Why Brain Health Is the Missing Link in Sustainable Business Success
By Natalie Mackenzie, The Cognitive StrategistFor my whole career, I’ve worked with injured brains.
That’s 25 years with brains altered by trauma, illness, stroke, or accident. Lives changed in an instant. Futures rewritten without warning. I’ve sat with people whose ability to think, plan, speak, work, or even recognise themselves was suddenly no longer a given.
When you do that work long enough, you don’t just learn about the brain. You learn about consequence - and its fragility, despite its brilliance.
You see how profoundly cognitive injury ripples through every part of a person’s life: identity, relationships, work, confidence, independence. And you also see the other side - the immense power of rehabilitation and neuroplasticity when the brain is properly supported.
That combination of fragility and resilience fundamentally changes how you view success.
Once you’ve seen what happens when the brain is damaged, it becomes impossible to treat it as expendable.
The Brain Isn’t Mindset - It’s Infrastructure
That perspective shapes how I build businesses.
I don’t see the brain as about mindset or motivation. I see it as infrastructure. The system beneath judgement, leadership, creativity, emotional regulation, and decision-making under pressure. You can override it for a while, but eventually something gives.
I learned that early.
At 24, my business was built overnight. I responded to a crisis, stepped in where people needed support, and put individuals first. There was no grand strategy or five-year plan - just a clear cognitive instinct: assess the situation, stabilise it, protect people, and build from there.
That’s always how my brain has worked.
It’s why people come before profit in my leadership decisions, and why responsibility weighs heavily for me. Because once you’ve seen how quickly lives can change, you don’t take outcomes lightly. This in itself has sometimes gotten in the way of business decisions.
Leadership in High-Risk Environments
That matters because I operate in a highly regulated, high-risk environment.
My work involves vulnerable clients, strict regulatory oversight, local authority contracts, and operating within the litigation system where detail is everything. Standards are non-negotiable. The margin for error is small. Decisions carry ethical, legal, and human consequences.
Over the last three years in particular, leadership has become more cognitively demanding than at any other point in my 20 years as a business owner. Employing 70-80 staff in an increasingly complex HR and employee-rights landscape has introduced challenges that go far beyond growth or performance.
When you’re responsible for people’s safety, livelihoods, and wellbeing, leadership isn’t just strategic. It’s neurological. And when judgement is part of your professional duty, brain health becomes a leadership responsibility - not a personal preference.
What My Brain Does Well - And Where It Struggles
One of the things my brain does well is seeing the bigger picture.
I’m naturally strategic, comfortable with forward planning, and strong at spotting patterns in people, systems, competitors, and where industries are heading. I’m calm under pressure and have high emotional intelligence. For me, people always come before business - which has probably made me less money.
That philosophy shapes how I build teams. Every member of my senior leadership team started in entry-level roles and progressed through mentoring, development, and training. I don’t just scale companies. I grow people.
But I’m equally clear about where my brain struggles.
I’m not good at small, repetitive tasks. Administrative detail drains me. If something isn’t completed or captured properly, it can fall off my radar. I generate ideas easily, but holding unfinished tasks in working memory is not my strength. For years, I also struggled to say no - leaving me cognitively stretched and constantly compensating.
When the Old Strategies Stopped Working
The moment this became impossible to ignore wasn’t dramatic. It was cumulative and quiet.
Too many people were waiting on things I hadn’t completed. I could see the impact on my team. At the same time, I was hearing comments at home: “Are you working again?” The familiar signs that work was bleeding into everything else.
Around that time, I began experiencing chronic pain, fatigue, and persistently low energy. My productivity dipped. Decision-making felt heavier. My confidence wobbled. For the first time in my career, the strategies that had always carried me through stopped working, because the stakes were now higher.
Eventually, I sought therapy. Not because I was falling apart, but because it became clear that something had to change.
That was a turning point.
The most important realisation was a humbling one: I am not superhuman. Believing I was - or should be - wasn’t leadership. It was arrogance, and it came at a cost.
Why Rest Isn’t The Enemy of Productivity
Most high performers misunderstand the brain. They don’t treat it as their engine; they treat it as personality - something to override, push through, or ignore.
The biggest myth about productivity is that rest slows things down. In reality, rest is what allows the brain to consolidate learning, regulate emotion, and make sound decisions. Working harder works - until you no longer know why you’re doing it, or you keep moving the goalposts without ever stopping to acknowledge what you’ve built.
I’ve seen this pattern too often, in both rehabilitation and leadership, to dismiss it.
So I changed how I work. Not by doing less, but by working with my brain rather than against it.
Designing Work Around Cognitive Reality
I don’t work Saturdays. Ever. I may travel on a Sunday evening, but I don’t work then either. I used to work late most evenings; now I limit that to two or three nights a week.
I’m also seasonal. Spring and autumn are intense, filled with conferences, travel, and strategic work. I no longer fight that rhythm. I plan for it - and I protect recovery outside those peaks.
Running three businesses means cognitive load has to be managed deliberately. I assign different days to different businesses. I rely on time-blocking, structured routines, and clear task lists. I have a PA who keeps me accountable, because expecting myself to suddenly become brilliant at admin is fantasy.
Delegation has been one of the most important shifts. I still learn how systems work - because the best way to embed understanding is to teach it - and I’ll admit I’m still a control freak at time. Once I understand a process well enough to explain it, I hand it over. I no longer do meeting minutes, write up reviews or reports, or complete £1 jobs.
I’ve built teams to handle compliance, operations, invoicing, and governance so my cognitive energy is used where it adds the most value: growth, strategy, and leadership.
Technology supports this too. I use automation and AI deliberately, but I don’t outsource thinking. I train systems, understand them, and embed them into workflows that support people rather than replace them.
Refining Success Through Brain Health
There’s a reason I take this so seriously.
I worry about how little ambitious people respect their brains while building success. Chronic stress, poor sleep, and sustained pressure don’t disappear once success arrives. They change the brain over time and increase the risk of long-term cognitive decline, including dementia. I’ve seen the consequences too often to ignore them.
Sleep is non-negotiable for me. It’s the foundation everything else rests on. Without it, emotional regulation, clarity, and judgement deteriorate. No strategy compensates for a brain that hasn’t recovered.
Success, to me, isn’t about extracting everything from your brain while you can. Success is building something you can still enjoy living in - something that doesn’t cost you your health, your relationships, or your future.
The reason I’ve been able to build and sustain multiple businesses isn’t because I’ve just hustled, it’s because I have respect for how the brain actually works - for its limits, and for its extraordinary capacity when it’s supported properly.
If we want success that lasts, we have to stop treating the brain as something to override and start treating it as something to protect.
