Imposter syndrome: the thought destroyer

Imposter syndrome is a silent condition that exists amongst the global population. Like hypertension, it presents with symptoms that may or may not be indicative of something going wrong, but without prophylaxis or management, it gives rise to risks and conditions that could be avoided with early intervention. This blog gives you a brief overview on what Imposter Syndrome is and in a format that you may be familiar with *wink wink*, along with some final words for you, my fellow medic reader.

Definition:

An overarching feeling of being inadequate, even though there is enough evidence to suggest capability and/or success.

Epidemiology:

Very very common - Approximately 70% of people may have atleast one instance of imposter syndrome during the whole span of their lives. It is likely that this would increase in higher achievers.

Aetiology:

• Upbringing - attachment styles, pressure from parents and older people in the family.

• Interrelationships - friendships and social surroundings

• New work or school opportunities - culture of the new environment, adjusting to new people, surrounding yourself with other high achievers

• Personality - this can be explained below.

Signs/ Symptoms

Imposter syndrome can be subdivided into five personality types; perfectionist, superhero, expert, natural genius and soloist. These are not strict categories and there can be clear overlap in signs and symptoms.

Perfectionist

• Tends to set extremely high goals for self - if unachieved gives rise to immense doubt in self-worth and work.

• Tends to want to work independently to get tasks done.

• Tends to rarely be satisfied with success and believes more could be achieved or done better.

Superhero

• Tends to think that they are not as good as the people they work with.

• Tends to stay behind and overwork themselves to compensate for this feeling.

• Tends to seek validation from people around them to boost their confidence and belief in their work.

Expert

• Tends to measure their ability on the things they know and how much they know.

• Tend to feel like they don’t know enough.

• Tend to be afraid that others may see that they do not know enough.

Natural Genius

• Tends to set standards that are extremely high (as with perfectionists).

• Tends to judge things based on the given standard but also on getting things done on the first try.

• Tends to think that being intelligent should just be an “in-built” characteristic.

Soloist

• Tends to not want to ask for help as they see this as a sign of weakness.

• Tends to work independently and see this as proof of worth of achievement when successful.

• Tends to not internalise compliments or praise for achievements

Investigations:

Screening questions:

• Are you distraught by making even the smallest mistakes in your work?

• Are you easily upset by receiving constructive criticism?

• Do you try to make sure that you know all information and seek to know more so that you are an expert in your work?

• Do you tend to set very high goals for yourself and want to make sure that you achieve them quickly?

• Do you tend to work independently and use this to show that your achievements were truly because of you?

Management:

Perfectionist

• Be proud of everything that you do! Your achievements, successes, and ticks off on that to do list - they’re all worth celebrating!

• Accept that it’s okay to make mistakes - take it as a learning curve and use it to provide a framework for future tasks!

• Get that thing you want to get started now! Not tomorrow, not next week! But nowwww!

Superhero

• Sit within yourself and have compassion - recognise that you are more than capable of what you’re doing!

• Own your intellect and talent - be confident in your abilities!

• If anyone provides constructive criticism don’t take it personally! Use it to improve your work, not your whole frame of thinking!

Expert

• Although it’s great to have a breadth of knowledge under your belt, it is not a requirement to know everything!

• Make sure you allow yourself to have a limit to what you need to know so that the information you have in mind is useful!

• Consider teaching other people so you are able to showcase your abilities according to the relevant curriculum!

Natural Genius

• Be patient and take steps to praise small progressions in your learning!

• Don’t beat yourself up when you don’t reach the goals that you have set

• It’s great to be a high achiever and people know it, but be careful that this does not become the drive to maintain!

Soloist

• It’s okay to ask for help, especially if you have no idea what you’re doing!

• Team work can really make the dream work! Different people have different skills and can contribute to get the job done!

• And it’s perfectly normal to prefer to work independently but be careful that you don’t use this to prove yourself worthy of achievement!

Prognosis:

When the management options are explored, prognosis is usually good.

The effect of imposter syndrome when studying/in practice:

Imposter syndrome is a condition that debilitates a lot of individuals, especially in the medical field. In an environment where there are many students or professionals who have attained high achievements, it is easy for this condition to be exacerbated on a daily basis. When studying, imposter syndrome may make you feel like you’ve not created the best study method e.g. with flashcards or written notes as everyone else around you seems to be doing. On the wards, it may look like you haven’t a clue what answer to give the consultant when surrounded by other medical collegues. It may also look like you don’t want to do any work or be around anyone because you feel like a failure and you don’t deserve to be there. All of this is very likely to be untrue and may cause you to stop reaching out or looking for opportunities to showcase your abilities and work ethic thus, working against your efforts that prove it wrong.

Finally:

My final words for this blog post are that you have truly got this in the bag! You’ve got this far in life with all this well-earned success and achievement, so why continue to doubt your abilities now? Yes, it is easier said than done, and moments of failure do happen, but take it as a learning curve to improve tomorrow’s tasks and challenges. With small steps everyday, you can begin to unravel thoughts that bring about your feelings of imposter syndrome. Though it has started from somewhere, known or unknown, you can definitely take control and stop it’s affect in your future moves. With time and effort, this feeling can become history, and looking back you’ll realise how human you are and are entitled to live in a way that allows you to be at peace, not with constant tension and anxiety. Take notes of the management options and implement them on your day to day. AND always remind yourself that “You’re doing amazing sweetie!” because you truly are, if no one ever lets you know? I’m proud of you!