I'm a therapist in Silicon Valley. My high-achieving clients refuse to do the one thing that will help them most.

• Nicholas Sanchez is a Silicon Valley therapist whose clients are high-achieving professionals.
• Stress, imposter syndrome, and work-life balance are the biggest client concerns.
• Existential-integrative therapy helps clients explore purpose beyond work for lasting fulfillment.

This as-told-to essay is based on a conversation with Nicholas Sanchez, a 36-year-old therapist from the Bay Area. It's been edited for length and clarity.

Being a therapist in Silicon Valley is full of dichotomies.