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Executive and leadership coaching

Silvia A. Bernardi, M.D. · Psychiatrist & Neuroscientist · New York & Milan · Updated October 2026

Leadership coaching at MIND FIRST is offered to a small number of founders, CEOs and senior leaders. Dr. Bernardi brings psychoanalytic and psychodynamic skills, applied to leadership: the trained capacity to read what drives a person beneath what they say, the recurring patterns they bring into every relationship, and the unconscious pulls that shape decisions. To that she adds a psychiatrist's understanding of how people work under pressure, and a neuroscientist's understanding of how judgment, emotion and fatigue interact. It is coaching, not psychotherapy, and it is kept distinct from clinical care.

Dr. Bernardi's neuroscience research, published in Cell and in Decision Neuroscience: An Integrative Perspective (Dreher and Tremblay, eds., Elsevier, the second edition of the Handbook of Reward and Decision Making), studied how the brain abstracts knowledge and assigns value to choices; her clinical research included national studies of impulsivity and anger. Her psychoanalytic training, in Transference-Focused Psychotherapy and the object-relations tradition of Otto Kernberg, gives a precise reading of the interpersonal patterns — with boards, partners, co-founders — that so often limit capable people, and of how a leader is experienced by the people around them.

What we work on

• Decisions under pressure — how stress, sleep loss and emotion bend judgment, and how to protect high-stakes decisions from them.
• The people around you — recurring patterns with co-founders, boards, investors and direct reports; reading people accurately in hiring and negotiation.
• Transitions — a new role, a fundraise, an acquisition, a succession.
• Sustained performance — sleep, energy and recovery, optionally followed with objective data from your own wearable.

How it works

Engagements are confidential and defined in advance, combining scheduled sessions with brief contact between them. Coaching is not a treatment relationship: if a clinical need emerges, it is addressed separately and explicitly, with appropriate consent.

Engagements are discussed individually.

Questions

What is the difference between executive coaching and therapy?
Executive coaching focuses on performance, decisions and professional relationships and is not treatment for a mental health condition. Psychotherapy treats psychological problems within a clinical relationship. At MIND FIRST the two are kept separate.

Why work with a psychiatrist as a coach?
Dr. Bernardi applies psychoanalytic and psychodynamic skills to leadership — reading motivation, recurring interpersonal patterns and unconscious influences on decisions — together with a neuroscientist's understanding of how stress, sleep and emotion affect judgment.

Is executive coaching confidential?
Yes. Engagements are confidential and are defined in advance with the individual leader.

Related reading

• ADHD, narcissistic traits or Asperger's? Telling them apart in adults
• Narcissistic personality: beneath the confidence
• Insomnia and sleep problems, measured over months

MIND FIRST sees patients in Midtown Manhattan (Grand Central) and the Financial District, and by telehealth for patients located in New York, Florida or Milan. Dr. Bernardi is licensed to practice medicine in New York, Florida and Italy.