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“It’s always been my mission to take psychological concepts that are often overly complex and jargony and put them in language that people can actually understand and take action on,” says Dr. Emily Anhalt, Psy.D. This knack is perhaps best displayed by Anhalt’s Twitter game, where she’s able to unpack convoluted theories of psychology in 280 characters or less.

When she’s not dropping knowledge on social media, Anhalt’s efforts are more specifically aimed at founders. She grew up in Silicon Valley, and was fascinated by the mind of the entrepreneur from an early age. After she finished her training, Anhalt made a career of studying entrepreneurs, cementing herself as an experienced psychologist who’s spent more than a decade helping executives and founders work through their emotions.

It’s important — and much needed — work. In the face of long hours, the turbulent financial path to building a new company, and pressure to make key decisions, founders confront a unique set of mental wellbeing challenges. They're often walking a thin tightrope between self-belief and self-doubt — the steadfast optimism in their vision to change an industry, and the fear that they don’t have the chops to pull it off. “Founders will go above and beyond to do what’s necessary for their company. But they often stop short when it comes to fulfilling this same commitment to themselves and their mental wellbeing,” says Anhalt.

At the core of Anhalt’s approach is her steadfast belief that if founders make taking care of their mental health an ongoing and proactive practice, it will reverberate through their companies, forging more resilient startups with healthier cultures and happier employees. In other words, strong companies take shape when emotionally fit founders are sitting at the top.

“Here’s what I mean by emotional fitness: Beyond having good coping mechanisms to deal with anxiety, depression, self-doubt and a series of curveballs that are completely out of your control, a founder must be able to form and maintain good relationships. You must be able to communicate effectively with co-founders, investors and employees,” says Anhalt. “Studies show that 72% of entrepreneurs have mental health concerns — but I very much doubt that a similar proportion of founders are currently in therapy. And far too often we see the consequences of a failure to do that work when startups implode, whether it’s due to a toxic work culture, co-founder conflict, or deep-seated leadership challenges.”

Part of the uniqueness of Anhalt’s approach is that it is shaped by both her experience as a therapist and researcher and as a founder herself. As the co-founder and Chief Clinical Officer of Coa, Anhalt is scaling access to the tools founders need most by building a mental fitness community that offers therapist-led group classes (typically in person, but now virtual) and therapist matchmaking services.

Dr. Emily Anhalt, Psy.D

“Someone recently asked me, ‘How have your views about emotional fitness changed now that you’re a founder?’ I certainly have a new appreciation for how tough it is. But I also have a profound conviction in how important it is,” says Anhalt. “That one hour a week you set aside to tend to your emotional health frees up so many hours that would have otherwise been spent on thoughts that were subtly pulling you away from your work.”

And there couldn’t be a better time for us all to listen intently to what Anhalt has long been preaching. A founder’s path has always been paved with big emotional boulders, but it’s particularly fraught now.

In this exclusive interview, Anhalt provides a roadmap for how founders can get to work on their emotional fitness. What we really appreciate about Anhalt’s approach is that she takes topics that are generally squishy and pins them down into concrete frameworks and accessible tips. In addition to making a compelling case for setting aside the time — especially in the midst of a crisis — to work on emotional fitness, she draws on her research and day-to-day work with founders to further break down seven specific traits of emotional health, why they’re important for founders and a set of “exercises” for building up each of those muscles.

THE CASE FOR HITTING THE EMOTIONAL GYM:

“Even if you aren’t feeling ill, that doesn’t mean you have a clean bill of physical health. You may not be exercising or eating healthy. Preventive care is crucial — when you work on your physical fitness, you get stronger and you’re less likely to get sick later,” says Anhalt.

“Emotional health is similar. Many people wait until they’re having debilitating anxiety before they start to think seriously about taking action. Maintaining emotional fitness is an ongoing, proactive practice that increases self-awareness, positively affects relationships, improves leadership skills and prevents mental and emotional health struggles down the line. Think about it less like going to the doctor and more like going to the gym,” she says.

