels of intrinsic motivation. These are people that can really sort of, when they determine a purpose and sort of put stock behind that, they’re really able to sort of be drivers of their own sort of trajectory, whether it be at home or in their career.
Thinking more sort of externally. Generally, we’re seeing people that have really high emotional intelligence as well. That many high performers, they have sort of that keen intrinsic motivation, but they’re very aware of the world around them. They’re very perceptive about what other people might need around them. They have strong sense of accountability, strong sense of collaboration. Most high-performance individuals have learned they need to work well with other people to advance their own objectives. These are the very sort of personality traits we look at. Many of these are reflective of their strengths. These are the strengths we need to be optimizing when we’re helping somebody to recover as well.
Sarah Moore: Yeah, for sure. That’s a good way to look at it. I mean, in some cases, I think some of those personality traits maybe, we’ll learn a little bit more about how they might actually be a hindrance as well. Elke, with the clients that you work with, do you also sort of notice some similarities in the personalities and in the sort of, what’s the traits that have helped make them as successful as they are?
Elke Rubach: And again, we treat absolutely every individual, not just family, every individual as such, right? Everybody’s different and as many cells in their bodies. But what I find is that the higher they are, the more weight they have on their shoulders.
And they feel that changing their minds or changing routes or directions of whatever plan they had could be seen by the family members as failure. They cannot allow failure. They cannot allow disappointment.
And sometimes when you talk to them about the situation and you’re close enough, it’s very easy to facilitate a conversation where you realize that the family members weren’t even aware of the fact that they were carrying this weight. So, it’s unnecessary weight they carry on their shoulders that with a proper conversation and talking about it, it just becomes so much lighter.
If I don’t recognize that in my family, there’s somebody with depression, closer or further, depression, suicide, financial issues, bad decisions, terrible family dynamics. Not all siblings get along as families continue to grow when you have the cousin consortiums and all these things. It’s human, it happens. If you don’t talk about it, maybe you’re really talking about something that was not an issue. So, you’re not talking about something that is a very minuscule issue and you’re making it bigger in your head. And that’s where people burn out. So, if you talk about it and it’s real, I think it’s easier. So, it’s a wide range and the level of pressure and it’s different for women and men. And some women can take more, some men can take less, different generations are built differently, millennials and Gen Zs and it’s a very different, guilt is a massive one, a massive, massive one that affects people. So, it’s really being the sounding board that it’s okay, we all have issues, some more, some less, some more now, some less now, but we all take turns. If you make it a comfortable and safe place, treating everything with the utmost confidentiality and respect, I think it’s a massive help to avoid sending them to active treatment.
Sarah Moore: Right, right. You’ve touched on some of the mental health challenges that this cohort can find itself facing.
Paul, I’ll turn to you. Are there, I mean, Elke’s mentioned depression, she’s mentioned substance abuse. What sorts of, you know, we’ve talked about the personality traits that might be common among this group. What are some of the mental health challenges that you see that they’re facing that this particular group might encounter?
Paul Obermeyer: Yeah, great question. Before I get there, I will just add something. I concur with both of those responses and just add that this population tends to derive a lot of identity from their achievements, which can be good, but then can p over and be very harmful. So, what I typically see at the front door is a lot of anxiety, some imposter syndrome, some just burnout and exhaustion from trying to keep up to all the pressures that they’re under. A lot of substance abuse from ineffective coping and having the availability and the resources to again a lot of substances, which can be a real problem. Those are the main things I see.
Sarah Moore: Same question to you, Ben. Just what are some of the challenges that you see among this cohort?
Dr. Ben McCutchen: Yeah.
I think one thing that working in this field has taught me is that no level of high performance or wealth protects you from mental health challenges. Anyone can be susceptible. So, we do see some of those common conditions, like Paul referenced, depression, anxiety, substance use disorders, PTSD or other conditions.
Paul mentioned burnout, and that’s something that we see all the time.
Burnout is not, I think we’re probably at the beginning of a cultural conversation about burnout. It’s not formally a mental health condition.
In many ways, I see it really as a precursor to the variety of different possible mental health conditions. And what we’ll see is esteemed executives, they’re pushing, pushing, pushing all day long, year after year with intense pressures on them. And over time, things can shift.
There’s this sense of physical exhaustion, psychological exhaustion, starts impactng relationships.
