LAUSR

“Yeah, but everyone feels unqualified sometimes.” These words, spoken by a faculty member during a panel on imposter syndrome, gaslit me; the dismissal of an experience that is my own, the blindness to a topic that's worth seeing for what it is. Reduced to “feeling unqualified.” Is this what we are talking about when we talk about imposter syndrome? Imposter syndrome describes a person who believes they are deceptive, their real self hidden behind a welldeveloped façade, their successes undeserved. To have imposter syndrome is to feel like a liar. It is to be successful, but to have your success tainted by your very involvement or attributed to factors outside your control. Conversely, it is to take your failings and attribute them to weaknesses in yourself. It is deeply personal. How did this become a thing? The easiest way to understand the existence of imposter syndrome is as a social phenomenon. Social theory suggests that intergroup dynamics are how people understand their roles in the world. The ingroup, or group with power, maintains a status quo through conscious and subconscious behaviors and biases that sustain its position. In medicine, this group is White men, and that tradition is well documented and persistent. Outsiders who share categories with the ingroup, such as sex, race, education, or age, are recognized as belonging with the ingroup and therefore receive social cues of belongingness that promote cognitive assonance, allowing them to accept their successes as earned by virtue of category sharing. In other words, they identify with the powerful group and accept their power because of their own socially verified, reinforced biases. This defines privilege. Conversely, outsiders who have little overlap in their categorical membership with the ingroup are not perceived by the ingroup as belonging, even with similar “success.” These outsiders perceive these ingroup biases, ultimately feeling rejected and disconnected from the group. This is why imposter syndrome is more common in groups that are cued to feel that they do not “belong” here on the basis of race, sex, or other categories. Lack of belonging is an intrinsic part of imposter syndrome, but it is not the only part. Those with imposter syndrome cannot cheer for their own successes, and they incorporate their mistakes as a moral failing. To explain this, it is helpful to look harder at the process of social categorization. Social categorization is the cognitive and often subconscious process by which we sort individuals into social groups, assigning status and importance on the basis of easily definable categories in an automatic fashion. Female? Mentor. Male? Leader. Young? Inexperienced. Old? Wise. The same process that allows outsiders to identify with a powerful group by categorical matching alone allows us each to assign individuals to many hierarchical structures as a simple heuristic. Within our subconscious, we rapidly process individuals into desirable or nondesirable categories by which we understand the world. This is bias. For those in the group we have categorized as desirable, most commonly the ingroup, we attribute their successes to them and their failures to things outside their control. In the nondesirable group, we attribute their successes to luck or circumstance and their failures to their character flaws. Sound familiar? In this way, imposter syndrome is a form of unconscious bias held by the individuals that have it against their own selves. People with imposter syndrome have socially categorized themselves, automatically and subconsciously, and found themselves lacking, placing themselves in a nondesirable group. Their bias is extrinsically reinforced by group dynamics and systemic biases that also fail to extend belonging. This climate shapes the internal dialogue of these individuals, who cannot find common categories with the ingroup, reinforcing that they are outsiders and do not belong. What that means is, imposter syndrome will not be fixed by telling outsiders to be more confident. Confidence is not the issue. It will not be fixed by hiring outsiders into a group that does not promote their inclusion. Diversity does not create ingroup belonging