319 Bonus 3 - The Hidden Cost of Leadership: Sarah Buino on Lonely at the Top
“The process of business ownership is literally the hardest thing I have ever done in my life, and I never wanna be a boss again. I'm happy to be a leader, but I don't wanna be a boss again.” ~Sarah Buino
Sarah reflects on selling her therapy practice, surviving burnout, and discovering that healing sometimes means walking away.
This week we're sharing a conversation that originally aired on Lonely at the Top, hosted by Rachel Alexandria.
Rachel works with CEOs, founders, executives, and high performers navigating the emotional weight of leadership, so it makes sense that this conversation was about one of the most transformative—and painful—chapters of my professional life.
We explored what it was really like to build and eventually sell my group practice, the loneliness that comes with leadership, and the ways my own trauma showed up in the process. I shared openly about burnout, residential treatment, suicidal ideation, and the moment I realized that continuing to lead the way I had been was no longer sustainable.
One of the things I appreciate most about this conversation is that Rachel wasn't interested in surface-level leadership advice. Instead, we talked about the emotional realities that often go unspoken: the burden of responsibility, the challenge of power, the fear of causing harm, and the courage required to ask for help when you're the one everyone expects to have answers.
In this episode:
Why leadership can become profoundly lonely—even when you're surrounded by people
The hidden relationship between trauma, workaholism, and burnout
Navigating residential treatment and recovery during COVID
What suicidal ideation can reveal about feeling trapped and overwhelmed
Why asking for help may be one of the most important leadership skills we develop
If you've ever felt trapped by success, isolated by leadership, or overwhelmed by the pressure of holding everything together, I hope this conversation reminds you that you're not alone and that healing doesn't require perfection.
Originally aired on Lonely at the Top in 2025. Special thanks to Rachel Alexandria for hosting valuable conversations about leadership, vulnerability, and what it really costs to carry responsibility.
RECOMMENDED EPISODES
Rachel Alexandria - The Enneagram Episode (2020)
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