Just because founders aren’t having daily panic attacks does not mean that they are emotionally fit.

“The COVID-19 crisis has further illuminated how important ongoing work on emotional fitness is. I’m seeing off the charts anxiety and stress from founders lately. None of us could have seen this coming, of course, but the people who were already working on their emotional health are better equipped to handle this unexpected patch of turbulence,” she says. “They understand what their triggers are, the healthy and unhealthy ways they react to adversity and how to reach out for support.”

If working on your emotional fitness wasn’t a priority or possibility beforehand, Anhalt recognizes that it may feel overwhelming to start now, in the midst of a seismic crisis. “But it’s never too late to start thinking more deeply about your own emotional fitness and it's never been more important to make that investment. While I do want to acknowledge that issues of access and privilege make this much more challenging for some entrepreneurs, I want to push every founder to seriously examine the notion that they ‘don’t have time’ for this work right now, that they just need to ‘get through’ this crisis,” she says.

“I understand the need to keep going and stay focused — but I also know that the very things that make founders successful are also the things that can get in their way. Whether it’s the ability to work autonomously, push through exhaustion, or not let criticism deter you, these strengths can quickly become weaknesses that cause you to make unnecessary mistakes and miss important perspectives.”

The ability to work through exhaustion can get founders from point A to point B, but it isn’t sustainable. Don’t wait for this emergency to pass — start on your self-care now.

Of course, this isn’t the first we’re hearing about the importance of emotional health and self-care. But all too often, the conversation stays surface level. The meaty “how” of where founders should get started and what they should specifically focus on is often fuzzy.

Over the course of several years, Anhalt worked to dig deeper by conducting an interpretive phenomenological analysis of more than 100 interviews with psychologists and entrepreneurs to identify what exactly it is that makes a founder emotionally fit. After analyzing the interviews and coding them by theme, she distilled her findings into seven traits:

Some of these traits, like resilience and communication, have crystal-clear ties to the success of a founder and ultimately the startup. Others may seem more offbeat. "From giving better feedback, to being less defensive, to staying calm during uncertain times — most leadership skills and areas for emotional growth align with at least one of these seven traits. And most align with multiple,” says Anhalt. “The good news is, you don't need to always work on them individually. As you work on any of them, the others will naturally improve.”

SELF AWARENESS

Dr. Anhalt’s definition: Emotionally fit leaders are self-reflective. They understand their triggers and biases and continuously check in with themselves. They are patient, resilient and willing to be vulnerable with others. They can tolerate frustration and manage their emotions. They understand that the feelings they have about others have a lot to do with their own selves.

There’s a reason that Anhalt gives self awareness top billing — while it is perhaps the hardest trait to cultivate, it’s also the most significant. “It’s the foundation of all the other traits, because if you can’t reflect on your own experience and whether or not it is impacting how you interact with others, the rest of the list is tough to achieve,” she says. Here, she offers two specific pointers for working on this cornerstone trait:

Start with yourself and see what you’re transferring.

“There’s an interesting psychological phenomenon that I’m seeing a lot of right now called institutional transference,” says Anhalt. “Institutional transference happens when we put feelings about something other than work onto our place of work, or vice versa.‬ And it’s especially intense right now. We have a lot of feelings — and not a lot of control. We also feel guilt for complaining when others have it worse, so our emotions have nowhere to go. They get disguised as other, more acceptable issues. Fears about the future morph into concerns your team isn’t pushing hard enough. Your fights with your co-founder might be coming from something you have going on at home. And we have no idea that some of these feelings might be about something else entirely.”

If new or worse-than-usual problems are popping up at work or at home right now, Anhalt advises taking a step back and thinking about what else might be at play. “Taking the time to trace back to the root of what you’re feeling — and what you may be unfairly shifting onto others — is an important component of self-awareness,” she says.

Practice taking responsibility for your part before asking anyone else to change.

Get to therapy, if you can — especially if “nothing’s wrong.”

