Imposter syndrome and perceived failure

In this episode I take a look at imposter syndrome. Imposter syndrome leaves you feeling like you don’t deserve your success. You feel as if you have achieved everything through luck, easy obstacles and without merit. This can make you constantly afraid of being ‘found out as a fraud’, prevent you from applying for a better position and constantly belittling your own abilities.

I also discuss the reasons as to why imposter syndrome is affecting more and more people progressing through their academic life as well as why I believe it affects a number of healthcare workers.

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Transcript

Imposter syndrome 

Hello everyone and welcome to A Doctor’s View. I’m Dr Polyvios.

I would like to talk about impostor syndrome. Imposter syndrome is a very interesting psychological phenomenon in a way. It is essentially when you believe yourself to be, for want of a better word a ‘fraud’. You don’t consider your successes to be as a result of your own merit, you believe your success is because you’re lucky or you think that the tasks you had to do to attain your successes were easy. There are signs that you might recognise like feeling inadequate, you deny your own success and you also fear that you’re gonna be found out; there’s this fear of discovery whereby you hope that people don’t realise that you’re not that good. It’s a very difficult thing to overcome. It seems to be that CBT and talking to people is the main way of dealing with this problem as well as teaching yourself to overcome certain thought processes to help you own your successes.

 I believe imposter syndrome happens a lot in medicine and it actually happens a lot in podcasting whereby a lot of very successful shows, a lot of very successful hosts often think that they are a success because they had a show out at the right place and the right time or they had the right guest on or they had that one episode that sent them skyrocketing and they’re not deserving of their influence and of their position in the podcasting world. And you listen to these people shows and you realise that their shows are fantastic and they deserve all the success and accolades that they can get.

 So why did decide to talk about this? well I was in the operating theatre a short while ago and we were doing a routine operation, it was an elective case and the surgeon was closing up the case, he was sewing up the patient and he turn around and said we should all acknowledge what we’ve done today. It’s amazing. And he was in no way trying to be egotistical or self-indulgent, he was being genuine and sincere and was addressing everyone from the surgical team to the theatre nurses to the anaesthetist to the support workers, and he genuinely meant it. He said it’s a simple, straightforward procedure and we do this all the time but this is will dramatically improve this patient’s life and we don’t we don’t acknowledge it enough because we do it all the time. And I thought about that realised that he had a point; we do a procedure that’s routine, we send the patient to recovery and then we sent for the next patient and you stop thinking about the previous patient because their care has been passed on to the ward team. And even though this isn’t imposter syndrome -per-se, it did make me think about it how we dismiss certain successes.

 Now there is also a fine line between being acknowledging success and that you’ve done something good because you’re capable and intelligent and skilled and developing a God complex where you feel you are in control of other peoples’ happiness and because of you, and only you, has someone managed to live longer or you have saved someone’s life and an example of that would be say when we do what I still consider to be one of the most incredible procedures in modern medicine which is organ retrieval surgery on organ donors for organ implantation where an incredibly generous and selfless individual has donated their organs after they have tragically passed away and those organs are removed by an organ transplant team and implanted into another patient who is in desperate need of them.  And there’s a lot of things that go into that and I have been involved in these operations as an anaesthetist and it’s a complex procedure and there’s a lot of things that go on behind the scenes to make something like that happen; the logistics and family discussions and co-ordination required is unimaginable. And this is a massive thank you to all the transplant nurses who without them none of this coordination would take place. They are phenomenal people. And whilst I’ve never witnessed this from an organ transplant surgeon, it’s very easy for the transplant surgeon to say I’ve just saved five peoples’ lives because I’ve taken five organs from this donor. But you can’t really say that because you don’t know the outcome. You don’t know if the recipient of those organs had them implanted successfully, they might die of complications post-operatively they might end up with other life changing problems because of the procedure. Of course that doesn’t happen often because otherwise we wouldn’t do something if the risk of the procedure outweighed the benefits but at the same time it’s not impossible for it to happen, so you may have inadvertently caused harm, you don’t mean to of course and you are trying to save that person‘s life and give them a life that they been dreaming of for many years but at the same time it’s very difficult and impossible to just give yourself that immediate credit and it can run away with you and you see it sometimes where you wish people were a little bit more humble shall we say.