Often times we’ll start to see this lack of enjoyment, like this work that I previously enjoyed. It’s not giving me that same feeling anymore, or even some of these relationships. Now, for people that are in early burnout, they might be doing okay during the workday, and it’s really noticeable when they get home or when that day stops. There’s the impact on their family. There’s the impact that they sort of see in their communication with their kids or other people.
So, burnout is a really significant issue. And eventually we can see the development of other primary mental health conditions. See a lot of people with anxiety disorders, right? That sort of perfectionism or particular sort of drive or rigidity again, can propel them towards success. But that same sort of level of worry can at times become excessive. It’s hard to sort of put the brakes on and start to control those worries.
Sarah Moore: I was staying with you just for a moment, Ben. I’m assuming in the same way that each person is individual and faces their own challenges. I’m going to assume that in some cases, or a lot of cases, you’re talking about coexisting challenges. So, someone who is depressed and it sort of moves into substance abuse, that kind of thing.
Dr. Ben McCutchen: Yeah, exactly.
Especially down the road. I think most conditions if left untreated, we start to see a higher risk of what we would call comorbidities or concurrent disorders, where there’s more than one condition happening. And I think there’s a variety of like sensible reasons that can happen. Now for somebody that’s dealing with anxiety, let’s say, well, left untreated for years, they might, other things might happen. That anxiety might also erode their mood and they develop a concurrent depression. So then we see really frequently is the use of substances.
That’s, that becomes sort of the tool and in the absence of other ways to manage that anxiety, the use of things like alcohol to sort of slow down at the end of the day or while some of those stresses that are coming up. So it’s really common by the time I’m meetng somebody, let’s say they’re later in their illness or they’ve had years of untreated illness, often, there’s going to be more than one thing going on at that time. For example, alcohol plus an anxiety disorder.
Sarah Moore: Before we move on to just talking about how to manage these kinds of conditions, I wanted to, and we’re sort of still staying with the area of the kinds of challenges this group can face. I wanted to zero in a little bit just on women specifically, and maybe Elke I’ll turn to you, in terms of are there sort of unique pressures that high performing executives who are women that you’ve seen in your practice that you, that they’re facing?
Elke Rubach: Again, hard to wrap everyone with the same name, but I think I frequently see women who have a lot of guilt because they’ve been working hard on breaking the glass ceiling and missed the festival of the caterpillar or the birthday or the parents gathering, and then they try to make up. I saw this exponentially during COVID, the gallons of alcohol that flowed through those homes, it was remarkable.
And it was a way of coping. You’re being pulled in a trillion directions. And fortunately, most of the people that we work with, they can afford help at home, right? But that help still needs to be coordinated and kids still need attention. And some have little kids and some have adult kids, and some of the adult kids started with substance abuse situations. And then you have marriage breakdowns and everything at the same time. So, for some reason, some of the women that we work with felt that it was a failure on their part that during COVID their marriage broke up or broke down and the kids started drinking. So, there’s the internalizing things that you can’t, I mean, you can’t just say I have no responsibility, but the constant pressure of performing, delivering, going from meeting to meeting every 30 minutes, Zoom nonstop, that made many of them burn out.
I think that was the most common one that led to, pill consumption and cocktails of pill and alcohol, some a bit more complicated. And it’s unfortunate. I think at the end of the day nobody should go at it alone. It happens to all of us. That’s why we’re human beings and we’re supposed to be coexisting and talking about things. And shame is not going to solve the problem. You have to talk about it. And if you don’t want to talk about it with your family, you start with professionals. And sometimes people think that going to a therapist is a failure, they’re going to be considered crazy. And nothing could be further from the truth. Ultimately, you’re hearing yourself and trying to solve a problem that might not be as complicated. So, it’s really not trying to go at it alone because you’re not alone, period. You’re not alone unless you choose to be alone. And by the same token, if you don’t choose to look after yourself and give yourself that half an hour of meditation, that half an hour of looking at the wall because you don’t believe in therapist or you’re scared to go, like start somewhere. Start with a friend. That friend might lead to something. There’s so many people that really don’t talk about it, that it just becomes a cocktail in their head and then they blow up. And it’s very sad to see situations that could have been solved by talking.
Sarah Moore: Agree completely. I think we’re sort of, you’re talking a little bit about stigma and some barriers to care that this group in particular might be seen as a failure or they don’t want to appear weak in any way. Paul, what you’ve described yourself as the sort of first line that people meet when they arrive at the residence at home?
