Behind the Podium: The Psychology of High Performance
- Schoen Clinic UK
- Oct 29
- 5 min read
By Dr Bradley Powell, Chartered Clinical Psychologist
When I worked in the UK Parliament, I was struck by the dissonance between what the public sees and what’s really going on behind the scenes. In public, we see poise, polished messaging, and composure.
In private, there is pressure, self-doubt, and a fuel tank at risk of running low. The demands on a politician often mirror those experienced by people in high-pressure, high-performance roles; whether they’re senior executives, entrepreneurs, healthcare professionals, or lawyers.
At Schoen Clinic Chelsea, we frequently support professionals in these settings, offering tailored mental health treatment for professionals in high-pressure roles.
The Hidden Cost of High Performance
Nowhere is the mental strain of performance more visible than in moments like Prime Minister’s Questions (PMQs).
Take David Cameron, for example; he was known to prepare rigorously for PMQs, rehearsing lines, anticipating attack points, and crafting flawless delivery. What audiences rarely witness is the psychological intensity behind those minutes of performance. The scrutiny, the pressure to appear unwavering, and the knowledge that one wrong sentence could become a headline, all of this takes a toll.
Even Rishi Sunak, amidst an unrelenting schedule, found decompression through high-intensity Peloton workouts. This is not just about fitness, it’s about having structured, intentional ways to manage stress. What this reveals is critical: even those at the very top need recovery strategies to avoid burnout.
A 2025 report by Mental Health UK found that 91% of working adults experience high or extreme stress levels, with more than a third reporting symptoms of burnout [1]. This highlights a growing need for recovery strategies and therapy for burnout and emotional wellbeing.
Common Psychological Challenges Among High Achievers
Whether you’re launching a startup, in the media spotlight, or leading a global organisation, the psychological demands are enormous. In my work with high-achieving individuals, I frequently see the following themes:
Chronic pressure to perform and maintain composure under scrutiny
Cognitive overload with complex decision-making and minimal room for error
Public visibility, which can bring both admiration and unforgiving critique
Imposter syndrome — even when achievements are clear and accolades abundant [2]
Isolation, where expressing vulnerability feels professionally risky
Physical and emotional fatigue, with minimal time for true rest
These high-pressure careers often reward control and decisiveness, but they rarely reward slowing down. And yet, it is precisely that pause that the nervous system craves for sustainable performance.
At Schoen Clinic Chelsea, we integrate occupational therapy for work-related stress and burnout to help individuals restore balance and reconnect with themselves.
Insights from Parliament: Burnout and Resilience in High-Pressure Roles
My time in Parliament offered a powerful lens through which to understand both the risks and resilience strategies of high-performance roles. Many MPs, advisors, and senior staff were operating in a state of near-constant hyper-arousal. This always-on mentality — an inability to switch off — left many of them feeling disconnected from their sense of self.
A particularly common challenge in these roles is identity fusion: where who you are becomes indistinguishable from what you do. Personal values become enmeshed with organisational goals. While this alignment can drive purpose, it also creates emotional vulnerability. When setbacks occur, they’re not just professional; they feel deeply personal. Over time, this fusion can lead to emotional blunting, or even full-scale burnout [1].
We advocate at Schoen Clinic for therapy that helps separate role from identity — enabling sustainable performance rather than costly endurance.
Understanding Imposter Syndrome in High-Achievers
Imposter syndrome is rampant among high achievers. Despite external markers of success, many individuals in demanding roles live with an inner voice that says, “I’m not good enough,” or “Soon they’ll find me out.” This cognitive distortion often leads to perfectionism, people-pleasing, and a fear of failure [3].
For early-career professionals, especially those entering prestigious or high-stakes environments, this can be amplified. Without adequate support or reflective space, these thoughts can evolve into chronic stress, anxiety, and eventual burnout.
But it doesn’t have to be this way.
