You’re an Imposter!

True story: I was seeing one of my very first clients in a staff-model HMO mental health clinic. I was officially “Dr. Whitehead” but the ink was still wet on my diploma.

The client spoke of problems in her marriage, problems with her kids, chronic anxiety, bouts of depression, and a general sense of being overwhelmed and inadequate. I had the conscious thought, “Wow, this woman has a lot of problems. She should see a doctor!” This thought was closely followed by “Wait, she IS seeing a doctor. She is seeing me! Help!!!”

Sound familiar? A great many recent graduates suffer from “Impostor Syndrome,” the name for the emotionally convincing sense that you are impersonating a competent therapist. You’re a sham, a poser, and very soon the client is going to figure this out and confront you. You fear that you will be the object of devastating public humiliation and shaming.

The fantasies can be very rich and detailed: you can almost hear the sound of your favorite graduate school instructor tearing your degree in half in the fantasized “court martial” proceedings. Alternatively, you could just have a vague sense of dread and incompetence without any detailed fantasies. 

It’s OK to have these feelings.

A great many therapists have them from time to time, especially early in their careers. Some therapists report having them occasionally even after years in private practice.

Helpful thoughts when Imposter Syndrome comes calling

What do you do when you feel like an imposter as a mental health professional? Here are some points to keep in mind.

I hope they will be helpful in putting your mind at ease if you fear that, very soon, someone will tear off your competent-therapist mask and expose the face of a frightened imposter:

• It is common. I’ve interviewed a great many therapists, and asked them specifically if they had experienced this phenomenon. All these therapists reported having the feelings at least occasionally.
• You’ve had this feeling before yourself. Remember driving right after you passed your driving test? Didn’t you feel as though you were impersonating a competent driver? And didn’t that feeling decrease over time?
• It is logical. Clients don’t come to you until they have spent weeks, months, or years struggling to find a solution to their difficulties. These are smart people who couldn’t find a solution; of course you are going to have rational doubts that you can fix in an hour what they haven’t fixed in years.
• You can actually think of it as an asset. We have important work to do, and (as research shows) having mild anxiety about a project can improve performance on that project. If you have to choose between overconfidence/arrogance and mild anxiety/self doubt, choose the latter: you will be more helpful to your clients.
• It will lessen over time… but for many of us, that time is measured in years, not in days or weeks.
• Get comfortable with thinking “Hello, old friend–I see that you are back again” when the thoughts emerge in mid-session. Normalize it for yourself, since it is absolutely a normal phenomenon.

What to say to Clients when Imposter Syndrome is Hitting Hard

Here is a dilemma: if you are in the clutches of the Imposter Syndrome, should you lie when a client asks “Do you think you can help me with these problems?”

Yes and no. Think of going to a dermatologist with a skin rash and hearing “Wow, I’ve never seen anything like THAT before! What the Hell is that thing???” Probably not what you were hoping to hear, and you probably won’t be going back to that physician.

Like it or not, you are being paid to be “the strong shoulder to cry on” and you must exude some degree of confidence even when you aren’t feeling it.

But it needn’t be an outright lie. Say something like, “If your problems were simple, you wouldn’t be asking for help. I’m going to stand beside you with that help for as long as it’s needed. I’m confident that, working together, we can beat this thing.”

Not a bad message to give yourself about your Imposter Syndrome, too, even if the person supporting you IS you.

To quote Albert Camus: “In the midst of winter, I found there was, within me, an invincible summer. And that makes me happy. For it says that no matter how hard the world pushes against me, within me, there’s something stronger – something better, pushing right back.”

Best of luck