What kinds of things do you see? Like what sorts of levels of anxiety do they have when they come in? Are they awash in guilt? Are they, you know, is stigma a real kind of barrier, do you think?
Paul Obermeyer: Yeah, yeah. Before I get to that, I think it’s worth mentioning another trend that we see quite often is around, and it’s around identity, which I mentioned earlier, and it’s that transition period, whether that be a career ending injury for an NHL player or that executive who is moving into retirement and has given his life and identity to that role and now has no purpose. So, there’s a lot of existential crises we see from people being admitted. And that’s, we see a lot of anxiety around that. The anxiety at this point, when they’re considering treatment, unfortunately is ofentimes quite severe to the point that they’re so ambivalent that they need encouragement from family members and other supports to actually make very kind of basic, or what we would consider very basic decisions. So, they’re a term I use frequently is they’re paralyzed by this anxiety. And there’s this doubt and this questioning if this treatment’s really going to work. And it’s a very, very common theme that I see at the front door. Fortunately, I get to see them weeks out and see a much improved level of anxiety and gratefulness for persevering and going through the admission process.
Sarah Moore: Ben, Elke has talked a lot about how open communication can help sort of at least kind of give some oxygen to some of these problems and issues that this cohort might be facing.
In terms of what are the dangers of not addressing a mental health issue, whether it be depression or any of the other sort of conditions that we’ve talked about this morning?
Dr. Ben McCutchen: Yeah, I think broadly speaking, when we think about the definition of a mental health condition, there’s certain mental health symptoms, but really the defining feature is either impacts on somebody’s quality of life or impairment and function. And in most cases, both of those things are happening simultaneously.
So when we’re talking about an untreated illness, really those patients or those people will be, they’re going to have a higher risk of maybe not enjoying their quality of life or not having sort of the possible fulfillment that they could have or actually not functioning the way that they could based on their skills. And for some people that’s more apparent, that functional impairment, but I also know that sometimes it’s more subtle. Somebody might have a mental health condition and they’re realizing, boy, this is really impacting my performance at work, but sometimes it can happen in subtle ways too.
It’s only until after they’ve received treatment that they realize this really was impacting.
What am I doing with my relationships? This was impacting, I was talking to my coworkers, this pessimism that I thought was intrinsic to my group of colleagues here. Actually, that was something that was coming from me.
Scientifically, what we’re learning, and this is sort of over decades, but what we’re learning is there’s also risks with what we call duration of untreated illness. Meaning when a condition is left untreated, there’s certain changes that can happen that over time can make this harder to treat or slower to recover or have a higher risk of relapse. And there’s probably a couple of different things that are happening there. So, if you think about a really active depression, in some ways it can have an effect on the brain where it’s then harder or slower to respond to eventual treatments. And then there’s also psychological dimensions to that. When we think about depression, sometimes, well, many people are probably familiar with the language of cognitive distortions, and sometimes there’s these skewed ways of seeing ourselves in the world and people around us. Sort of left untreated, those pessimistic or negative or catastrophic ways of seeing things, they become more ingrained, more entrenched, harder to sort of separate from this illness from our worldview or how we see ourselves.
Regardless, any mental health condition is treatable, even when left untreated.
But recovery is sometimes more robust and quicker and more nimble when we can treat it early.
And I’ll also say it’s not uncommon though, that we’re meeting people that might have years or even decades of untreated illness. That is still the norm in many ways, especially in certain professions.
Sarah Moore: Elke, with the folks that you work with, and if you start detecting that there might be some issues, how do you get families to sort of, whether it ends up being a recommendation to seek professional help or just to sort of get them talking once you sort of sense that maybe not everything is as it should be, how do you help families and clients navigate that?
Elke Rubach: We do encounter that quite often, more than we would hope.
For me, it’s important too. My firm doesn’t take, we’re not a retail shop, we’re taking 3000 clients a week. When we have our clients, we really dedicate a lot of me to their own situation. You get to know them, they start confiding in you the things that might be bothering them. For me, it’s important to know where my limits are from a capacity and professional standpoint, and be a resource to them and say, “Listen, you know what? This is bigger than what I can handle for you. Do me a favor, let’s go talk to fill in the blank.”
I encourage them, and I always say, I’m not the good news fairy. If there’s a financial problem, I’ll tell them. If there’s a psychological problem, I’ll tell them. If I see addictions and weird behaviors, I’ll tell them. Because ultimately, I’m here to make suggestions, but they decide.
