mental health

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Mental health startup eQuoo will be distributed by Unilever in new global youth campaign

Last December (yes, in the before-times) U.K.-based mental health startup eQuoo had a round of announcements, becoming the NHS-approved mental health game, as well as signing Barmer, the largest insurance company in Germany, as a client.

It has now been selected as the Mental Health App for Unilever’s new global initiative aimed at the mental health of young people. The move came after Unilever’s People Data Centre (PDC) selected eQuoo out of all the mental health games on the Google Play store, being, as it is, one of the few backed by scientific research. Unilever’s new brand campaign, which will feature eQuoo app, will be marketed to over 70,000 18 to 35-year-olds.

“eQuoo teaches important skills in a fun and engaging way,” said Unilever’s Global PDC Search and Social Analyst, Janelle Tomayo. “The game teaches you how to become a better communicator using fictional characters to navigate through difficult circumstances with skills and storylines empirically based on current psychological research.”

Silja Litvin, founder and CEO of eQuoo said: “1 in 3 young adults experience an anxiety disorder, crippling and harming too many people at the cusp of their adult lives. Together eQuoo and Unilever will equip thousands of people with the personal resilience to manage the pressures of today’s world.”

PsycApps, which makes eQuoo, is a digital mental health startup that is using gamification, cognitive behavioral therapy (CBT), positive psychology and AI to treat mental illness, using evidence-based features. It has achieved a top rating at ORCHA, the leading health app assessment platform, and is also available through the GP EMIS data bank, meaning that NHS doctors can now refer their patients to eQuoo to improve their mental health and well-being.

The market for mental health-oriented games and apps is increasing considerably. AKILI, the first ADHD game for children, attained FDA approval. In June, the European Medicines Agency approved Akili’s digital therapy for attention deficit hyperactivity disorder (ADHD), which uses a video game to treat the underlying cause of the condition. The European Commission has granted a CE mark for the game called EndeavorRx, allowing the product to be marketed in Europe.

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On-demand mental health service provider Ginger raises $50 million

Ginger, a provider of on-demand mental healthcare services, has raised $50 million in a new round of funding.

The new capital comes as interest and investment in mental health and wellness has emerged as the next big area of interest for investors in new technology and healthcare services companies.

Mental health startups saw record deal volumes in the second quarter of 2020 on the heels of rising demand caused by the COVID-19 epidemic, according to the data analysis firm CB Insights. More than 55 companies raised rounds of funding over the quarter, even though deal amounts declined 15%, to $491 million. That’s still nearly half a billion dollars invested into mental health in one quarter alone.

What started in 2011 as a research-based company spun out of work from the Massachusetts Institute of Technology has become one of the largest providers of mental health services primarily through employer-operated health insurance plans.

Through Ginger’s services, patients have access to a care coordinator that is the first point of entry into the company’s mental health plans. That person is a trained behavioral health coach — typically someone with a master’s degree in psychology with a behavioral health coaching certificate from schools like Duke, UCLA, Michigan or Columbia and 200 hours of training provided by Ginger itself.

These health coaches provide the majority of care that Ginger’s patients receive. For more serious conditions, Ginger will bring in specialists to coordinate care or provide access to medications to alleviate the condition, according to the company’s chief executive officer, Russell Glass.

Ginger began offering its on-demand care services in 2016 and counts tens of thousands of active users on the platform. The company charges companies a fee for access to its services on a per-employee, per-month basis and provides access to mental health services to hundreds of thousands of employees through corporate benefit plans, Glass said.

More than 200 companies, including Delta Air Lines, Sanofi, Chegg, Domino’s, SurveyMonkey and Sephora, pay Ginger to cost-efficiently provide employees with high-quality mental healthcare. Ginger members can access virtual therapy and psychiatry sessions as an in-network benefit through the company’s relationships with leading regional and national health plans, including Optum Behavioral Health, Anthem California and Aetna Resources for Living, according to a statement.

“Our entire mission here is to break the supply/demand imbalance and provide far more care,” said Glass in an interview. “Ultimately we want Ginger to be available to help anybody who has a need. Being accessible to anybody, anywhere, is an important part of the strategy. That means direct-to-consumer will be a direction we head in.”

