Just in the last few days, I had two encounters with the imposter syndrome. An eminent psychiatrist told me, “On my bad days, I feel like a total imposter.” A prospective client wrote, “Despite two degrees, I don’t feel qualified to do more than a menial job.” 

It’s not surprising that a self-reflective person sometimes feels like an imposter. It’s so hard to know all you need to consistently make correct professional decisions. In so many cases, we must decide based on incomplete knowledge.

For example, it’s tough for a lawyer to keep up with the latest case law and statutes, even within a specialty. And all those may be overridden by the facts of a particular case.

Exacerbating the imposter syndrome, much training is conducted by professors that have limited real-world experience. So you may graduate longer on theory than on how to address real-world problems. Ironically, the problem may be worst with that lofty degree, the Ph.D. It’s a research-centric degree so if you got the Ph.D to be a practitioner, for example, a psychologist, that degree may not make you much more practically competent than masters degree holders but people will assume you are. The larger the gap between perception and reality, the more likely you are to feel like an fraud.

So, what to do about a gnawing case of the imposter syndrome? It depends which category you fall into:

The very skilled.  If you’re self-reflective and not unduly defended, you’ll inevitably have to confront the limitations of your knowledge of the field and of the particular situation. For example, it is impossible for physicians to know, for sure, whether to tell a patient who has come in for an annual checkup, "You're fine." Doctors must make life-and-death decisions based on incomplete information.

I recall a perhaps apocryphal story of what the chief resident at a prestigious medical center said to the incoming residents. He said something like,

Each of you is entitled to one clean kill. Some patient will reasonably expect to be cured and you’ll kill him—wrong diagnosis, wrong treatment, human error in implementing, something. Alas, no matter how much we supervise you, those errors are a necessary prerequisite to becoming a good doctor. Please remember that your value as a physician is measured not by an individual error, even a bad one, but by your overall record over your lifetime. So forgive yourself and let’s get on with it.

If you’ve been well trained, stay reasonably current, and do a cost-beneficial amount of investigation into each case, you must accept humankind’s fallibility—if you want to avoid driving yourself nuts. You’re doing as well as a person can reasonably be expected to. Forgive yourself and get on with it.

Underskilled and know it.  A self-reflective person will be aware of fixable gaps in expertise, for example, communication style: “If only I were better at calming people who unfairly criticized me.”

The solution is obvious: execute on a self-improvement plan. Which are your true deficits that are fixable? And to remediate them, do you need self-reflection, to read, take a webinar, watch other professionals, have them watch you, attend a professional conference, and/or take a continuing education course offered through your professional association?

Underskilled and don’t know it. Alas, some people are too defended or unintelligent to realize how deficient they are. If that could be you, perhaps it’s time to get some feedback. For example, should you do a client/customer satisfaction survey? Get a 360-degree evaluation: feedback from your boss, coworkers, supervisees, and friends? If you’re concerned that won’t yield candor, consider using TalentCheckup, a free service that allows you to invite three to eight people to provide feedback anonymously on a website. Don't necessarily accept all criticism as valid but do reflect on it before rejecting it.

Poor aptitude for the profession.  Some people may have received good training and try hard yet still are too often ineffective. For example, teachers get admitted into university training programs mainly on their academic record, not on whether they have that ineffable gift of getting children to like and respect the teacher so they behave and the ability to inspire kids to learn mandated curriculum that may seem irrelevant, for example, graphing the area of a parabola.

In conclusion. The standard advice on how to deal with the imposter syndrome is to forgive yourself. Indeed, that's sometime wise, but before doing that, check in with yourself: Should you do something to become more competent?

Marty Nemko was named “The Bay Area’s Best Career Coach” by the San Francisco Bay Guardian and he enjoys a 96 percent client-satisfaction rate. In addition to the articles here on PsychologyToday.com, many more of Marty Nemko's writings are archived on www.martynemko.com. Of Nemko's seven books, the most relevant to readers of this blog is How to Do Life: What They Didn’t Teach You in School. His bio is on Wikipedia.

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