Anhalt also views getting external support as a core part of a founder’s journey to better understanding who they are, both as a leader and as a human. “Starting a meditation habit, focusing on your yoga practice or journaling every day can be impactful and I love these practices. And, sometimes you also need to dig deeper to get the support you need,” she says. “But you don’t want your company to become the catch-all for your unprocessed emotions. And that’s where therapy can help get you centered.”

Anhalt is the first to acknowledge there are considerable barriers to therapy. “Cost, insurance and access are huge hurdles,” she says. “People of color also face the added challenge of a lack of representation among therapists.” First Round’s own research for our annual State of Startups report last year highlighted other gaps as well. While founders under the age of 40 were more likely to report enlisting a therapist or psychiatrist compared to their over-40 counterparts, the divide was even more stark across gender, with female founders three times more likely to report utilizing a mental health specialist than male entrepreneurs.

Even putting issues of access aside, many feel a general sense of prickly unease at the mere suggestion of getting into therapy. “There’s still a huge group of people in the world who would never even consider doing something like therapy. They don’t think anything is inherently ‘wrong’ with them. I hear all the time, ‘Well I’m not depressed,’ or ‘I don’t have any trauma.’ This makes mental health more stigmatized and seen as this reactive thing. We need to shift the narrative of therapy from something you access only when you're unwell to something you proactively do to promote wellness,” she says.

“Founders also often convince themselves that they don't deserve support in this area, whether that’s because their problems ‘aren't bad enough’ or because of their relatively privileged situation. Especially amid a health crisis like this, it’s easy to think, ‘Well there are people dying or facing true economic hardship, so who am I to need support?’ Part of the value in going to therapy is giving yourself permission to acknowledge that your problems are important and valid,” says Anhalt. “As a founder, it's extra important to take care of yourself because you're also responsible for so many other people. Therapy provides a space to process anxiety, frustration and other feelings, so that they don’t leak into the business and onto employees.”

An Olympic athlete wouldn’t be expected to reach their full potential without a coach. But for some reason, many founders think that they should be able to soldier on and shoulder their emotional burdens without any support.

EMPATHY

Dr. Anhalt’s definition: Emotionally fit leaders can (and do) put themselves in others’ shoes on a regular basis. They recognize that what they feel about things might not necessarily be what others feel, and they strive for empathy even when it is difficult. Although they must sometimes make unilateral decisions, they consider how those decisions will affect others.

Tap into how your team is feeling.

“There’s all sorts of ways that lack of empathy shows up at a startup. For example, right now I think a lot of founders are like, ‘Oh yeah, of course you should take a vacation. I’m not going to take a vacation, but you should do it.’ Then everyone says, ‘Well, should I actually? Because if you’re not doing it, maybe we’re really not supposed to.’” Anhalt says. “In this instance, exercising empathy is about recognizing that the emotional constitution of a founder is often very different from the people who might work at a startup. A founder is someone who’s used to running through walls, at the expense of their own health sometimes. I’ve seen founders face issues where employees say, ‘It’s clear that you want to keep pushing, but we’re at our limit,” she says.

As a founder, it’s easier to empathize with your team when you understand them. When we’re in a crisis, we often skip over the work of uncovering what others may be going through. Overcoming these blindspots is key to cultivating empathy.”

Because needs and strengths vary by individual, Anhalt suggests deploying an Emotional Fitness Survey to get a fuller picture of your team’s experience. “The survey is an easy way to make sure that supporting each other is top of mind right now. There’s a list of questions that everyone at the company, including founders, fills out about what they need to be doing their best work. These questions might include:

Remember to refill your reserves.

“Some founders worry if they show empathy, then it suddenly becomes their job to fix everyone's problems. But empathy does not mean that your problem is now my problem, or that I have to change the feeling. It just means I'm present in it with you,” she says.

“It’s also common to feel like you have to be empathetic all the time, in every moment. But boundaries and empathy are not mutually exclusive. Learn to be clear about what you can offer others, and what you don't have the capacity to give in any particular moment.”

Empathy is not an endless well. Reserve time to refill.

