Are you an Imposter of Your Authentic Best Self?

Are you afraid that people important to you will find out that you're not as capable as they think you are?

As someone who has changed career path every 7 years over the last 30, I have appreciated feeling like an imposter on numerous occasions: as an intensive care and obstetrical nurse in the USAF, as an internal medicine nurse practitioner (NP), as a manager, emergency medicine NP, as a family practice NP, and most recently as an entrepreneur starting a coaching practice (while becoming a kundalini yoga instructor and a Reiki practitioner). My love of learning earned me a string of new degrees and certificates in order to gather skills to fit in. When I first became an NP 22 years ago, I shunned the idea of therapeutic touch, in lieu of learning medicine; and interestingly, as I was learning Reike this past weekend, I chuckled that I was feeling inadequate at something that is considered impossible to do wrong. Sometimes you have to get out of the way of yourself, so you can be yourself.

 Up to 70 % of successful people in the USA may have impostor feelings (Clance, 2001).  Imposter phenomenon was initially thought to be more prevalent in women, however more recent studies have shown less marked gender differences (Seritan & Mehta 2015). While it can drive superior achievements, it can be associated with counterproductive behaviors such as maintaining a low profile, self-sabotage, micromanagement, procrastination and acting out (Seritan & Mehta 2015).  Individuals with impostor phenomenon are at risk for persistent workaholism, burnout, anxiety, and depression, including suicidality (Seritan & Mehta 2015).  From the institutional standpoint, those with impostor feelings can have difficulties leading teams due to their inability to delegate due to the tendency to micromanage and set impossible goals for their teams. They may catastrophize, need to plan for all possibilities, have difficulty finalizing decisions, and lower other employees’ moral.  Clinicians with the impostor phenomenon may rely heavily on consultants due to self-doubt about the management of clinical cases, which may contribute to poor patient outcomes (Seritan & Mehta 2015).  Perfectionism partially overlaps with impostor characteristics however perfectionists feel validated by achieving their goals, while those with impostor phenomenon are less able to internalize successes. 

The flip side of Imposterism is Presence (Cuddy, 2015).  Presence is the state of being attuned to and able to comfortably express our true thoughts, feelings, values, and potential.  Presence is both about showing up and how you show up.  Behaviors shape attitude, more than attitude shapes behavior and small successes in managing behavior beget larger ones. Challenging situations are healthy because they offer opportunities to demonstrate acts of courage, which can be built on with each new challenge.   According to Cuddy (2015) when workers begin their work tasks thinking about their individuality, or start a job describing their true self or individuality, they are more attentive, connected, focused, happier, and perform better and make fewer errors.  Physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification (Gazelle 2015). Coaching has been demonstrated to be supportive for fatigue, low sense of accomplishment, self-doubt, compromised relationships, cynicism, decreased sense of purpose and inattention to personal health.

Are you afraid that people important to you will find out that you're not as capable as they think you are?

You can test yourself here: http://www.paulineroseclance.com/pdf/IPTestandscoring.pdf

Cuddy (2015) recommends “acting” with presence in order to change one’s mindset.  The power pose allows you to be the best version of you.  Don’t just fake it till you make it, fake it until you become it!  Breath in and out slowly and deliberately. Keep your shoulders back so that your chest remains open. Keep your chin up but not in a way that makes it look like you are looking down on others. Use deliberate motions when speaking. When stationary, keep your feet grounded. Beyond taking up physical space you should also take up “temporal space” or time itself. Feeling like you have to rush you might seem like you want to escape from the situation you are in and this is not a good presence. When you make a mistake don’t follow that up with collapsing inward.

https://www.youtube.com/watch?v=RWZluriQUzE

Seritan & Mehta (2015) recommend:

Strategies for individuals:

Develop self-awareness regarding impostor phenomenon and associated behaviors (i.e., hiding out)

Practice accepting compliments graciously

Write down the steps you took to earn the success you achieved

Keep a record of positive feedback/evaluations you received

Celebrate accomplishments

Create a supportive mantra for yourself

Recall the people you think you “have fooled,” practice telling them how you tricked them, and imagine their response

Seek mentors and sponsors

Consider individual/group psychotherapy

Strategies for institutions:

Provide educational workshops on impostor phenomenon

Develop mentorship programs

Design targeted support and mentorship programs for international medical graduates and underrepresented minorities in medicine

Offer leadership training and coaching

Foster a culture that does not punish mistakes

 

Coaching can increase self-awareness, align personal values with professional duties, focusing on strengths, questioning thought patterns and beliefs, promote resilience, and provide a supportive partnership (Gazelle 2014).  

