Motivation and emotion/Book/2021/Imposter syndrome

Overview


Picture this - you and a friend have spent years studying the cell cycle. All of this hard work finally pays off when you both receive a Nobel Prize in Medicine. However, the so called joy that should come with such an achievement is plagued by guilt, leaving you to state:

"Oh Tim, I've just had a most ghastly weekend because I felt so unworthy." (Chrousos, 2020)

As surprising as it may seem, this quote was stated by Paul Nurse to Tim Hunt after winning a Nobel prize in 2001 - illustrating the so called 'Imposter Syndrome' (IS). Described in the 1970s, IS has become a prominent area of research with half of all publications being published since 2014. The syndrome is characterised as a psychological state in which people experience self-doubt about their successes, despite factual evidence, or peers explaining otherwise (Kolligan, 1991). Those with IS suffer from nagging fears of being exposed as a fraud or that they will be de-masked and seen as incompetent (see figure 1). Those with IS feel less productive, insecure, prone to failure, and are likely to procrastinate. This chapter will examines this phenomenon, with a focus on what causes it, how individuals may experience it, and what can be done to deal with it.

"I never negotiated a salary because I was scared I would get caught as incompetent." (Kip, 2016)

What is imposter syndrome?
Whilst IS is not recognised in the Diagnostic and Statistical Manual of Mental Disorders, it has a large commonality. Approximately 70% of individuals will experience IS at least once in their life (Kolligan, 1991). But what deviates it from everyday stress, or guilt?

Origins


Pauline Rose Clance and Suzanne Ament Imes formulated the term 'imposter syndrome' after publishing 'The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention' (1978). Their studies researched issues in workplace dynamics, particularly in the anxiety of women beginning to work in male dominated workforces (see figure 2). The prevalence of IS was investigated with undergraduate, and high - achieving women. Results portrayed that, despite the evidence of external validation, they lacked internal acknowledgement of their accomplishments. The participants stated that their success was luck, was temporary, or others were overestimating their competence (Clance & Imes, 1978). Based on this research, Clance and Imes initially targeted IS towards high achieving women who were displaying such 'phoniness'. The absence of men stemmed from the observation that they inherently attributed their successes. This meaning that men based their success on their own intelligence and worth (Gleason, 1979). However, since publication, studies have determined that IS occurs in demographics outside of high achieving women.

Symptoms
Dr Valerie Young, a renowned expert on IS, has identified five different types of imposters. Acknowledging the different symptoms of each imposter allow the development of the right tools and interventions tailored to their unique set of criteria (Young, 2008).

 https://www.youtube.com/watch?v=h7v-GG3SEWQ

The perfectionist
The perfectionist is the most common type of imposter. The perfectionist sets goals with unreasonably high expectations for themselves. When the perfectionist fails to reach these goals, they experience major self-doubt and lose their self worth (Lewis, 2020). To them, success is rarely satisfying due to the belief one could have done better. For example, a score of 99 out of 100 equals 'utmost failure'. At times when they do achieve a goal, achievement is blamed on luck. This lack of celebrating achievements can lead perfectionists into burnout and low self-confidence.

The expert
The expert is the knowledge version of the perfectionist. To them, the quantity of their knowledge is more important than the quality of their work (Neilson, 2020). The expert has a constant need to read more books, take more courses, and get more certificates. Those who experience this form remain under the assumption that they never know enough, and base their worth on things they do not know, rather than what they do (Lewis, 2020). The expert can be held back from applying for promotions or starting new activities. Fear and anxiety arise in them when they fear others will find out they are incompetent or unknowledgeable.

