Knowing how to beat imposter syndrome anxiety symptoms can test your patience. Dr.Gazelle looks at some examples and treatment of imposter syndrome anxiety.
Mindfulness in Medicine – A 12-Part Series
This series looks at the positive impacts that mindfulness can have on a physician’s career. This week, we look at the Imposter Syndrome, an insidious condition commonly experienced by physicians and other high-achieving professionals.
A Typical Case of Imposter Syndrome
Dr. S is a 44-year-old academic cardiologist at an elite medical center in the Northeast. She writes:
“Dear Dr. Gazelle,
I’m someone who always wanted to be a doctor. And I’ve always found teaching and taking care of patients satisfying. But I don’t know how much longer I can continue, as I’m really exhausted. And I’m not really that good at it, nowhere near as good as others. I feel like a total imposter, as I know that my colleagues are much better teachers than I’ll ever be.”
Clearly, Dr. S, you are manifesting the classic symptoms of Imposter Syndrome, the condition that makes you feel like you are not meeting the expectations of your role, and a fear that you will be found to be “faking” your expertise. Thank you for writing with such honesty – I know that my readers will appreciate it.
You’re not alone in feeling this way – the Imposter Syndrome is something many physicians struggle with. In fact, in the over 500 physicians I’ve coached in the last decade, the only ones who didn’t suffer from the feelings of inadequacy that Imposter Syndrome anxiety brings were immensely arrogant and egotistical. The Imposter Syndrome tends to occur in high achieving individuals. Like other chronic conditions, there may not be a cure, but there are measures you can take to decrease disease burden.
Traditional Methods for Managing Imposter Syndrome Anxiety
Traditional guidance about managing the Imposter Syndrome involves finding sources that will remind you of your accomplishments. So, if you have to take your boards and there’s Imposter Syndrome test anxiety, for example, you might find someone who reassures you that you’ve always passed tests in the past. While not a bad strategy, I wonder if this type of external validation changes your sense of being an imposter? For most of us, the answer is no. We’ve already gotten many accolades, and they haven’t shifted this negative view of ourselves. In fact, when others tell us how wonderful and successful we are, it often serves to cement our perception that other people don’t understand that, in reality, we’re a big fraud.
Managing Imposter Syndrome Anxiety with Mindfulness
To combat our creeping sense of inadequacy, a good dose of mindfulness is what’s called for. Mindfulness is another word for awareness. When we practice mindfulness, we become aware of patterns, just as we do in making a diagnosis in a challenging case. The patterns we need to be cognizant of are our own. The first one we need to look for is what I call “the cycle of perceived inadequacy.” We tend to be overly focused on what we perceive we didn’t do well, and gather data that supports this perception.
“I wasn’t very articulate in that meeting.”
“I’m not a good teacher.”
“Why can’t I do better in presenting a case to a colleague?”
We can also make a lot of comparisons between ourselves and others, and focus on their accomplishments and the things we perceive they’re doing well.
“Look at how articulate they are.”
“Aren’t they a great teacher.”
“Wow, what a great case presentation that person gave.”
What we’re doing is creating a false imbalance between the abilities of others and our own. But we don’t stop there – we fuel the cycle by continuing to be hyper-focused on our deficits and equally hyper-focused on other peoples’ achievements. Not a very objective process, and you can see where it takes us.
Overcoming Our Cognitive Distortions
The second pattern we need to recognize consists of what are known as cognitive distortions. These are irrational thoughts and beliefs that we unknowingly reinforce over time. At the heart of cognitive behavioral therapy is the idea that distorted thought patterns about ourselves and the world around us can drive our own perception of our experience, and lead to unnecessary fear, anxiety, and depression. These cognitive traps not only include the magnification and minimization inherent in the cycle of perceived inadequacy, but others as well. All-or-nothing thinking leads us to see ourselves as either imposters or superstars – or to the cognitive distortion of mindreading, where we’re sure that someone sees us as a fake. Whichever one we gravitate to, there’s a distortion of the truth, and this leaves us experiencing a lot of unnecessary anguish.
The third pattern that’s critical to unpack is perfectionism. Many people who suffer from the Imposter Syndrome believe that every task they tackle has to be done perfectly. Yet perfection is an unattainable standard, and the outcome of continued perfectionism will always be a sense of inadequacy.
How Mindfulness Helps Imposter Syndrome Anxiety
What does all this psychology mumbo-jumbo have to do with mindfulness? At its core, mindfulness is about awareness, paying attention to what’s going on, questioning thoughts and assumptions, and seeing things more clearly. Once we achieve clarity about our own mental patterns, we can successfully intervene to change them.
There’s a Buddhist adage about mental perception that we can draw upon:
“What is thought?
Thought is your friend.
Thought is your enemy.
No one can harm you as much as an unwise thought.
No one can help you more than a wise thought.”
Once we get to know our thoughts, we can work with ourselves to eliminate the ones that do not have our best interest in mind.
Put Mindfulness to Work for You to Overcome Imposter Syndrome Anxiety
Here are some practical strategies you can try this week:
1. Pay attention to your thought processes. Notice each time you accuse yourself of being an imposter and name it to yourself. Something like “there I go again, believing I’m an imposter.” This process of paying attention begins to create a vital distance between you and these thoughts.
2. Question your thoughts. Once you’ve noticed the imposter thoughts, ask yourself some questions:
“How do I know that the thought that I’m an imposter is true?”
“What am I magnifying here?”
“What am I minimizing?”
“Am I indulging in a bit of mindreading?”
3. Make it your mission to pay attention to your strengths. Doing so creates natural ballast for countering imposter beliefs.
4. Follow the above steps, and pay attention to how good it feels when you’ve left the shroud of Imposter Syndrome. It’s an unnecessary burden that definitely plays a part in physician burnout. And, as we’ve outlined, while it can be a chronic condition, it’s definitely one that can be effectively managed.
In summary, Imposter Syndrome anxiety is a thought process and not one that is based on fact. The awareness of mindfulness provides a path to a more objective examination of our stressful thoughts. Use the mindfulness strategies in this series to examine your perceptions. If you find yourself suffering from Imposter Syndrome, take the necessary steps to correct it. You’ll feel a great weight lifted from your shoulders.
The Mindfulness In Medicine Series
If you’ve missed any of our previous blog posts in this series, here’s a list of them for your convenience.