RefinedSelf
Private Psychiatric Care
You're still performing.
That's how you've hidden it.
Psychiatric care for senior finance professionals who can't switch off — and can't be present in their own lives.
The numbers are fine.
But you check your phone before your feet hit the floor. You replay the meeting for three days after it ended. You're at dinner with your family — but some part of you is still at the office.
You've called it "wired." Or "intense." Or "just how I am."
It's not how you are.
It's a pattern that got out of control. And it's compounding.
The Invisible Cost
You optimized everything external. And you feel worse than you did five years ago.
Sleep is a negotiation you usually lose.
Mind racing at 3am. Wake up with the residue of yesterday's decisions. First hour of the day spent climbing out of a hole.
Your fuse is almost gone.
Snapping at your wife. Short with your kids. Guilt afterward that you swallow and move on.
Drinking to come down.
It started as unwinding. Now it's the only reliable off switch.
You're watching your life from behind glass.
At your kid's soccer game. On the vacation that was supposed to fix everything. In bed with your wife. Your body is there. You're not.
This isn't stress. Stress has peaks and valleys.
This is a loop that runs all the time.
It's not burnout you're worried about. It's not breakdown.
It's this:
"I'm becoming someone I don't want to be."
Distant. Hard. Absent. The father who's never really there. The husband who's always somewhere else.
"What if this is permanent? What if this is just who I am now?"
Why Nothing Has Worked
You've tried.
Therapy
Open-ended. No structure. No timeline. The therapist didn't understand your job — the pressure, the pace, why you can't just "set boundaries."
Coaching
Surface-level. Accountability and goal-setting. Doesn't touch what's actually broken.
Meditation
Works for some people. Not people whose minds won't stop. You tried the apps. You sat in silence watching your brain run scenarios.
Exercise
You're already doing it. Still feel this way.
Time off
You bring the pattern with you. By day three of vacation, you're checking email again.
Medication from PCP
They gave you a prescription in 12 minutes without understanding what's actually happening.
None of them can see the full picture. A therapist can't order bloodwork. A coach can't evaluate medication. A meditation teacher can't identify whether this is a cortisol rhythm problem, a cognitive loop, a sleep architecture issue, or all three running together.
You've been treating symptoms. The pattern stayed.
What This Actually Is
A pattern with four components
Rumination
Your brain won't close files. Decisions you made last quarter are still open tabs. Conversations from months ago still replay.
Anticipation
You've already had Monday's meeting ten times in your head. By the time it happens, you're exhausted.
Broken Recovery
Your downtime isn't restorative. Sleep is shallow. Vacations don't reset you. There's no activity that fully absorbs you anymore.
Absence
When you're there, you're not there. You've lost the ability to be present. Things feel flat.
This pattern is structural. It's running in the background all the time.
And it compounds — getting a little worse each year.
Who I Am
Dr. Andrew Amicarelli
I'm a psychiatrist. I work exclusively with senior finance professionals — investment banking, private equity, venture capital, asset management, hedge funds — running exactly this pattern.
Before medicine, I worked in capital markets. I've sat in the rooms you sit in. I understand the pressure, the culture, and why most mental health advice doesn't land for people in your seat.
I was Chief of Psychiatry and Chief of Staff at Florida's largest state hospital. I've treated severe presentations — but I built RefinedSelf because I saw what was missing for high-functioning professionals.
The Refined Protocol
A 10-week private psychiatric program that identifies what's driving your pattern and shuts it down.
Diagnostic
Full psychiatric evaluation. Pattern mapping. Bloodwork if indicated — cortisol rhythm, thyroid, inflammatory markers. Sleep assessment.
Output: A clear formulation in plain English. What's driving your specific pattern, what's maintaining it, and what will interrupt it.
Intervention
Custom protocol based on your diagnostic picture. Rumination interruption. Anticipatory load reduction. Nervous system regulation. Sleep architecture. Presence rebuilding.
Output: Weekly sessions. Secure messaging between sessions for acute moments.
Stabilization
Stress-test the protocol under real pressure. Identify weak points. Build your maintenance system.
Output: A system you can run yourself. Clear signals for when you're slipping.
What Changes
By week 10:
You're actually there.
Dinner. Weekends. Your kid's game. You're there — not watching from behind glass.
Your mind quiets.
Not silent. But the background noise drops. The constant replay and rehearsal fades. There's space again.
Decisions stay made.
You make the call. You move on. The 72-hour second-guessing loop stops.
Sleep becomes restorative.
You fall asleep without negotiating with your brain. Wake up without the residue.
Your fuse grows back.
The patience returns. You stop snapping at people you love.
You enjoy things again.
Things have color. You remember what it feels like to be absorbed in something that isn't work.
Investment
Your health shouldn't depend on insurance.
The Refined Protocol
- Complete 10-week program
- Weekly 45-60 min sessions
- Secure messaging between sessions
- Bloodwork coordination if needed
- Personal protocol documentation
Payment plan available
The Presence Protocol
- Same framework as private clients
- 7 modules, 3-4 hours total
- Implementation guides
- Work at your own pace
- Lifetime access
Format: Video sessions. Private. No insurance. No records in any system.
Life is short?
We disagree.
The pattern isn't going to resolve on its own. Patterns like this don't. They deepen.
The people who fix this aren't the ones whose lives got easier. They're the ones who decided to stop paying the tax.
— Dr. Andrew Amicarelli
Founder, RefinedSelf