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Feature

Is There an Imposter Among Us?

Tosha Harris, DNP APRN NNP-BC
NANN E-News Editor

It happened! You have achieved your goal. The shift, promotion, or degree you have been working so diligently to obtain is yours. As you begin to settle into your new role and responsibilities, you find yourself questioning your abilities, feeling unworthy and inadequate, and grappling with fear, anxiety, and intense levels of self-doubt. You ask yourself, "What in the world was I thinking? How could I ever have believed that I was capable of doing this job? I am going to fail, and then everyone will know that I am a fraud—an impostor."

Mullangi and Jagsi (2019) define imposter syndrome (IS) as a "pattern of behavior wherein people (even those with adequate external evidence of success) doubt their abilities and have a persistent fear of being exposed as a fraud."

If you have never experienced self-sabotaging thinking such as this, consider yourself fortunate. If you have, you are not alone. Buckland (2017) estimates that up to 70% of successful people have experienced these feelings at some point in their life. However, the incidence may be more prevalent than approximated because many people find it difficult to openly discuss their most intimate feelings, especially those with negative connotations.

IS, in conjunction with unhealthy thinking patterns, can adversely affect one's social and professional development. Current literature suggests that familial, personal, and environmental influences may predispose one to IS (Hoang, 2013; Sakulku & Alexander, 2011). Unfortunately, an exact cause remains unknown.

Psychologists Clance and Imes (1978) identified IS (initially termed "impostor phenomenon") during their study of 150 high-achieving professional women. Participants were women who had earned advanced degrees and were highly regarded professionals in the respective fields or students recognized for outstanding academic achievement. Despite the accolades for their achievements and accomplishments, they could not acknowledge or internalize their success. Persistent feelings of self-doubt led them to believe that their success was undeserved and happened only by mistake or chance. They lived in constant fear of being exposed as frauds or imposters (Clance & Imes, 1978).

Recent investigations into IS have revealed that these feelings of incompetence occur in both women and men, across many professions, and among multiple ethnic and racial groups (Bravata et al., 2020).

IS can occur at any point in someone's career but increases during transitions or new professional challenges or responsibilities (LaDonna et al., 2018). Barrow (2019) postulates that IS is temporary in some individuals who are taking on new roles but that others experience it as a chronic personality constellation with constant imposter feelings.

Every individual has their own definition of competence. How you define competence directly impacts how competent you feel. According to Young (n.d.), a world-renowned expert on IS, individuals who have IS tendencies can be grouped into five categories based on how each defines competence:

  1. The Perfectionist. The literature has shown there is a close association between perfectionism and IS. Perfectionists focus on task execution and results. Anything less than perfect equals failure (and subsequently shame) due to unrealistically high standards and expectations.
  2. The Expert. The expert focuses on what and how much they know and how much they can do. They believe they must know everything and fear exposure as inexperienced or unknowledgeable. A little lack of knowledge denotes failure. They are hesitant to ask questions or speak up in meetings because they fear looking stupid if they don't already know the answer.
  3. The Soloist. The soloist only cares about who completes the task. They desire to work alone. Assistance is equivalent to failure.
  4. The Natural Genius. This imposter cares about how and when tasks are completed. Competence is getting things done quickly and correctly the first time.
  5. The Superwoman/Superman. This imposter measures competence based on how many duties or roles they can balance and excel in. Falling short in any role results in perceived failure and shame. The superwoman/superman is a workaholic. They are addicted to the validation that comes from working, not the work itself.

To acquire confidence, you must be willing to self-evaluate, identify, and redefine your personal meaning of competence. You must eliminate any self-limiting thought processes that will prevent you from reaching your full potential.

If there is an imposter among us, which one are you?

Intermittent episodes of feelings of inadequacy and uncertainty are needed for professional growth and development. These brief occurrences serve as reminders to continue to work on building our competency. Problems arise when IS tendencies are not managed. Robinson-Walker (2011) described the adverse effects of unmanaged IS. The effects can include

  • a heightened level of performance anxiety disproportionate to one's role and responsibilities
  • a tendency to overprepare and habitually overwork, which can lead to decreased job satisfaction and burnout
  • a decreased ability to be present in the moment and actively listen
  • a warped perception of leadership—becoming more focused on having all the right answers than on having some of the answers and the courage to ask the right questions
  • ineffective leadership
  • a decreased interest in speaking up and in pursuing positions of greater responsibility and contribution
  • a tendency to influence others to lower their expectations.