For now, the company will use the money to build out its partner ecosystem with companies like Cigna, an investor in the company’s latest $50 million round. Ginger will also look to getting government payers to reach more people. Eventually direct-to-consumer could become a larger piece of the business as the company drives down costs of care.

It’s also investing in automation and natural language processing to automate care pathways and personalizing patient care using machine learning.

The company’s $50 million Series D round was co-led by Advance Venture Partners and Bessemer Venture Partners, with additional participation from Cigna Ventures and existing investors such as Jeff Weiner, executive chairman of LinkedIn, and Kaiser Permanente Ventures. To date, Ginger has raised roughly $120 million. 

Even as Ginger is working through the existing network of employer benefit plans and standalone insurance providers to offer its mental health services, other startups are raising money to offer employer-provided mental health and wellness plans. SonderMind is working to make it easier for independent mental health professionals to bill insurers, AbleTo helps employers screen for undiagnosed mental health conditions and SilverLight Health partners with organizations to digitally monitor and manage mental health care. 

Meanwhile, other startups are going direct-to-consumer with a flood of offerings around mental health. Well-financed, billion-dollar-valued companies like Ro and Hims are offering mental health and wellness packages to customers, while Headspace has both a consumer-facing and employer benefit offering. And upstart companies like Real are focusing on providing care specifically for women.

With its funding round, Ginger is adding David ibnAle, a founding partner at Advance Venture Partners (AVP), which is the investment firm behind S.I. Newhouse’s family-owned media and technology holding company, Advance; and the digital health investment guru Steve Kraus from Bessemer Venture Partners. 

“AVP invests in companies that are using technology to tackle large-scale, global challenges and transform traditional businesses and business models,” said David ibnAle, founding partner of Advance Venture Partners. “Ginger is doing just that. We are excited to partner with an exceptional team to help make high-quality, on-demand mental health care a reality for millions of more people around the world.”

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As demand for mental health services soars, SonderMind raises $27 million to expand its services

“Our real focus is on democratizing mental healthcare,” says SonderMind co-founder chief executive, Mark Frank.

His company, founded back in 2017, is having a moment. With the restrictions and economic stresses caused by the government’s efforts to mitigate the spread of the COVID-19 epidemic in the U.S., demand for mental health services is soaring. And it’s compounding what was already a mental health crisis in the U.S. 

A 2019 article from Bloomberg Businessweek laid out the scope of the problem in stark terms. In 2017, 47,000 people died by suicide in the U.S. and there were 1.4 million suicide attempts — a suicide rate that’s the country’s highest since World War II, according to the Centers for Disease Control and Prevention. Drug overdoses, another measure of the nation’s anguish, killed 70,000 people in 2017. Another 7% of U.S. adults reported suffering at least one major depressive episode in 2018.

Taken together, the data points to a tremendous health problem. One that the current healthcare system is only now grappling with.

SonderMind’s chief executive sees his company as part of the solution.

Most mental health practitioners don’t operate within a healthcare network or take insurance, which means that the only folks with access to care are the ones that can afford the high price of therapy. SonderMind changes that equation by offering practitioners a toolkit and back office services so they can bill insurance providers and take care of the operational side of running a healthcare practice. It also acts as a funnel, gauging the needs of potential patients and connecting them to the therapists that are best suited to provide them the care they need. That lets practitioners focus on seeing patients, the company said.

The company currently counts 500 providers on its marketplace, which operates in Colorado, Arizona and Texas, and has raised $27 million in its latest round of financing to extend its services to other parts of the U.S.

The San Francisco-based investment firm General Catalyst led the financing, which also included additional new investors F-Prime Capital and participation from previous investors like the Kickstart Seed Fund, Diōko Ventures (managed by FCA Venture Partners) and Jonathan Bush. 

“This financing provides the fuel to support our growth objectives and advance our mission to make behavioral health more accessible, approachable and utilized by building a modern marketplace that holds great appeal to both clinician and patient,” said Frank in a statement.

