How to Deal With Imposter Syndrome

man in disguise struggling with imposter syndrome

In 2016, Lou Solomon gave a TED talk in which she described something many of us know all too well. Despite all the success she had experienced in her career, she felt like she was fooling everyone. She felt that it was only a matter of time before her luck ran out and people would learn the truth.

Solomon was talking about imposter syndrome, a phenomenon estimated to affect about 70 percent of people at some point in their careers. Her talk left people everywhere nodding their heads and racing to the comments section. Finally, someone had put a name to something they’ve felt their whole lives.

Solomon didn’t actually coin the phrase, though. In fact, imposter feelings have been studied for decades. But she shed light on an issue that impacts professionals in every industry, most notably healthcare practitioners. No matter whether you’re a nurse or an APN, an OT or a PT, almost everyone would acknowledge they’ve felt this type of fear and self-doubt at some point during their career. The key is to understand what imposter syndrome is, how it makes you feel, and how to overcome those feelings so you can be your best self and give your patients the highest quality care possible.

What Is Imposter Syndrome?

Imposter syndrome goes by a lot of different names — the “imposter phenomenon,” “fraud syndrome,” “imposter complex” — but it all boils down to one thing: feeling like a fraud. It’s when smart, successful people fail to see their accomplishments as valid or good enough, and any evidence to the contrary is explained away as dumb luck or the result of others’ efforts and not their own. As a healthcare provider, it could strike when you’re finally left on your own to do a procedure, or when you first walk into work in an advanced practice role and suddenly have more control over patients’ lives than you’ve previously experienced.

What Does Imposter Syndrome Feel Like?

When you’re experiencing imposter phenomenon, you live your life feeling that at any moment, the world will realize you’re not as smart, successful, or competent as they think you are. It doesn’t matter how good your grades were in school, how many credentials or certifications you’ve earned, how often you’re requested by patients, or how many kudos you get from your boss. With this syndrome, you feel like a fraud and are constantly afraid of being exposed and, ultimately, fail.

Five Examples of Imposter Syndrome

In her TED talk, Solomon summarized the feelings of imposter syndrome with what she called the “fantastic four”: anxiety, perfectionism, self-doubt, and fear of failure. Those feelings can manifest themselves in different ways and cause people — and particularly healthcare professionals — to do things they might not have done otherwise. Here are five examples of what imposter syndrome can look like.

Example #1: You're passing up on great opportunities because you don’t think you’re qualified.

Healthcare practitioners who feel like imposters might choose to forgo chances to advance their careers — such as serving on committees or taking on leadership roles — because they’re afraid they don’t have what it takes or that their inadequacies will be more apparent if they continue to climb the ladder. This is also why “imposters” are reluctant to ask for raises: they don’t think they deserve them.

Example #2: You're downplaying your achievements.

While those with imposter feelings are quick to doubt and blame themselves when things go wrong, they are much slower to give themselves credit when it’s due. Any successes are dismissed as “luck” or wholly the result of others’ inputs and not the practitioner’s own efforts.

Example #3: You're over-preparing and over-achieving.

Because “imposters” hold themselves to an unrealistically high standard and are afraid of failure, they can over-prepare for things or, in some cases, do way more than is expected to avoid being exposed as a “fraud.”

Example #4: You're sabotaging yourself.

While some healthcare professionals might over-prepare in an attempt to overcome imposter feelings, others’ fear of failure might lead them to procrastinate. This results in a sort of self-fulfilling prophecy, since waiting until the last possible minute to do something might make them more likely to fail.

Example #5: You're feeling anxious, depressed, or dissatisfied in your current role because you’re afraid to seek out new ones.

All this self-doubt can lead some practitioners to stay in roles they aren’t happy in because they’re worried they won’t be able to do better elsewhere.

