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A number of vets in counselling have said to me “I’m a fraud, and everyone is about to find out”.
While Fear of Failure is rife amongst our newer graduates (more about Fear of Failure next month), feeling like a fraud or “Imposter Syndrome” is more common amongst those of us who are graduated a little longer and are wondering why on earth our fractures are healing, or how come we are “getting away with it” when our cardiac failure patients are feeling great.

First described by psychologist Suzanne Imes, PhD, in the 1970s, Impostor Syndrome occurs among high achievers who are unable to internalize and accept their success.

By definition, most people suffering from imposter syndrome suffer in silence. Most people don’t talk about it. Part of the experience is that they’re afraid they’re going to be found out, Yet I would estimate that 50% of my clients have experienced it at some stage of their careers, so it’s not uncommon.
How does Imposter Syndrome get out of hand? The trigger is often perfectionism. In its mild form, as vets, a healthy degree of perfectionism provides the energy than can lead to great accomplishments clinically. Of course, this is desirable as we are, after all, looking after living beings and we don’t really want to learn from our mistakes.
‘Benign perfectionists’, who do not suffer feelings of Imposter Syndrome, derive pleasure from their achievements and don’t obsess over failures. ‘Neurotic imposters’, however, cannot appreciate their achievements as anything but a stroke of luck.
Many people who feel like impostors grow up in families that place a big emphasis on achievement, in particular parents who send mixed messages — alternating between over-praise and criticism. This can increase the risk of future fraudulent feelings in the child.
“There can be a lot of confusion between approval and love and worthiness. Self-worth becomes contingent on achieving.” says Innes.
So, as parents, it is our duty to attach our children’s self-worth to more than just good grades or medals at football. Kindness is an achievement in kids too. So are empathy, self-regulation, resilience and the ability to be self-aware of our strengths and weaknesses.

So what can I do?
With effort, you can stop feeling like a fraud and learn to enjoy your accomplishments.
See a counsellor

Often the vets and nurses affected by impostor feelings don’t realize they could be living some other way. They don’t have any idea it’s possible not to feel so anxious and fearful all the time.

Recognize your expertise
Teaching younger students or new graduates is an instant way to boost your confidence and realise that you have indeed, got knowledge and expertise.
Remember what you do well
Write a list of what you do well. Now write a list of what you don’t (yet) do well. There, it’s in the open.
Talk about it.
Be the person in your practice who instigates monthly M and M rounds (morbidity and mortality rounds, where mistakes in patient care are openly discussed without blame, in order to establish protocols to help avoid a reoccurrence).
In this way, not only are you facing your own Imposter Syndrome head on and thus negating its effect on you, you are helping all your other colleagues secretly suffering from the same syndrome, to face their demons and rise above them. That’s a real achievement, not one borne out of pure luck.