Workplace conversations rarely address childhood traumas or personal disappointments. Yet these formative experiences shape how people communicate, handle stress, and build trust–skills that are critical for leading a business. For founders, these influences often emerge while navigating the challenges of growing a team and company, raising the question, “Should we be bringing our whole selves to work?”

Matt Cahill certainly thinks so. The Toronto-based therapist applies couples therapy techniques to co-founders as a form of business coaching, making him one of a handful of therapists in this niche. He helps founders work through the issues that can sink a start-up, such as improving communication and reconciling different working styles, to build stronger, more collaborative partnerships. Research from Harvard University suggests that about 65 per cent of high-growth start-ups fail due to co-founder conflict, underscoring how personal dynamics can truly make or break a business. 

Today, founders face a host of pressures, from rising financial uncertainty to burnout. Cahill also notes that social media has heightened expectations for founders to put themselves—not just their products—at the centre of the business. He warns that this can distort priorities if not carefully balanced, “especially with co-founders who prefer working out of the spotlight.” These stressors can create friction between co-founders, leading to clashes over decisions or differing approaches to problem-solving.

The idea for co-founder therapy came naturally to Cahill after working with several tech founders individually at his practice. He often helped them navigate communication challenges with their co-founders—much like the couples he counselled in his therapy sessions. In 2023, he launched a dedicated branch of his practice, Downtown Therapy, which he calls “business therapy,” now accounting for about 10 percent of his clientele.

Co-founders often come to Downtown Therapy after recognizing issues in their working relationship, typically a year or two into the business. Because co-founders often start sessions once a problem has already been identified, he says the process can progress faster than individual psychotherapy, which usually requires time to uncover the core issue. “Co-founders can usually articulate the areas that aren’t gelling, making the process more immediate and solution-focused,” he says.

In the first session, Cahill encourages co-founders to openly share tensions and pinpoint where communication is breaking down. He notes that one partner often needs some persuading to engage, and when that happens, he may suggest a one-on-one session to uncover the root of the resistance or address a personal issue privately—reflecting his psychodynamic view that behaviour is shaped by past experiences and often influenced subconsciously. 

While significant progress can be made in the initial meeting, it usually takes two or three sessions to fully develop solutions and strengthen habits like active listening. But co-founder therapy isn’t just about understanding the other person, Cahill says. “They learn about themselves, and in that process, they come to understand each other better.”  

In many co-founder pairings, he has observed that one partner often excels at analysis, numbers, and the practical aspects of running the business, while the other leans toward creativity, non-linear thinking, and an openness to “moving fast and breaking things.” “Those kinds of pairings can definitely work, but over time, they can lead to frustration,” Cahill says. “Often, they reach a point where they need to sit down and have a summit to evaluate their differences and how they interact with each other.”

To navigate these differences, he recommends having intentional conversations that surface the assumptions partners make about each other. For example, one partner might assume the other will manage sales, while the second assumes responsibility for marketing, which can lead to unmet expectations that can quickly lead to frustration and resentment.

These challenges can be heightened when co-founders bring pre-existing relationships into the business partnership. Some partnerships involve friends, family members, or romantic partners, so Cahill tailors his approach to account for that history. He notes that boundaries are often clearer between friends but can blur in family businesses or romantic partnerships. While he usually works with two co-founders at a time, he has also led sessions with more than four partners simultaneously.

Co-founder therapy often ends when partners learn to work through issues independently. Once they understand what they need to address, many stop attending sessions, but Cahill encourages them to incorporate his strategies into their daily routines. He recommends regular check-ins—a practice surprisingly absent in many start-ups. “Too often, especially in the start-up space, you’ll have two founders who retreat to their individual corners and lose track of what the other is doing,” he says. “They’re typically very good at what they do individually, but that’s not the same as working together.”

Related:Why You Might Need a Burnout Coach

Cahill draws on his own professional experience to relate to much of his clients’ stress. He spent 20 years in film and television post-production, much of it in project management. “I have an intimate understanding of working with deadlines, unreasonable people, and all the juggling required to make a project work,” Cahill says. “For me, it isn’t theoretical, and I think that helps me engage with clients better.”

His real-world experience informs his work with co-founders, where therapy becomes a tool to explore the inner dynamics of a business partnership. “[Therapy] shines a light on behaviour, assumptions, and communication patterns that often go unnoticed in the day-to-day,” he explains. “It lets us examine our expectations—both those we’ve explicitly shared with our co-founder and those we haven’t been able to express.”