American Association for Physician Leadership

Overcoming Impostor Syndrome in Healthcare Leadership: Twenty-five Strategies

Laura Hills, DA


Feb 1, 2024


Volume 2, Issue 1, Pages 3-12


https://doi.org/10.55834/halmj.1013299174


Abstract

Impostor syndrome is a common psychological phenomenon that makes individuals feel that they are fakes who will be exposed as frauds. Research suggests that it is more likely to occur in high-achieving individuals, healthcare professionals, and leaders than in other workers. That should make the topic one of particular interest and concern for healthcare administrators, leaders, and managers, and for the organizations that employ them. This article defines impostor syndrome and differentiates it from the normal everyday doubts and fears most people face. It explores the emotional and financial costs of impostor syndrome to the leaders who experience it and to their organizations. This article then suggests who will be most likely to experience impostor syndrome. It considers childhood influences, underrepresentation, negative stereotyping, participation in high-pressure communities, psychological disorders, high-risk personalities, the culture of medical and nursing education, and other special circumstances. Finally, this article offers readers 25 practical strategies for preventing, managing, and overcoming impostor syndrome and quotes 12 famous and highly accomplished people who have experienced impostoristic feelings.




Whenever I feel afraid, I hold my head erect,

And whistle a happy tune, so no one will suspect,

I’m afraid.

—Oscar Hammerstein, “I Whistle a Happy Tune” from The King and I

Are we rewarded when we stuff our feelings, as suggested in the song above? Arguably, yes. “Fake it till you make it” has become a commonly accepted narrative in our culture. In fact, some very successful people have suggested that we should fake our confidence when it fails us. The megastar, singer, and businesswoman Rihanna,(1) for example, suggests that when we lack confidence, we fake it. She says, “Pretend…I mean why not? It’s either that or I cry myself to sleep, and who wants to do that? You wake up with puffy eyes the next day. That’s a waste of tears.” Many of us assume the guise of confidence to help us overcome our stage fright, ace a job interview, meet our in-laws for the first time, or tackle a daunting work project or task. As Oscar Hammerstein suggests in his lyrics, we whistle a happy tune at one time or another in our lives and hope that, as the song later suggests, “The result of this deception is very strange to tell, for when I fool the people I fear, I fool myself as well.” A charming sentiment, yes. But is that true? And is this sound advice?

Almost all of us doubt our abilities and feel fear at some time in our lives and careers. We may fake our confidence, passion, or drive, not for nefarious purposes or because we enjoy deceiving others, but because we want to propel ourselves over the daunting hurdles we face. The deception seems harmless enough, and it can work. However, there are concerning long-term implications of regularly pretending to be what we are not. Leadership coach Alan Ibbotson(2) refers to the “fake it till you make it” narrative as “literally the birthplace of impostor syndrome.” He says, “The advice is to fake it until you’re successful. A fake is a phony, a counterfeit, a sham, a fraud, a hoax. And this is advice? Be a phony until you’re successful? Really?” Ibbotson and many others believe that by normalizing false confidence and abilities, “the deception” in Hammerstein’s lyrics, we begin to descend a dangerously slippery slope. If you fake it often enough, Ibbotson says, part of you comes to believe that you are indeed a fake, someone not fit for the role you are about to step into or already hold.

Impostor syndrome is loosely defined as the internal experience some of us have of believing that we are not as competent as others perceive us to be. It is a psychological phenomenon in which individuals doubt their skills, talents, accomplishments, or fitness for a position or role they play, and have a persistent, nagging internalized fear of being exposed as a fraud. Unfortunately, the problem is widespread. In fact, White(3) suggests that impostor syndrome has become the “new normal.” According to Psychology Today,(4) “Around 25 to 30 percent of high achievers may suffer from impostor syndrome. And around 70 percent of adults may experience impostorism at least once in their lifetime.”

Impostor syndrome affects people in all stages of their education and careers. However, Kets de Vries(5) observes that the problem runs rampant in C-suite, managerial, and leadership positions. He distinguishes fleeting impostoristic feelings from what he calls neurotic impostorism. Kets de Vries explains, “To some extent, of course, we are all impostors. We play roles on the stage of life, presenting a public self that differs from the private self we share with intimates….” Displaying a facade is, in fact, part and parcel of the human condition, Kets de Vries says, and a likely reason that the feeling of being an impostor is so common. We are taught to stifle our feelings and to act in ways we don’t want to, starting at a very young age. For example, we are urged to kiss our Aunt Peggy, who scares the bejeebers out of us, to share toys and treats we’d rather keep for ourselves, and to pretend that we like a birthday gift we received, when, in fact, we don’t like it or want it.

