The imposter phenomenon, explained.

"The persistent inability to believe that one's success is deserved or has been legitimately achieved as a result of one's own efforts or skills."

(The Oxford Dictionary definition of imposter syndrome)

Throughout this page you'll find the evidence, and also my own insights from years of speaking on this topic and talking with people about it. This isn't a sales pitch, and it's really not about me. I want it to be useful, encouraging and inspiring.

The imposter phenomenon (often called imposter syndrome, or impostor syndrome) is defined as an individual doubting their accomplishments and having a persistent, internalised fear of being exposed as a fraud. This is a common phenomenon amongst veterinary professionals, medical fields, celebrities and beyond; this is not just one industry that experiences this. Despite external evidence, those feeling this way will struggle to 'own' accomplishments. This may seem to appear and disappear or remain at a low grade. It's one chapter of self-doubt.

It's important to say from the start that this phenomenon is not a mental health condition listed in the DSM V, but it is more complex and individualised than some of the explanations that you might see online, often lacking nuance. This explanation is not designed as a 'diagnosis', this is for education and widening awareness.

My aim is always to normalise and de-stigmatise this experience, it is what connects so many of us, yet not to minimise or dismiss how you actually feel. In medicine, a syndrome just means a cluster of things that tend to turn up together. Most people hear it as a diagnosis, which is why I prefer phenomenon.

Each and every one of us has a different story, a varying set of experiences, beliefs, values, and, on some level, traumas. Whilst there are common themes in society that contribute to lots of our experiences similarly, such as stereotypes and stories around success and failure, we do have individual differences and hence there's not a one size fits all approach to what helps us when it comes up.

It's also important that we look at the wider aspect of this as a society, and our responsibility to be inclusive, build psychologically safe workplaces and remember that our value as humans extends beyond our achievements.

For many imposter thoughts do come at times of growth, comfort zone stretches, and moving forward (whatever that direction actually is) - but equally, for some people, it is a voice of past experiences and the blanket advice of 'enjoy it' really isn't that helpful.

Be wary of anyone promising a quick "cure", or a single new way everyone should look at it. There are things that can help, but they don't look the same for everyone. If in doubt, reach out to a professional - whether that's a therapist or medical professional, or a coach who comes with genuine recommendations and testimonials.

Here's your permission slip to find the things that work for you - there are some suggestions below to start with. Throughout all of this, I want you to remember that you are a 1 in 400 trillion, valuable one-off human - even when you forget.

In my blog you'll find many of my personal reflections on imposterism, and life in general.

I hate the word 'signs', this isn't a disease, as I have said. How might we come to the conclusion that this label fits our experience?

On a personal level, I believe that it boils down to listening to a story that says "you're not good enough, and someone will find out" - everything else branches off this. For many people, this might feel like a voice that pops up, but others might experience thoughts in different ways - as feelings, colours, somatic experiences. Some people might call this the 'inner critic', others might call it 'the script'. In my book, I call him Jim. But again, everyone's different. The important thing is to know you didn't choose it, it was handed to us without our knowledge, and often the standards 'it' tries to hold us to are beyond human capability, always asking us to jump one inch higher. It actually has very little to do with present reality - but understanding that takes self compassion, self awareness and sometimes external guidance.

When we peel it back, feeling like an imposter is rarely about the thing in front of us. It's not really about the consult, the presentation or the new job title. It's about what we think it would mean if we got it wrong.

For most of us, it goes something like this. If I don't know the answer, they'll find out. If they find out, they'll think less of me. If they think less of me, I won't belong here. And underneath all of it, the quiet question: am I enough, just as I am?

That's why it can feel so big. At our core, we're wired for connection, and the fear of being found out is really a fear of being on the outside. It makes complete sense that our nervous system treats it as a threat.

Here's the thing, though. The worry is real, but the conclusion isn't. Not knowing everything doesn't make you an imposter. A mistake doesn't make you a mistake. And your belonging was never meant to depend on being perfect.

