The renowned academic presents me with a copy of the latest edition of his critically acclaimed book. He apologetically answers a quick phone call. It is his recently arrived Taiwanese research assistant, who is boosting her career by shadowing the master for three months. He gives her some instructions and sighs as he puts away the phone, before proceeding to tell me how much of a failure he is. I should know better than to point to the book, to the hundreds of scientific papers or even from how far people come to be an assistant for a short period. Doctor, he says, it just makes me feel worse.

Since its first description in the late 1970s by Dr. Pauline Clance and Dr. Suzanne Imes, the impostor phenomenon (aka impostor syndrome) has gained increasing attention from the public. It describes the experience of high-achieving individuals who, despite an objective measure of their success, are troubled by persistent doubts about their ability and their achievement, fearing being exposed as an impostor or a fraud. Accomplishments are often attributed to luck, opportunity, charm, or others misjudging their abilities or competencies. It does not go away with success.

The initial research focused on high-achieving women as the original impression was that this phenomenon was almost exclusively female. As further attention was dedicated to this problem, it became apparent that this was not the case; some studies show a nearly equal male-female distribution, and others show a mild predominance in women.

Some personality characteristics appear to predispose to it, in particular high neuroticism, low conscientiousness and low extroversion. Prevalence rates vary a lot between studies, too much to be useful, but it is thought to affect up to 70% of individuals at one point or another in their career.

Many accomplished professionals will relate to the anecdote I described. They will understand the feeling of bouncing around between perfectionism, self-doubt and fear of failure while working in complex environments with increasingly greater exposure. Allowing successes and failures the power to define us brings about the risk of exposure to our insecurities.

Dostoyevsky’s Crime and Punishment is possibly one of the greatest studies on the psychopathology of guilt. Raskolnikov tries to hide his guilt while knowing that Porphyrius not only knows the truth but will also make him reveal it. At any moment the dreaded tap on the shoulder may come. Sufferers of the impostor phenomenon, when severe, can carry on their lives with this dimension of guilt. As shared by the American poet Maya Angelou, “I have written eleven books, but each time I think, uh oh, they’re going to find out now. I’ve run a game on everybody and they’re going to find me out.”

Although not a recognised psychiatric condition, the impostor phenomenon is strongly associated with conditions such as anxiety disorders or depression. It is also associated with burnout, increased stress levels and lower satisfaction at work. Individual psychotherapy and group psychotherapy may help. Checking for the presence of depression or anxiety disorders is important; if left untreated these may affect normal functioning in personal, social or professional life.

The nature of work requires creativity to deal with novel situations, trial and error, guesswork and risk-taking. Quite often the individual characteristics that have contributed to professional success also predispose one to the experience of the impostor phenomenon. Like on many other occasions, humility is a friend here. Question your knowledge, your attitudes, your approach and your preparedness, and improve them when needed. But in doing so, you do not need to question yourself.

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Tim Burrill
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