The investment extends General Catalyst’s funding into healthcare services in recent years and represents a continued emphasis on healthcare services for the firm. “Healthcare is obviously a really important thesis for GC as a whole,” says Holly Maloney, a managing director at General Catalyst. “This is going to be one of the largest value drivers for VC this decade.”

General Catalyst already had a robust portfolio of healthcare-focused companies — including Livongo, OM1 and Oscar Health.

For Maloney, the investment in SonderMind grew out of the firm’s exposure to mental health investment through another portfolio company, Mindstrong Health. “Mindstrong forced us to explore… access to care and finding care,” says Maloney. 

The General Catalyst investor sees the investment in SonderMind as also helping to open doors for more people to join the profession.

“It helps people to start their business for sure. It helps more people pursue it as a career path,” she said. And that’s good for a country where more mental health professionals and better access to care are desperately needed. 

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Torch & Everwise merge into affordable exec coaching for all

While companies might pay for a CEO coach, lower level employees often get stuck with lame skill-building worksheets or no mentorship at all. Not only does that limit their potential productivity, but it also makes them feel stagnated and undervalued, leading them to jump ship.

Therapy… err… executive coaching is finally becoming destigmatized as entrepreneurs and their teams realize that everyone can’t be crushing it all the time. Building a business is hard. It’s okay to cry sometimes. But the best thing you can do is be vulnerable and seek help.

Torch emerged from stealth last year with $18 million in funding to teach empathy to founders and C-suite execs. Since 2013, Everwise has raised $26 million from Sequoia and others for its peer-to-peer mentorship marketplace that makes workplace guidance accessible to rank-and-file staffers. Tomorrow they’ll official announce their merger under the Torch name to become a full-stack career coach for every level of employee.

“As human beings, we face huge existential challenges in the form of pandemics, climate change, the threats coming down the pipe from automation and AI” says Torch co-founder and CEO Cameron Yarbrough. “We need to create leaders at every single level of an organization and ignite these people with tools and human support in order to level up in the world.”

Startup acquisitions and mergers can often be train wrecks because companies with different values but overlapping products are jammed together. But apparently it’s gone quite smoothly since the products are so complementary, with all 70 employees across the two companies keeping their jobs. “Everwise is much more bottom up whereas Torch is about the upper levels, and it just sort of made sense” says Garry Tan, partner and co-founder of Initialized Capital that funded Torch’s Series A and is also a client of its coaching.

How does each work? Torch goes deep, conducting extensive 360-interviews with an executive as well as their reports, employees, and peers to assess their empathy, communication, vision, conflict resolution, and collaboration. Clients’ executives do extensive 360-interviews. It establishes quantifiable goals that executives work towards through video call sessions with Torch’s coaches. They learn about setting healthy workplace boundaries, staying calm amidst arguments, motivating staff without seeming preachy, and managing their own ego.

This coaching can be exceedingly valuable for the leaders setting a company’s strategy and tone. But the one-on-one sessions are typically too expensive to buy for all levels of employees. That’s where Everwise comes in.

Everwise goes wide, offering a marketplace with 6,000 mentors across different job levels and roles that can provide more affordable personal guidance or group sessions with 10 employees all learning from each other. It also provides a mentorship platform where bigger companies can let their more senior staffers teach junior employees exactly what it takes to succeed. That’s all stitched together with a curated and personalized curriculum of online learning materials. Meanwhile, a company’s HR team can track everyone’s progress and performance through its Academy Builder dashboard.

“We know Gen Z has grown up with mentors by their side from SAT prep” says Torch CMO Cari Jacobs. Everwise lets them stay mentored, even at early stages of their professional life. “As they advance through their career, they might notch up to more executive private coaching.” Post-merger, Torch can keep them sane and ambitious throughout the journey. 

“It really allows us to move up market without sacrificing all the traction we’ve built working with startups and mid-market companies,” Yarbrough tells me. Clients have included Reddit and ZenDesk, but also giants like Best Buy, Genentech, and T-Mobile.

