In this article we explore what the imposter syndrome is about, why it’s prevalent among therapists, and what strategies you can use to navigate through it.
Related articles: Identifying and Managing Therapist Burnout, Why Therapists Need Therapy, The Fine Art of Compassion
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Introduction
You want to write a blog article for fellow professionals about an area of current interest but worry that no one would want to read it. A prospective client comes to you with a presenting issue that you have never worked with before. Although you have been trained in this area, you fear you will waste the client’s time with ineffectiveness and consider referring on immediately. Or maybe you have a professional opportunity beckoning: to give a talk at a conference or take up a new job a little beyond where you are operating now – and you think, “No, better not. Saying ‘yes’ would mean I would finally be exposed for the fraud that I am.”
If any of these situations resonate with you, chances are you are among the 70-82% of mental health professionals who have had periods of self-doubt so strong that you are certain the job opportunities, awards, and successes that have come your way arrived via good luck or deception, rather than through any genuine ability on your part (Abramson, 2021; Travis, n.d.). Welcome to the Imposter Syndrome Club!
In this article, we explore what “imposterism” is about and why it’s prevalent among therapists, the reasons for it and effects of it, and strategies for navigating through it: both for your sake and that of your clients.
What the imposter syndrome is, and why are therapists are susceptible to it
Despite being labelled as a “syndrome” (though not one with a DSM diagnosis) by psychologists Pauline Clance and Suzanne Innes decades ago in 1978 (McKean, 2024), imposter syndrome has recently gained much traction as a widely-occurring phenomenon or experience among professionals, and particularly mental health professionals.
Definition
It refers to the persistent belief that one’s achievements and successes have resulted from either luck or deception rather than real ability, despite evidence to the contrary. Individuals experiencing imposter syndrome often feel like frauds, fearing that they will be exposed at any moment. The syndrome, or phenomenon, affects high-achieving individuals and can “bully” professionals of all stripes, at all career stages, as they wrestle with the self-doubt and feelings of inadequacy which characterise it.
The paralysing fear of failure, constant comparison to others, and difficulty accepting praise cause self-sabotage, keeping a person from moving forward and improving. Anxiety, depression, and insufficient career risk-taking are rife. These effects not only hinder our own success as mental health professionals (because we don’t do the things that would move our practice forward), but they also stop us helping people who need it (Abramson, 2021; McKean, 2024; Travis, n.d.).
Why mental health professionals?
There are reasons why mental health professionals are so susceptible to imposter syndrome. For start, our broader field is dynamic and constantly evolving. New research, techniques, and approaches are constantly emerging; we can feel overwhelmed by the need to stay up to date. As therapists, we often are working on complex problems, where there may not be a clear path forward, as when there are comorbid or unusual conditions. And we can’t see what’s going on inside the mind of the client; they could be making definite progress that has not yet manifested to the outer world, rendering us (as a therapist) feeling inadequate as a professional; that is particularly troubling because the deep connections and genuine care we have for our clients means a significant personal investment in their welfare.
Moreover, the nature of our work means that we are vulnerable to constant comparing of ourselves to peers, supervisors, or mentors, further fuelling a sense of inadequacy. For all those reasons, combined with the typically high standards of empathy, understanding, and wisdom that we are held to (that we hold ourselves to!), there is at least inward, but probably also some outward pressure to be “perfect”, which contributes to imposter syndrome (Taylor, 2023; Travis, n.d.).
Psych Tests assessment for imposter syndrome
If you would like to take a short, scientifically validated assessment to check whether you may be suffering from imposter syndrome, click this link.
Getting the big picture: How the imposter syndrome develops
So, how does this distressing phenomenon get started, and what are all the effects on us, the professionals suffering from it?
How imposter syndrome originates
It won’t be news to anyone dealing with imposter syndrome that it likely originates in childhood experiences: mostly adverse ones. Unhelpful parenting styles, such as parents who are highly demanding without being responsive – or just overly critical or “absent” – can cause children to do double backflips trying to get positive parental attention: a habit that, in adulthood, extends to trying to please authority figures and the world in general. Any child who had a sibling deemed “the smart one”, or who was always being compared to them, may easily have introjected the message that, “You don’t count; you aren’t as (smart, brilliant, competent – or fill in the blank) as your brother”. Once that message gets into a person’s head, it feels like it is coming from a part of themselves, not the external, maladaptive introject that it is. There are undoubtedly myriad reasons why we can arrive at full professional status and yet feel like we don’t really “belong in the club”. Look at the effects this syndrome has on us.
