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.

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.

My clients want work-life balance but refuse to work less. They want to climb the corporate ladder but the rat race has them burnt out. They have everything, but it's not enough.

My job is to help them step outside the Silicon Valley bubble and explore their purpose beyond work.

I work with high-achieving professionals in Silicon Valley

I'm the founder and CEO of Silicon Valley Therapies. For the past decade, I've seen 25 clients a week. Most of my clients have been high-achieving tech, law, or entrepreneurship professionals.

Unlike a more general pool of clients, whose typical concerns center on family or personal matters, my Silicon Valley clientele largely come to me with work concerns.

Many of my clients are caught up in the corporate rat race, having spent their lives chasing money, esteem, and material things. But their insatiable thirst for more leaves them feeling dissatisfied with life and confused about why. That's when they turn to me.

It's often the same story. They have the house, the Tesla, the career, and the family, yet they're still unhappy and confused about what they did wrong.

On a more symptomatic level, I work with people who have overwhelming amounts of stress and imposter syndrome. The most common conditions I treat are anxiety, depression, autism spectrum disorder, and learning disabilities. Weed and alcohol are often used as a form of self-soothing, in these cases.

Burnout and work-life balance are some of the biggest concerns

My clients' biggest goal is to have a better work-life balance. They often workday and night, never quite clocking off from the day mentally, and are desperately burnt out.

Ironically, the biggest pushback I get is about my suggestion to work less. Even people working over 60 hours a week tell me they'll do anything else but work less. It's funny because I'm sure they'd find instant relief if they changed that first.

The second most common goal my clients come to me with is to work their way up the corporate ladder. They want to know how to become the best version of themself so they can get promotions and succeed in the workplace.

My main approach is existential-integrative therapy

There are hundreds of therapeutic techniques, and I truly believe in creating a customized treatment plan for every client.

One of the most widely used forms of therapy is cognitive behavioral therapy, or CBT, which is symptom-reduction-based. CBT can be a useful starting point because I can advise specific interventions to decrease their most urgent symptoms. But I've found that once symptoms are reduced, many clients are left with the lingering question of how they ended up that way in the first place.

That's when I open up the conversation to existential psychotherapy, a depth-oriented therapy that encourages patients to explore the meaning of life and their purpose. My philosophy is that if they sit with those difficult questions regarding their core beliefs, values, and purpose, they can create lifelong change and find fulfillment.

Acknowledging death can help my clients live a better life

One of my main modalities is using the acknowledgment and confrontation of one's death. If and when a client feels comfortable with verbal discussions about mortality, I'll introduce them to specific exercises, including meditation, journaling, and bodywork in which confronting death is the focal point of the experience.

Engaging in these spiritual practices won't rid their lives of anxiety, depression, and other emotions pertinent to the human condition. Still, if they shift how they view themselves within the world, I believe they'll find significant relief from the ailments they arrive with.

My clients are highly motivated to grow

Every client is unique, but I've found some commonalities among my Silicon Valley clientele. They're often highly motivated, open to discussions about mental health, and show up from day one ready to make changes.

These clients are often just as committed to personal growth as career growth, which makes them a force to work with.

If you work with high-income, over-achieving professionals and want to share your story, please email Tess Martinelli at tmartinelli@businessinsider.com.