Purpose Under Pressure examines the conversations and judgments boards require when organizations operate under complexity, scrutiny, uncertainty, and rapid change. Janet Attwood draws on experience in regulation, governance, and board advisory work to explore how directors can strengthen accountability, assurance, risk oversight, and organizational decision-making before emerging problems develop into crises. The book emphasizes the importance of governing at an appropriate level, distinguishing strategic oversight from operational involvement, and recognizing signals that may indicate weaknesses in culture, capability, safety, or organizational systems. It also considers how boards can ask more effective questions, clarify responsibility, test assumptions, and maintain trust when familiar governance practices are no longer sufficient. Written for board chairs, directors, chief executives, governance professionals, and leaders of purpose-driven organizations, the work provides a practical framework for more disciplined and constructive boardroom conversations