The question is whether Everwise’s materials are engaging enough to not become just another employee handbook buried on an HR site that no one ever reads. Otherwise, it could just feel like bloat tacked onto Torch. Meanwhile, scaling up to bigger clients pits Torch against long-standing pillars of the executive coaching industry like Aon and Korn Ferry that have been around for decades and have billions in revenue. Meanwhile, new mental health and coaching platforms are emerging like BetterUp and Sounding Board.

But the market is massive since so few people get great coaching right now. “No one goes to work and is like, ‘Man, I wish my boss was less mindful,’” Tan jokes. When Yarbrough was his coach, the Torch CEO taught the investor that while many startup employees might think they thrive on flexibility, “people really want high love and high structure.” In essence, that’s what Torch is trying to deliver — a sense of emotional camaraderie mixed with a prod in the direction of fulfilling their destiny.

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TC’s Greg Epstein and Kate Clark talk mental health startups and the ‘Cult of the Founder’

Some weeks, tech ethics is in the news. And some weeks, it IS the news. This week was one of the latter.

There were so many ethically fraught news stories about technology companies over these past few days, I had trouble keeping track of them all. So I’m delighted that my latest interviewee for this series on ethics and technology is TechCrunch’s own Kate Clark, a reporter covering startups and venture capital.

Kate is one of the tech reporters on whom I rely most heavily for insight into what the hell is going on in Silicon Valley, and not just because she’s prolific, a fine writer, and so hardworking she seems to attend every VC dinner and startup product launch in Northern California (though she is all of those things).

I also turn to her (well actually, I turn to her Twitter — we’ve never met in person) because, though she would never claim to have any special training or authority in ethics, she has three of the top qualities I look for in an ethical leader: a passion for equitable inclusion; a well-modulated bullshit detector; and enough compassion for humanity to expect better of us all.

When Kate and I spoke on Wednesday afternoon, she was as harried as you might expect, at least based on her tweets.

image1 1

Image via Twitter / Kate Clark / @KateClarkTweets

Alright anyone else that tries to generate headlines today is selfish and rude and must be stopped!!!

— Kate Clark (@KateClarkTweets) September 25, 2019

Greg Epstein: I’ve been looking forward to talking to you for a while now, and I certainly picked a busy day.

Kate Clark: Not as bad as yesterday.

Epstein: I follow your work closely; it informs mine. I’m sitting here in Cambridge, Massachusetts, where I work, and I’m thinking about the ethics of technology.

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When someone great is gone: How to address grief in the workplace with empathy

Tamar Lucien
Contributor

Tamar Lucien is CEO of MentalHappy, lives in the Bay Area and enjoys spending time hiking, cooking new vegetarian recipes, meditating and dancing to 90’s music!

Birthday cakes, gift cards, free lunches, snacks, movie tickets, and other perks are generously bestowed on employees to celebrate life’s happy moments. This is an improvement from the industrial approach to management, but can we go deeper for our work-family members?

Life’s darker moments hold the greatest opportunity to exemplify a genuine and caring 21st-century workplace culture. One which fosters empathy and camaraderie. Employee turnover is highest when employees take leave, claim FMLA, or use PTO. According to Global Studies, 79% of employees report their reason for quitting was simply due to feeling unnoticed (lack of appreciation).

Appreciation for your employees is best demonstrated as an act of kindness in moments that really matter, like the loss of a family member. Acknowledging that someone great is gone, instead of ignoring the uncomfortable aspects of grief, is a valuable way to embed empathy into your workplace culture.

Recently, while working with a mid-sized (500+ employees) tech company, I asked what they were doing to support employees during the negative life moments. The HR Director replied, “um, nothing really”.

Once realizing how crappy that sounded, another executive countered her by saying he sent an employee a t-shirt and card after a miscarriage. I later learned that the employee he was referring to had been with the company for over 5 years, so it’s safe to assume that she had a couple of company swag t-shirts in her collection prior to getting one as a get well gift.

Even in the largest and most notable companies, where a variety of employee amenities and benefits are offered, the concept and practice of empathy is often neglected. Perhaps you haven’t come across such extreme examples of indifference in your workplace, but you may have participated in signing a generic condolences card or chipping in for some flowers.