The superhero
The superhero remains under the impression that they are frauds compared to their peers. Such mindsets cause them to work hard and push themselves to extreme levels to prove their worth (Lewis, 2020). The superhero covers up their insecurities with excessive workloads. Such actions can lead to harmful effects on their mental health, as well as affecting their relationships (Bowling, 2012). They are found among workaholics and mothers. Symptoms arise when they feel guilt by not juggling tasks effectively. They are often motivated by external validation. Such reliance on external validation can be damaging to individuals. It can lead to the inability to confront or disagree with others (Weber, 2003).

 https://www.youtube.com/watch?v=Gy17Le6Uo9g&t=92s

The soloist
Soloists believe that asking for help will reveal that they are weak. Hence, the soloist refuses assistance to prove their worth (Neilson, 2021). Whilst independence is beneficial, they experience it on an unhealthy level. Because soloists view asking for help as a sign of weakness, they rather fail tasks, or spend more time researching than seeking help. Soloists provide little help when working in a team. This proves detrimental in their academic and work lives as they only succeed when they are leaders or major contributors in a group. When group work does succeed, soloists do not internalise praise, and believes it 'does not count' because it was not completed on their own (Hinds, 2021).

The natural genius
The natural genius is closely tied to the perfectionist. However, they do not base their worth on the amount of effort they put into a task. Instead, they base their worth on the speed and ease of a task (Hinds, 2021). If a task takes longer to master, they feel inadequate and hold feelings of shame. As such, feelings of fraud arise when skills are not coming easily, or if they have to exert more effort. This results in the natural genius struggling to pick up new skills or hobbies and lead to feelings of insecurity (Hinds, 2021). Effects may snowball for this type of imposter whereby if natural geniuses are not efficient at the start, activities will be abandoned due to shame or embarrassment.

 {I have just started playing chess. Although I am winning tournaments, I feel as though I am not learning quick enough. I should just stop trying now. What type of imposter am I? - The expert + The natural genius - The superhero
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What causes imposter syndrome?
IS is likely the result of multiple factors. However, research suggests that its prevalence differs between gender and racial minorities. Personality characteristics such as self-esteem levels have also been identified, as well as environmental factors such as an individuals upbringing.

Gender differences
 Maureen (2021) is a former propulsion engineer at NASA. Despite working there for 13 years, she experienced self-oubt. For years, she thought NASA only hired her because they needed women. She felt under-qualified and like a fraud.

Complex relationships between gender and IS have been identified. One study looked at the relationship between gender, feelings of fraud, and the achievement of goals. Correlating to Clance and Imes  studies, results concluded that females experienced IS more than males (Kumar & Jagacinski, 2010). Reasons for this relationship may lie in sexist behaviours. For example, another study found that men defaulted to seeing women as lucky, rather than competent in stereotypical male roles. When competence was acknowledged, women were liked less (Heilman, 1997). Such acts affect a woman's mental health, physical health, job satisfaction, and overall; their motivation (Heilman, 1997). The same effects were found amongst medical students (see table 1). Out of 68 students, 47% were found to have experienced IS, with 53.5% of them being female (Qureshi, 2017). Those most at risk are women of colour and women in the LGBTQ community. Individuals in these groups, like Maureen Zappala, experience larger amounts of prejudice and are made to feel undeserving of success (Zappala, 2021). IS arises in these individuals when they achieve success' that go against the narratives they have been made to believe. Sexist stereotypes also play a role in causing IS. Stereotypes such as "Women are not good leaders because they are emotional" (Brescoll, 2016, p. 416) lead women into doubting themselves and their accomplishments. Even the focus on female beauty can increase self-doubt. If a woman grew up with the belief that her looks, rather than intelligence were most valued, she may believe that her achievements are the result of her looks, not her competence (Laux, 2018). However, this research is not to say that men do not experience IS. Instead, they experience it in altered ways. For men, IS is driven by the fear of being unsuccessful, or not good enough. In a study that saw men and women complete quizzes, men experienced more stress when receiving negative feedback, and when told their answers would be told to a professor (Badawy & Gazdag, 2018). This suggests that males fair worse than females when confronted with performance cues, and greater anxiety under conditions of high accountability.

Table 1:

Imposter Syndrome Among Medical Students (Qureshi, 2017). Note - percentage refers to those that answered yes.