Some self-doubt is normal and, in fact, prevents us from being narcissistically delusional about our capabilities and achievements.

Fortunately, our occasional, momentary feelings of being an impostor usually are not debilitating. They may be, in fact, the price we must pay for taking part in a civilized society, and necessary so we get along with one another. Neurotic impostorism, on the other hand, occurs when phoniness becomes normalized for individuals who believe that there is tremendous, relentless pressure on them to fake it. A steady diet of faking it leaves them feeling fraudulent, ashamed, and alone. Kets de Vries says, “Because they view themselves as charlatans, their success is worse than meaningless: It is a burden.” Neurotic impostors believe that they are bluffing their way through their lives and their careers, and they are haunted by the constant fear of exposure. With every success, they think, “I was lucky this time, fooling everyone, but will my luck hold? When will people discover that I’m not up to the job?” Neurotic impostors will feel this way even when they are doing an objectively good job, are highly qualified, and are deserving of the recognition, praise, and rewards they receive. They brush off their accomplishments as flukes or mistakes and feel undeserving of the accolades, rewards, and opportunities heaped upon them.

Some self-doubt is normal and, in fact, prevents us from being narcissistically delusional about our capabilities and achievements. You won’t need to do much or anything if you experience doubts that are short-lived and rare, as long as they don’t stop you from doing what you need and want to do. However, you will need to take quick action if you are plagued by strong, frequent doubts about your abilities, especially if you have a nagging fear that you will be found out as a fraud. This is especially true if such thoughts cause you anguish, keep you up at night, hold you back, or undermine your leadership. You won’t be able to live a happy and productive life, let alone lead others in your healthcare organization to the best of your abilities, if you feel that you are a fraud who is minutes away from being caught.

Impostor syndrome is not a hopeless and incurable condition, but it can cause immense distress and deserves our attention. In the following sections we will learn more about impostor syndrome and identify which healthcare leaders may be more vulnerable to it than others. We will explore when impostorism has the potential to interfere with or sabotage leadership. We will consider, too, what healthcare leaders can do to prevent impostoristic thinking and nip negative thoughts in the bud. Fortunately, leaders who feel like impostors can do quite a lot to gain or regain their confidence. To start, let’s understand more about impostor syndrome.

What Is Impostor Syndrome?

Clance and Imes(6) first coined the term impostor phenomenon in an article published in 1978. They defined impostor phenomenon as “an internal experience of intellectual phoniness” and initially focused their research on women in higher education and professional industries. Clance and Imes posited that the impostor phenomenon was less prevalent in men. However, later research found that the impostor phenomenon is spread equally among men and women. For example, Langford and Clance(7) report in 1993 that surveys of several populations found “no differences between the sexes in the degree in which they experience impostor feelings.” Furthermore, later studies of college students, college professors, and successful professionals failed to reveal any gender differences in impostor feelings, suggesting that males, at least in these populations, are just as likely as females to experience impostorism. However, Badawy, Gazdag, et al.(8) suggest that men may be more likely than women to have severe reactions to the impostor phenomenon. The researchers report that the men in their study reacted “significantly more negatively under conditions of negative feedback and high accountability” than their female participants did.

Impostor syndrome is not a diagnosable psychiatric illness (although it can be addressed with many kinds of psychotherapy). Rather, impostor syndrome is defined by the Cleveland Clinic(9) as “a pattern of thinking that can lead to self-doubt, negative self-talk and missed opportunities.” It is identified by the symptoms the individual experiences, identifies, and reports. Cleveland Clinic says that these may include crediting luck or other reasons for success, fear of being regarded as a failure, feeling that overworking is the only way to meet expectations, feeling unworthy of attention or affection, downplaying accomplishments, and holding back from reaching attainable goals. Charleson(10) suggests that there also are external signs of impostor syndrome that others may notice, including minimizing or deflecting positive feedback, overpreparing, not trying for fear of failure, and distrust of others.