So, when we listen to, and believe, these 'not good enough' stories on a regular basis, what can it lead to? You might not resonate with all of these things.

• Anxiety and worry; we know from the Bravata et al. 2019 review paper that often the imposter phenomenon does not come alone, being found to often be co-morbid with depression and anxiety. The waters often get muddied between these two, and hence if this experience impacts you on a daily basis, reach out for help.
• We don't praise ourselves or acknowledge how far we came, as the stories and feelings we are experiencing spotlight our perceived shortcomings.
• We might self-discount and pass up on opportunities, or take every opportunity in the hope to close down the stories of not being good enough.
• Bravata et al. suggest links to reduced job satisfaction (2019).
• We might procrastinate or avoid new tasks due to the fear of failure.
• We might find ourselves overworking in a bid to know everything, to match up to our perceptions of everyone else in our workplace.
• We might pursue new qualifications or accolades without consideration for whether they actually interest us.
• We might avoid doing new things or feel to pressurise ourselves to do everything quickly and easily the first time.
• We worry that we said the wrong thing, or might say the wrong thing.
• We might burn out trying to keep up with these internal expectations, there is some evidence again from Bravata's review that this might be the case.
• We might have feelings of frustration and isolation, not wanting to speak out for fear of not being supported.
• We might experience shame, and be concerned that others will not accept or value us if we don't know all the answers, or things don't go to plan.
• Regular concern about "being found out."

If we notice these things, let's take the judgement off. This is very common, and whilst uncomfortable, there are people and things that can help. Many of the pressures that we listen to have been handed down through the generations, and we'd never ask them of someone else that we love or value. As isolating as it feels, often these experiences are what unites us in commonality.

Some might argue it's not always a "bad" thing. One study by Basima Tewfik at the MIT Sloan School of Management, published in Academy of Management Journal (2022), found that people who had imposter thoughts at work were rated by others as better at working with people, partly because they tend to focus more on the people around them. It didn't find a cost to performance, but it did find that these thoughts lowered self-esteem. I'd argue that's great news for employers, but does it really help the person living with it? We have to be careful not to slip into toxic positivity.

My personal thoughts are that we need to take the emphasis off this being always 'bad' or 'good' and start by noticing it without judgment as a common human experience. I often find many frustrations come from the extra level of pressure of how individuals think they should be experiencing it, or stories of what it means about them as a person.

Clance and Imes first documented the "imposter phenomenon" in 1978 in high achieving women, but it has since been shown to affect all genders (Bravata et al, 2019). The figure you'll see most often is around 7 in 10 people (Gravois, 2007, as cited in Sakulku and Alexander, 2011), but estimates vary a lot depending on how it's measured. Bravata et al. found rates anywhere from 9% to 82%. Honestly, we still don't have enough evidence to know an exact number. People experience it differently, not everyone feels able to talk about it, and researchers use different definitions.

Who experiences it is a bit of a mixed picture. Bravata et al. found it was common in both men and women, and particularly high among people from ethnic minority backgrounds. A 2024 meta-analysis of 108 studies found that women tend to score slightly higher on average, with a smaller gap in Asia than in Europe and North America (Price et al., 2024), although individual studies have been mixed and it isn't yet clear what that difference means for success or wellbeing. As conversations around neurodivergence grow, that may add another layer too, because many neurodivergent people feel pressure to do things in ways that don't suit how their brain works.

This last paragraph is further testament to why approaches to the imposter phenomenon should not just be about ourselves, but looking at the wider world too. How can we help everyone to feel included?

All this being said, there will be a percentage of people that don't experience this phenomenon. I've had conversations with individuals who have concerns that they almost feel in the minority for not experiencing the imposter phenomenon (ironic). Depending on our background, present environment, levels of self-compassion, and growth mindset, we might not conclude that our experience aligns with the imposter phenomenon. That's ok too.

