The type of people who survive long at that level have all been through this stuff thousands of times. On different sides of the story. As they climb the ladder, its all much smaller scale and private. So by the time the public starts noticing them, they already have been through this shit so many times that they have elaborate stories running in their head about "this is how you get things done/this is how you survive/those who cant are weak and will get crushed" etc etc. And most are driven by some Fear. Some are scared of failing (not succeeding), of loosing status, loosing control etc etc. So the process is driven by fear/guilt/shame/loss aversion. But what they actually say publicly is the total opposite. Therefore the cognitive dissonance. Most of them just burn out cause thats what that environment is optimized for. Its not an environment that allows sustainable leadership. You will see more and more burnout/dropouts as rate of change increases.