And if I see that there’s something just not clicking, and you have to be reading body languages and seeing conversations and understanding the family dynamics, and really listening really hard, pay attention to what they’re saying. Because there are certain words that have a much deeper meaning than your dad’s favorite.
Sarah Moore: Right.
Elke Rubach: Whoa, okay, because then we feel less, we feel hard done by, we’re knocked out of breath. But you try to open up the conversation, and if they’re willing, we can guide. And again, with full awareness that there’s a limit, right? I’m not a psychologist, I’m not a trained therapist or anything, but I’m human, I see it, and I see that there’s an opportunity for this person to explore that feeling. And it’s ultimately a bunch of feelings that come together that create a lot of noise in their head, and then that’s when you see suicide, because they see no hope, they had no one to talk to, in their head, they had no one to talk to. And that’s what I want to avoid. Or substance abuse, I mean, substances are available everywhere.
One of the questions that I ask is like, how much money do you need to wreck a child? Because sometimes people say, I don’t want to leave too much money to my kids. I’m like, how much is too much money?
How much is ecstasy worth? Or any of those pills? And they’re 20 bucks, they’re available everywhere. You just need one bad luck with fentanyl, and off you go. So how much money do you really need to wreck a family or a kid? It’s better to have the conversation, right? And talk about things openly. And they’re not going to go anywhere if you don’t, like the two-year-old kid that covers their eyes, hoping that the problem is going to disappear, it doesn’t. So, let’s talk about it.
Sarah Moore: I think, Paul, I’ll turn to you when you have an opportunity to see up close when residents have got to the point where they’re seeking treatment.
What Elke was talking about, the voices in the head, or just the negative self-talk. What do you see over the course of, as people are encountering treatment, do you see changes that they’re going through or just giving, allowing the space to either express themselves or actually find the space in the time to really do some self-evaluation? Do you see the sort of effects of that?
Paul Obermeyer: Yeah, it’s interesting. You bring that up. There’s a pattern I see that this population wants to be busy, busy, busy during treatment because that’s the life they’re used to. And what they need to adapt to, or they eventually learn, is that they need time to actually process all the therapy and the individual sessions that they receive. So people at the residence get eight to 12 individual sessions each week. And some like to think, I want to be busy 20 hours a day. And really, it’s part of the treatment plan that is developed by this interdisciplinary team to actually insert downme for people, which is interesting. It’s an interesting model, but quite appropriate.
I think Dr. McCutchen would speak better. I lose clinical contact once a person commences treatment. So I don’t get an upfront clinical understanding of the progress they’re making. And maybe Dr. McCutchen can elaborate on that a bit.
Sarah Moore: Ben, do you want to take it from there?
Dr. Ben McCutchen: Yeah, of course, yeah.
Treatment has to be patient-centered and based on a person’s preferences. And so good treatment can look really many different ways. For some people, that’s psychotherapy. For other people, that’s finding the right medication. For other people, that’s more interpersonal interventions like building up or bringing the community around them to be supportive, absence from substances.
Paul, I think touched on a really interesting idea, which is, I think it’s relevant for this group and it’s relevant for protecting against burnout, which is finding that balance between productivity and leisure and relaxation.
Most sort of driven, esteemed professionals, they’ve mastered the productivity piece. And they take that same mindset into treatment. How can I do as much as possible in the smallest amount of me?
One thing I’ve learned over time is that leisure, relaxation, these are skills.
They’re skills that sound simple and they’re not.
They’re skills like any skills. If we don’t use them, we lose them. They need to be practiced.
And sounds simple, but it’s really not. How do you build leisure into your life? Especially a life that’s been based around productivity, where it’s all about getting things done, hitting certain targets.
And for many people, that productivity, it takes up a lot of space in their life. Especially when they’re at a point in their careers where when they’re really at the peak of their careers, usually it’s also productivity in other parts of their life. They’re raising children, they’re caring for parents. Everything becomes about a certain drive or to meet a certain task or achieve something in particular.
Sarah Moore: That’s interesting having to teach leisure, but it makes sense in the sort of fast pace hyper productive environment that many of us feel ourselves in. Just staying with you briefly, Ben, I’m thinking about resilience and whether or not that’s also, how do you kind of help people, whether it’s towards the end of treatment or equipment with tools so that they once they are back out in the world or they’re finished treatment, that they can navigate challenges on their own.
Dr. Ben McCutchen: Yeah, many different things that are used. It really depends on each person’s context, right? There’s no one size fits all with mental health treatment. It has to be tailored. And that’s why all good treatment starts with a really thorough assessment.
That’s what makes this feel pretty interesting day to day is that depression in one person is going to look different from depression in another. And so good treatment typically involves in building things like resilience, really understanding what are the factors in this person’s life that are actually contributing to this illness and how then will treatment directly address those things. Broadly speaking, this is tailored care and we believe it’s essential.
An example would be, if we’re taking illness like depression, we need to look at all dimensions. There’s going to be biological dimensions, someone’s family history, medical conditions that are contributing, substance use disorders, genes and other things that are going to contribute to illness, but there’s also psychological dimensions. How is somebody’s personality contributing to this, previous traumas or adverse experiences as well as social factors?
What does the world around this person look like? What does their community look like? And once we get that biopsychosocial understanding, then we can start to figure out what’s needed here, both to treat this illness as well as the resilience. The resilience is a big piece about how do we prevent this from coming back?
Sarah Moore: Right.
Ben McCutchen: By the time they’ve met us, this illness has had a big impact on their life. We want to help somebody not just feel better, but also stay well over the course of their lifetime. So there’s a lot of different things we look at. Some of it is universal, exercise, eating healthy, receiving psychotherapy if it’s warranted. Then there’s other treatments, you know, that involve family and friends and things that we need to do and communicate to make sure that we have support. For some people it’s medications, other things that help them to stay well.
Sarah Moore: Yeah, I think that the family dynamic is really important.
And Elke, maybe I’ll turn back to you in terms of what you maybe get kind of an up close view on family dynamics and how that sort of impacts, whether it’s financial planning or just navigating the future. And how do you help families achieve the goals that they’ve set for themselves?
Elke Rubach: That’s what I love about what I do. Every family is different. So, the thing is that you’re dealing with two or three or four generations with very different mentality.
To just pick one starting point, say generation one. Newcomers, post-war children, where their parents never took the time to talk about emotions or feelings or dad went to work, mom cooked, they fed you, they sent you to school, you’re properly dressed. What are you talking about emotions kid? You’re going to be a doctor, a lawyer, a dentist, an accountant. And other than that, you’re a failure. Okay, off you go. Well, off goes generation two, doctor, accountant, lawyer.
And some were born to be that, but a vast majority were not.
And they would never question the parents’ decision or seeking approval from the parents. And they live a half-lived life and they’re not thrilled but they can’t pinpoint what’s going on but they would never change their mind because they would be a failure to society.
My personal case, when I left law, people looked at me like, did you hit your head?
Well, it was not an easy decision but I don’t regret one second of it. And then the people we work with or even more so when dad created a company and generation two is expected to run the company.
And then generation two says, well, I like the lifestyle.
I can’t really betray my dad. So off I go to run the company. And the value of the enterprise may start hurting because they really didn’t have it in them. They didn’t have the same vision, the same passion or if they’re trying to make changes, dad flips the table. And then you have generation three that says, there’s absolutely zero chance in hell I want to do with anything that my parents are doing because I actually want to have a relationship with my kids. I actually want to drop off my kids in school when I have to. And my dad thinks that I’m a lazy body because I drop off my kids in school and I’d rather sacrifice a profit over time with my family. So it’s a very different approach to us very,
I would say not the same issue because nobody lives the same issue.
Everybody takes it differently and it’s allowing vulnerability and open conversation that may solve the problem. And once they agree how to maximize the value of the enterprise, be it a career, be it a business, be it as so on, sometimes the best thing to do is to change course and look after yourself because it really is of zero use to have $10 million in the bank or $100 million in the bank and be dead or be dead alive, it’s even worse, right? And I’ve seen suicides and I know what they cost to the family and that trauma is really hard to come back from.
And I always protect the kids and I want them to be in the healthy environment. You can’t save everyone, but it’s only by talking about it.
Sarah Moore: And when you have an opportunity to guide people into open communication, I’m assuming you’ve seen circumstances where that has made a difference. You’ve been able to sort of encourage everybody to kind of lay their cards on the table and that has helped.
Elke Rubach: Very quick, I have an example of a father planning for the next generation and his words were, these kids are going to burn every dollar and leave them. Oh, okay, have you ever told them your story?