The imposter phenomenon is not a diagnosis, but a psychological reaction to a set of stimuli. Often the stimuli can be doing new things, our environment, achievements, stressful situations - amongst other things.

Sometimes our experiences are contributed to by imposter thoughts, but it's not the whole picture.

Studies have shown that feeling this way is often co-morbid with depression and anxiety, reduced job satisfaction, and burnout among many employees (Bravata et al, 2019). Whilst the imposter phenomenon is not a mental health condition itself, it can progress and have wide-reaching implications; hence the importance of understanding how we can advocate ourselves when it does appear.

It is important to remember that if this feeling has a persistent, negative effect on your life, speaking out can be valuable. You're not alone. Clinical anxiety and depression are best discussed with a mental health professional. There can be other things playing into it too, such as neurodivergence (e.g. ADHD or autism), hormones (both male and female, conditions such as PMDD, changes in perimenopause, low testosterone etc), chronic pain and more. For some people these are part of the picture, but they aren't for everyone, and feeling like an imposter doesn't mean you have any of them.

As feeling like an imposter has the tendency to isolate us, even taking the steps of talking about it in a safe space can have genuine value. Advocate yourself, you are worth it.

This is the bit I talk about most on stage, because it changes everything.

So much of what we're told about feeling like an imposter puts it squarely inside our own heads. Think more positively. Believe in yourself. Fake it till you make it. As if it's purely a confidence problem, and the fix is ours alone.

In medicine, we know that very few human experiences have a single cause, which is why we use the biopsychosocial model. It looks at the biological, the psychological and the social, and how they weave together. I think the imposter phenomenon deserves exactly the same lens.

Biological: our nervous system and its threat response, sleep, hormones (PMDD, perimenopause, low testosterone and more), neurodivergence, chronic pain, and plain old exhaustion. When our body is already on high alert, the voice tends to get louder.

Psychological: the beliefs and stories we picked up along the way, often long before we had any say in them. Perfectionism, the inner critic (or Jim, as I call him), past experiences, and how we've learned to measure our worth.

Social: the workplaces and cultures we're part of. Psychological safety (or the lack of it), shame-based learning, stereotypes about who 'looks like' a vet, a leader or an expert, being part of a marginalised group, comparison, and the highlight reels we scroll past every day.

This is why I call it a phenomenon rather than a syndrome. It isn't a fault that lives inside one person. It's what happens when a very human brain meets a particular body, history and environment. And it's why the answer is never just 'fix yourself'. It's also about how we build teams, workplaces and professions where people are allowed to be human.

Rather than "getting rid" of it, how about we see it differently? If we aim to eliminate the feeling completely, then the next time we do something big and there's even a whisper of it, we can decide we've "failed" at overcoming it, and feel like even more of a fraud. What we resist, persists.

This is my take, from years of speaking on this topic and talking with people who experience it. Rather than pushing it away or ignoring it, I find the way through is to understand it. What is this experience actually made of? What might be playing into it? And what do I need as I move forward?

Often it's made of beliefs we never chose. Some come from specific moments, like a harshly critical caregiver, or putting your hand up in class, getting it wrong and hearing people laugh. Others build through repetition: what we watch other people do, the media, and the constant message that we'll "be enough when" we achieve more, own more or look a certain way. Many of us concluded long ago that we should know everything, do things quickly and do them alone to be worthwhile. Those conclusions made sense at the time. They just aren't always useful now.

When we step into something new, our nervous system can read it as a threat, based on the past rather than the real risk in front of us. We feel the fear, the thoughts turn up ("I'm not good enough to be here"), and we decide we must be a fraud. In that moment our thoughts feel like facts, but they're shaped by the emotion we're having. Most of us were never taught this. I certainly wasn't. Doing new things feels uncomfortable because it activates our nervous system, not because we're doing it wrong.