“How can you tell when you’ve overdrawn from your emotional bank account? Well, you might feel it physically before you notice it anywhere else,” says Anhalt. “There is a psychological concept called psychosomatization, which means the physical manifestations of emotional states. If you’re feeling lethargic and don’t physically have the energy throughout your day that you’re used to, it could be because your empathy stores are dwindling. In other words, we store our issues in our tissues.”

WILLINGNESS TO PLAY

Dr. Anhalt’s definition: Emotionally fit leaders understand and encourage the importance of play. Play sparks spontaneity and creativity, and is a crucial part of emotional health and interpersonal cohesiveness. Playing means trying on thoughts or concepts to see how they feel. It means having a free exchange of ideas and meeting of the minds.

According to Anhalt, this is one of the traits founders are struggling with most right now. “In ‘normal times,’ play is essential to create a safe space where people feel like they can suggest new ideas without being judged or ridiculed. When we’re in the thick of a crisis, it might seem like we’re short on time and need to be laser-focused without distraction. But play is actually ten times more important during times like these,” she says.

Our natural ability for levity and playfulness is reduced because we’re anxious, vigilant and remote. We feel less connected to each other. Sparking creativity and increasing joy is a core part of a founder’s mandate right now.

Like all of the other traits, willingness to play starts at the top. “A lot of founders are really austere because they take their job so seriously and they forget that it’s actually okay and really important that there is lightness, silliness and levity in their work as well,” she says.

“It can be as simple as starting your meetings off with an ice breaker game. Do a virtual tour of everyone’s homes, MTV Cribs style. Organize an online scavenger hunt. There are so many creative ideas out there now.” (When we were chatting with Anhalt, we’ll admit that we paused to regal her with tales of First Round’s internal virtual cooking competition, which briefly derailed our interview into a sidebar about the power of garlic and the challenges of plating for Instagram shots. No surprise that she brought us back to the topic at hand by pointing out the underlying magic at work. “The fact that we’re talking about this and laughing about garlic is proof that investing in play at a company is really important, because it diverts some of the focus and energy away from all of the intense anxiety about what may or may not be happening,” she told us.)

CURIOSITY

Dr. Anhalt’s definition: Emotionally fit leaders understand and tolerate the difference between what they want to be true and what is true, and they make it a habit to ask questions and be curious, even when the answers to those questions are uncomfortable.

Curiosity is at the core of what drives the entrepreneurial spirit — the belief that you can solve problems with unique solutions and innovate on the status quo. Building a company relies on curiosity about testing different hypotheses and continuously iterating.

“This might be unexpected, but I always tie this trait back to feedback,” says Anhalt. “Curiosity is often framed as this kind of solo quest. ‘I’m curious about this, so I'm going to research this and read that,’ and so on. But I also think curiosity is the best skill to counteract defensiveness. When someone comes to us with constructive feedback, often our first instinct is to defend ourselves or explain why they got it wrong. If instead we get curious and ask questions like, ‘Tell me more about that?’ or ‘What could I do differently next time?’ we avoid this defensive reflex and open ourselves up to growth.”

At the core of curiosity is understanding that you see the world through a particular lens of your own experience. By getting others to share their perspective, you’re gathering more data points and arriving at a more accurate view of the truth.

To solicit ongoing feedback and get a more thorough picture of what those around you are seeing, she suggests cultivating your listening skills. Here are some tips that Anhalt has developed in her years working with clients as a therapist:

MINDFULNESS

Dr. Anhalt’s definition: Emotionally fit leaders can sit with and process through discomfort. They are able to have tough conversations, be transparent about uncomfortable information, share complicated feedback and sit with a problem until it has been fully thought through.

For Anhalt, mindfulness is about getting comfortable with being uncomfortable — and the first step is getting a sense of how you relate to discomfort. “Some founders blame everyone else when they’re in an uncomfortable situation. Some turn inward and get really down on themselves. Understanding what your reaction is to discomfort gives you more power to change that reaction if it’s not serving you,” she says.