The High Cost of Impostor Syndrome

Strong feelings of self-doubt can be costly to the individual even beyond the unpleasantness of fear, anxiety, and stress. They also can be financially costly. Mint(11) says, “Impostor syndrome is an extreme case of self-doubt that impacts your performance and success—which, in turn, can hinder your earning potential.” Individuals who experience impostor syndrome may avoid taking on projects and reasonable risks or believe that they don’t deserve a salary increase. Mint reports that the estimated costs in the following list represent missed opportunities and increased health costs for the average American who experiences impostor syndrome:

  • Burnout and stress: $988/year;

  • Work tension: $2,244/year;

  • Lack of sleep: $2,569/year;

  • Lost productivity: $3,400/year;

  • Not negotiating pay: $7,528/year; and

  • Unnecessary purchases: $1,800/year that could have been saved or put toward a side hustle.

Impostor syndrome robs even the highest achievers of their motivation each year, Mint says. It is hard to quantify, but, nonetheless, is related to one’s lifetime earning potential. The costs of impostor syndrome extend beyond the individual. Leaders who suffer from impostor syndrome ultimately can do great harm to their organizations. Executive coach Alexandra Friedman(12) says, “The procrastination, perfectionism, over-preparation, self-sabotage and self-censoring that characterize impostor syndrome can deplete time and resources, and, most adversely, employee morale.” Moreover, faking it can subtly and negatively permeate the work culture and become a prevalent strategy within an organization, especially when leaders model or encourage the tactic. Organizations that have leaders and employees who grapple with impostor syndrome can suffer from a lack of transparency and authentic communication. Critical feedback may be withheld and opportunities for growth missed. Organizational culture consultant Judith Belton(13) warns, “Employees may feel pressured to present themselves as infallible, hindering open communication and vulnerability.” The veneer of perfection that impostoristic leaders model can stifle innovation, impede authentic connections, and perpetuate a culture of pretense, Belton says.

Who Is Most Likely to Experience Impostor Syndrome?

There are several potential causes of impostor syndrome, and some may surprise you. For example, Psychology Today says, “Calling attention to one’s success, ironically, can unleash feelings of impostor syndrome.” Some people begin to experience impostor syndrome when their successes are broadcast publicly, and they become the object of profuse praise, attention, and applause. For example, they may feel undeserving and doubt their abilities when they win a prestigious award, are promoted to a prominent position, or have a flattering article written about them.

Fortunately, most people handle positive recognition well and enjoy the limelight without suffering negative consequences. However, career success is not the only potential trigger of impostor syndrome. Several other experiences and conditions also can begin the spiral of self-doubt. For example:

  • Communities that have low representation or are marginalized: Individuals who are put in positions where they do not see others like themselves may be more vulnerable to impostor syndrome. Benisek(14) explains, “Studies show that those who are different from most of their peers, such as women in high-tech careers or first-generation college students, are more likely to have impostor syndrome.” Research also has found that impostor syndrome is common in Black American, Asian American, and Latinx college students in the United States, Benisek says. Charleson explains, “The lack of role models can lead to low confidence, a lack of peer support, and a feeling of not belonging—all of these factors can contribute to impostor syndrome.” Keep in mind, however, that feeling like an outsider is not necessarily a result of impostor syndrome. In some cases, it can occur because of actual discrimination or exclusion due to systemic bias. Cuncic(15) explains this important distinction. She says, “With impostor syndrome, the feeling of being an outsider is caused by internal beliefs. With discrimination, the feeling is caused by the actions of others.”

  • Negative stereotyping: Negative stereotypes may fuel impostor syndrome, even when they are not overtly expressed. For example, Duszynski-Goodman(16) says, “Research points to the way society defines leadership qualities with masculine traits as a potential trigger for impostor syndrome in women seeking leadership roles.”

  • A stressful upbringing: The seeds for impostor syndrome can be sown in childhood. Benisek says, “Many people who have impostor syndrome grew up in families that stressed achievement and success. If your parents went back and forth between overpraise and criticism, you may be more likely to have feelings of being a fraud later in life.” Cuncic suggests that parenting styles characterized by being controlling and overprotective may contribute to the development of impostor syndrome in children. She adds, “Studies also suggest that people who come from families that experienced high levels of conflict with low amounts of support may be more likely to experience impostor syndrome.”

  • High-pressure communities: Society’s pressures to achieve can also contribute to impostor syndrome. Benisek warns, “It’s easy to measure your self-worth by what you’ve accomplished,” which, in turn, can encourage impostoristic behaviors and feelings, especially for those who believe that they can’t keep up. Individuals who are members of extended families, communities, academic institutions, organizations, workplaces, or professional societies that heap a lot of pressure on their members to succeed may be more susceptible to impostor syndrome.

  • Transitions: Impostor syndrome appears to be more common when we are going through transitions and trying new things. Cuncic explains, “The pressure to achieve and succeed, combined with a lack of experience, can trigger feelings of inadequacy in these new roles and settings.” That inadequacy, when taken too far, can make us believe that we are undeserving fakes who eventually will be found out.

  • A failure after a string of successes: Psychology Today says that even one setback can shake one’s self-confidence and “make us critique and question our overall aptitude.” Two or more failures following success may undermine our confidence even more and make us feel that we fooled people but finally have been found out.

  • High-risk personality traits: Cuncic says that certain personality traits have been linked to a higher risk of experiencing impostor syndrome. These include low self-efficacy (i.e., your belief in your ability to succeed in any given situation); perfectionism (i.e., the belief that you cannot risk ever saying or doing the wrong thing); and neuroticism (i.e., higher levels of anxiety, insecurity, tension, and guilt).

  • Social anxiety: People with social anxiety disorder may feel as though they don’t belong in social or performance situations. Cuncic says, “You might be in a conversation with someone and feel as though they are going to discover your social incompetence. Or you may be delivering a presentation and feel as though you just need to get through it before anyone realizes you really don’t belong there.” Keep in mind, however, that while the symptoms of social anxiety can fuel impostor syndrome, that does not mean that everyone who experiences impostor syndrome has social anxiety, or vice versa, Cuncic says.

  • Depression: Depression has many ripple effects, and the crippling self-doubt of impostor syndrome is potentially one of them. Shaikh(17) says, of her own depression, “While one does not need to have depression to feel like an impostor, I sometimes feel like one when my depression intensifies.” Depression can make us believe that we do not have and can never achieve the level of competence that we think you should have. Therefore, Lee(18) says, nothing we do is ever going to be “good enough” and can make us feel that others have incorrectly placed their confidence and trust in us. The result is that we feel like undeserving impostors.

  • Unfavorable comparison: Playing the comparison game can lead to feeling down or inadequate if we are not achieving our goals at the same rate as others. That, in turn, can make us feel like frauds who are faking it.

Impostor Syndrome in Healthcare

Several sources suggest that impostor syndrome occurs in new healthcare practitioners with greater frequency than it does in many other populations. For example, Gottlieb, Chung et al.(19) say, “Impostor syndrome (IS) is increasingly recognised as a condition among physicians and physicians in training.” Edwards-Maddox,(20) who conducted a literature review of studies of nursing students and clinical nurse specialists, found that impostoristic feelings among study participants ranged from 36% to a whopping 75%. Edwards-Maddox explains, “Due to changes in nursing education resulting from COVID-19, self-doubt and uncertainty among new nurses are expected to be heightened,” leading to burnout and impostor syndrome. That said, Aubeeluck, Stacey, and Stupple,(21) who reviewed studies of nursing students pre-COVID, similarly found, “Graduate nursing students may be particularly susceptible to ‘Impostor Syndrome.’”

The seeds for physician impostor syndrome often are planted at the student level.

It is not surprising that impostor syndrome would be higher in students and new practitioners, as it is usually associated with high-achieving individuals and those who are just getting started in their careers. However, several sources suggest that senior healthcare practitioners are not immune to it either. For example, LaDonna, Ginsburg, and Watling(22) found that even physicians at advanced career stages question the validity of their achievements and can identify as impostors. Armstrong and Shulman(23) suggest that the impostor phenomenon could be one of the reasons that female neurologists at all career points still lag behind men in publications and job promotions. And Moskal(24) reports that Stanford Medicine’s study of about 3000 practicing physicians in various stages of their careers found that impostor syndrome is “more prevalent in physicians than in other U.S. workers.”

Why is impostor syndrome so common among healthcare professionals? Watt(25) suggests, “Students embarking on a career in the healthcare profession quickly learn that they have entered a culture that expects perfection. There is little room for error, and ‘high achiever’ is the predominant personality type.” Therefore, the seeds for physician impostor syndrome often are planted at the student level. Watt explains, “Students attribute their success to luck, good timing, or someone else’s recommendation rather than their own hard work. This leads them to believe that they are undeserving of their role and don’t belong.” However, even beyond training, Davis(26) says, impostor syndrome does not go away and continues to be underacknowledged in the healthcare community. Davis warns, “Individuals who experience it rarely talk about it. Left unaddressed, impostorism can lead to inaccurate self-assessment, affecting professional identity and fulfillment of potential.”

Impostor Syndrome in Leadership

Are leaders, like healthcare professionals, more prone to impostor syndrome than other populations? Yes. In fact, Mattone(27) describes impostor syndrome as “the bane of leaders everywhere” and warns that it sabotages the work of many talented executives. Leaders are seen as exemplars of competence and confidence, and they often strive to model those attributes for their followers. The pressure they feel to maintain this façade creates the perfect breeding ground for impostor syndrome. That can explain why, Cherry(28) says, “Many leaders experience impostor syndrome, and its effects can have far-reaching consequences.”

Many leaders strive to appear unruffled to their followers, no matter what happens.

Of course, leaders may not always feel free to reveal the full extent of their doubts and fears to their followers. They always must be aware that others look to them for optimism, strength, and confidence, especially during trying times, and most feel pressure to be a positive role model. As the ancient Chinese Taoist philosopher Laozi(29) famously said, “Leadership is your ability to hide your panic from others.” Whether you agree with Laozi or not, Smith and Grandey(30) refer to this as the “emotional labor” of being a leader. They say, “Effective leaders have long managed the emotions they display at work. They project optimism and confidence when team members feel thwarted and discouraged. Or notwithstanding their skepticism about the company’s strategic direction, they carry the company flag and work to rally the troops.” The emotional labor leaders bear can make them feel that they are straddling the fine line between authentically sharing how they feel and presenting more confidence and optimism than they have. On top of that, many leaders also strive to appear unruffled to their followers, no matter what happens. Belton explains, “Leaders may feel compelled to project an image of infallibility, fearing that any admission of self-doubt or vulnerability will diminish their authority.” This paradox—the expectation of unwavering confidence and the internal struggle of impostor syndrome—can be a “lonely and debilitating journey” for those in leadership positions, Belton says.

Impostor syndrome can occur at any point in a leader’s career, and even the most seasoned leaders can fall prey to it. However, new leaders seem to be especially susceptible to it. Several sources suggest that those first steps into leadership occur in an especially tender moment in a leader’s career. For example, Vistage(31) says that impostor syndrome can be “especially tough for new CEOs, who have put in years of work and now sit at the top, which can be a very lonely place indeed.” Friedman suggests that emerging leaders often believe that “they don’t deserve their success.” As well, Van Born(32) says that it is common for first-time leaders to feel self-doubt and that impostor syndrome can lead them to “unhelpful attitudes of perfection-seeking, rigidness and overwhelm.” Clearly, leaders who are new in their roles, especially their first roles, seem to be at greater risk for impostor syndrome.

Twenty-five Strategies for Preventing, Managing, and Overcoming Impostor Syndrome

As we’ve seen, impostor syndrome is common among high-achieving individuals, healthcare professionals, and leaders—creating a perfect storm for high-achieving leaders in a healthcare organization. Fortunately, there are many things that healthcare administrators, leaders, and managers can do to prevent, manage, or overcome impostor syndrome in themselves and in their employees. Here are 25 strategies you can use:

  1. Assess whether you have impostor syndrome. Self-doubt does not necessarily mean that you have impostor syndrome. Clance(33) offers a free online impostor phenomenon assessment test that consists of 20 multiple-choice questions and is self-scored. You, your employees, and your mentees can take it anytime to determine whether you have impostor phenomenon characteristics and if so, to what extent you are suffering from them. Clance’s test is available at https://paulineroseclance.com/pdf/IPTestandscoring.pdf .

  2. Understand the syndrome. Keep in mind that actual frauds don’t have impostor syndrome. Benisek says, “The very fact that you have impostor syndrome shows that you’re not an impostor.”

  3. Stop dismissing your feelings. Don’t try to ignore, disregard, or dismiss your feelings of not belonging and impostorism. Cunci says, “Instead, try to lean into them and accept them.” It’s only when you acknowledge these feelings that you can start to unravel the core beliefs that are holding you back, Cuncic says.

  4. Don’t expect too much from yourself. First-time leaders and those who are new to their positions are especially prone to impostor syndrome. Manning-Schaffel(34) says, “Give yourself the grace of building up the confidence you need in the role and allow yourself to sit back and learn from those around you.”