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‘This is Your Life in Silicon Valley’: Former Pinterest President, Moment CEO Tim Kendall on Smartphone Addiction

Welcome to this week’s transcribed edition of This is Your Life in Silicon Valley. We’re running an experiment for Extra Crunch members that puts This is Your Life in Silicon Valley in words – so you can read from wherever you are.

This is Your Life in Silicon Valley was originally started by Sunil Rajaraman and Jascha Kaykas-Wolff in 2018. Rajaraman is a serial entrepreneur and writer (Co-Founded Scripted.com, and is currently an EIR at Foundation Capital), Kaykas-Wolff is the current CMO at Mozilla and ran marketing at BitTorrent. Rajaraman and Kaykas-Wolff started the podcast after a series of blog posts that Sunil wrote for The Bold Italic went viral.

The goal of the podcast is to cover issues at the intersection of technology and culture – sharing a different perspective of life in the Bay Area. Their guests include entrepreneurs like Sam Lessin, journalists like Kara Swisher and politicians like Mayor Libby Schaaf and local business owners like David White of Flour + Water.

This week’s edition of This is Your Life in Silicon Valley features Tim Kendall, the former President of Pinterest and current CEO of Moment. Tim ran monetization at Facebook, and has very strong opinions on smartphone addiction and what it is doing to all of us. Tim is an architect of much of the modern social media monetization machinery, so you definitely do not want to miss his perspective on this important subject.

For access to the full transcription, become a member of Extra Crunch. Learn more and try it for free. 

Sunil Rajaraman: Welcome to season three of This is Your Life in Silicon Valley. A Podcast about the Bay Area, technology, and culture. I’m your host, Sunil Rajaraman and I’m joined by my cohost, Jascha Kaykas-Wolff.

Jascha Kaykas-Wolff: Are you recording?

Rajaraman: I’m recording.

Kaykas-Wolff: I’m almost done. My phone’s been buzzing all afternoon and I just have to finish this text message.

Rajaraman: So you’re one of those people who can’t go five seconds without checking their phone.

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Youper, a chatbot that helps users navigate their emotions, raises $3 million in seed funding

Youper, a mental health app with a chatbot it calls an “emotional health assistant,” has raised $3 million in seed funding from Goodwater Capital. The funds will be used to accelerate development of Youper’s artificial intelligence-based capabilities and grow its user base.

Based in San Francisco, Youper was co-founded in 2016 by Dr. Jose Hamilton. For a decade, Hamilton worked as a psychiatrist in clinical settings, seeing more than 3,000 patients. While talking to them, he realized that a handful of barriers kept many people from seeking help earlier, even if they had dealt with anxiety or depression for years.

“The first one is fear, taking care of yourself, talking about your mental health, understanding your mental health,” he tells TechCrunch. “Seeing a therapist or psychiatrist is super intimidating. That’s why all of my patients used to say the same things. The second barrier is cost, of course. Psychiatrists and therapists are super expensive.”

Hamilton teamed up with co-founders Diego Couto, the startup’s chief product and growth officer, and Thiago Marafon, its CTO, to create an app that would make mental healthcare less intimidating and more accessible. They originally created an app that did not have a conversational interface. Instead, Hamilton says it took a similar approach to Calm and Headspace. But that resulted in a very low user engagement rate and, after a year, the team realized Youper needed to provide a more personalized experience, matching users to the right psychological techniques, including cognitive behavioral techniques and mindfulness, for their needs.

Youper is part of a growing roster of apps that use AI-based chatbots to help users improve their emotional health, including Woebot, Wysa and X2’s Tess. Hamilton says Youper wants to differentiate with its focus on personalization, combining mental health research and user data to match the right psychological techniques with users.

Screenshots from Youper, an app for emotional well-being.

Screenshots from Youper, an app for emotional well-being.

The startup claims Youper has been downloaded more than one million times so far. Most of its users are young adults, and there are more women than men who use Youper.

“I think that’s because women are facing new challenges in our society by conquering new spaces and assuming new roles, and that poses an emotional toll. Another reason is that women are more tuned into self-care than men,” he says. “Sometimes I feel that we men wait for too long suffering in silence.”