 So I’ve got to thinking as to why people might develop imposter syndrome and I got back to thinking to school days and for those who aren’t in the UK we have a system where we have GCSEs and A-levels, these are the exams you take before going to university and they determine whether you get your place or not and every year when I was growing up waiting to sit these exams and even the year that I did actually sit them in the subsequent years afterwards when you follow the news, I read the same articles the saw the same interviews each time and it was always people of an older generation saying the exams are much easier this year and nowhere near as difficult as when I was young and when we took them you had your headmaster walk round the exam hall and smack you round the head with a cricket bat every 15 minutes just to keep you on your toes. And when your hearing stuff like that year in and year out where the incredible success that these kids are achieving by obtaining these grades and high marks is being belittled it’s really demoralising and it’s not fair because I tell you one thing that I’ve learnt is trying to get top grades is not an easy thing. It requires commitment and a lot of dedication and even though yes, I will acknowledge that the exams may have easier line of questioning than they did in the past, the one thing they don’t talk about is the fact that you need a lot higher grades and in more subjects than you did before. You could get into medicine for example without an A at one point. You try that now. You won’t even make the first stage of the application process they won’t even look at your application. I lost track of what you need now, it’s something like 4 A’s with A stars and another entrance exam things that that are even beyond the things I did.

And if you think that these pupils somehow got four or five A stars at A-level without workout hard and didn’t deserve it, not a chance. Absolutely not a chance. They worked their guts out. And if you’re constantly giving this message to young pupils. It’s not going to bode very well for them.

 And the same thing carries on at university… “University was much harder back when I was a there…” yes I’m sure it was but also life is different now compared to what it was. Before you had one job: to study. And you were virtually guaranteed a good job at the end. You try and do that now whilst trying to cope with all the different stresses that modern life has to give you. Be it the high chance of unemployment, the rising cost of living, fees for universities which are just the verging on ridiculous and the pressures that young adults and children and teenagers must go through now to on top of exams in part thanks to the monumental rise of technology and social media and the constant fear of causing offence to others. And then if you do succeed and obtain a good degree and a good job there is always someone on Twitter to shut you down with a generic message of social justice; it’s because you’re from a privileged background, or because you’re haven’t had to give birth or because you’ve never fitted an oppressed stereotype in your life so of course you’re going to succeed. Never mind if you’ve spent all your time buried in books and working nightshifts at bars or in a hospital to try and pay your way through university. That doesn’t count. I hate Twitter and I can’t stand comments that aim to dismiss meritocracy and the hard work of others.

 it’s also worth noting that imposter syndrome can really affect you in a high-powered profession or position where you’re surrounded by successful people and I’m going to talk about medicine now because it’s something that I know and it’s environment that I know well and it’s very very unusual that you will be perceived by the general public to be a failure if you are a doctor or if you have chosen to do something in a medical field it’s not really heard of at least not to my face. But I believe there’s a lot of medics who will still feel like they are a failure and that’s because it’s surrounded by hyper successful people, people that have passed exams become consultants become professors reached a level in their training where others might be struggling to get to or they can’t get the same number of operating cases or they’re not have the same interaction with patients it can very easily turn into and spiral into a sense of really feeling like a failure and feeling inadequate in your job and it’s only because you’re surrounded by these hyper-successful people that you can feel like this. I do want to say to anyone who is listening perhaps junior doctors struggling to get to the point where they want to be or are feeling intimidated perhaps by seniors because they are in a position that they really want to be get to. Just because you may be struggling now to achieve that goal doesn’t make you a failure at all; you’ve still achieved a lot. You’re surrounded by very very successful people as I’ve said and everyone works on a different timeframe and just because you’re not where you want to be yet doesn’t mean you won’t be and just keep trying, keep going, it doesn’t make you a failure at all and this doesn’t just resolve around medicine it includes other professions as well and I know it’s mainly other professions that research has been has been done and I do know that imposter syndrome affects women more than it does men for a number of different reasons.