Clinician concerns and sample coaching questions:

Fatigue, low sense of accomplishment: “The demands on my time are too much; I’m exhausted and not accomplishing anything.”

Sample coach questions: “What’s another way of looking at this?” “What’s a new viewpoint?” “Will you start a ‘got-done’ list? Nightly, write down three things that went well.”

Self-doubt: “I should be smarter and more efficient. I don’t have what it takes.”

Sample coach questions: “I’m hearing a ‘not-good enough’ message. How are you experiencing this right now?” “If we could wipe the slate clean, what would you do differently going forward?”

Compromised relationships: “I get angry with staff and sometimes lose it. We’ve worked together for years; I don’t know what gets into me.”

Sample coach questions: “I hear disappointment in yourself.” “What happens physically just before you lose control?” “When you experience this, is there another response?”

Cynicism, decreased sense of purpose: “I’m like a hamster on a wheel. Why go on?”

Sample coach questions: “What gives your work value and meaning?” “What energizes you?”

Inattention to personal health: “I’d feel better if I played tennis regularly, but I never do.”

Sample coach question: “Will you put tennis on your calendar twice this week?”

Joyce M. Roché (2013) suggests interventions for imposter syndrome, which include: Take a hard look at your work habits. Learn to internalize external validation. Turn like-minded people into allies. Don’t suffer in silence. Look in an accurate mirror. See others objectively. Look at your fear. Take stock of your success. Have a sense of humor. Find the life you really want.  One of her tools for imposter syndrome is to write a letter to your younger self.

Dear younger Michelle,

I know that you strive to be more all the time because you have not felt that you are enough.  Listen to your heart.   Know deeply that you are indeed enough.  You do not have to be the best, just show up.  You do not have to be the most therapeutic, just listen. You do not have to keep doing, you are allowed to just be here now. Embrace your quirky, and sometimes intense, personality.  Your tribe will find you.  Stay creative and love what you love.  Keep learning and growing, and enjoy your spirituality as you find it.  Be compassionate not just to everyone around you, but also to you.  Use your fatigue to energize you, challenge your self-doubt with awesome coaching questions, listen deeply to those around you (especially when you disagree), find value and meaning in each moment, and get out there and run, wiggle and chant to your hearts content.  You are loved and you are love. Be the change you want to see in the world. 

Peace to all, love to all, light to all, and note to self for all,

Shelby (AKA “Big Michelle”)

 

Bibliography

Clance (1985) The Impostor Phenomenon

http://www.paulineroseclance.com/pdf/IPTestandscoring.pdf

Amy Cuddy (2015) Presence: Bringing Your Boldest Self to Your Biggest Challenges

Cuddy, A (retrieved January 19, 2016) Power Pose https://www.youtube.com/watch?v=RWZluriQUzE

Cuddy, A (retrieved January 19, 2016) Presence: Bringing Your Boldest Self to Your Biggest Challenges

https://www.youtube.com/watch?v=NLslB13b7GM

Gazelle et al.:(2014) Physician Burnout: Coaching a Way Out

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371007/pdf/11606_2014_Article_3144.pdf JGIM 

Roché, JM (retrieved January 19, 2016) http://shriverreport.org/10-ways-to-overcome-impostor-syndrome-joyce-roche/

Roché, JM (2013) The Empress Has No Clothes: Conquering Self-Doubt to Embrace Success

Seritan AL. Mehta MM. (2015) Thorny Laurels: the Impostor Phenomenon in Academic Psychiatry Acad Psychiatry