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Dealing with Imposter Syndrome in Physical Therapy

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Imposter syndrome is common for early career professionals in any field, but even more so in a service-based field like health and fitness.

People come to us to help them, right?

It’s something we all have gone through as we gain more experience, so we wanted to share some advice on what we did to gain more confidence.

To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 281: Dealing with Imposter Syndrome in Physical Therapy

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Show Notes


Transcript

Student:
All right. Eric from New Jersey asks, what advice do you have for dealing with imposter syndrome?

Mike Reinold:
Okay. So I have a confession to make, and I usually don’t do this. I made this question up. It’s not that I made this question up, but this was one of our past students, Eric. And as I was reading this, I’m like, “Wait, was he from Long Island?”

Student:
He was in fact from Long Island. Yes.

Mike Reinold:
I get Jersey. This is one of the questions that Eric asked me during his clinical rotation with us and we ended up chatting with Eric and Kim from the past episode. I really remember that day and I thought “You know what? This is probably an important topic that we should hit.” So this is Eric from Long Island that we all know and love.

Mike Reinold:
But I mean, a great question though, imposter syndrome is definitely something we’re hearing a little bit more about. I think as we as a profession are focusing on making sure that we’re putting ourselves in positions to succeed and early career professionals are being developed and mentored in appropriate ways. I feel like this is something that is… I’m seeing a lot of chatter about this. I mean, I know we have tons of advice. Len, do you, what-

Lenny Macrina:
Well, I don’t know if I have advice. If we’re all telling our deepest, darkest secrets, I had no idea what this was. I had to literally Google search it last night and I never often look at the questions ahead of time I just happened to, and I had no clue what it was. And I’m still confused by this whole concept.

Mike Reinold:
That’s a great idea.

Lenny Macrina:
So you guys educate me on why we have created this imposter syndrome. Remember syndrome is not always tangible.

Mike Reinold:
I know, right. Isn’t that funny. So as a rehab community we are shaming anyone that calls anything a syndrome, but then we make up more syndromes. But, no. It’s not that we made it up.

Mike Reinold:
Traditionally, I remember 10, 20 years ago when we thought of imposter syndrome, to me, this was a little bit more somebody that was perceived as being a leader, an elite, a top person.

Lenny Macrina:
Right.

Mike Reinold:
That felt on the inside that they didn’t deserve that. Right? I think now, and I may be wrong, that’s just my unique perception of it. I think now students are coming on that day one, feeling that. When it’s really just probably lack of self confidence, Len, right.

Lenny Macrina:
Right, exactly.

Mike Reinold:
But I get that concept. Think about this. We are in a service-based industry and you get handed a piece of paper saying that you’re now a physical therapist, and then you have a caseload tomorrow and those people are coming to you for help. Right. And I think this is actually gigantic for us as early career professionals in any service industry, but especially a medical health, fitness kind of setting where people are coming to you for help and you have to help them. Right. So I can see where that’s coming. So I don’t know, who wants to start, because I think this could be a big conversation. But Dave, what do you think?

Dave Tilley:
I’ve had this twice that I can share. Once it was in the realm of gymnastics, when I was early in my career, two years out, luck meaning opportunity, meaning a lot of other things happening. I was thrown into the spotlight of people who wanted my help or guidance. And I felt extremely unprepared, or not unprepared, but I felt as though there’s so many other people out there that are probably way more equipped to do this. And I instantly started working with elite gymnasts, two years in. Right. And working with what maybe you guys consider pro athlete equivalent.

Dave Tilley:
So I’m like, “These people are some of the best coaches and gymnasts in the planet. And they’re asking me to help them with their injuries.” I’m like “What in the world?” So I felt really under, I don’t know, I guess imposter syndrome is the only way to say it. I felt like I was in the wrong shoes. Right. This is not for me. I shouldn’t be doing this. And then you guys might not know this, I had this again when I first started working at Champion. Right. I got hired-

Mike Reinold:
Oh, we could tell. Yeah. We could tell.

Lenny Macrina:
Yeah, that was obvious.

Dave Tilley:
I was the first external hire and I was sitting between you and Lenny in this tiny little desk on a stool. And I remember getting the email for the job offer. And I was like, “What is happening right now?” This is insane. I never thought in a million years I’d be able to work for these two. Its huge idols of mine. And I’m sitting between you at a desk and I have all of Lenny’s patients, I’m like, “What is going on?” There’s no way that I [inaudible 00:07:03] I felt like I had no idea what to do.

