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Impostor Phenomenon

By Mary Cozart posted 03-02-2022 08:59


Do you worry about others finding out you are a fraud? Have you ever been too scared to say yes to opportunities? Do you tend to feel you “got lucky” even though you are well-qualified? Do you “qualify” your accomplishments thinking someone else deserves the bulk of the credit for or that your contribution wasn’t “that much,” or downplay congratulations for a job well done saying it’s “not a big deal”? If these seem familiar, you may be an impostor… or at least think you are.

Even as I write these words, with months of research into this subject and countless books and articles consumed, I feel those familiar thoughts creep in. Should I take the opportunity to share what I’ve learned? What if I’m not “expert enough”?

Unfortunately for us as pharmacists, Impostor Phenomenon, also known as Impostor Syndrome, is prevalent among healthcare providers and trainees. But unlike other syndromes we hear about in medicine, this phenomenon doesn’t mean the affected individual is diseased or “broken.” This syndrome is about how we see ourselves and how our version lines up with reality. The available literature regarding healthcare professionals points toward Impostor Phenomenon being more common in women and minoritized populations, with studies estimating the incidence of this phenomenon in medical professionals being as high as 66%. Data also correlates Impostor Phenomenon with burnout so identification of and action targeting our impostor tendencies is crucial.

So how do we know we have Impostor Phenomenon? A trademark of this phenomenon is lowering your own self-worth. This doesn’t mean healthy fears or self-doubt or skepticism. Rather, Impostor Phenomenon is when a mismatch is found between your internal beliefs that you aren’t worthy of success and the external evidence that points to the contrary. Even more specifically, this phenomenon is most easily evidenced by constant thoughts that hold the individual back from successes. People with Impostor Phenomenon struggle to internalize success and often feel inadequate even after successes. This phenomenon tends to show up in our day-to-day practice when we don’t give ourselves due credit – saying we “got lucky” or someone “felt sorry for us” and that is why we achieved a goal or advanced to a particular position. These statements and ones like them point out that the root of the problem with Impostor Phenomenon is that we tend to not feel worthy.

As mentioned earlier, women and minoritized individuals tend to have increased impostor thoughts, in part due to daily messages from society. Microaggressions are often unintentional and often are not even noticed by those unaffected. This could be as simple as asking someone “where were you born?” which is then interpreted as an assumption they don’t belong, or maybe a little more blatant by assuming a high ranking individual in a company is a service worker solely because of their race. Invalidation is another common theme underlying impostor thoughts, and can be evidenced by ignoring the titles of female professionals, such as using “Ms.” Instead of “Dr.” Impostor Syndrome can be amplified by situations like these and lead to individuals self-selecting themselves out of the pipeline for advancement. In contrast, the more minoritized individuals that “make it into the room,” the more these individuals feel they actually belong and are likely to be self-confident and advance in their roles.

There are many areas we can focus on to help minimize our impostor tendencies, including emotional self- regulation, authenticity, and a healthy balance of praise and criticism. If emotional regulation is suboptimal, we tend to internalize emotions and begin interpreting them as absolute truth. Without authenticity, we feel more and more like we really are a fraud. When we tend to remember every detail of our failures, but not our successes, we will internalize the belief that we are predominantly a failure and convince ourselves we just aren’t good enough. But what if we could focus on our strengths with the laser like intensity we typically reserve for our failures? I want to challenge each one of us to stop today and create a list of personal achievements without qualifiers. And when someone congratulates you on an accomplishment, say thank you without qualifiers. Maybe even give yourself a high five in the mirror for a job well done. It’s time to change our internal dialogue!

Continue the imposter phenomenon discussion with us at the ASHP Roundtable on April 20th at 1pm EST. Register today at the following link: