Success doesn’t make people immune to depression, marital problems, parenting issues, stress or any of the other reasons people pursue psychotherapy. But, in addition to those common problems that often lead people to get professional help, there are some issues that are a bit more unique to people who reach high levels of achievement. Here are the five most common reasons highly successful people seek therapy:
1. Imposter Syndrome
Although imposter syndrome doesn’t appear in the Diagnostic and Statistical Manual, the persistent feeling of not being good enough can be just as problematic as a diagnosable condition. Despite proven competence and expertise, imposter syndrome causes people to feel like a complete fraud. Rather than feel pride in their achievements, successful people may attribute their success to luck or temporary effort, rather than inherent ability.
People with imposter syndrome often present to a therapist’s office with a separate issue – perhaps anxiety or depression. They usually don’t want to acknowledge their underlying feelings of inadequacy, even to a therapist. The issue tends to emerge after a few therapy sessions, and successful treatment brings the person’s thinking in-line with the facts about her achievement so she can feel more authentic.
2. The Hidden Reason Behind Their Drive
Successful people are driven. They usually work harder, persevere longer, and bounce back from adversity faster than others. While some people are just natural go-getters, drive sometimes stems from hurt and pain. High achievement may temporarily mask a person’s heartache, but the anguish lurks just beneath the surface.
For example, a child who was told by his parents that he’ll “never amount to anything,” may make his sole purpose in life to prove his parents wrong. Or someone who experienced a painful divorce may decide that success is the best form of revenge. Therapy can help people discover how to heal their past wounds so they can be even more effective as they move forward.
3. Fear of Losing Everything
The more a person gains, the more he has to lose. The fear of losing everything can cause some successful people to become paralyzed by fear. They worry that they’re just one decision away from ruining everything they’ve worked so hard to gain and they often struggle to allow themselves to take a break.
Therapy can help successful people recognize that their net worth isn’t tied to their self-worth. This can help them recognize that even if they fail, they’ll still be okay. Treatment can also teach healthy ways to cope with anxiety and offer strategies for calming the constant self-doubt.
4. It’s Lonely At the Top
High achievement may ostracize successful people from family members and friends. Physical distance can also contribute to loneliness when high achievers relocate for new job opportunities. Additionally, successful people are often placed in high-level management positions where it may be inappropriate to befriend their subordinates, leaving them with fewer opportunities to socialize at work.
Treatment to address feelings of alienation may involve helping people identify and live according to their values. A person who values friends and family may recognize that she’s been placing too much emphasis on work, for example. Therapy may also encourage finding ways to replace professional networking with casual opportunities to form genuine friendships.
5. Guilt that Stems from Success
Quite often, the first thing a successful person says when entering my therapy office is, “I probably shouldn’t be here. There are people with a lot bigger problems who need your time more than I do.” While there’s a common notion that successful people feel entitled, many of them also feel guilty. They may question whether they deserve a new car, or they may feel guilty about going away on a vacation.
Therapy often focuses on helping people shift their core beliefs so they can stop feeling unworthy of their accomplishments. Treatment may also involve helping people recognize how their success affords them an opportunity to have a bigger impact on the world.
Be Willing to Ask for Help
Talk therapy can address a multitude of problems that may be holding you back. A trained professional can help you continue on the path to reaching your greatest potential, even when you’re already wildly successful.
This article originally appeared on Forbes.com.