Why should I? They don’t need to know that I slept in the car, so we organized a tour of the plant. Did I really need to know how these widgets are built? No, but we went with the kids and I was asking the dad because he refused to talk to the children, all these questions. So, when your loans were not going through and you couldn’t make payroll and you had to split the soup and four pieces, how did you do it? And the kids were like this, just listening to dad or the story, we turn around and we have three completely fully grown adults crying and saying, “Daddy, you never told us this.”
Because he felt that that would be weak on his part and I’m like, it’s human, right? So if you enable those conversations, I’m not saying it’s going to work, but at least you got to try.
Sarah Moore: I’m wondering maybe I’ll turn to Paul, whether that kind of anecdote, does that resonate with the kinds of things that you see in your work when something is split open and the kind of effects that that can have?
Paul Obermeyer: Yeah, yeah, absolutely. I would add that we know from lots of research that the more family support, the better the outcome. So we, as a team always strive to have family involved now that there’s a personal health information protection act that we have to consider when trying to include the family.
Yes, I see a lot of pressure to live up to the legacy of the family and keep that going. And that’s where I see a lot of kind of in foster syndrome or just burnout or really worried about letting dad or mom down that they don’t want to follow suit. But I would agree with Elke, there’s a, you get that kind of first generation assuming that the offspring are going to take it over. And that’s not always in their plan for life.
Sarah Moore: Right, just thinking about individuals that have either had a breakthrough or have undergone treatment. Ben, what do clients and patients tell you about once they’ve been through that kind of journey, how that’s impacted their lives?
Dr. Ben McCutchen: Yeah, yeah, it’s always exciting to hear those comments, right? I’ll generally see a patient on the first day of treatment and the last day of treatment. And we hear diverse things. Probably some common themes would be, I wish I had done this sooner, right? When they’re coming in, often times there’s reluctance to treatment, right? Didn’t know if this was going to work, I didn’t know if this was worth it. I wasn’t sure if the time I was going to dedicate to this would have an impact. And then leaving treatment, it’s, oh, I wish I had done this five years ago.
I don’t know why I was so hesitant to go down this road.
Somebody might be coming in with a certain objective. Let’s say I’m struggling with depression, I’m hoping to feel less depressed. That will happen over treatment, but often it’s these other changes that they weren’t expecting. I didn’t expect to find my work enjoyable again. I didn’t expect to be having as much fun with my kids again. I didn’t expect that all of these things I thought were challenges. Now I’m sort of looking at them as like, mountains I want to climb. I’m approaching this with now a different level of enthusiasm and excitement and optimism. And I hadn’t realized that all this other stuff that was going on was actually ed to my mental illness. I thought that was just my surroundings. So those are the types of transformations we see. And sometimes it’s big, sometimes it’s small. It’s not always a breakthrough. Some people it’s, I now feel ready to keep doing this. I feel ready to keep with continued treatment. I now know how important this is. Those are the types of things we really get excited when we hear.
Sarah Moore: Paul, it sounds like we’ve talked a lot about how it sounds like people get into, I mean, high performing individuals, all of us, kind of a rut, right? And you don’t just as Ben said, you don’t even realize maybe it’s actually part of a mental health challenge.
I wonder if you could just comment further on that about how, particularly people who have a lot of pressure on them and families are relying on them and businesses are relying on them, how it’s, you can kind of get tunnel vision in a way.
Paul Obermeyer: Yeah, yeah.
Oftentimes, like Dr. McCutchen said, people are coming to us pretty reluctantly and have a lot of external pressure from family or sometimes coworkers that are partners in their practices or businesses.
And so, they are reluctantly coming in and they’ll often look at something like medication. Okay, I’ll look at medication. But as Dr. McCutchen said, with this kind of interdisciplinary approach, there’s a lot of benefits that they didn’t expect to come through. So that might be working with a rec therapist around leisure and having this catharsis that that has been missing in my life for 40 years, or working with an occupational therapist around mindfulness and really becoming centered and present and seeing things.
So, I would absolutely concur that they do come, a lot of people come in with this narrow goal and realize that mental health is quite pervasive and it affects every area of our life. And some of the things that they would think are hokey, like horticulture therapy, are actually very therapeutic for people. So I see a lot of that. That’s actually one of the best things I see here. This kind of poo-pooing the idea of horticulture therapy. And then weeks later, these same people are showcasing what they made in horticulture therapy to me. And so just like Dr. McCutchen said, there’s a lot of improvements that people don’t anticipate that actually add to their success for coming into treatment.