Lenny Macrina:
Imposter.

Dave Tilley:
Yeah. I felt like a total sham.

Mike Reinold:
So what’d you do? How’d you get over that? Cause I mean, those are two big hurdles.

Dave Tilley:
Yeah. I think two things. So one is on both of those, I think I just found a way to get more educated on what the things were I needed to do. Right. Like with [inaudible 00:07:19] for gymnastics I studied an uncomfortable amount, an unhealthy burnout level of ConEd, right? Way too much to get more comfortable with certain things that I was seeing. I was talking to mentors. I talked to a lot of people who were helpful. And then on the Champion side, I just tried to do the same things, learn all the systems that you guys use and learn everything I could, I took three or four year courses at once. I remember doing the knee, the shoulder one again, and a functional stability one. So I just tried to learn as much as I could. And then I just was honest when I didn’t know stuff.

Dave Tilley:
I just straight up told people “Hey, I don’t know what to tell you right now. I’ll go back home and I’ll learn this.” And I remember telling Mike a couple times, I don’t remember why this stuck out but some girl hurt her elbow and had a fracture and I remember typing in Slack and showing you as a fake “Hey, what do you think of this?” It was like, “Her arm is broken. What do I do?” And you were like, “Hey, all right.” And you typed back. So I was just being honest about, I don’t know how to handle these things and getting mentorship.

Mike Reinold:
Yeah. I think that’s a good way of doing it too. It’s helpful when you have mentorship. I think you’re… Obviously most times when you have imposter syndrome, I think part of that concept is that you are prepared. You just don’t feel prepared enough. And I think that’s the thing. So you did actually have that, right. If you’re not prepared, I don’t think you get imposter syndrome. I think you just know you’re not prepared and you’re mad at yourself. Right. You’re not worried about it. You’re just mad at yourself. Right.

Dave Tilley:
That was experience that was like having to literally throw myself in the fire more often. I had to go through more evals, more people and it’s like a graded exposure to something you’re scared about. Right. I just had to do it over and over and over. And I’ve probably treated a thousand gymnasts now that I feel pretty comfortable. But those first two years when I was working with high level people who come to the clinic, I was nervous. I was legitimately very nervous doing evals. Cause I was like, “This is a big moment. They’re so high level.” And then it got better over two years.

Mike Reinold:
Yeah. Yeah. What do you think Lisa? Because I’d say Lisa’s probably, of our group, she’s the latest to jump into the cash based environment. And that has its own set of imposter syndrome that we all went through. That I went through almost 20 years into my career and I went through that. But Lisa, what do you think?

Lisa Lowe:
I mean that side of things, some days I feel like I’m still going through that. But I mean definitely in starting at Champion, it took me a while to feel like the people walking through the door, coming to me, especially rowers specifically, for help that I was well enough equipped to help them with whatever it was. And it was mostly going off a lot of what Dave has already said of almost arriving at the point where I was confident enough to just be able to be like, “I’m not sure here” and not just I’m going to go home and look this up, but you are here for help with me right now. And these people around me could potentially help us figure this out. So I’m not going to be worried about you thinking that I’m any less of a good PT because I personally couldn’t help you with this exact issue.

Lisa Lowe:
And I’m going to ask these people around me and just be really upfront with you of what I know, what I don’t know, what you know, and make it that teamwork effort and not just, I have all of the answers that you could ever want about rowing injuries. Right. Cause I don’t.

Lisa Lowe:
And so I feel like growing the confidence to be… I mean, I’ve always kind of prided myself in being willing to admit when I don’t know something, because I feel like that’s early on how I learned how to grow as a PT. Kind of that you don’t know what you don’t know until it happens. But yeah. I mean, definitely the whole imposter syndrome thing, I feel like it depends, sort of still semi depends on the day and it just happens less frequently now because I’ve…

Lisa Lowe:
I feel like I’ve learned so much and I’m still obviously learning a ton, but I think it is partially like we kind of started out saying, a confidence thing. And I think in having done a lot of other things before I’ve arrived here, I know that in starting in a new setting or with a new population, there’s that learning curve initially of you have a lot to learn and you’re going to be uncomfortable and you just have to be patient and it’s hard to be patient and push through to keep learning things and reaching out for help and all that kind of stuff. I feel like it… You shouldn’t feel, if you care about what you’re doing, I feel like you shouldn’t feel comfortable to an extent always it’d be weird if you did.