Anhalt likens strengthening mindfulness to how the practice of yoga involves holding your body and settling into poses that might feel uncomfortable in the moment. “If you’re making a decision or taking an action purely to move away from discomfort, take a moment to reflect on whether the discomfort is really so intolerable. Sit with it for a while, take a deep breath and prove to yourself that you can handle it. You do not need to break every silence, fix every issue immediately or avoid difficult conversations,” she says.

In addition to encouraging founders to take up a yoga or meditation practice to continue building this muscle for tolerance, she also presses upon the importance of self-care. “Right now, in the midst of uncertainty, anxiety and added stress, we’re more inclined not to engage with our self-care and healthy habits, because we think, ‘I deserve a break.’ But it’s more important than ever that you’re focusing on those rituals.”

Self-care is one of the first things to go when times get tough, but if you want to lead and help others through times of struggle, you need to put on your own oxygen mask first.

Here are four specific tactics Anhalt recommends:

That last one struck us as particularly impactful. “It sounds a little trite, but if you schedule time to worry, that means you’re able to be more present for the rest of your day, rather than feeling constantly overwhelmed by tides of anxiety, which ripple out to impact how you interact with others,” says Anhalt. “When you find yourself getting worried, perhaps tossing and turning in bed at 2:00am, gently say to yourself, ‘That’s not my problem right now, that’s ‘6:00pm me’s’ problem. I’ll worry about it then.’”

“In therapy we call this ‘the frame,’ which is anything that provides reliable structure, like starting and ending at the same time and being in the same room every week. When we trust the stability of the frame, we’re more available to unlock the messy but important parts of our emotional selves,” she says.

This technique helps manage what she calls “anticipatory trauma,” something she’s seeing a lot of these days. “There’s a difference between scenario planning for the future and thinking through what your company might look like in six months versus trying to figure out how to deal with emotions that are tied to things that haven’t happened yet,” she says. “It’s the difference between asking, ‘What is my cash runway if our projected revenue is cut in half for the year?’ and ‘How am I going to handle it if my company fails in six months?’

As a founder, you often make the mistake of allowing yourself to slip into tomorrow’s worries instead of handling the challenges of the moment. You’re suffering future pain, needlessly.

“Founders typically do this because, subconsciously, they think it will make them more prepared. The purpose of anxiety is it makes us feel like we are going to be able to handle a tough thing if it happens. But especially now, there’s so much uncertainty, so we have no ability to know what will happen. It sends people into a tailspin that’s not really useful,” Anhalt says.

It's your job to handle the emotions that are true right now. If you're more present in what you’re currently experiencing, then you’ll be able to start the work of unpacking the issues you face and dealing with them, instead of pushing them away until they build into this totally insurmountable situation that you don’t even see coming,” she says.

“It’s about trusting your future self — the version of you that is better equipped than your present self with greater experience and wisdom to solve problems. A quote I love that captures this idea is, ‘You can only see as far as your headlights, but you can still make the whole trip that way.’ Believe that there is a version of you that will be more qualified to handle any potential future scenarios that are giving you anxiety right now.”

RESILIENCE

Dr. Anhalt’s definition: Emotionally fit leaders know that more is to be learned from failure than success, and can bounce back during trying times and can take in difficult feedback. Their desire to grow is genuinely greater than their desire to avoid criticism or failure. They are flexible and can adapt quickly.

When it comes to startups, we’ve seen again and again that it's survival of the most adaptable and resilient. More than most careers, the founder journey will stress-test your resilience in countless ways — facing down the discouraging odds of your company’s success, the twists and turns along the way to building a product, and many factors (like a global pandemic) far beyond your control.

But those that have a strong sense of self are less likely to be knocked off course. Anhalt emphasizes the importance of leaning on your network of other founders and entrepreneurs. “The founder perch can be a lonely one, and it can help immensely to stay connected to your fellow founders and witness how they’re tackling their own challenges, pivoting, and working on their own emotional fitness to inspire you to push forward,” she says.