For users who have never consulted with a provider, Youper provides a gentle introduction to the types of questions and exercises they might experience in therapy. The questions and exercises given by Youper’s chatbot are meant to help users achieve a better understanding of their emotions, thoughts and behavior.

Youper’s chatbot asks users to focus on their thoughts and identify how they are feeling from a menu of descriptive words. Then a scale lets them rate the strength of that emotion from “slightly” to “extremely.” More questions help them narrow down what is causing those feelings and track their mood. Users are also given options for mindfulness exercises and journaling prompts.

Hamilton says that the average time users spend during each session with its chatbot is about seven minutes, with 80% reporting a reduction in negative moods after one conversation. The startup also claims that after 30 days, a quarter of people who signed up for Youper are still active users.

Youper is currently free, though the company may test a freemium model in the future with premium features. It uses anonymized user data in its own research to improve Youper, but keeps it private and does not share or sell user data or information.

Of course, an app is not a replacement for seeing a therapist or psychiatrist, but Youper presents a much lower barrier to entry for people who worried about the stigma of seeing a professional. Hamilton says he hopes using Youper will encourage more people to seek medical treatment sooner if they need it by making them more comfortable with the idea of discussing their emotional health.

“On average, it takes 10 years for someone to finally talk to a health provider. This could become 10 minutes with an app like Youper,” Hamilton says. “Having an app with a super low barrier to entry, no stigma, something that is about emotional health and taking care of yourself, shows that you don’t need to be afraid.”

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As a founder, I mistook my work for self-worth

Dale Stephens
Contributor

Dale Stephens was one of the first Thiel Fellows and ran an education company for six years. These days he works an executive coach, helping entrepreneurs and executives grow as fast as their companies.

These days, most days are good days. My clients are founder and executives, I set my own schedule, and I live in a city I love. As an executive coach and advisor, I work with founders and CEOs of companies who have raised more than $100M. Like any enterprise, it’s taken a lot of building, planning, and failing for me to get where I am.

What I’m supposed to tell you is that I worked hard and persevered – and I did.

But what I’m not supposed to tell you is how it felt to do all that failing, and above all how, for years, shame was the primary emotion that guided my life and career. How, at my lowest point, I felt worthless. How I even contemplated self-harm.

It takes a herculean energy to start a company, which is maybe why, so often, our stories sound like myths. Mine went something like this: If I could just raise money from a top-tier VC, get to $1M in revenue, and sell the business for more than $5M, then I’d be good enough. I’d be the successful young adult I wanted to be. Then, once I had made my first million, I could take a swing and start a billion-dollar company.

The fact that I didn’t feel worthy of love, that I lacked inherent value, drove my decisions. My failure to reach the goals I set reinforced the belief I that I was unworthy. Luckily, I eventually found the self-awareness to realize that blindly pursuing goals I couldn’t achieve was unhealthy.

But I didn’t expect that walking away from my job as CEO would break me, nor did I realize how far I would sink.

I thought that if I was “successful,” people would see that I wasn’t flawed, and I’d finally be worth something.

After extensive therapy, it’s easy for me to see how misguided I was from the outset. Shame, most of the time, is a thing of the past. But for a long time, it fueled every decision I made yet never seemed to exhaust itself – there was always more. In the business world, this is more common than we’re led to think — almost every entrepreneur I meet shares an experience “otherness.” We glorify failure, but we don’t have the patience to honor the pain that turns into the shame of feeling “I’m not good enough.”

We are supposed to be resolute, driven, and resilient. To that end, I want to share what I’ve learned so others who struggle with worthlessness know they aren’t alone, and that happiness – and enjoying success – is still possible.

Accidentally Starting a Company

At 19, I didn’t have a grand plan to change higher education. I was simply a pissed off freshman in college. In an interview with the Chronicle of Higher Education, Jeff Young asked me: what would I do with UnCollege, the site I’d just put online?

UnCollege was a fledgling website I’d created out of my frustration in college. It was designed to create a community of people who were frustrated with the status quo in higher education. In that pivotal moment, when Young asked about my plans for the site, I immediately tied my self-worth to its future. It was, after all, the reason I was being interviewed by a major publication. I had to turn UnCollege into something, or else I’d be a failure – and worse, everyone would know it, because now it was public.

