I'm Nate Parish, a licensed therapist (LMFT) and executive coach based in San Francisco. For the last five years, a significant portion of my clinical work has focused on ADHD — working with individuals and families to understand how the condition actually operates in day-to-day life, not just on paper.
That work taught me something most people miss about ADHD: it's not a deficit of attention. It's a different relationship with attention, motivation, time, and reward — and it touches every corner of a person's life. How they run a meeting. How they handle a hard conversation. How they make decisions under pressure. How they recover from setbacks. How they treat themselves when no one is watching.
I now bring that clinical understanding into executive coaching for founders and senior leaders whose brains work this way. The work is focused on leadership — how you operate your company, make decisions, manage your team, protect your time, handle conflict — but informed by a real understanding of what's actually happening underneath.
This isn't therapy. We're not digging into your history for its own sake. It's coaching — focused, tactical, forward-moving — with a clinical understanding underneath it that keeps us from wasting time on strategies your brain won't actually use.
About me
Clinical depth, not clinical distance
Years of ADHD-focused clinical work gives me a working understanding of how this brain actually operates — executive function, rejection sensitivity, shame cycles, the gap between capacity and output. That shows up in every session, whether we're talking about a hiring decision or a hard email you haven't sent.
Coaching that fits the brain you have
Most productivity and leadership systems are built for a neurotypical brain. They fail quietly, and the failure feels like a personal flaw. The work here is to build structures, habits, and decision-making frameworks that actually survive contact with how you operate.
Founders, not students
There's plenty of ADHD content pitched at kids, college students, and knowledge workers. Very little of it speaks to people running companies. The pressure, the stakes, the isolation, and the visibility of the role are different — and the coaching has to match.
Coaching tailored to your unique challenges and goals.
Founding and leading a company invites people into intense, often uncharted terrain. The demands of performing at the highest levels—while managing investor expectations, navigating team dynamics, and maintaining a personal life—can stretch even the most resilient leaders. I approach executive coaching as a partnership grounded in clarity, curiosity, and emotional depth.
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Translating vision into consistent action when your attention and energy are uneven. We build practical structures for planning, prioritization, and follow-through that don't rely on willpower or rigid productivity systems. The goal is momentum that survives a bad week — not a perfect one.
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Rejection sensitivity, reactivity, conflict avoidance, people-pleasing, and the inner critic that shows up louder for ADHD leaders than most. We work on how you communicate, how you take feedback, and how you hold your ground when the stakes are high — without either flooding or shutting down.
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ADHD leaders often over-function at work and under-function everywhere else, or burn through cycles of overdrive and collapse. We work on values-driven boundaries, realistic pacing, and a way of operating that doesn't quietly cost you your health, relationships, or self-respect.
If you're a leader who's ready to perform at your best — and actually feel like yourself while doing it — I'd like to talk.