Feeling like you’re not good enough or are always on the brink of failure can have some serious consequences for care providers and their patients, says nurse coach Keith Carlson, RN, BSN, NC-BC. Healthcare professionals who lack self-confidence can end up making poor decisions or act inefficiently because they don’t trust their clinical knowledge or intuition, he says.

Research backs him up. Surveys in a variety of fields show evidence that having imposter feelings might hold people back in their careers. One study, for example, found that professionals with imposter syndrome were paid less, felt less satisfied in their jobs, and were less likely to be promoted.

Why Do Healthcare Professionals Experience Imposter Syndrome?

Health practitioners are consistently ranked as the most trusted professionals in the U.S., according to Gallup. If that’s so, then why do some feel they aren’t good enough?

The answer is complicated. There’s still a lot we don’t know about why some people have imposter feelings while others don’t. But what we do know is that it often has to do with their own expectations for themselves, the steep learning curve that comes with taking on new roles in any healthcare profession, and the personal history people bring with them to the job.

Reason #1: Unrealistic Self-Standards

In her book “The Secret Thoughts of Successful Women,” imposter syndrome expert Valerie Young laid out the five kinds of imposters. Each exhibits a different view of what it means to be competent or successful.

Perfectionists: For these healthcare professionals, any stumble — no matter how small — is enough for them to think they failed. While everyone is praising what a stellar job they did, they can’t get over the one thing they might have done wrong.
Experts: This type of “imposter” feels like they should already know everything there is to know about their particular field and patient care. Not knowing the answer to a question — however obscure — can make them feel like a failure.
Soloists: Caring for patients takes a team, but there are some practitioners who feel like they have to do things all on their own. To them, asking for help would mean they aren’t up to the task.
Natural Geniuses: For these care providers, it’s not enough to master new skills. They feel huge amounts of pressure to master new skills very quickly or on the first try. Struggling to learn a new skill or absorb information makes them feel inadequate.
Super Caregiver: While healthcare practitioners are generally used to juggling a lot of tasks, these professionals measure themselves against how many tasks or roles they can take on flawlessly and at the same time. They strive to “do it all,” personally and professionally, and they feel like imposters if they fall short in any aspect of their lives.

What all of these types of “imposters” have in common is distorted expectations — not from supervisors, patients, or colleagues, but from themselves. What they feel like they need to do or know in order to consider themselves a “good nurse” or a “good OT” is unrealistic and unattainable.

Reason #2: Transitioning Between Career Stages

Over the course of their careers, healthcare practitioners have to shed their former roles and take on new ones as they get promoted or switch positions. Nowhere is this transition as tough as when they graduate and start their first job. During that time, care providers go from the protected walls of their vocational school to an often high-stress environment, where mistakes can have life-altering — sometimes even fatal — consequences for their patients.

This transition can be especially jarring for advanced practice professionals, whose newfound responsibilities in healthcare decision-making can add to the pressure they already feel to provide quality care to their patients. They’re taking on a new identity as an expert in their field, and that can leave them feeling insecure or unprepared for what’s expected of them.

Reason #3: Pressure To Succeed or Constant Criticism

Some practitioners face more pressure than others to succeed, increasing their chances of feeling like a fraud. People of color, for example, are more likely to feel imposter feelings than others, as are those who grew up in families that prioritized achievement or who doled out intense and constant criticism. When you were the “smart one” growing up or feel like you are always having to prove yourself to others, it can be difficult to feel confident in your abilities as an adult.

How to Overcome Imposter Syndrome: 7 Tips & Tricks

You don’t always have control over when or how these imposter feelings crop up, but there are some things you can do to manage them better over time.

1. Seek out criticism.

This might seem counterintuitive, but hear us out. When you equate criticism with failure and avoid it at all costs, you miss out on important opportunities for growth, says Melody Wilding, a coach who specializes in helping women overcome imposter syndrome. She recommends taking control of the situation by proactively seeking out feedback, like asking your boss: “What should I stop doing? What should I start doing? What should I continue doing?"