Biology can turn the volume up too. Hormones, sleep, other health challenges or plain exhaustion can all add to our overall stress levels and make these thoughts louder. And our environment matters. If a workplace lacks support, safety or room for mistakes, it hands us even more "evidence".

So this isn't because we're actually imposters. If anything, I believe the script that keeps being handed down is the imposter, not us. And change is possible. We can form new beliefs and connections, which is the power of neuroplasticity.

If I could say one thing to everyone reading this, it would be that you are already valuable - you always have been and always will be. You are the one underneath the thoughts and the experiences, as intense as they may feel. I'm sorry the world has taught so many of us that our value depends on fitting a mould we never chose. When the imposter thoughts come, how could we be a little more curious, and a lot kinder to ourselves?

Different things help different people, at different times. Some may find self-help strategies and practices beneficial, for example journaling to create space between the stories we listen to and the listener - us, mindfulness to notice and release the pressures without judgement, self-care practices to regulate our nervous systems, for example breathwork (box breathing is a good place for many to start, or 7-11 breathing). Self-compassion is very evidence-based and there are tonnes of resources on Dr Kristin Neff's website, self-compassion.org. Some might listen to podcasts and others sharing their stories, whilst remembering that what they explain is their perception, and it's ok if ours is different. There are many stories you'll see online about 'you should enjoy imposter syndrome' - please don't force yourself to have to, if it doesn't feel right, there are many different things that can help. Oftentimes these statements are made through one lens and lack the nuance of individual experiences and backgrounds.

Some embrace the idea of getting familiar with their 'inner imposter' - when does it come up, what could it more innocently be trying to keep us safe from or trying to achieve? Some name it and thank it for its input, and provide reassurance to the person underneath. A quick check-in as we do new things to assess our skills and capabilities isn't a bad thing, as long as we do it through a factual and compassionate lens. Alongside this, they get to know the real them - behind job titles, achievements and accolades - and what's important to you. Some might notice when they do new things they take life a little slower and do more of the things that fill their cup back up, or they have a friend or mentor that they know will listen to them. If you do this, it's important to do it without judgement, and embrace curiosity, rather than criticism. This takes practice.

Many people ask what they can actually do?

Because this experience is different for everyone, I'd say if you've tried self-directed exercises and practices without much difference, or if it is having a wide-reaching effect on your life, to reach out for help to another person. Someone who can help you to hold the space to explore and understand the experience, and to get to know yourself. If your mental health is adversely affected, you might wish to speak to a medical professional or therapist, especially if there is potential trauma involved. Many people find this helpful. You can find licensed UK therapists on the BACP website, check their prices and find out the ways they work - there are many types of therapy that exist, not just CBT. Alternatively, speaking to a GP, or checking out your workplace resources, such as Employee Assistance Programmes. One of the most important things connected to positive outcomes is how connected you feel with your therapist - again, testament that different things help different people.

If you're keen to make changes to a particular area of your life, then coaching can be beneficial - if you're not sure where to start with finding one, start with asking for personal recommendations, reading testimonials and setting up a discovery call.

A mentor can be helpful if you're walking a new path in business or career, and they've done similar. This might be someone in a formal role at work, or someone you reach out to.

And, don't forget to take a wider look at your environment too - it's easy for us to assume something is just 'our' imposter syndrome, and yet, there might be other factors at play. This can again be helpful to soundboard with others, confidentially.

I regularly give talks and workshops for teams on this, so please do get in touch.

If you're in the veterinary profession, be sure to check out the Vet Empowered Signature Programme.

This 'experience' has been associated with burnout indices, and studies in American medical students have also brought about calls to avoid shame-based learning. (Villwock, 2016). Remember that correlation does not always mean causation - hence there are many potential reasons why those experiencing the imposter phenomenon might also experience burnout, and the relationship between the two could be more complex than one simply causing the other.

