Confidential advisory for executives under sustained pressure
A senior executive’s judgment enters every major decision a company makes. Under sustained pressure, the executive is rarely the first to notice it eroding, and the cost grows with the size of the organization and the number of people who depend on those decisions.
Therianos Advisory is a confidential advisory practice in Lausanne, Switzerland, for CEOs, senior executives, founders and partners under that kind of pressure. It works on the capacity a senior executive is paid for: judgment, and the cognitive and emotional performance it rests on.
Each engagement starts from the executive’s own baseline and is aimed at keeping judgment and decision-making intact through demanding periods.
The practice is led by Dr. Stavros Therianos, who brings more than twenty years as CEO and chairman in Swiss biotech and healthtech together with training as a psychologist (MSc, University of Lausanne) and a neurobiologist (PhD, University of Basel).
Executives engage the practice privately, or a company, board or investor offers the engagement to them.
Confidential, 30 minutes, without commitment.
Or start with a three-week Decision Latency Review.
Under sustained load, feeling fine stops being good evidence
Judgment draws on experience, knowledge and character. It also draws on a capacity that moves with load, sleep and recovery, and that part gives way under sustained pressure.
After weeks or months of heavy load, the quality of judgment and decisions can decline while the executive still feels fine. Fewer of their own errors get noticed, holding results takes more effort and more time, and the people closest to them hesitate to voice doubts.
Work on sleep loss and chronic stress describes the mechanism: the signals that should reveal the change weaken as judgment erodes.
Dr. Therianos calls this self-concealing performance loss. It is why Therianos Advisory assesses each executive against their own baseline, from records and structured observation as well as from how they feel, and why the work is preventive: it acts before the loss shows in results.
What one executive’s capacity is worth can be measured. A study of Danish registry data found that a CEO’s hospitalization reduced company profitability and investment, an effect not found for other senior executives[1]. The higher the role, the more of the company, profitability included, rests on one person’s judgment.
Because an executive’s own sense of things can be the weakest signal, the first reading comes from objective records. The clearest trail sits in the calendar: how long decisions wait, how many agenda items spill over to the next meeting, and how many come back for a second look. Under sustained load, these numbers can move before results do, and before the executive feels any change.
Decision Latency Review
How many days do your decisions wait?
Under sustained pressure, decisions tend to gather around the person at the top, and few organizations know how long they wait. In a global survey, 52% of managers did not agree that their organization makes decisions quickly, and those who said decisions were taken at the right level were 6.8 times more likely to work for a company that decides both fast and well[6].
The Decision Latency Review measures it in three weeks, with the executive alone. Five recent decisions are reconstructed from the executive’s own calendar and email records, the decisions now waiting are sorted with the executive into those that protect the business and those kept by habit, and validated questionnaires describe how the executive decides under load.
The executive receives a map of the five decisions, six measures of their decision circle, three decision rules to apply the next morning, and a confidential reading of the habits behind the numbers. Thirty days later, the measures are taken again.
- DurationThree weeks, then a check at day 30
- Executive’s timeFour meetings with Dr. Therianos, about seven hours in total
- ConfidentialityNo one else in the organization is involved, and the report belongs to the executive. When a company, board or investor offers the Review, it receives at most the scorecard, and only with the executive’s written consent.
- FeeFixed, agreed in the first conversation. Half is credited against an engagement that follows.
Discuss a Decision Latency Review: 30 minutes, without commitment
Private engagements
Senior executives rarely have anyone they can speak to without consequence. The board is one of their principals, the team depends on them, peers may be competitors, and family often sees only part of the load. A private engagement gives the executive a clear, informed and confidential reading of how that load is affecting their judgment, and a plan to protect it, with a peer who has held the role.
There is rarely a single trigger. Executives get in touch when the load has risen and stayed high: a new role, a transaction, a restructuring, a crisis that has run longer than planned. Sometimes it is pressure from a board, a fund or a parent company, or a period when work and private life both demand more at once. Some come without a named event. The role has started to cost more, cognitively and emotionally, decisions take longer or feel less certain, and recovery no longer keeps pace.
In a private engagement there is no commissioning party and no reporting to anyone. No one in the executive’s organization is informed unless they decide otherwise. Fees are paid personally or from a budget the executive controls, and the method is the same as in a company-sponsored engagement.
The first conversation establishes whether an engagement is the right response to the situation. If it is not, Dr. Therianos says so plainly and suggests what would serve better.
Engagements offered by a company, board or investor
Replacing a senior executive can cost up to twice annual compensation[2]; at senior Swiss pay levels, that is about CHF 760'000 to 1'300'000 per departure[3]. Forced CEO changes are typically preceded by a year of weaker shareholder returns[4], and in private equity, CEO turnover peaks around the second year of the hold[5].
A company, a board or an investor (private equity or venture capital) can offer the engagement to an executive entering a demanding period. Some offer it with every new appointment, so that no one is singled out. Participation is voluntary: the executive agrees in writing before any work begins. A confidentiality agreement signed by both parties sets out what the company receives and what stays with the executive (see Questions). The engagement is contractually separate from evaluation, remuneration and succession decisions, which is what allows the executive to engage candidly.