IS is often associated with anxiety, elevated levels of stress, lack of confidence, self-doubt, fear, insecurity, incompetence, unworthiness, and depression (Gill, 2020). Those with a predisposition to IS find it difficult to accept praise, recognition, or positive feedback for their accomplishments. They have a propensity to focus only on the negative (i.e., their mistakes and shortcomings) (Hoang, 2013).

Currently, there are no therapeutic cognitive interventions to treat individuals with IS. However, screening for depression and anxiety may be necessary because IS often coexists with other mental health illnesses. (Cader et al., 2021).

Cader et al. (2021), Robinson-Walker (2011), and Sherman (2013) suggest the following strategies to mitigate the effects of IS:

  1. Always be kind to yourself.
  2. Be conscious of your thoughts. Work diligently to change your mindset.
  3. Let go of the need to be perfect.
  4. Leave your comfort zone. Don't let the fear of failure keep you from new experiences.
  5. Find a mentor or life coach.
  6. Celebrate your successes, no matter how small.
  7. Know your authentic self. Make a realistic list of your strengths and have your list validated by your mentor or life coach.
  8. Accept that no one knows everything.
  9. Know the signs and focus only on the facts.
  10. Competence builds competency. Regularly assess the skills needed to be successful in your role and seek out learning activities that will enhance your competency.

Self-doubt, in moderation, is necessary for growth. Growth means that we must be willing to embrace our imperfections, celebrate our successes, and be comfortable with the answers we have and those we don't (Robinson-Walker, 2011).

References:

  1. Barrow, J. M. (2019). Impostorism: An evolutionary concept analysis. Nursing Forum, 54(2), 127-136. https://doi.org/10.1111/nuf.12305
  2. Bravata, D. M., Watts, S. A., Keefer, A. L., Madhusudhan, D. K., Taylor, K. T., Clark, D. M., Nelson, R. S., Cokley, K. O., & Hagg, H. K. (2020). Prevalence, predictors, and treatment of impostor syndrome: A systematic review. Journal of General Internal Medicine, 35(4), 1252-1275. https://doi.org/10.1007/s11606-019-05364-1 
  3. Buckland, F. (2017, September 19). Feeling like an impostor? You can escape this confidence-sapping syndrome. The Guardian. https://www.theguardian.com/commentisfree/2017/sep/19/fraud-impostor-syndrome-confidence-self-esteem
  4. Cader, F. A., Gupta, A., Han, J. K., Ibrahim, N. E., Lundberg, G. P., Mohamed, A., & Singh, T. (2021). How feeling like an imposter can impede your success. JACC: Case Reports, 3(2), 347-349. https://doi.org/10.1016/j.jaccas.2021.01.003
  5. Clance, P. R., & Imes, S. A. (1978). The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241-247. https://doi.org/10.1037/h0086006 
  6. Gill, P. (2020). Imposter syndrome– why is it so common among nurse researchers and is it really a problem? Nurse Researcher, 28(3), 1-14. https://doi.org/10.7748/nr.2020.e1750 
  7. Hoang, Q. (2013). The impostor phenomenon: Overcoming internalized barriers and recognizing achievements. The Vermont Connection, 34(1). https://scholarworks.uvm.edu/tvc/vol34/iss1/6
  8. LaDonna, K. A., Ginsburg, S., & Watling, C. (2018). "Rising to the level of your incompetence": What physicians' self-assessment of their performance reveals about the imposter syndrome in medicine. Academic Medicine, 93(5), 763-768. https://doi.org/10.1097/ACM.0000000000002046
  9. Mullangi, S., & Jagsi, R. (2019). Imposter syndrome: Treat the cause, not the symptom. JAMA, 322(5), 403. https://doi.org/10.1001/jama.2019.9788
  10. Robinson-Walker, C. (2011). The imposter syndrome. Nurse Leader, 9(4), 12-13. https://doi.org/10.1016/j.mnl.2011.05.003
  11. Sakulku, J., & Alexander, J. (2011). The impostor phenomenon. The Journal of Behavioral Science, 6(1), 75-97. https://doi.org/10.14456/ijbs.2011.6
  12. Sherman, R. O. (2013, May 11). Imposter syndrome: When you feel like you're faking it. American Nurse, 8(5). https://www.myamericannurse.com/imposter-syndrome-when-you-feel-like-youre-faking-it/ 
  13. Young, V. (n.d.). The 5 types of impostors. Impostor Syndrome. https://impostorsyndrome.com/5-types-of-impostors 

Please note: The information presented and opinions expressed herein are those of the authors and do not necessarily represent the views of the National Association of Neonatal Nurses. Any clinical or technical recommendations made by the authors must be weighed against the health care provider's own judgment and the accepted guidelines published on the subject.

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