Upbringing and family life


Studies have shown that IS may be linked to an individuals parenting style (see figure 3). If caregivers provide praise to a child for things they did not deserve praise for - the individual can become instilled with feelings of phoniness (Gunderson, 2013). Such praise includes being consistently told "Good boy!". On the contrary, receiving no praise can also lead to a child feeling inadequate. One study portrayed that appropriately praising a child's effort encourages them to adopt incremental motivational frameworks (Gunderson, 2013). This meaning that the child believes their abilities are malleable, attribute success' to hard work, and generate strategies for improvement. A lack of entitlement has also been linked to IS. If children are disciplined using phrases such as "You do not deserve this candy because you did not do your homework", children may generalise such language and believe they are not a deserving person. Consistently using entitlement as a form of punishment can alter the child's understanding of what it means to truly deserve something (Segrin, 2012). One study emphasised that family labels are among the highest predictors of developing IS (Gunderson, 2013). Some children grow up identifying with roles in the family. Therefore, a child who was referred to as the 'athletic one' who excels in academic settings, can have their achievements overlooked (Gunderson, 2013). This leads the child into doubting their intelligence. Further, labels are hard to escape even when behaviour adapts away from that defining label. Relating to the theory of cognitive dissonance, when an individuals personal views of themselves do not equate to what they have always been identified for, it leads to self-doubt and dissonance (Lacey, 2017). In most cases, individuals with IS do not adequately adjust their labels to their new persona (Hinds, 2021). This results in the symptoms of fear, anxiety, and lack of motivation.

Self-esteem
Low self-esteem has been strongly linked to IS. Social media has resulted in an increased number of people experiencing IS (Lacey, 2017). The social platforms have made it easier for individuals to get caught up in others achievements, their happiness, and how effortless it is portrayed as. As such, it is easier to feel as though others have more than themselves, leading people to feel like imposters. Low self-esteem causes individuals to feel less motivated to try new things. Further, those with low self-esteem are less motivated to improve a negative mood, even when offered activities that will heighten their mood. As a result, these lead to IS with those who achieve still anxiously critiquing themselves, always feeling as though they have underperformed.

Racial minorities
 Fredrick (2013) is a fourth-year PsyD candidate. He has struggled with impostor feelings throughout schooling, and says he feels like he's progressed not on his own merits, but due to sympathy from others. As an African American, he was taught that he would need to ‘work twice as hard to be half as good'. This makes him feel as though his efforts will never be enough.

A group that appears especially vulnerable to IS are racial minorities. These individuals experience what is known as minority stress. Minority stress refers to chronically high stress levels faced by members of stigmatised minority groups (Chrousos, 2020). This stress contributes to feelings of IS. Due to the micro-aggressions experienced in real life, individuals become their own aggressors; doubting themselves and undergoing negative internal dialogue. This proves detrimental to their mental health, as well as their career due to a lack of motivation. In the circumstance whereby an individual does not face stereotyping, stress, or racist behaviours - factors such as being different can spur imposter feelings. A sense of belonging fosters confidence. When individuals are surrounded by those that behave as them, the more confident they feel. For racial minorities, having fewer people behave like them impacts their confidence. For individuals like Fredrick Hives, lacking a cultural connection in his workplace fuelled, and led to, his IS. This lack of confidence resulted in Fredrick feeling as though he was hired to fulfil a diversity quota and not for his competence (Hives, 2013). According to a business report, 59% of 1500 workers experienced the same as Fredrick. Their lack of confidence fuelled their self doubt and exacerbated their feelings of fraud, despite external evidence portraying that they were competent (Chrousos, 2020).

Treatment
IS can be paralysing to individuals, However, treatment is available. Treatment options range from guided sessions, through to interpersonal strategies such as embracing ones own success and reframing thinking.

Therapeutic approach
Approaches that incorporate multi-modal therapy are most effective in debunking imposter feelings. In particular, group therapy settings or interactional groups are recommended. In these groups, it is emphasised that individuals should experience similar thoughts (Russel, 2017). Individuals feel as though IS should remain a secret. However, if one individual is willing to share their secret, others are motivated to share theirs. This feeling of belonging and the sharing of beliefs is beneficial to them. They are astonished, and relieved to find out that others share the same thoughts. Group settings also prove valuable as an individual can see the thoughts of another individual against their accomplishments, and recognise the lack of reality involved (Chrousos, 2020). Group settings also prove valuable in improving their communication and socialisation skills. As some of these individuals are plagued by anxiety, they may find communicating their thoughts difficult. Further, it teaches them how to accept criticism from others, without making themselves feel like a failure.

