Imposter syndrome differential diagnosis:

Have you ever had that feeling where you suddenly realise that you are being trusted to carry out thousands of pounds’ worth of experiments and investigations, or given heavy responsibility in any scenario, and you think to yourself – why me? I’m not skilled enough to do this? I don’t know what this means? I’m just a fraud, when will they realise I’m faking it? If so – then you’ve come down with a case of imposter syndrome.

What is it?

Imposter syndrome (or fraud syndrome) dates back to 1978, when two clinical psychologists – Dr Clance and Dr Imes – published their observations in Psychotherapy. The authors used the term ‘imposter phenomenon’ to describe high achieving individuals who internalised their ‘intellectual phoniness’. Despite the subgroup of individuals’ numerous achievements and successes, they believed that they were really not very bright and had instead just managed to fool everyone who ever questioned them. Seem familiar? This syndrome breeds wildly in high stress and competitive environments *cough cough* academia.  It is certain that it also manifests in other sectors such as business and medicine. It is often speculated among colleagues that excelling in a career is, in part, a complete ego and confidence trick (fake it till you make it!).

Imposter syndrome is not perceived as a mental disorder, but is thought to be a reaction developed to certain situations, and is thought that certain people are more prone to experience imposter syndrome dependent on their personality. Clance and Imes explained that there are four main traits of imposter syndrome:

  1. Diligence – high achievers work hard to get where they are, and when they feel like an imposter, they work even harder to prevent people from discovering that they are ‘faking it’. This hard work leads to more praise, more success and more achievement, which only acts to perpetuate the original feeling of faking it.
  2. Feeling phony – imposters attempt to give their superiors the answers that they want to hear, rather than what they truly believe, furthering the imposter feeling.
  3. Charm – high achievers often use intuition, perceptiveness and charm, and seek out superiors and mentors who will help them develop their abilities. When praised for developing such abilities, they feel like the praise is based on the charm, rather than the ability.
  4. Avoiding a display of confidence – a person with imposter syndrome may think that if they actually believe in themselves their abilities may still be rejected by others – convincing themselves that they are not intelligent and do not deserve their successes.

‘Imposters’ are not alone though, up to 70% of people will consider themselves frauds at some point in their lives, and up to 40% of successful people consider themselves to be faking it. Famous examples of imposter syndrome include Tommy Cooper, Neil Gaiman and Emma Watson.


As imposter syndrome is not a formal mental disorder, it does not have a standardised treatment. However, if imposter syndrome is not recognised and continues to perpetuate, it can lead to stress, anxiety and depression. One of the main ways of addressing imposter syndrome is talking about it, discussing with people early on in their career path, with mentors reflecting on their experiences of imposter syndrome, and remembering – you are not alone. Many people who suffer believe that they are the only ones, but many other people endure feelings of inadequacy.


It is key to talk about what you are feeling, to open up the discussion and reflect on your feelings, list your accomplishments and listen to positive feedback and your own successes. The key to tackling this is a strong support system. Remember you are in control, and think of how far you’ve come. The next time you come down with imposter syndrome – don’t panic – it’s OK, you’ve got this! Take a few deep breaths and take it one step at a time. No, you haven’t fooled everyone you’ve ever met – and you do deserve what you have achieved :).

Dr M Yates

Matt Yates gained his PhD in 2014 studying the role of macrophage migration in neuropathic pain and atherosclerosis. His interests lie in psychobiology, haematology and dogs. He is currently working in a clinical haematology field.