  5. Separate feelings from facts. Be on guard against impostoristic feelings, identify them, and be ready with a response. The Cleveland Clinic recommends, “If your mind says, ‘I don’t know what I’m talking about,’ remind yourself that you know more than you think you do and are capable of learning.” Whenever you feel like an impostor, grab a pen and paper, draw a line down the middle, and jot down your feelings on one side and facts on the other. Benisek says, “Realize that they [your feelings] are just emotions. Remind yourself that you are capable of success.” Ibbotson, who uses a similar pen-and-paper exercise with his coaching clients, says that it can help you get out of the “emotional tsunami” that is your fear.

  6. Distinguish inexperience from inability. Duszynski-Goodman says, “An important step to dismantling impostor syndrome is to first distinguish feeling inexperienced from feeling like you are undeserving.” Just because you are doing something for the first time does not mean that you don’t belong there or that you are incapable of learning, Duszynski-Goodman says.

  7. Welcome more questions. Leaders must put down their defenses and learn how to become comfortable answering questions with “I don’t know.” Friedman says, “Leaders must create a culture of learning, where asking questions is the norm, where a gap in knowledge invites collaboration and sharing — rather than withdrawal and shame.” How can leaders do this? “Conclude meetings with a mandatory round of questions from all attendees,” Friedman says. Also, thank employees who are willing to ask you the most pressing and challenging questions. Mattone says, “Turn questions into tools that help you solve issues.”

  8. Say your name aloud. Bennett(35) suggests that the simple act of adding our name to a positive affirmation (for example, “Jessica is awesome”) and speaking it aloud can help us to manage our impostoristic feelings. “And before you get bashful, Bennett says, “LeBron James does it.” According to Bennett, James said “‘I wanted to do what was best for LeBron James’” when he explained his decision to leave the Cleveland Cavaliers for the Miami Heat in 2010. Bennett also says that the Nobel laureate Malala Yousafzai used the strategy when she wrestled with her decision to speak out against the Taliban. According to Bennett, Yousafzai asked herself, “If he comes, what would you do, Malala?” Then, she replied to herself, “Malala, just take a shoe and hit him.’’ Bennett suggests that if the strategy of saying our own name aloud is good enough for a top athlete and a Nobel Peace Prize winner, “I’m pretty sure it’s good enough for the rest of us.”

  9. Stop comparing. Comparing yourself with others is an unnecessary distraction that will keep you from embracing your own capabilities. Instead, focus on measuring your own achievements. The Cleveland Clinic says, “Turn impostor syndrome on its head: Remember that smart, high-achieving people most often deal with impostor syndrome.” Ironically, the people you compare yourself with and admire may be experiencing impostor syndrome too.

  10. Note your strengths and accomplishments. It’s likely that your classmates, peers, colleagues, managers, and employees, and even strangers have pointed out your skills. Mint says, “Revisit all these compliments when you may be feeling discouraged.” Keep tangible reminders of your success in a place where you can see them when doubts start to creep in. The Cleveland Clinic suggests, “When your manager sends you an email recognizing your excellent work on a project, save that email in a special folder.” Hang your diplomas and awards and display cards of appreciation that you receive too.

  11. Embrace and model authenticity. Leaders who seek to break the cycle of “faking it” in their organizations must prioritize authenticity. That means that they must create a culture where vulnerability is not viewed as weakness but as a strength. Leaders can set the tone by openly discussing their own challenges and doubts, and by fostering a safe space for others to do the same. Belton says, “In this environment, impostor syndrome loses its power, as individuals realize that they are not alone in their struggles.” Leaders who embrace their authentic selves, acknowledge their limitations, and openly share their journeys empower others to do the same. This authentic form of leadership fosters trust, encourages open communication, and paves the way for more inclusive decision-making processes, Belton says.

  12. Get out of your head. Saymeh(36) suggests that rumination, a pattern of circling thoughts, goes hand in hand with impostor syndrome. She suggests that impostoristic feelings will become less powerful when “they aren’t circling.” Do whatever you need to do to stop unproductive rumination. For example, write down your thoughts, go for a walk, engage in an engrossing activity, or practice mindfulness.

