Hello everyone. Welcome to episode 47 of the EMDR Doctor podcast.
Recently I have been chatting to a couple of young doctors about their career trajectory… such interesting and heartfelt conversations, because these young doctors are so committed to helping people, so enthused about the science and the art of medicine, have so much regard for their patients, so much education, and yet have so much despair about continuing medicine that one was considering leaving medicine and going to start a cleaning business, and one was imagining just knuckling down, making enough money to retire and then leaving altogether. Both these wonderful young doctors were getting up in the morning with a sense of dread, about what mistakes they might make, about what their bosses would think, about being revealed to be deficient, or dumb (these are a couple of the most intelligent and thoughtful people you could hope to meet). They are white knuckling through their day, stretched tight with anxiety, and getting to the end of the day with relief over having got through another work day feeling like they are on borrowed time, and despair at having to do it tomorrow. There is a constant thought of “Im not good enough, what am I even doing here, everyone can see what a failure I am” and their most urgent impulse is to get out of there, to leave and never come back. Which would be an absolute tragedy.
Now I know that we could substitute the word doctor here, for almost every profession - I have friends in corporate, in government, in teaching, who have the exact same fears and concerns.
In the old days we might have called it a lack of self esteem, or low confidence, now we have a beautiful title for it, Imposter Syndrome. And it can apply to any gender, any age, in any profession, any area of life. The common factors are a belief about not being good enough, fear of being caught out, thinking that achievements are ‘just luck’ and working really hard to try and be perfect and to compensate for that perceived lack of talent or ability.
I have had my own experience of Imposter syndrome - not recently, as I feel like I have found my calling and my tribe in the field of EMDR, but earlier in my career, I had quite severe imposter syndrome. When I got in to med school, in the 1980s, I achieved the HSC mark that just scraped me in to Med school, and I had this ongoing fear that someone would find out that I shouldn’t have been allowed in, that as the last on in, I would be the first one they chucked out, and this fear followed me through my whole uni career and then in to the next maybe 20 years of my GP life.
Imposter syndrome is often incredibly well hidden - from the outside, that individual looks amazing, and most people would have no idea that the person is suffering so greatly and tormented by the thoughts of not belonging and not achieving.
Importantly, feeling like you are an imposter, does not mean that you are! Thoughts are not truths, one of the basic tenets of CBT therapy… but how to get rid of it?
And more interestingly, how can EMDR help it?
In EMDR therapy we work in the past, present and future, and taking this framework to solving Imposter Syndrome, we might look for the early origins of those beliefs around “I’m not good enough” or “I don’t belong here” - very likely we will find some childhood memories of being ridiculed or put down for not performing at school or in the family, or some bullying memories around exclusion, not being allowed in to a childhood friend club, or exclusion from the family, or some memories involving shaming for not achieving. If we work on those memories, resolve the distress around them, then we can bolster some good adaptive beliefs around “I do my best, my efforts are good enough, I have skills, I can solve problems” or other beliefs that are helpful.
We can also work from a strengths based perspective with some really simple resourcing, enhancing those memories of having done well, or being accepted.
Or we may start with removing the barriers to actually accepting praise or positive comments - we may use the Positive Affect Tolerance Protocol which helps you allow those beliefs that “I am doing a good job” become stronger, and to allow some warm fuzzies to develop, letting yourself feel good and praiseworthy.
We would look at some current present day triggers or situations where the imposter syndrome is very present - for one surgeon I know, that is the moment of suturing up the patient at the end of the operation - most surgeons are relaxing and feeling good about the op by that point, for this surgeon it is the moment of highest anxiety. For some people those triggers may be presenting in a meeting, talking to the boss, starting a new day or a new project, meeting new team members. Resolving those triggers as a present day target can be so helpful. And then working through future expected difficulties, and settling down the anticipatory anxiety will be really helpful.
And what’s the difference between normal anxiety and Imposter syndrome?
I have just been listening to a Jay Shetty podcast where he talks about Imposter syndrome and his experience of it. Now I hate to contradict such a leader in the wellness field, but I do think that he may be confusing Imposter syndrome with just normal job anxiety. He talks about the idea of flow being when your skills match your challenges, which is a lovely idea, and a lovely space to be in, and when your skills are more advanced than your challenges then you are probably in a state of boredom, and when your skills are not as advanced as your challenges then this is what he defines as imposter syndrome. But I think this is missing a huge part of the definition of Imposter syndrome, that despite our qualifications and skill level, we feel a sense of inadequacy that is unfounded, but pervasive and difficult. These doctors I have been talking to have the skills, have the experience, to manage the challenges they are facing, they are just overcome with a sense of not belonging, not being good enough, a sense of impending doom if they are ‘discovered’ to be inadequate, despite all the evidence of having done that work for years to a high level of proficiency.
I guess the difference is that most people will experience some level of anxiety if they are asked to do something outside of their skill level, but people with Imposter syndrome experience this anxiety even when they are perfectly qualified and capable. In that situation they ‘should’ be in a state of flow, confident and easy, absorbed in the work without being overcome by it. So we would find the history, find the events that are impeding that state of flow, and remove those blocks using EMDR so that the state of flow is available, there is more confidence, more ease, and more dare I say it, enjoyment of work. It is possible, it is doable, and an EMDR therapist can work with you to find that way forward.
I’d love to hear your experience of Imposter syndrome, please feel free to comment below if you are watching on Youtube, or send me an email at admin @therapynest.com.au if you would like to explore this for yourself and work with me on your Imposter syndrome.
I am also about to open up some spots in my week for consultation for EMDR therapists, so if you happen to be an EMDR therapist and you are looking for consultation, perhaps shoot me an email and we can figure out a time to suit.
Alright, I hope that's been helpful. I will talk to you again next week. In the meantime, take good care. Bye for now.