This certainly is not isolated to those in the veterinary profession. Medics, dentists, lawyers, business owners, sports people, teachers. Everyone. It is common. You are not alone. This is experienced by vets and nurses at all experience levels, from students to diplomates. The figure you'll see most often is around 7 in 10 people having struggled with feeling like a fraud at some point in their lives (Gravois, 2007, as cited in Sakulku and Alexander, 2011), though estimates vary. The same paper adds that anyone can end up feeling like an imposter if their success never quite sinks in.

First up, you're not (...not even you). I get asked this question frequently, and the fact that it comes up so often speaks volumes. There is, of course, a line between self-belief and knowing our own limitations. Having awareness of this distinction can be valuable because, for example, in the vet profession it means we don't perform surgeries that are way beyond our skillset.

Sometimes we have listened to the imposter narrative for so long that the waters can really get muddied between "am I really not good enough to be here" or "do I not believe in myself and my skills enough?". In an ideal world, the first focus would be on self-compassion. This would involve being kind enough to ourselves to acknowledge that asking for help doesn't mean we're underperforming, or that someone will find us out; there is value in discarding the negative inner critic that labels asking for help as being evidence toward not being good enough.

For skills-based tasks, speaking with a mentor or a more experienced, trusted colleague can be helpful. Discussing with them, and asking them to hold a mirror back up regarding your skill level can help to gain clarity to disbelieve that negative narrative, and borrow a little confidence from them. Eventually with this support, it can become easier to tune into our authentic selves and trust our gut instinct on our abilities in that moment.

Remember, someone who is genuinely pretending doesn't usually sit and debate whether they deserve their space. They know full well that they're pretending. Think of the film Catch Me If You Can, where Leonardo DiCaprio's character poses as an airline pilot. He isn't agonising over whether he earned his place. He knows he hasn't. I've met lots of people who feel like imposters, but I've yet to meet an actual one.

All are accepted. All spellings are equally legitimate, and you'll see every one of them in the research.

Personally, I prefer "the imposter phenomenon". The word syndrome, to many, implies a clinical condition, or something we own as an ongoing diagnosis, and phenomenon feels truer to what this is: a very human experience, shaped by our biology, our psychology and the world around us. The other true thing about phenomenon is that, if you dive into phenomenology, the idea is that everyone's experience of a phenomenon is slightly different. I still use "imposter syndrome" in places for searchability, but phenomenon is the word I'd choose.

Nobody minds which one you use.

Dr Valerie Young, an educator and author who has spent decades studying and working with people who feel like imposters, started to notice patterns. The imposter pressures and thoughts people described tended to lean in certain directions, and she grouped them into five archetypes (you'll often see them called the five types of imposter syndrome): the perfectionist, the expert, the natural genius, the soloist and the super person.

Now, this isn't one of those 'what kind of pancake are you?' Facebook quizzes. Most of us recognise bits of several, and none of them are boxes to put ourselves in. I find them useful for one reason: they help us dig a little deeper than 'I'm a fraud and I'm going to get found out', and notice the specific pressure underneath.

Once we can see the pressure, we can get curious about it. Would you hold a friend to that standard? What would you say to them if they told you this was how they felt?

I ask this in talks all the time: where did these pressures actually come from? Most of the time, the answer is school, upbringing, society. Rules we picked up long before we had any say in them, and ones we'd never expect of anybody else.

Which is often the moment we realise those pressures were never really ours to begin with.

Personally, I wouldn't bother.

If you're resonating with the above, you have probably experienced imposter thoughts. Remember, around 7 in 10 people are thought to have felt this way at some point, so you're in good company; it's really not uncommon. It doesn't matter how many (or few) qualifications or achievements you have, this is experienced at all levels. We are all human. There's no such thing as being "too qualified" or "not qualified enough" to experience this.

Atlanta psychologist, Dr Pauline Clance published the IP Impostor Scale. There is the opportunity to go through the questions in this PDF and receive a score; you may see this referenced as a tool in scientific papers.