  13. Define what success looks like. Impostor syndrome means that success is important to you. While doubting your abilities can be harmful, self-awareness is positive. Vistage says, “Use self-awareness to your advantage by asking yourself what, exactly, success looks like. Are there benchmarks for success? How can you ensure that each day, week, month, and quarter are successes? What should success feel like? How will you celebrate success with your team?” Most importantly, how can you achieve the success you’ve defined authentically, without having to fake your way to it?

  14. Escape the “I must know everything” trap. Leaders with impostor syndrome often feel that people around them expect them to know more than they do. However, Mattone says, “Admitting that you don’t know everything can be liberating and empowering.” Stop trying to act like an omniscient higher entity. Mattone says, “Being vulnerable and susceptible to making mistakes is profoundly human. Intelligent leadership is not about avoiding failure. It’s about dealing with it constructively and moving towards success.”

  15. Assess the evidence. Our self-doubts may not be grounded in reality. To find out, Saymeh suggests that you make a simple two-column list. On one side, list “Evidence that I am inadequate” and on the other side, list “Evidence that I am competent.” Saymeh says, “This list enables you to combat impostor syndrome by collecting, acknowledging, and reflecting on proof of your competency.”

  16. Stop the negative self-talk. Shift your negative thoughts when you start telling yourself that you are a fraud. Manning-Schaffel suggests, “We have to interrupt the cycle and replace those maladaptive thoughts with adaptive thoughts and positive messages that make sense for us.” For example, you can tell yourself, “I am confident. I’m doing the best I can. I deserve to be here,” Manning-Schaffel says.

  17. Give yourself permission to fail. Accept failure as a natural part of the growth process. Learn from failures what doesn’t work and focus more on what does. Mint says, “Pick yourself up and work harder to reach your career and financial goals.”

  18. Use social media cautiously. Overuse and misuse of social media may be related to feelings of inferiority. Cuncic warns, “If you try to portray an image on social media that doesn’t match who you really are or that is impossible to achieve, it will only make your feelings of being a fraud worse.”

  19. Note when you’re not feeling like a fake. There will be times when you feel that you do know what you’re doing and that you are being authentic in your role. Take note of these moments. Manning-Schaffel says, “Own the expertise you’ve picked up and lead with it on future goals and projects.”

  20. Embrace resilience. A resilient mindset can help you overcome impostoristic feelings. Von Born says, “Resilience is adapting and recovering from setbacks while remaining optimistic instead of letting inexperience or mistakes overwhelm you. It keeps you focused on your goals and potential instead of adversity.” Von Born adds that you also strengthen your resilience by prioritizing your self-care, getting enough rest, exercising, and enjoying activities that bring you fulfillment.

  21. Say yes to new opportunities. Leaders with impostor syndrome may avoid new challenges for fear of being found out to be a fraud. Watt says, “Don’t let fear of failure stop you from trying something new. In permitting yourself to fail, you may find new skills.”

  22. Don’t fake it, wing it. Reframe the way you describe moments when you must do something when your confidence is not fully there. Ibbotson says, “There’s only so much preparation that you can do for anything. Winging it is a skill set that refers to the ability to assess your situation and judge it accurately.” Winging it also is about being open to learning how instead of pretending to be. Ibbotson says, “It’s about how creatively, on the fly, you’re able to pull your resources together to find a solution to something or improvise.” Reframing faking as winging it will help you develop the confidence you need to trust all you’ve learned over the years, step into the unknown, and believe that everything will work out. Unlike pretending to be what you’re not, winging it is a truthful and healthy way to frame the way you face your challenges.

  23. Adopt a growth mindset. A growth mindset offsets self-doubt because it focuses on what you can learn to be an effective leader instead of what you don’t know. Von Born says, “It acknowledges that abilities and intelligence can be developed over time with focus and dedication.” When you believe that you can grow, each day is a chance to work hard, gain new knowledge, and make your mark. Vistage says, “If you felt like an impostor yesterday, that leaves today, tomorrow and the rest of time to prove that you belong” because of your curiosity, drive, and work ethic. “People who adopt a growth mindset see obstacles—like the feeling of being an impostor—as temporary, as things that can be overcome,” Vistage says.

  24. Change your culture. Moskal suggests that medical organizations can mitigate impostor syndrome by fostering a culture that allows physicians to express vulnerability and to share personal stories in small group discussions. Particularly, Moskal says, experienced physicians, who often appear to have it all together, can describe their own “failure resumes” for junior colleagues to demonstrate that their role models also have difficulties. He adds, “De-stigmatizing and normalizing help-seeking could also contribute to more professional fulfillment.”

