Lindee Abe, APRN
Imposter Syndrome causes real feelings of anxiety. Mental health has recently become a focus for healthcare providers. It is essential for us to take care of ourselves to take care of patients. The pandemic had a huge impact on our mental health. One area that existed before the pandemic and will continue to exist after the pandemic is imposter syndrome. I have been in the same position for several years and haven’t thought much about the feelings of imposter syndrome. Recently, I encountered a student who brought up imposter syndrome as a cause of their anxiety related to school. It reminded me of what it felt like when I first started and the need to discuss it. If we talk about it, it does help to know that we are not alone. Most healthcare providers have felt some form of imposter syndrome during their careers. I wanted to look further into the topic to learn more about it and how to overcome it.
Imposter syndrome, also known as the imposter phenomenon, was first described in 1978. A study by Clance and Imes observed female PhD participants who were praised for their work. The study showed that despite the praise, the participants still felt inadequate and that their success was due to luck.
The Anxious Cycle
This study also identified the cyclical nature of imposter syndrome. The cycle starts with a new task or skill. This may be something like suturing. The healthcare provider hasn’t ever performed sutures on a patient and has only read about it. This causes the healthcare provider anxiety, and they may start watching videos and reading more about suturing in anticipation of the first patient they suture. Other healthcare providers may not want to even look at anything related to suturing as a coping mechanism for the anxiety related to the subject. The healthcare provider then encounters a patient in the clinic that needs sutures. They perform the task, and the patient is happy with the results. The healthcare providers feel good about being able to suture and have a good patient outcome. The patient may return to the clinic later, and another healthcare provider who removes the sutures may compliment the person on how nicely it healed. Again, the healthcare provider may feel a sense of accomplishment.
Then, the doubt starts to set in, and the healthcare provider starts to think that maybe they were just lucky and the laceration was more straightforward than most, and that’s why the patient had such good results. This then causes the healthcare provider to have more anxiety, thinking that the next laceration will be different and they won’t know how to handle it because the laceration they sutured was an “easy” laceration.
Types of Imposter Syndrome
There are five types of imposter syndrome: perfectionist, superhuman, natural genius, soloist, and expert. The perfectionist focuses on how work is done and the results. The perfectionist will concentrate on the one failure out of 100 and minimize the 99 successes. The superhuman bases success on how many different roles they can successfully juggle. The natural genius focuses on the ease of accomplishment. The natural genius believes that if things don’t come quickly, they are failures at the task. The soloist believes that tasks only count if you complete them without anyone else’s help. The expert expects themselves to know everything. If the expert doesn’t know one small detail, they feel inadequate.
As you can see from the above descriptions, imposter syndrome affects high-performing individuals. Imposter syndrome is not a DSM-6 diagnosis, although it can be associated with anxiety and depression. It is a way of thinking. It is a form of self-doubt, but much stronger than self doubt. This also means that as part of the self-doubt, we don’t want others to know we are experiencing the feelings of self-doubt. The fear of being “found out” that we don’t know as much as we should or aren’t as successful as we should be is one of the primary sources of anxiety related to imposter syndrome. It makes sense that we wouldn’t want to draw other people’s attention to this. Talking about the feelings related to imposter syndrome is the first step to overcoming imposter syndrome.
Management
There are several other ways to overcome the imposter syndrome, including separating your feelings from facts, acknowledging your emotions, and knowing that everyone has moments when they feel like they should know something but don’t. It’s normal not to feel good after this happens, but you should recognize the feeling and move on from it. People who feel they are not part of a group tend to experience imposter syndrome more often. Recognizing that you may have a different perspective because of your background can negate feelings of being “wrong” with your opinion. Having differing opinions is essential in professional settings to developing the best possible outcomes and should be celebrated.
Accentuating the positive can be challenging to do. It is difficult to change your mindset if you are a perfectionist and focus on the positive and not the negative. One way I have tried to reinforce this in my own life is to reflect on our day on the way home from picking my son up from school and choose one positive that happened that day. Often, there is more than one, but it causes me to reflect on the good things that happened that day. It also opens up a discussion about our days with my son.
Failure is Normal
If you fail, having a healthy mindset regarding the failure is essential. No one likes to fail, but failure is a part of success. There is not a single successful person who has not failed at some point in their life. Instead of thinking about what a failure you were at that moment, use the opportunity to congratulate yourself on learning something new from the experience and becoming better.
The saying “fake it ’til you make it” can also be used with imposter syndrome. Confidence is often crucial to success. You may never feel completely confident in your abilities, but you likely know more than you think. That isn’t to say that you shouldn’t ask for help or ask questions when appropriate but still have confidence in the subject. When I first started nursing, I worked in the emergency department. I think for the first six months, I suffered from imposter syndrome. One day, a mentor told me that every patient coming to the emergency department was coming here for our knowledge and that no one was more equipped to treat the patient than we were. That sunk in and made me feel more confident in my ability. No matter what area you work in, no one is more capable of treating the patient than you.
Imposter syndrome can take a toll on healthcare providers, especially new graduates or healthcare providers switching specialties. It is important that we have conversations regarding imposter syndrome. Mental health is so important for healthcare providers, and by starting the discussion regarding imposter syndrome, we can help improve some healthcare providers’ mental health.
References:
Fotya, K. (2020). The imposter syndrome doesn’t go away. Here is what you need to
know. https://www.karolinafotyga.com/imposter-syndrome
Mass General Brighma Mclean, (2023). A guide to imposter syndrome-and overcoming
it. https://www.mcleanhospital.org/essential/impostor-syndrome
Young, V. (n.d.). 10 steps you can use to overcome imposter
syndrome. https://impostorsyndrome.com/articles/10-steps-overcome-impostor/
Young, V. (n.d.). The 5 types of imposter syndrome. https://impostorsyndrome.com/articles/5-
types-of-impostors/
