Meet the man who helps the most powerful people in the world find mental balance

Has a cosmetic surgery gone wrong? Or wait, could she be finally leaving Prince William? Is the botched photo pointing to something wrong going on with her?

If you are Kate Middleton, chances are each headline coming up in the news outlets the world over will pierce through your heart. If you are Kate Middleton, chances are that you would still be expected to come out in the public and flash a smile at the cameras, presenting your best self for public consumption. But underneath the HRH title, there is also a human being, who, like William Shakespeare’s Shylock, may just be silently asking, “If you prick us, do we not bleed?”

We want to be on top of our game. And yet, fewer places are as lonely as the one on top. Because once you’re there, you are not allowed to fall or fail. Sometimes, this is what the world expects of us; at other times, we are crushed by the weight of our own ambition. The world of high achievers might seem glitzy and desirable, but the human underneath is often, if not always, left suffocated. Enter Jan Gerber, who apart from being the founder and CEO of Paracelsus Recovery, a Zurich-based state-of-the-art facility providing mental health support to ultra high net worth individuals, is also an important voice in the global conversation around mental health.

What is really at stake for the rich and powerful who experience anxiety or depression, one may ask. To give a perspective, Gerber rewinds to 15 years ago when a “friend of a friend” of his family sought his help. A CEO of a New York Stock Exchange-listed company was struggling to admit himself to a rehabilitation centre simply because he was anxious that the revelation of his addiction would impact the stock market price.

“We set up everything around him, got him a butler and a chef, and a complimentary therapist,” recalls Gerber, who was born and raised in Switzerland. The challenges faced with this individual put the spotlight on the need for one-client-at-a-time concept for high-profile individuals who may be struggling with mental health but cannot afford to reveal their status to the world for the fear of judgement.

Judgement is the key word here because, let’s face it, it is difficult to empathise with that 1 per cent, which has ticked all the boxes of conventional success. What can possibly go wrong with the swish set? Well, everything.

“Over a period of time, we also realised that in order to treat such patients, we needed therapists who could actually understand them differently. It is not just about the confidentiality aspect but also a different competency and knowhow because you have not lived their lives.” But isn’t that the case with therapy, in general? “Somebody not being emotionally well can be hard to deal with, but when it is someone very wealthy and successful, they can do things which often invites judgement.”

Recovery from addiction is one of the key pursuits of Paracelsus Recovery. But when you think of the C-suite job holders, you don’t necessarily assume it could be a problem. And yet, Gerber says, this is what he finds among most of his clients, even as he explains that addiction is only a symptom of underlying issues.

“It’s because pressures, emotions, stress or memories can be too painful to deal with in non-medicated ways. But once there is dependency on substance, it feels like the easy way out. Plus, think of the kind of pressure they face. You often see an attention deficit hyperactivity disorder because your mind is constantly thinking about one thing or the other. There is also a tendency to micromanage to generate new ideas for the business. But as you age, the stress takes its toll. You reach a tipping point and look for ways to numb yourself.”

In such jobs, it is nearly difficult to switch off. Which is why Gerber has adopted a different approach to treating ultra high net worth clients. He calls it humanistic pragmatism. “We cannot advise them to be on a break for a long time because the prospect of losing that role you’ve worked so hard for a long time achieve can cause anxiety. So we find pragmatic ways to first stabilise them and then have a structural approach to healing them therapeutically with some lifestyle improvements.”

The Succession Complex

In 2013, Ethan Couch, son of an owner of a metal roofing company, stole beverages and drove off in his father’s Ford F-350 pick-up truck and later ran over three people. When charged with intoxication manslaughter, Ethan’s defence team roped in psychologist G. Dick Miller who testified that he had been suffering from ‘affluenza’, which meant that he was never taught that his actions could have consequences.

Gerber says that if he were to keep the ethical issue aside, a person who’s been taught that wealth buys all privileges would actually look at his place in the world differently. And this is what most scions of wealthy families have to deal with. “To be frank, the way wealth is handled cross-generationally is such that we set the next generation up for failure. We don’t have real conversations about what wealth means, and what it means to have anything you can dream of. When you are born into a family where three or more generations have built an empire, you would know someone who has built that empire and in a way, you grow up in the shadow of that achievement. Deep inside, there will be a voice telling you that what you have done is nothing as compared to what your parent built. Your failures are spotlighted. You begin to develop something of an impostor syndrome. Also, you have less of a chance to learn the importance of delayed gratification and patience,” explains Gerber. At the same time, he says, being the child of a high-achieving family means your parent may not always be around when you are growing up and are deprived of that early attachment that defines adult life.

Addressing the stigma

One may argue, though, that being in a position of power, such high profile people can also potentially become role models for mental health advocacy. Then again, the fear of judgement looms. “The conversation around mental health may have taken a promising turn globally, but we still have a long way to go. If you experience psychosis or have schizophrenia, your condition will not seem relatable to those who have not experienced it. A majority of the world population does experience severe emotional pain at a diagnosable level, but people carry on until they crash. Professionally, it becomes harder to progress on the career path if you declare the state of your mental health, especially in leading positions. No one will hire you as a chief executive officer if they spot red flags in your behaviour even if your talents outweigh the risks,” says Gerber, recalling the case of a successful entrepreneur who was rejected by every clinic he went to because of the sheer amount and mix of substances he had been consuming.

“Even experienced addiction psychiatrists did not dare to touch him because if you have five or more heavy substances that are abused on a large scale, it has adverse effects. This person would have ended up in an emergency room or morgue. We took him in and had 15 specialists work on him.”

The seriousness of the work Gerber has been doing also took another dimension when he himself faced a mental health crisis during the pandemic, that left him “surprised because I knew a lot about mental health and had been reading a lot about the latest research”. Like many high achievers, the narrative he’d spun in his mind was that he had the spare capacity to tackle things but when the buffer eroded, he realised all was not well. “That was a humbling experience,” he chuckles.

Mental health in the Arab world

Today, many of his clients at Paracelsus Recovery from this part of the world come from Saudi Arabia and the UAE. In fact, Gerber is visiting the UAE to throw light on the issue of overprescribing psychotropic drugs, which, in turn, could lead to addiction.

“A lot of our clients from GCC often don’t understand what therapy actually means,” he says. “The way the mental health system works in this part of the world is medication-driven in that if you walk out of a psychiatrist’s office, you will be given a prescription. It may subdue the symptoms but when you stop medication, the pain comes back if it is not addressed therapeutically. The problem is medication will lose its effect over time and at some point, adverse side effects will outweigh the desired effects.”

Gerber also adds that there are less psychiatrists per population in this part of the world, which means the supply falls short of demand. “The way to save time is to issue a prescription. You need to make sense of symptoms and tests, you have to have many therapy sessions. If someone feels severely depressed and you give them medicines, they will stabilise but not become flourishing human beings. Psychotropic drugs can become addictive if not used responsibly. People often end up taking same dosage for 10-20 years.”

As we wrap up, we ask Gerber if he fears that the plush appeal of Paracelsus Recovery could eclipse the real work being done in the facility. “We do have a massive impact even though we only take a few dozen clients a year. If we help to heal one person who is deciding the fates of so many people, I would imagine we are impacting the whole ecosystem,” he says. “Remember, it is lonely at the top.” Indeed!

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