  25. Talk to someone. Our irrational beliefs tend to fester when we keep them to ourselves. Therefore, talk to trusted friends or family members who can help normalize your feelings and remind you that your fears aren’t based in reality. Speak to your mentor or a trusted colleague. Or, Benisek suggests, “See a therapist, who can help you develop tactics to overcome impostor syndrome.” A therapist can help you to validate the feelings, fears, and isolation that comes with feeling like an impostor. They can also challenge your negative cognitions of self and help you replace them with positive, affirming statements. Therapy may be especially helpful if your impostor syndrome is causing you anxiety and/or you have long-held beliefs about your incompetence in social and performance situations.


Twelve Famous People Who Have Experienced Impostor Syndrome

Healthcare leaders and employees who experience impostor syndrome are in excellent company. Self-doubt and the feeling of inadequacy affect many high-achieving individuals who don’t believe that they deserve the praise, recognition, and opportunities they’ve been given. Many also believe that they are fooling everyone and fear that they will be found out as frauds. Here are 12 famous examples:

I have written 11 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.”(36)
Maya Angelou, memoirist, poet, civil rights activist, and recipient of the National Medal of Arts and the Presidential Medal of Freedom

* * *

I still have impostor syndrome…It doesn’t go away, that feeling that you shouldn’t take me that seriously. What do I know?(37)
Michelle Obama, attorney, author, first lady of the United States from 2009–2016

* * *

No matter what we’ve done, there comes a point where you think, ‘How did I get here? When are they going to discover that I am, in fact, a fraud and take everything away from me?”(38)
Tom Hanks, actor, filmmaker, Hollywood legend, two-time Academy Award Winner, recipient of the Presidential Medal of Freedom

* * *

Who doesn’t suffer from impostor syndrome? Even when I sold my business for $66 million, I felt like an absolute fraud.(39)
Barbara Corcoran, founder of The Corcoran Group, syndicated columnist, television personality, investor

* * *

The beauty of the impostor syndrome is you vacillate between extreme egomania and a complete feeling of: ‘I’m a fraud! Oh God, they’re on to me! I’m a fraud!”(40)
Tina Fey, comedian, actress, author, nine-time Primetime Emmy Award winner, youngest-ever recipient of the Mark Twain Prize for American Humor

* * *

I am not a writer. I’ve been fooling myself and other people.(41)
John Steinbeck, novelist, author of The Grapes of Wrath, winner of the 1962 Nobel Prize in Literature.

* * *

Very few people, whether you’ve been in that job before or not, get into the seat and believe today that they are now qualified to be the CEO. They’re not going to tell you that, but it’s true.(42)
Howard Schutz, businessman, author, former Chairman and CEO of Starbucks

* * *

I’m always looking over my shoulder, wondering if I measure up.(43)
Sonia Sotomayor, attorney, jurist, Associate Justice of the Supreme Court of the United States

* * *

You think, “Why would anyone want to see me again in a movie? And I don’t know how to act anyway, so why am I doing this?”(44)
Meryl Streep, actress, three-time Academy Award winner, often described as the best actress of her generation

* * *

At any time, I still expect that the no-talent police will come and arrest me.(45)
Mike Myers, comedy legend, actor, screenwriter, producer, director, winner of seven MTV awards, and a Primetime Emmy Award

* * *

The exaggerated esteem in which my lifework is held makes me very ill at ease. I feel compelled to think of myself as an involuntary swindler.(46)
Albert Einstein, theoretical physicist, winner of the 1921 Nobel Prize in Physics, one of the greatest and most influential scientists of all time

* * *

Sometimes I wake up in the morning before going off to a shoot, and I think, “I can’t do this. I’m a fraud.”(47)
Kate Winslet, actress, winner of an Academy Award, Grammy Award, and a Primetime Emmy Award


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Laura Hills, DA

Practice leadership coach, consultant, author, seminar speaker, and President of Blue Pencil Institute, an organization that provides educational programs, learning products, and professionalism coaching to help professionals accelerate their careers, become more effective and productive, and find greater fulfillment and reward in their work; Baltimore, Maryland; email: lhills@bluepencilinstitute.com; website: www.bluepencilinstitute.com ; Twitter: @DrLauraHills.

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