Resilience Isn’t Just Grit — It’s Recovery
In psychological terms, resilience isn’t about being unbreakable. It’s about how you respond to setbacks, pressure, and uncertainty. Resilience involves:
Cognitive flexibility: the ability to reframe unhelpful thoughts and adapt to challenges
Emotional literacy: identifying, naming, and regulating your feelings with compassion
Values-based direction: staying connected to purpose and meaning beyond outcomes or applause
Intentional recovery: regular, protected time to restore your physical and emotional resources
From a clinical perspective, it’s not unrelenting endurance that sustains performance; it’s the rhythm between intensity and restoration. The nervous system, like any finely tuned instrument, requires tuning and rest.
Recent research from Queen Mary University of London highlights that workplace support systems and leadership training can significantly reduce burnout among professionals [4].
Practical Strategies for High-Performers
Whether you’re a senior executive, politician, founder, or medical professional, the following research-informed strategies can support sustainable high performance:
Schedule recovery like a meeting: Don’t cancel on yourself. Carve out time for decompression — whether it’s a Peloton session, a morning coffee without your phone, or a short walk in nature.
Separate your role from your identity: You are more than your title. Reconnect with hobbies, communities, and relationships where you’re not expected to perform.
Spot the early signs of burnout: Sleep disruption, emotional flatness, or irritability are warning signs. Don’t wait until the engine fails — respond early.
Revisit your why: When stress peaks or outcomes feel out of your control, return to the core reason you do this work. Anchoring yourself to your purpose can foster clarity and motivation.
Give yourself permission to feel: Emotional suppression is common in high-pressure environments. Create space to process emotions safely — through therapy, reflective writing, or trusted conversations.
Check your mental dashboard: Just like a car’s warning light signals something off, your body and mood do too. Tune in regularly to what your mind and body are trying to tell you.
Develop micro-recovery rituals: Quick, repeatable practices that signal safety to your nervous system — such as stretching, deep breathing, or stepping away from your screen for five minutes.
If you’re noticing early signs of burnout or imposter feelings, our consultants, psychologists and therapists in London can help with tailored, confidential support.
Moving Towards Sustainable Success
What unites high performers (from the House of Commons to the boardroom) is not ego, but often a deep desire to make an impact. A desire to contribute. But high performance without presence is unsustainable.
Sustainable success is not about doing more. It’s about doing differently. Prioritising rhythm over relentlessness, presence over perfection, and creating environments where you can thrive as a whole human, not just as a title.
What I learned from Parliament, and what I continue to see in my therapy room, is this: behind every composed leader is someone who also needs space to rest, reflect, and reconnect.
References
Mental Health UK. The Burnout Report 2025: The Silent Epidemic in the UK Workforce. Mental Health UK, January 2025. Available at: https://mentalhealth-uk.org/blog/burnout-report-2025-reveals-generational-divide-in-levels-of-stress-and-work-absence/
Chamorro-Premuzic T. How to Help High Achievers Overcome Imposter Syndrome. MIT Sloan Management Review, 2023. Available at: https://sloanreview.mit.edu/article/how-to-help-high-achievers-overcome-imposter-syndrome/
UCLA Health. Feeling Like a Fraud? Imposter Syndrome Is Common Among High Achievers. UCLA Health Newsroom, 2024. Available at: https://www.uclahealth.org/news/article/feeling-like-fraud-imposter-syndrome-common-among-high
Queen Mary University of London. Study Reveals How Changes in Workplace Support and Leadership Training Can Improve Mental Health and Reduce Burnout. 2023. Available at: https://www.qmul.ac.uk/whri/news-and-events/2023/items/study-reveals-how-changes-in-workplace-support-and-leadership-training-can-improve-mental-health-and-reduce-burnout-in-healthcare-professionals-.html
About the author
Dr Bradley Powell is a Chartered Clinical Psychologist at Schoen Clinic Chelsea with specialist experience in working with high-achieving individuals, burnout, imposter syndrome, and performance psychology.
He previously worked within the UK Parliament, providing psychological consultation in high-pressure political settings.