A board or an investor can also offer a Decision Latency Review: it measures the pace of decisions around the executive in business terms, without making it a question about the person.
How an engagement works
First conversation. Thirty minutes, confidential, on the situation and whether an engagement fits it.
Baseline, weeks 1 to 4. Three to four sessions across six dimensions: cognitive performance, stress and recovery, sleep, physical condition and lifestyle, emotional regulation, and purpose and alignment. The assessment draws on validated questionnaires, the executive’s own records (decisions, calendar, sleep) and structured interviews. The demands of the role are recorded alongside, so that a change in conditions is never mistaken for a change in the person.
Individual plan, week 5. No more than three priorities, each with what will be worked on and what will show measurable progress.
Work and review. Weekly sessions, direct access in acute periods and a written review at each milestone. A typical engagement runs six months, extendable to nine; an executive engaging privately can start with a shorter format.
A shorter first step. Some executives start with a three-week Decision Latency Review; half of its fee is credited if an engagement follows.
Scope and boundaries
Therianos Advisory works only on judgment and performance under professional pressure. It does not diagnose and does not provide therapy or medical treatment. Where signs appear that call for clinical care, Dr. Therianos clearly recommends a licensed provider and helps arrange the contact. The decision remains the executive’s, except where there is a serious risk to their life or safety, or that of others. The practice takes no part in hiring, evaluation or succession decisions.
Dr. Stavros Therianos
Dr. Stavros Therianos holds a PhD in Life Sciences (Neurobiology) from the University of Basel and an MSc in Psychology from the University of Lausanne, and held academic positions at the University of Pennsylvania and the University of Rochester. He then spent more than twenty years as CEO and chairman in Swiss biotech and healthtech, including as founding CEO of a Swiss diagnostics company that raised CHF 25'000'000 and brought a blood test for early cancer detection to market. He was the subject of an IMD case study and taught on it.
The practice rests on both halves of that record: the scientific rigor to assess judgment and cognitive and emotional performance precisely, and first-hand experience of running a company under heavy pressure. He has sat on both sides of the board table: as a chief executive reporting to a board, and as a chairman to whom chief executives reported.
Questions
Can I engage Therianos Advisory privately, without my company knowing?
Yes. A private engagement is often the most natural starting point, because there is rarely anyone inside the organization an executive can confide in without consequence. You receive a confidential assessment of how the load is affecting your judgment, your decisions and your recovery, measured against your own baseline, and then a plan with no more than three priorities to protect them. No one in your organization is informed unless you decide otherwise. Fees are paid personally or from a budget you control. The work is with Dr. Therianos alone, in French or English, in Lausanne or by video.
Can I start with something shorter than an engagement?
Yes. The Decision Latency Review takes three weeks and about seven hours of your time, and involves no one else in your organization. It measures how long decisions wait around you, where they wait and why, and ends with three decision rules and a second measurement thirty days later. The fee is fixed, and half of it is credited if an engagement follows.
I chair a board and am concerned about an executive. Can Therianos Advisory help?
Yes. The most effective step a board can take is to offer the executive a confidential engagement as support through a demanding period. The executive accepts it in writing, and the engagement is contractually separate from evaluation and succession, which is what allows them to engage candidly. At each milestone the board receives engagement status, progress on the objectives set at the start, and the structural factors around the role it can act on. Some organizations offer the engagement with every new appointment, so that no one is singled out.
What does the commissioning party receive, and what stays confidential?
A confidentiality agreement is signed by both parties before any work begins. The commissioning party (company, board or investor) receives engagement status, progress on the objectives set at the start, and the structural factors around the role it can act on. For leadership cohorts, findings are also reported in aggregate. Session content, personal disclosures and individual data stay with the executive, except where there is a serious risk to life or safety. Without that strict separation, no executive would speak openly, and the assessment would lose its value.
How does this differ from executive coaching?
Executive coaching develops leadership skills, strategic perspective and stakeholder management. Therianos Advisory works one level below, on the cognitive and emotional capacities those skills depend on under sustained pressure, measured against the executive’s own baseline. The two are compatible and can run side by side.
I feel close to burnout. Is this the right place, or do I need therapy?
Feeling close to burnout is a good reason to get in touch, and the earlier the better. The work stays on the performance side of the line: it assesses where your judgment, energy and recovery stand against your own baseline, and works to restore them while you remain in the role. Diagnosis and therapy remain with clinicians. If the first conversation or the baseline shows that clinical care is needed, Dr. Therianos says so clearly, recommends a licensed specialist and helps arrange the contact; the advisory work can continue alongside, where it does not compete with that care.
Where does the work take place, and in which languages?
In person in Lausanne and across the Lake Geneva region, and by video when necessary. Sessions are held in French or English.
Contact
The first conversation is confidential, takes 30 minutes and carries no commitment. Dr. Therianos replies personally, within two working days.
Dr. Stavros Therianos
stavros@therianos-advisory.space
Lausanne, Switzerland