The positive effects
Many professional environments are highly competitive; how do we measure up against illustrious, accomplished colleagues, we wonder? A little bit of self-doubt can be healthy, in that we may open ourselves up to helpful adaptations, increasing our flexibility and capacity to respond, especially in a new environment (all those new synaptic connections working overtime, right?). In some cases, it catalyses our growth, opening us up to new learning opportunities. Amazing discoveries and contributions have sometimes come from people who zinged in from an adjacent field with a different perspective and a willingness to learn. Imposter syndrome can fuel high achievement! And the achievement can help enhance the struggling therapist’s sense of competence, reducing the severity of the imposter syndrome.
Note here that we can see imposter syndrome as occurring on a spectrum, not a binary (either you have it, or you don’t) type of deal. Those making it work adaptively for themselves are likely to be at the mild end of the spectrum (Abramson, 2021). For those experiencing the more severe end of the continuum, the effects may be less helpful.
The negative effects
We noted above the end results of anxiety, depression, and lack of any risk-taking in one’s career. Obviously, any of these jeopardise a person’s mental health and general functioning, especially for underrepresented groups, such as minoritised ethnic groups and LGBTIQ+ individuals. But there is more.
Isolation
The mental health cost when achievement is driven by internalised self-doubt can result in isolation as well. If we think we are the “only ones” experiencing that we don’t deserve to be there, that we’re playing “dress-up in Mummy’s (or Daddy’s) shoes”, then the shame and stigma we experience from that may keep us from opening up to supervisors, trusted colleagues, or others who could normalise the experience for us.
Performance-affecting
Imagine this. You walk into an interview room for an interview about a job you’d really love to take up. You look around the room, and there is no one in the room or on photos on the walls that even remotely resembles you. Perhaps you are an aboriginal person or other person of colour, or you are a woman, and all the people are white men. You conclude that the job probably isn’t amenable to someone like you, and you give a less-than-your-best interview, resulting in not being selected for the job. In this case, the imposter syndrome has resulted in self-fulfilling prophecy, and is not adaptive.
Relationship-draining
We ask: how well can you connect with colleagues and clients when you are so frightened of being “found out” as incompetent that you put up psychological walls to avoid being “seen”? The “walls” take significant psychological energy to keep up and make it hard for you to be deeply present in the moment. Relationships stay superficial.
Risk-taking
As noted above, a person who sees themselves as secretly incompetent, who fears failure, may refuse to take up a new opportunity, thus limiting their career. Someone who feels less qualified than others (even when they hold all the relevant pieces of paper for degrees, etc.) is unlikely to negotiate higher salary or better conditions for themselves, or even put themselves forward to advocate for a cause dear to their hearts (Abramson, 2021).
Compassion fatigue and burnout
A 2021 study by Pamela Clark and associates (Clark et al, 2021) looked at the relationships between imposter phenomenon, compassion fatigue/burnout, and compassion satisfaction among mental health professionals. Most of their hypotheses were fully supported, and one was partially supported. Specifically, they found among the 158 mental health workers comprising their “convenience sample” that:
- IP (imposter phenomenon, as they called it) was negatively correlated with compassion satisfaction. Obviously, compassion satisfaction entails a sense of accomplishment and satisfaction resulting from doing one’s job well; IP ‘s essence is an inability to internalise success or the sense that one is doing a good job. This relationship held for clinicians at all stages of their career.
- IP is positively associated with compassion fatigue and burnout, regardless of age and years of work. Higher levels of IP suggest that an individual will have a tendency toward self-doubt and use negative work strategies, such as workaholism and procrastination, which can contribute to burnout within the workplace. Also, if someone has more severe IP, they are less likely to do the self-care that can balance the demands of working with mental health clients. Such therapists begin to feel a sense of not belonging, and being incompetent, which fuels more IP.
- IP decreases with years of work, suggesting that, as mental health professionals become more familiar with the demands of their job/profession, experience successes, and maybe get additional training, they create a mental health clinician identity and reduce feelings of IP.
- Age, years of work, burnout, secondary stress syndrome, and compassion satisfaction are predictive of level of IP for mental health professionals. With this last hypothesis, only burnout and compassion satisfaction were found to be significant contributors to IP. The information is helpful to identify mental health care professionals who may be at higher risk of experiencing IP (Clark et al, 2021).
So, imposter syndrome is real and prevalent. Its effects are serious. What do we do about it?
Strategies to overcome imposter syndrome
As the notion of imposter syndrome gains recognition, strategies to deal with it abound. Fortunately, they mostly converge on a path of acknowledging the phenomenon for what it is, accepting that it is affecting us, and then applying to ourselves some of the same “fixes” that we would use with a client: CBT-style challenges to negative self-talk and thinking, mindful self-compassion, and sharing with trusted others what we are going through – the feelings, successes and, yes, the failures. Here are the main strategies we uncovered.