Sarah Moore: Great.
This feels like a nice place to sort of transition to. We had some of the folks who registered today and some of the attendees had sent in some questions that they wanted to explore pertaining to this topic. And I feel like when we’re talking about how treatment can help and sort of how things like exploring horticulture and leisure and sort of getting more back in touch with self can help.
If it’s okay, I thought I would turn to a couple of the questions that attendees had sent us.
So, one that we received was how can we create space for high achievers to deal with mental health challenges without impacting their credibility and reputation in their professional world? And maybe Elke, I’ll start with you. I mean, we sort of talked a little bit about stigma, but somebody maybe who’s recognized in their professional world that they’ve got a challenge. How can we help them with that?
Elke Rubach: Literally, just do it. Whether it’s blocking time off your calendar, and you can name it appointment with whatever or meeting with whatever.
If you don’t start yourself, nobody’s going to notice it because everybody’s busy, right? And if somebody else notices first, it might be way later than you would have wanted that to happen. So, if you’re feeling off, you’re feeling that you don’t have joy for what you do, you’re not sleeping well, that probably means that your cortisol levels are high. Why is it? Just be mindful and not necessarily.
Seeking help doesn’t mean you’re crazy. Seeking help doesn’t mean you’re weak. Seeking help doesn’t mean you’re a failure. If anything, call it an opinion. Reach out to someone and have the conversation. Let the pressure out.
If you need an hour a week to go for a walk and not talk to anyone and just get in your head and see when things, you know, deal with nature or something together or bake something, go for it. The other thing I recommend to people when I start seeing them a little stressed is like I share with them that one time I was tasked with five minutes of doing nothing.
That is so hard. You can’t be, and she said, you can’t have any, at the end of the five minutes, you cannot have anything you’re proud of. You did not empty the dishwasher. You did not write anything. You have to sit down and do nothing for five minutes.
And of course you start and you’re like, okay, made it to 20 seconds, okay, made it to 45 seconds. I don’t think I’ve ever made it to five, but I’ll keep trying. But it’s really separating your well-being. At the end of the day, you are the goose, and I’m talking about these high performers. You’re the goose that lays the golden egg.
If you’re gone, there are no eggs. Okay, so the goose is needed. If you own that goose, what care would you give that goose if it was in your hands?
Another question we ask is, what advice would you have given yourself when you were eight years old? Obviously, ours is from a financial perspective, right? And it’s kind of like …it’s okay to make changes. It’s okay to the, from the psychological point of view, I assume it is the same. How would you treat your eight year old? How would you think about it? It’s okay. It’s okay. You’re not crazy. You’re not a failure. We all go through it. And if you recognize it, you’re ahead of the curve. You’re off to the races. But you have to make a point of blocking that hour, two hours, whatever hours you need.
Sarah Moore: Absolutely.
Ben, this question sort of speaks a little bit to, without impacting credibility and reputation, sort of speaks to confidentiality and this sort of fear maybe that people have in seeking health in the first place. Is this going to get back to my public reputation?
And I can only assume that that’s sometimes a barrier to seeking care, but do you find that maybe in today’s world, that mental health challenges and talking about mental health is a little bit more in the vernacular or are you finding in talking to your clients that when we get to the C-suites in the upper echelon, it’s still taboo?
Dr. Ben McCutchen: Yeah, that’s a great question. I think in general, yeah, I agree that culturally we’re having more conversations about mental health, even conversations like the one we’re having today. Probably wouldn’t have been having this conversation many years ago.
Despite that, there’s certainly a lot of that, that taboo that remains, that internalized stigma that comes from our experiences, especially for those high performing professionals where they are concerned about the impact on their career, the impact on their life insurance or their disability insurance or all of these other things, even within the protection of confidentiality.
What I’ve learned over time is that having tailored and discreet care is vitally important.
Outwardly, somebody can be an advocate for mental health and yet when they’re receiving treatment, it can be really hard to share that.
It’s not uncommon that I might be working with someone that outwardly they’re able to have a conversation about maybe the health of their employees, but they might be struggling to share with their partner or their brother that they themselves are receiving treatment.