Anhalt also recommends another tactic you can do on your own — starting a self-esteem file for yourself (and encouraging your team to do the same). “In a startup, often every accomplished goal is also the start of ten more goals to work toward. But if you never pause to celebrate achievements, it can be tough to summon motivation to always be pushing to the next one, Write down or screenshot every single piece of positive feedback you receive from investors, customers or colleagues and put it in a folder that you can look at when your self confidence is low. You can also have a team self-esteem file that shares praise for the team and the work you’re doing as a group,” she says.

In addition to tapping into a stockpile of past praise and successes, Anhalt encourages you to talk back to your harsh inner critic. “When you hear that self doubt creep in, summon your healthy self to say, ‘That’s not the whole story.’ Remind yourself of the valuable, impactful work that you’re doing.”

Don’t let the voice saying you’re not good enough be the only voice onstage.

EFFECTIVE COMMUNICATION

Dr. Anhalt’s definition: Emotionally fit leaders are able to put words to their needs and expectations. They are able to talk through issues in a proactive, ongoing way. They can balance flexibility with maintaining their authority and appropriate boundaries.

Those of us that aren’t used to working remotely are feeling the challenges of completely shifting our communication habits that we utilized in the office. “Feedback in particular is extra important right now. You need to be really clear about what people are doing well and where they might have areas of growth. You’re not getting the feedback you would normally get when you walk by people in the halls and say, ‘Oh hey, great job.’” If you haven’t already, set up a #thanks or #praise channel in Slack to publish positive feedback and shout-outs that can be viewed company-wide.

Within her own company, Anhalt and her co-founder have started using what they call “remojis” that are more conducive to remote communication, which can often feel tone deaf. “Choose emojis that represent emotions that are difficult to express, like ‘I’m feeling unhappy with this, but need time to think,’ ‘I’m in full support of this, I’ve got your back’ or ‘we’ve exhausted how much we can talk about this via Slack, let’s take this offline.’” Here are some examples of remojis that Anhalt uses with her co-founder:

When it comes to handling outright conflict, such as when you and your co-founder or a senior leader can’t agree on a decision, Anhalt suggests that you have the argument again, but switch positions. In her work with founders, she’s seen this help in a few different ways:

TYING IT ALL TOGETHER: THE EMOTIONALLY FIT COMPANY

For Anhalt, a founder's emotional fitness is where it all starts. “It will reverberate through the company, make it better for everyone who works there and everyone who uses the product. Not only will people look to you as the founder to understand the culture of the company, but your beliefs will seep into your choices without you even realizing it,” she says.

”In Silicon Valley, where so much of the culture and community is rooted in the tech industry, the presence of more emotionally fit founders would have a huge ripple effect on society. Young people working in tech are taking their example of how to collaborate and lead from current CEOs and founders. If they are working in an environment that teaches them how to be communicative, transparent and empathetic, they will take those lessons with them when they become the next generation of founders,” Anhalt says.

It’s like how a parent’s emotional health will drastically affect their child's emotional health. The more work the parent does on themself, the better it is for the kids.

While it may seem especially urgent to focus on these emotional fitness skills when it feels like the sky is falling, these tips aren’t just valuable in times of crisis. Establishing these healthy founder habits will impact your own success as a founder and your company’s success long beyond the current turmoil.

“People who are just now trying to tend to their mental health for the first time have this really big challenge of trying to work through a crisis. But it’s not too late to start integrating these new habits,” says Anhalt. “One way I’ve started thinking about this world-shaking crisis is that it‘s blanketing our society with fresh snow, which means we all have the opportunity to create new tracks — new tracks for how we treat each other, the planet and ourselves. For example, I hope for a world where we're taught and supported to think deeply about our thoughts and feel our feelings — even the messy ones. What kind of new tracks do you want to create?”

If you’re interested in learning more about emotional fitness, Dr. Anhalt’s start-up Coa is now offering free online emotional fitness classes for founders and therapist matchmaking services. Learn more at www.joincoa.com

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