Acknowledge the feelings of “fraud” or inadequacy and normalise them
This means really admitting to yourself that you are being “bullied” by a sense of your own incompetence, and then recognising how many others are in that situation, too. Chances are, it doesn’t occur on your most successful days; rather, it rears its ugly head when you are trying something new or have been challenged around something you did or said. When you recognise imposter syndrome for what it is, you are able to say, “It (the inadequacy) is not real; it’s just my insecurities talking.” Then you can know that the “wobble” you are experiencing is temporary, and you can ride it out, like a boat in a storm.
Comparisons are invidious: Stop them, now!
In this age of wide, wild communication (think social media posts and easy self-publication through podcasts and videos), it’s difficult not to compare yourself with peers and others, but we must remember: the flash appearance of their video, podcast, post or whatever is likely to be highly planned and curated; underneath the polished presentation, they will have their own insecurities. Whatever they produced probably didn’t just roll of the top of their head. When a colleague gets an award that you would have loved to receive, you say, “Good on you!” and feel happy for them, knowing that your skill set, life experience, and wisdom is different to theirs, and so will be your contributions.
Really own – and celebrate – your part in the successes you’ve had
It wasn’t “deception” when they gave you those degrees; you earned them. The email you received raving about your recent talk/course/podcast/video was genuine, and the thank-you note from that grateful client shows your work with them really made a difference to their life. Save these proofs of success. Post what you can near where you work to remind yourself on the difficult days and start a serious scrapbook/file/collection of acknowledgements that you promise to look at regularly to keep convincing yourself that you weren’t just “winging it”, manipulating the situation, or pretending, and it wasn’t an accident. You deserved these accolades and are worthy and competent. Where there may not be external “proof” of your “enough-ness” hitting you in the face, keep a journal to record those triumphant moments.
Share: feelings, successes, and failures
Share your feelings. Recall the isolation effect we talked about before. More than one group supervision session has been greatly enlivened by one counsellor speaking up about their distressing feelings of not being good enough – especially professionally – and thereby creating an opening for what became a huge, healing sharing of similar feelings of self-doubt and inadequacy. You aren’t alone in this (remember the 70-82% in our profession who have felt these feelings at one time or another). Do be strategic about whom you share with; careless sharing with the “wrong” person can promote comparison, increasing imposter syndrome, but trusted people, possibly outside your professional circle, can provide a helpful picture of your value and accomplishments.
Share successes, because they’re fun to share, and you have the right to feel proud about things that have gone well. People suffering from imposter syndrome often are “stones” who let praise roll off their back and away. Instead, be a “sponge” who allows in the acknowledgements, which are fair to share with deserved positivity.
Share your “failures”, too. Discussing failures in a group can help paint a more realistic picture of what other people are struggling with. For example, you may see that a colleague has just published a paper, but you don’t know how many rejections they had before a publisher agreed to take the piece. Or maybe you finally got something accepted for publication, but it took several rounds of critical comments from the publisher and rewrites on your part to come to an agreement for the final copy. Discussing such processes openly can tell the world that you realise these things happen to everyone, and that you feel ok enough about yourself to talk about your process of growing and learning as you move (inevitably) toward success. And what a boost to the psychological safety of your work organisation or group supervision group (or wherever you are sharing it)! Another way of talking about this strategy is to say, “Embrace your vulnerability.” Paradoxically, it is your strength. The capacity to show vulnerability is not weakness, but a testament to your courage and authenticity.
Do the CBT thing: Replace negative thoughts with kinder, more helpful ones
Have you found yourself saying things like, “I’m hopeless”, “I’ll never get this stuff”, or “I need to work harder than others to achieve the same successes”? How would you deal with these harsh and irrational statements if a client or a friend were saying them? We know that CBT- and REBT-style therapies would ask where the evidence was for such statements. They would want to know what feelings were underlying the statements. And they would ask you to find replacement statements which are kinder, more helpful, and more realistic. OK, so your intervention sourced from a new therapy you are learning didn’t go to plan. What did you learn from trying it? Is “I’m hopeless at this” really something you can prove? Or is it more truthful/kinder/more effective to say, “I realise the client didn’t react well to that intervention, but I am just learning that therapy now. I have good therapeutic alliances with my clients, and most of the interventions I make are received well.”
In the style of the cognitive behavioural schools, you can also re-evaluate whether your standards are realistic. It may help to establish realistic goals with clear, tangible definitions of success. Ask yourself what a “good enough” performance looks like. In the case of learning something new, that might mean allowing yourself time to learn it rather than expecting to deliver the interventions perfectly right away.