From then on, I started a mental list of what I needed to do to be a successful entrepreneur. My list grew quickly and each item carried a familiar caveat. I must write a book or I’m worthless. I must start a company and raise $1M or I’m worthless I must speak at conferences around the world or I’m worthless.

I did raise money. I did start the company. I got to $1M in revenue. Each time I checked one of these boxes, I wasn’t happier. I started to be afraid I would never feel I was enough. I didn’t feel “successful,” especially in the way I saw success portrayed by others, both online and in the industry.

I thought that if I was “successful,” people would see that I wasn’t flawed, and I’d finally be worth something. What I didn’t know is that each time I checked something off my mental checklist, I’d be consumed with shame and insecurity, needing to check the next item off the list in order to feel worthy.

Instead, I felt trapped. I didn’t yet know that self-worth must come from within.

Mistaking my work for self-worth

I realized quickly that I’d committed myself to starting a company because I was afraid of failure, not because I had carefully considered what problem I wanted to dedicate the next ten years of my life to solving. Nonetheless, UnCollege enrolled its first students in September 2013.

That fall, I began to suspect I’d made a mistake. But I was afraid to tell my investors, and those that had supported me to get the business this far. My survival skill was to smile and act like I knew better than everyone else. If only I’d had the courage to sincerely ask for advice.

One consequence of not asking for help was I had to let go of two of the first people I hired, and layoff two more because we didn’t have the cash.

The first cohort was a disaster. I hadn’t designed a properly structured curriculum, and students were dissatisfied. The students liked the community of self-directed learners, but the company wasn’t delivering value beyond the community. Two weeks before the end of the semester, the students declared mutiny and demanded to know what we were going to do to improve the program.

I was terrified and wanted to leave, but we’d already taken money for the next cohort of students. I believed I didn’t have any other choice. We created a coaching program, hired coaches, built two dozen new workshops, and started working to get students placed into internships. The coaching model we built worked, and we spent the next two years improving it.

In the spring of 2015, I called my lead investor, my voice shaking. He knew that I had my share of fear and insecurity, but I told him clearly that day “I can’t do this anymore. It’s going to break me.”

Ignoring my feelings was a survival skill as child. Ignoring the doubt and anxiety caused by early critics allowed me to push through and launch a company. But it was also my achilles heel.

At the same time I was experiencing burnout, the company was pivoting from a college alternative into a pre-college program. The board agreed: it was time to hire a CEO.

After hiring a CEO, it became more difficult to motivate myself to go to work every day. Getting out of bed became a chore. One morning, after a breakfast with a prospective investor at the Four Seasons, I sat down on a bench outside and began to cry. Looking up, I saw one of our previous students waving at me, and quickly wipe away my tears to give him a faint smile.

I felt embarrassed, weak, and helpless.

Deriving identity from my work wasn’t working, and I knew I had to put an end to it. But what were my alternatives?

I was excited for my company and its new leadership, but I was anxious. I was empty. I didn’t know where the company stopped and I began. At my 25th birthday dinner, I couldn’t eat. I was consumed by shame, by fear. I managed to hold off all through dinner, but as soon as I arrived home I broke down sobbing.

Shame is a Habit

In December, I was no longer CEO of my own company. Six months later, I couldn’t get out of bed.

Those first few months I spent catching my breath. I was still on the board of the company, but I didn’t control it. As I began constructing a life post-UnCollege, I had no idea where to start. I didn’t yet realize it, but I needed to go through the individuation process – to figure out who I was and what I believed, independent of my family of origin. Already 25, I’d managed to avoid these questions. The irony is not lost on me that most of my peers faced them in college.

Shame is a consumptive state of being. The longer I went without answers to questions tied to my selfhood, the more shame ate me up. What did I care about? Did I make the right choice? Was the sacrifice I’d made to start this company worth it? Had I taken the wrong path? Was all the pain I’d been through a waste? Would I ever learn to feel happy again? I was beginning to feel as if I had no self at all.