Mike Reinold:
Yeah. Well you’ve got to push yourself to grow a little bit. I like what you said there, is that you’re the type of person that you’ve accepted the fact that it’s okay to say, I don’t know, but then you’re not satisfied with not knowing, right. You’re going to go home and figure out the answer. And you’re probably going to Slack all of us and talk about it and that’s super important.

Mike Reinold:
But you know what one word stuck out with me, and I know we kind of talked about this a little bit earlier, but one word you said stuck out with me a little bit, is the word confidence. And if we take a step back and think about what’s the definition of confidence or more so, almost think of it as a construct within a research methodology type of thing. What is confidence? Confidence is your understanding of whether or not something’s going to work, right. Is how reliable is something going to work? That’s confidence.

Mike Reinold:
If you have no experience, how on earth would you have… You may have confidence in your knowledge, may have confidence in your skills, but you’re not going to have confidence that what you are going to do is definitely going to help that person, you’re going to serve that person. So there’s almost an inherent… You’re not supposed to be fully confident in yourself day one and maybe embracing knowing that is that you need some experience to be fully confident. Maybe just embracing that imposter syndrome is just something that we all have to go through when we’re just thrusted into the service based industry.

Mike Reinold:
But yeah, Dan, I know I think I saw you kind of raise your hand in there, but what’s up Dan?

Dan Pope:
Yeah. Everyone here kind of covered a lot of what I was going to say, but I think the big thing is that when we think of an imposter syndrome, comes apart as negative, right? And there’s this thought that anything negative is bad, but some of these negative emotions are oftentimes really good motivators.

Dan Pope:
And I always look back to that chart that has two circles, right? One is your comfort zone, the other one’s success. And they’re nowhere near close to one another. Right? And oftentimes you have to make those overlap to get to where you want to be. And I think sometimes some of those negative feelings and maybe not just imposter syndrome, but other types of lack of confidence, whatever else it is, it’s good to push into that and it’s also a very potent motivator.

Dan Pope:
So if you feel like you really aren’t the expert that you think you should be, right, and that’s part of what imposter syndrome might be, then maybe learning some more and having some of this feeling in the back of your mind that you’re not good enough quite yet is a good motivation to push you to learn a little bit more so.

Dan Pope:
And obviously there’s a point where it can be unhealthy. And I honestly think that speaking to a specialist that can help you with that is actually really helpful, right? If you have a lot of anxiety or stress around it, maybe that’s the route that you go, if you truly are a real expert, but you don’t feel that way. But at the end of the day, I think for a new grad, especially of course, like you said, they’re going to feel like an imposter and that emotion is probably going to help them to try to learn more and become an expert and push more into discomfort and get better over the course of time. And slowly some of the imposter syndrome may go down with that.

Mike Reinold:
I love that. Dan, I love the way you kind of laid that all out. I mean, I think it’s about embracing the concept, right. And in putting your head down and figuring out a plan that’s going to get you to that comfort level that you’re confident that you’re going to have good results.

Mike Reinold:
You see how you put this all together. And yeah, absolutely, I mean if this is actually causing stuff like anxiety and stuff like that, then yeah, this becomes a bigger issue. That’s just more of lack of experience. That’s something that you get help with to deal with. But I actually think just with time if you just focus on your growth, I just think you’ll naturally get more comfortable in your shoes with that. But Diwesh what do you think?

Diwesh Poudyal:
Yeah, I mean, I think Dan pretty much nailed what I was going to say. And I think to kind of add on to what Dave’s said too, is that I think we do kind of look at it as a negative right away when it could just be a tool to help you kind of push to the next level. I know I was in a similar shoe as Dave kind of coming in being a little overwhelmed with almost the people in the building and the amount of knowledge that they had. And then for me, it was also the other side where I knew I had to be a good strength coach, but I also knew that I needed to learn enough on the rehab and injury end of the spectrum. So I could have at least an understanding of how to help someone go from one end to the other, or kind of meet somewhere in that transition period and kind of help them at least have an awareness of what’s happening on the other side.