Drop the perfectionism; cultivate self-compassion
While you are re-framing the negative thoughts, go one step further and try to shift from that external locus of control, in which you must be perfect to be ok, to an internal locus of control that knows you are doing your best and is willing to cut you some slack for mistakes, missed goals, and times where your performance wasn’t optimal. Mindfulness exercises can be useful here, as they reinforce that you are a human being, not a human doing, and you are ok just as you are. Remember, when you don’t meet your own standards, you can reframe it as an opportunity to learn and grow, which moves you toward the success you seek. It also helps you break out of rigid roles.
You will never know everything; don’t rush into getting another qualification
Say you have a session with Dan, who is dealing with prolonged grief disorder. You have a rush of imposter syndrome panic and decide you had better sign up for a quick course on complicated grief. This is ok if you were going to do it anyway; growth and learning is a good thing. But are you taking on the course because you really want to delve into this topic, or because you feel inadequate to sit with Dan in his grief when you are wallowing in imposter syndrome? If it’s the latter, step back. Take a deep breath and consider whether enrolling in this course is the best use of your resources; perhaps you are inadvertently feeding the syndrome. Maybe you just need to trust yourself, trust the process, and allow yourself not to know everything.
Take a risk: Say ‘yes’ when you’re not sure you’re ready
Maybe you have been invited to give a talk or take on more responsibility at work. If imposter syndrome strikes, you will be tempted to say, “Oh no, I can’t do that”. Do it anyway, even if you question your readiness to take on the challenge. Chances are, you’ll work it out and have another success to post on your victory board. The more you act before you are “ready”, the more you realise you’re never really ready for anything – but neither is anyone else! Of course, don’t forget to reward yourself at the end of the challenge.
(Strategies adapted from Abramson, 2021; Travis, n.d.; Taylor, 2023; Azab, 2023; McKean,, 2024).
Conclusion
Even if you adopt all of these strategies, you probably won’t be able to say that you have tamed the bully of imposter syndrome forever. Especially at challenging times, such as when taking on new things or having career setbacks, the bully will come charging at you again. Accept this. The more you learn to work with it, the less it can lessen your wellbeing. And the more you recognise it for what it is, the less it can drive things from “underground”. The really good news is that your “lived experience” with this phenomenon can be invaluable to similarly struggling clients; your added empathy and wisdom will be an immense source of support.
Key takeaways
- Imposter syndrome has been defined as the persistent belief that one’s achievements and successes have resulted from either luck or deception rather than real ability, despite evidence to the contrary.
- Up to 82% of people face feelings of impostor phenomenon; the self-doubting belief that job opportunities, awards, and successes that have come their way arrived via good luck or deception, rather than through any genuine ability on their part.
- While it can have positive effects, the negative effects on relationships, career, and wellbeing generally overshadow the positive aspects.
- Many strategies have been proposed to tame the bully of imposter syndrome, from CBT-style reframing of negative self-talk to owning, celebrating, and sharing successes to offering oneself compassionate acceptance of what is happening.
References
- Abramson, A. (2021). How to overcome imposter phenomenon. American Psychological Association. Retrieved on 1 July 2024, from: https://www.apa.org/monitor/2021/06/cover-impostor-phenomenon
- Azab, M.. (2023). Overcoming imposter syndrome: 6 evidence-based strategies. Psychology Today. Retrieved on 1 July 2024 from: https://www.psychologytoday.com/au/blog/neuroscience-in-everyday-life/202308/overcoming-imposter-syndrome-6-evidence-based-strategies
- Clark, P., Holden, C., Russell, M. et al. The Impostor Phenomenon in Mental Health Professionals: Relationships Among Compassion Fatigue, Burnout, and Compassion Satisfaction. Contemp Fam Ther 44, 185–197 (2022). https://doi.org/10.1007/s10591-021-09580-y
- McKean, B. (2024). Imposter syndrome in the workplace: Navigating professional challenges. CBT Professionals. Retrieved on 1 July 2024 from: https://cbtprofessionals.com.au/imposter-syndrome-in-the-workplace-navigating-professional-challenges/
- Psych Tests. (2024). Imposter Syndrome Test. Author. Retrieved on 4 July 2024 from: https://testyourself.psychtests.com/testid/3803
- Taylor, N. (2023). Navigating imposter syndrome: A guide for therapists. LinkedIn. Retrieved on 1 July 2024 from: https://www.linkedin.com/pulse/navigating-imposter-syndrome-guide-therapists-noella-taylor/
- Travis, J. (n.d.). How to beat imposter syndrome: A guide for therapists. Janetravis.co.uk. Retrieved on 1 July 2024 from: https://www.janetravis.co.uk/beat-imposter-syndrome/