Developing the Imposter Syndrome, the change from undergrad to being therapists in training, and stress

September 9, 2023 at 6:59 AM
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Developing the Imposter Syndrome, the change from undergrad to being therapists in training, and stress

Kathleen Laursen UA’21, Mecca Brooks UA’22, Rachel Dolowich UA’22 , and Jim Stellar

This blog is from three co-blog posters who recently wrote blogs on the application of clinical psychology to cortical-limbic integration and the lessons learned for experiential education. Now they are all in clinical psychology graduate schools just starting their second years of their master’s degrees and we are doing it again. This time we are focusing on the imposter syndrome and their experience of it themselves as they become professionals. So we begin with three stories.

KL: I was with a client who is about twice my age and he called me his therapist.  While I consciously know that I am now someone’s therapist, hearing someone else say it threw me into a full-blown imposter syndrome panic. I am not sure whether this was due to our age difference or just the concept of someone coming to me to help navigate through life, when I haven’t been on earth nearly as long as he has. As I’ve continued my journey as a new therapist I have overcome a lot of different challenges, some of which being my own personal obstacles. Mainly I have developed a sense of confidence as a clinician and have gotten over the belief that I have to cure everything within two days. I have come to the understanding that therapy is a process and it cannot be done overnight, it can be as long as years before someone makes progress, which is the true definition of consistency and is key.

MB:  My introductory practicum work in the assessment and referral space began almost immediately with direct work. I struggled to balance the newfound responsibility of handling a caseload, engaging with clients, as well as learning referrals well enough to connect these clients with. Each meeting, I began to question if I had the skills to provide effective outreach. I wondered whether it was evident to my clients that I have just commenced my training; if I am being taken seriously in my role. My experience with imposter syndrome in my training to be a helping professional makes me question my use of competencies and skills that grants me merit to be effective in my work. There lies a subtle dance that is done in this work to grant myself grace in knowing that skills and knowledge are meant to be built upon, while also feeling compelled to give the best service and information to clients, who are often in great need of resources and intervention. In all, wanting to be the best for myself and clients produces both anxiety and inspiration.

RD: To define my own experience of imposter syndrome, I can only narrow my thoughts to not one, but an assemblage of events over the past year. In starting my first job out of my undergraduate career, I found myself working on many projects I hadn’t previously worked on before. Some of these tasks were small, administrative tasks, while others involved careful planning, coordinating and working with children. Over the course of the last year, I found myself questioning how I got here on many occasions and wondered how someone could hold so much trust in my work which inturn, meant me. Along the way, I’ve had to learn tough lessons through mistakes made and personal wins. A year later, I find myself still holding the same unanswered question I posed to myself last year, how did I get here? What I’ve begun to learn is that I may never have this answer. However, with great trust comes great responsibility. I’ve learned to take this imposter syndrome feeling and use it as a strength in my work.

Everyone knows the loose definition of imposter syndrome, but here is a more formal definition in a paper by Chakraverty in 2020 for the STEM field. It was based on a survey where three themes emerged: “occurrence, attribution, and identity.” We think that applies to us. In technical terms, imposter syndrome can be defined as the idea that those working in the professional world experience a lack of self-confidence in the current environment in which they are working. The article by Chakraverty also states that this lack of self-esteem is linked to negative feelings of one’s own self and is tied to mental health concerns. This idea is not well known to many however, but we found that when explaining what imposter syndrome is, many professionals can fit themselves into the “box.” As professionals in the early stages of our therapist careers, it is easy to feel out of place within our environment. Having this understanding of imposter syndrome can help ourselves as well as others to outwardly recognize this feeling and not let it interfere with daily living.

Imposter syndrome has also been extensively studied among medical professionals (Bravata, et al., 2020). Yet, not much focus has yet been granted to these experiences among mental health professionals. However, imposter syndrome is very common for those entering mental health careers, presenting as negative self perceptions of one’s abilities to perform responsibilities. In addition to this, mental health professionals may also question their belongingness in their field of practice. The literature highlights the presence of imposter syndrome in helping professionals during their training, specifically focusing on those pursuing doctoral training in psychological studies and research in academia (e.g. Sverdlik, et al., 2020; Abdelaal 2020).  However, whether in a clinical psychology doctoral program, a master level social work or mental health counseling program, the experience of doubting one’s own competencies is often present. This may be due to the balance that students have to establish when partaking in mental health professional training. Students are challenged with orienting themselves in the perspectives, skills, ethics, and values of their prospective helping professions while also remaining present with themselves and their  often heavy workload. This subtle dance between the professional, novel, and personal may create a barrier to internalizing successes in the learning process and practice. Overall, although not much research has looked into imposter syndrome across mental healthcare trainees, it is clear that the demands of the field along with the rigor of study and professionalism combine to make the experience of imposter syndrome commonplace.

As Mecca said above, imposter syndrome and stress does a very good job of playing on people’s mind and body. There is a large correlation between feeling overwhelmed in the mind, and that taking a toll on your body. Imposter syndrome is just one of those feelings that could affect your confidence, which in turn affects your behavior – when your mind is off everything else falls out of place as well.

As is the general theme of this blog series, we believe that the limbic system (implicit thinking) generates feelings and learns from experience that filters into the cognitive system (explicit thinking) sometimes without awareness. This effect can be the basis of bias and certainly is the basis of much clinical therapy itself.  We see it as the basis for the imposter syndrome. While one, even a clinician, can intellectually understand this point, the syndrome can only be successfully abated by experience, by doing the work in the clinic or in any other profession where one learns from experience implicitly as well as explicitly. The advantage to this process is that when the stress of the impostor syndrome abates, it becomes easier to focus on the task at hand, in this case assessing, treating, and dealing with the patient.

The amygdala, anxiety, and college student decision-making

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