 And it’s important to acknowledge imposter syndrome because the nature of it means you don’t realise you have it. And this sense that you are not good enough can very easily hinder you in your progression and your future endeavours; if you’re constantly thinking that you’re not worthy of the position that you’re in or you not deserving of a certain job title or you’re not deserving of a certain exam result it’s not going to bode well for your self-esteem and it does in a way gives of a certain impression about you to other people as well, it can make you seem less confident for example.

 One characteristic that seems to be very common with people with imposter syndrome is perfectionism, not sure why but there is a common trait with perfectionism and you can see that in medicine where many doctors have this level of perfectionism where if they haven’t done something perfectly they think they’re not successful. So for example if you get 90% in an exam you’re seeing yourself as a failure or not deserving to pass because you didn’t get 100% that say and that’s a very difficult thing to try and overcome because this behaviour you’ve been practicing for a long time and it’s probably why you are actually in a very successful position because you have such high standards, so it’s a balance.

 Very recently I took part in a webinar with Doctor’s in Distress, a charity we have discussed before on the show and something was brought up as a consequence of the discussions which I think is relevant to the podcast. And that is the notion that being labelled an NHS hero as a result of COVID, could contribute in a way to burnout because you have a certain expectation to live up to.

With regards to imposter syndrome, it could be argued that it highlights this even more because many may not feel like a hero.

 I don’t know how to fix it and I apologise to anyone listening to this they’re going to get a solution I don’t have the answer for imposter syndrome I’ve tried to find the answers and there was a problem when I was looking up the answers. I came across a lot of people and I was trying to work out should I bring an expert on to the show, shall invite someone to talk about this? Because I don’t know very much about it. And I didn’t want to because I was looking at all these experts about impostor syndrome and I just didn’t have much confidence and faith in a lot of them and I didn’t know who to trust because as one thing that I’ve learnt with podcasting is you get a lot of people write to you wanting to be on the show perhaps or wanting you to acknowledge something that they’ve done and there’s a lot of people out there who feed off the unfortunate situation of others and capitalise on their desperation for help so I do believe there’s probably a lot of charlatans out there who are these self-proclaimed self-help gurus shall we say imposter syndrome gurus and I just I didn’t know who to believe I didn’t know who to trust and I didn’t want to start writing to people and get someone on the show to essentially at the end of the day sell a book that they’ve authored or to make you listen to their webinar that they charge £200 for whatever it might be so I thought the best way to go about it was just to be honest and say I don’t know the answer for how to deal with it, but from a pragmatic perspective I have done some reading and I do know that people have said that the best thing to do is to try and acknowledge your feelings try and talk to others and try to develop a plan to be able to deal with this in the form of a  coping strategy and then I thought out how do you do that and came to the conclusion of something along the lines of CBT cognitive behavioural therapy which whilst may work for some more than others is probably a good way of starting this journey and to try to get a referral to a therapist who can just be someone to talk to. They might not give you the immediate answer but if you’re finding yourself in a situation where you feel more stressed than you should be, you’re feeling a lack of self-belief, an overwhelming element of doubt and inadequacy it could well be imposter syndrome. But you won’t know until you talk about it or do some research and do a bit of self-reflecting and acknowledge it, or even dismiss it, whatever the answer is, you can go about speaking to someone about it and seek help from a professional. And do your research on that person that you’re going to be speaking to because like I say the Internet is full of interesting characters and the last person you want to see is someone who has probably bought half of their doctorates and titles online and are going to charge you a lot of money to literally tell you nothing that you haven’t heard a million times before, likely from inspirational quotes that you get on Instagram and Twitter, often written by people who are never going to heed that advice but post it to fuel their narcissism with likes and follows and an even more cringe worthy comment section. So just be careful and seek the help from a professional and your doctor can advise you on this. If you’re a worker in the NHS in the UK you may be eligible for free help and CBT so it’s worth having a look at. And with that I’ll leave you and as always please look after yourself and I’ll will join you again next time, I’m Dr Polyvios, Goodbye.