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Working with a performance psychiatrist gives executives access to the same mental tools elite athletes use.

A five-part approach includes goal setting, CBT, visualization, emotional regulation, and strategy.

These strategies are based on performance research.

Several years ago, the CEO of a large financial company referred a high-performing partner to me to improve his presentation skills for a large conference. Let's call him Nathan*. He was a 45-year-old, experienced speaker who had given many presentations and conferences throughout his career. The CEO knew about my work as a performance psychiatrist who works with professional athletes and executives.

For three months, his stress was mounting. He was convinced he would shake in front of the audience and that the presentation would flop. The more he thought about it, the more anxious he became. By the time we met, the presentation was occupying his mind day and night. It was beginning to interfere with his other work. The conference was still a few months away, so we had time to address the challenges.

My approach to performance psychiatry is individualized, but five elements are essential to how I work with people who want to perform at a high level.

The first is goal setting. Research shows that specific, measurable goals increase motivation and "task performance." Nathan initially said he wanted to stop being anxious, but anxiety is a normal part of high-level performance and is not always within our control, although it can be reduced. Together, we set a more useful goal: "I feel confident, enthusiastic, composed, and fulfilled while giving my........

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