2. Watch your self-talk.

Stop telling yourself that your accomplishments are “no big deal” or that you just got lucky. Write them down instead, Wilding says. By keeping a running tally of moments you’re proud of, it can help you start to internalize your achievements and recognize your strengths.

3. Learn to welcome praise.

When someone says you did a great job or pays you a compliment, resist the urge to brush it off, Wilding says. Say “thank you,” and leave it at that.

4. Reflect on your own history and circumstance.

We’re all a product of our experiences, and the reason you feel like an imposter might not have anything to do with your competence as a healthcare professional. Carlson recommends care providers reflect on the circumstances or people who might have impacted their self-confidence so they can identify and work through what’s really at the heart of the imposter syndrome. In some cases, that means recognizing that transitions are almost always stressful. It’s not just you, and learning curves can take time to master.

5. Invest in positive relationships.

Find the people in your life — colleagues, friends, mentors — who you know are in your corner, Carlson says. They’re the ones who will help you see your strengths and accomplishments for what they truly are: yours.

6. Rethink how you define "failure."

Being a good PT or a good PA doesn’t mean that you’ll never make mistakes. Even the best practitioners mess up sometimes. Getting things wrong is how we learn, and remember that learning isn’t failure; it’s how all great care providers get better.

7. Don’t be afraid to ask for help.

People who have imposter feelings are more likely to experience mental health issues like anxiety and depression, says Kevin Cokley, director for the Institute for Urban Policy Research and Analysis at the University of Texas at Austin. This is especially true for people of color, who make up just a quarter of all nurses in the U.S. and who might already feel like they don’t belong. If you’re constantly feeling down, angry, or overly anxious, don’t feel ashamed to talk to someone or seek professional help.

Want to Learn More About Imposter Syndrome?

If you’d like to learn more about imposter syndrome and how to deal with it, check out the list of resources we’ve provided below.

Imposter Syndrome Self-Assessments

Imposter Syndrome Articles & Blog Posts for...

General Information

“How to Handle Imposter Syndrome” (Medical News Today, 2018)
“Yes, Imposter Syndrome Is Real. Here’s How to Deal With It” (TIME, 2018)
“Overcoming Imposter Syndrome” (American Psychological Association, 2017)
“The 5 Types of Imposter Syndrome and How to Beat Them” (Fast Company, 2017)
“Feel Like a Fraud?” (American Psychological Association, 2013)
“6 Strategies to Kick Imposter Syndrome to the Curb” (U.S. News & World Report, 2012)

Nurses & APNs

“Overcoming the Phenomenon of Imposter Syndrome” (Psychiatry & Behavioral Health Learning Network, 2017)
“Imposter Syndrome: When You Feel Like You’re Faking It” (American Nurse Today, 2013)
“Imposter Syndrome: A Source of Stress” (AllNurses.com, 2012)
“Imposter Syndrome in Nursing Leadership” (Emerging RN Leader Blog, 2012)

Occupational Therapists

“Uncertainty, Imposter Syndrome and the Journey to Becoming a ‘Real’ Researcher” (College of Occupational Therapists, 2016)

Physical Therapists

“Facing Imposter Syndrome as a New Grad” (Covalent Careers, 2019)
“Imposter Syndrome | The Train That Runs Across the Street” (The DPT Diaries Blog, 2018)
“My Biggest Challenge in Physical Therapy School? Imposter Syndrome” (American Physical Therapy Association, 2017)

Physician Assistants

“How to Not Feel Like a Fraud in a PA School Interview” (Be a Physician Assistant Blog, 2018)
“Imposter Phenomenon and Underrepresented Minorities: What Physician Assistant Educators Need to Know” (The Journal of Physician Assistant Education, 2018)
“The Imposter Phenomenon in Physician Assistant Graduates” (The Journal of Physician Assistant Education, 2007)

Imposter Syndrome TED Talks, Podcasts & Videos for…