Without a job to make me feel useful, I spent most days drinking at Dolores Park in San Francisco. I knew this wasn’t healthy, but I convinced myself I deserved it after years of hard work. Again, I was only 25. Life had lost its color. Things that once brought me joy no longer did. I could no longer grin and bear the pain. Believing my own bullshit about how I was going to be OK was no longer working. The more this cycle continued, the stronger it got, and the weaker I felt – all the more trapped.

Even the most successful people carry trauma, and often lash themselves onward with its whip

One Monday in October, I found myself completely unable to function. Alone in my house, I realized I hadn’t gotten out of bed or eaten a meal for several days. I was supposed to get on a plane to fly to Minneapolis, and I just couldn’t bring myself to do it. Instead, I called my dad, who encouraged me to message my doctor and say, “I think I might be depressed.” I was still too scared to pick up the phone, and it would be another few months before I uttered those words out loud. I started therapy, but things got worse before they got better.

Beyond “I’m sad that my company didn’t turn into what I wanted,” I didn’t have names for my emotions. A lightbulb moment came when my therapist asked, “When have you felt anxiety?” The only example I could think of was the time my company was only a few days from running out of cash.

“Have you ever considered that you only feel your emotions at extremes – a 20, for example, on a 1-10 scale? It’s human to feel anxiety in day-to-day life.”

That opened a door. I wasn’t just sad about leaving my company: I felt shame that I wasn’t “successful.” It wasn’t only my identity I’d tied to the business, but my self-worth. Deep down, my core belief that I – myself – wasn’t good enough. This is shame by definition: a hole that forms in our deepest selves we can never fill because it seems permanent; it seems, by nature, that this is who we are, not what we have done.

Shame often comes from feeling different as a child. In my case, I stuttered as a child. My voice was too ugly to be heard, so I concealed it. I used synonyms to avoid the sounds I couldn’t make. I did this because I couldn’t handle the intense shame of not being able to say my own last name without stuttering. In doing so, I learned to ignore, to numb those intense feelings of shame. I coped, and because I learned to cope so early in life, I learned to numb the rest of my feelings along with it.

By the time I launched a company, all those feelings that tell us “something’s wrong” – sadness, exhaustion, frustration, embarrassment, anxiety, guilt, and so on – were so buried and so unnamed that I could only tell myself “You are what’s wrong” when I hit a block, when I encountered the normal and natural failures that entrepreneurs face every day, no matter how successful in the long run.

Ignoring my feelings was a survival skill as child. Ignoring the doubt and anxiety caused by early critics allowed me to push through and launch a company. But it was also my achilles heel. It led me to derive my identity and self-worth from my work.

A CEO, the story goes, has it all together: a CEO is a visionary who sees around corners without any help. Because of this, I couldn’t give myself permission to ask for help, and when I left the company, I lacked the vocabulary or awareness to describe my feelings. My perfectionism, which long ago enabled me to ignore my stuttering, had associated help with failure, and failure with shame.

All these years later, I still couldn’t allow myself to ask for help.

Learning to tame trauma

Stress, overwhelm, burnout: these were the closest words I had to describe my feelings. This is startup lingo for things you cycle through now and again, and the story goes that we push past them and keep working. But these aren’t emotions. They are coverups for feelings of pain and shame. Ultimately, they describe trauma.

When most people think of trauma they imagine a car crash, or maybe a natural disaster or physical assault. An event that curtails your ability to function entirely. But trauma is simply a piece of the past we carry with us in the present that shapes us — in both positive and negative ways.

In my coaching career, I’ve worked with entrepreneurs and executives who felt too pretty, too ugly, too gay, too fat, too foreign, too dumb, too smart, too dark, or too light. These were the holes of shame they couldn’t fill and believed would always be there. They weren’t by any means failures: even the most successful people carry trauma, and often lash themselves onward with its whip. But shame is something even the best of us can’t outrun. Eventually it catches up with you. It took me years to understand this, and being compassionate towards myself will be a lifelong journey.

Once I had the vocabulary to separate my self-worth from my professional ambitions, UnCollege was a failure I could be proud of, not to mention a learning experience I could bring to my next project: Helping others learn to love themselves, and as a result, build wildly successful companies.

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