I personally don't use the scale, and I have never taken this test. I can see a value in this for research and formulating data, but less so for individuals. Remember that feeling like an imposter is not linear. Some days/weeks/months imposter thoughts will be louder or have more of an influence over our lives than others. Receiving a high score on the test can quickly become a label, and a part of our identity; "I am at the highest end of the imposter scale". Remember that "I am" is a powerful combination.

If you're struggling with your experiences, I'd suggest to reach out for support rather than get tied up in scales.

First, a little reframe. I'd gently swap "I have imposter syndrome" for "I'm having an imposter moment". Imposter thoughts. Imposter feelings. They come, and they go. It isn't a condition we have, or something that defines us. It's an experience we're having right now, and it will pass.

Around 7 in 10 people are thought to have felt this way at some point in their life. It's not just a vet 'thing', it's all professions and walks of life. Your peers, colleagues, friends, mentors, bosses, and tutors will have likely felt this way at some point too; acknowledging this helps many. There are other things that can help too.

It's important to remember, the imposter phenomenon is not a diagnosis (imposter can also be spelled impostor by the way, either is fine). It's not a label or fault, it's an experience. A psychological pattern in response to stimuli. Often it is when we are growing or achieving, and we just don't feel deserving, we tune into and believe that inner critic that tells us why we aren't good enough. This might be at work for case outcomes, when we gain new qualifications, promotions or whilst training too. It can happen at any point in our careers. When we zone into it and believe it, we can feel like phoneys.

The reality is that behind that inner critic is a valuable, unique person that is deserving of their achievements, we just need a little reminder to zone back into that person. We also need a reminder to take off some of society's unrealistic pressures too.

Finding the ways, the places and the permissions to reconnect back with you is valuable.

And remember, there are always people to listen.

I don't want to get too meta about this, but stay with me. Remember the definition? An internalised fear of being exposed as a fraud.

The moment we say it out loud to someone we trust, it isn't internal anymore. And something shifts. It rarely disappears overnight, but it tends to lose a bit of its grip.

This experience is incredibly common. That doesn't make it any less uncomfortable when it's yours. But it does mean the person you tell has very likely felt it too.

That person might be a friend, a partner, a family member, a colleague you trust, a mentor, a support group, or a helpline. Whatever it looks like for you, people who listen without judgement are worth their weight in gold.

So, gently: is there anyone you can think of who will listen?

This page won't change your life in one fell swoop. Change comes from action, learning about ourselves, self compassion, support and understanding. I'm done with one size fits all. If I only had three things to say, they'd be these:

1. If it's affecting your day-to-day, find someone to talk it through with. Not because it's a fault or a condition, but because it can help to have someone, and somewhere, to go one layer underneath the "I'm a fraud" worry. To understand what it is, where it might have come from, and how to tackle it when it comes up. That might be your GP, a therapist, or a coach with genuine recommendations and testimonials.
2. Build up your faith in your own abilities. That's called self-efficacy. In a study of 588 university staff, people with higher self-efficacy tended to report fewer imposter feelings, and, to a smaller extent, so did people who felt supported by their workplace (McDowell et al., 2015). It's a link rather than proof of cause, but it's a good reminder that this isn't all down to us. So save little wins every day. Take a moment to look back at how you actually got to where you are, because our minds forget. And find role models and mentors who've shared that they've felt this way too.
3. Try self-compassion. It's well researched, and Dr Kristin Neff's work at self-compassion.org is a great place to start.

This is your permission to start exploring what helps you. Keep your eye on my blog as I update it with not only my own insights and experiences, but also lots of resources.

That answer will be different for everyone.

Make sure you've subscribed to the newsletter to be kept updated. My book, Thank You, Jim, goes deeper into all of this. Head to Vet Empowered if you're in vetmed and interested in coaching, and drop me a follow on Instagram as @katiefordvet.

Dr Katie Ford