And I think it exists in many different ways. There’s the Bell Let’s Talk, which really promotes sort of this vocalizing of things. But on the other end of the spectrum is receiving discreet, private care and gradually inviting people into that circle of care when I feel comfortable, when I have the vocabulary to talk to my family about it, when I feel confident that there’s trust, when I know I’m sharing it with people where I’m going to be met with support.
Those are the ways that we sort of build up that conversation and openness in a private, discreet way.
Sarah Moore: That actually sort of touches on another question that we received from an attendee about how families can ensure that if they’re encountering mental health challenges, that it doesn’t somehow filter down to a younger generation. How can we help our children not be open and so on? And I’m just wondering if that’s also sort of comes up with people that you’re working with, whether or not they’re, if they’re concerned about that and how you help them with that.
Dr. Ben McCutchen: Yeah, it’s an interesting question. Because a lot of times younger people are teenagers, nowadays they might have a beer vocabulary around.
Mental health, well-being, and yet there’s skill a really important role for parents and families to be promoting these conversations. And how do we talk about this in a way that’s open, it’s not promoting shame, it’s not promoting guilt, so that younger people or teenagers, when they are struggling, they feel like they can reach out and they’re going to be met with nothing but support.
And yet it’s also an intricate sort of conversation. I think there’s also a value in sort of separating an illness from identity. I think there’s sometimes a risk that for younger people, that illness becomes a part of the identity. Yeah, that’s why we use the medical model. This is something that everyone is vulnerable to, that it requires dedicated treatment, that there’s no shame in experiencing this, but it’s also not who you are.
Sarah Moore: Right, right.
Before we wrap up, I just wanted to sort of throw this to the panel at large, just in terms of, is there anything that we haven’t touched on or that you think is important to emphasize in this conversation before we say our farewells? Maybe I’ll turn to you, Paul, is there anything that you think is important? Sort of underscore here.
Paul Obermeyer: Yeah, I would underscore a term that’s been used quite a bit today and it’s balance. So, some of the traits that have led to what we as a culture say are successful people can also be the double-edged sword that results in a lot of self-deprecation, doubt, and depression and anxiety.
So, I think it behooves all of us to really step back and look at our lives and try and aim for balance instead of one end of the spectrum or the other. That’s what I would reinforce to everybody.
Sarah Moore: Great, Elke, how about you?
Elke Rubach: I think each of us sits down and has a little conversation with ourselves and realizes that we’re in an uncomfortable place and there’s something we want to change for whatever reason.
Something I always want everyone to keep in mind is that your kids are watching, kids 40s, kids 10s, kids whatever. And you’re a role model to them. If you don’t want them to go through what you’re going through, you need to enable those conversations because otherwise they won’t know that it’s okay to talk about it. And it’s incredibly uncomfortable. The first one is harsh, the second one gets easier and the third one makes it more natural. But if anything, be the role model to remove stigma and really talk at the dinner table with your kids about your wins, your losses, your stresses, your what’s not working in my life. Because when you share that with your kids and your family around more than criticism, there’s a good chance you’ll find empathy.
And when you talk to other people say, well, my family too, and we had that too and I’ve heard that too. If we normalize a conversation, be it money, mental health, all these things, I think it’s a lot lighter for everyone. And ultimately if you don’t want that for your children, you have to be the change.
Sarah Moore: Yeah, I think that’s a good takeaway in terms of the conversations whether under the, if you’re talking about legacy planning or it doesn’t have to be just about what pot of money is going where, right? It is about normalizing things like failures along the way and that kind of thing. So, when you’re talking about those dinner table conversations, not just always to make it about money and financial planning, right? I’m assuming this is sort of, it’s a breadth of topics.
Elke Rubach: It’s never about money.
Sarah Moore: Yeah. Ben, last word to you.
Dr. Ben McCutchen: Yeah, sort of in conclusion, thanks so much for facilitating this. I think, generally, I’d encourage people to consider what an investment in their personal health and their personal well-being looks like. And even with a growing conversation around mental health, there can still be this underestimation of the value of taking care of your mental health and how that’s going to pay off in terms of quality of life, your relationships, your success in your career, your capacity to enjoy all of those things and see all of these stressors actually like challenges that you can grow with. So, thanks so much for facilitating the conversation today.
Sarah Moore: Great, well, thank you. Yeah, I’d like to wrap up by thanking our panelists. Everybody has been really generous with information and topics and anecdotes. And I think, it’s been a really nice, well-rounded conversation about facing mental health challenges. So thank you very much.
Elke Rubach: Thank you.
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