{Samantha cannot believe that Maya thinks she's stupid. Maya has a PhD in psychology, is a respected psychologist, and is intelligent. Based on Samantha's thoughts, what do you believe the outcome of her therapy will be? - Bad. Comparing herself to another person will result in negative thoughts. - It will not alter her thoughts, as she is her own individual person. + Good. Comparing the thoughts of another person to their accomplishments help individuals rethink their own thoughts about their reality.
 * type="[]"}

Reframe thinking
Research has stated that simply extracting self-doubt before an event occurs eliminates feelings of IS (Russel, 2017). Inner dialogue can spur images of success or failure and affect ones motivation to start tasks and overcome obstacles. Therefore, for individuals with IS, problems may end with the individual taking an inward look at their mindset and pursuing change. Cognitive Behavioural Therapy encourages individuals to see themselves in a more positive and useful way. When done with a therapist, they can help replace critical self-talk with a realistic, and constructive mindset (Seligman, 2011). The client is encouraged to employ techniques at home that encourage the awareness of negative thoughts. For example, an individual can become motivated to study for a test with the expectation of "I will do well", rather than, "I may fail". When this individual then succeeds, without prior self-doubt, it makes them less likely to predict failure and think of themselves as a fraud. For people who are not yet comfortable attending therapy, worksheets such as the Dispute Negative Worksheet help individuals capture negative statements, and find their inner-optimist. Working through each stage makes individuals more sure of themselves and confident in their achievements.

Embrace success
"We focus on where gaps in our knowledge exist. But for every time we feel inadequate, there is another moment when we realise a previous challenge is now mundane." (Russel, 2017)

To embrace success, individuals should understand the value they bring to their work, academic, and personal lives (Miller, 2019). Done either alone, or in a group, individuals can recall the people they think they have fooled, and explain how they have fooled them. Afterwards, individuals state out loud how each would realistically respond to them. Responses could include "I did not give you a promotion because you charmed me. I gave you one for your excellent time management and problem solving skills". This helps the individual embrace their success through imagining how others perceive them (Miller, 2019). Another technique is for individuals to keep record of positive feedback they have received, and why they could not accept the feedback. Once aware of the reason they deny the feedback, they are instructed to do the opposite. This includes to listen, accept and receive nourishment out of the feedback (Russel 2017). For individuals who find it hard to imagine, they can start an accomplishments box. The box includes a persons achievements. It encourages them to look at their accomplishments and the hard work that was put in. It allows them to embrace where they are, and how they have earned that spot. For some, 'faking it till you make it' can also help in embracing success. Studies have shown that assertive body language has been linked to high assertiveness and low anxiety - both of which are affected by IS. Holding a confident Wonder Woman or Superman pose for merely 60 seconds can increase such confidence.

Conclusion
With such a growing interest for IS - experts stress that prolonged symptoms of IS can lead to mental illness' such as anxiety and depression. Therefore, it is crucial that IS continues gaining attraction. Educating individuals about the symptoms, causes, and treatment options available, will save individuals from experiencing isolation and losing their motivation. For individuals affected by IS, it is important for them to know that it is not a forever thing. Though symptoms may be annoying, irritating, saddening and worrying - individuals such as Albert Einstein and Michelle Obama have recovered. With such a large array of treatment options available, help can start at home, or be done with other alike individuals. By doing so, high achieving people who previously considered themselves frauds, will allow themselves to state "I am competent, and I deserve my success".


 * Summary

IS is a state whereby people experience self-doubt on their successes despite counteracting evidence. It may be a result of upbringing, gender, self-esteem, or race. Treatment options include group therapy, reframing thinking, and embracing success.