Diwesh Poudyal:
So I kind of did what Dave had mentioned a little while ago. I almost consumed an unhealthy amount of ConEd. I remember my internship here is 45, 50 hours in the building and then probably another extra 20 hours outside the building just crushing courses. And I was like, “What is going on?” I just had so much information in my head, but anytime that I had questions about something, I could literally just go back into my Rolodex in my head and be like, “All right. I know at least a starting point for this.” Right.

Diwesh Poudyal:
Even if I don’t have the answer right away, I can start putting pieces together to help someone come up with an answer or at least give them some sort of guidance that is valuable. And that’s kind of what I relied on. I just relied on overpowering with the confidence of my knowledge. Right? You kind of said that, you have confidence in your knowledge and you have confidence of whether something’s going to work or not, but at least if you can develop the confidence in the knowledge that you acquire by learning, it can help you get started. I think that’s kind of what I relied on.

Mike Reinold:
And then realize that you also have the confidence, like Lisa said, to say, “I don’t know,” but realize that you also have the confidence that I’m going to go home and know. I will come back tomorrow knowing, right. That’s an important part for me.

Mike Reinold:
I always tell the story, I think it sounds similar to Diwesh and Dave a little bit here, but I always tell the story where when I first started working in professional sports I was very extremity based. Right. I didn’t do a lot of spine. So again, I did the same thing, I went bananas, unhealthy amount of ConEd to get better at the spine. And then you know what I found out, I just found out that I wasn’t as bad at the spine as I thought I was.

Mike Reinold:
I was thinking that there was something mysterious and miraculous out there that I didn’t know, and I didn’t possess that was there and I just didn’t have it. And then I realized that it wasn’t, and that my base knowledge and skill that got me to that point in my career was still valid and probably going to be.

Mike Reinold:
Helpful. So I think that’s another goal here too, again, is that you then seek it out. So that way you find out that maybe you’re not as inferior in your mind as you really think you are. But again, if you don’t go through that ConEd process and really dive deep, then you wouldn’t find that out. Right. So I think that’s pretty important.

Mike Reinold:
Mike, you got anything? I feel like so far everybody’s kind of jumped in. This is a good episode to maybe a little longer on, so I don’t want to limit anybody’s involvement.

Mike Scaduto:
Yeah. I think all you guys kind of nailed it. The big thing for me is you want to turn that into a positive motivating factor and you probably have to deal with the emotions and the anxiety and the stress. And I think contacting a qualified individual to do that is super helpful. It can kind of help you manage those emotions.

Mike Scaduto:
I think another thing that, especially PT students, they kind of think that PT school prepares them to be really good at clinical work in the PT clinic. And I think PT school is really designed to make you an entry level physical therapist. And if you’re comparing yourself to a PT with 20 plus years of experience, I think you’re always going to have a feeling of an inferiority. But I think recognizing that PT school is not designed to make you an expert in one specific field, but to enable you to safely treat a patient and have a base of information and knowledge and know when to refer out to another specialty to help, I think is really the point of PT school.

Mike Reinold:
I think that’s awesome. Yeah. That’s great. And again, I mean, I think if you put this all together, again it comes down to this is something that probably everybody goes through. Everybody has their own way of dealing with it, but I think if you really break it down, it’s one of those things where the progression we always talk about to become an expert is you have to develop your knowledge, your skill, get experience, and then you’ll have some judgment, right? You’re not expected to have judgment on day one with no experience. And if you even look at a lot of environments, if you go work in an outpatient orthopedic clinic, day one, for example, right? You may not have that judgment, but you might have the knowledge and skill.

Mike Reinold:
So do an evaluation, come up with a treatment plan and run it by somebody with more experience. That’s one way, right. If you’re stumped on something, right. If you can’t find something, I always say try not to not know the answer to the same question twice. Right. So somebody comes in with something that kind of tricks you a little bit, look it up.

Mike Reinold:
But other than that, I think the thing we talk about most with career development I think is doing your own personal audit, right? Where you take a step back and you say what are my strengths and what are my weaknesses? Right. And at the beginning it seems like there’s more weaknesses than strengths obviously, but it doesn’t really matter if I’m not good at cardiopulmonary physical therapy, if that’s not my work environment.

Mike Reinold:
So you got to get started, you got to get into your work setting and you got to say what do I need to excel here? Right. You may go to a clinic that does no spine. Right. So maybe that’s a great opportunity for you to say all right, I’m going to really focus on knees and shoulders because I don’t have to focus on spines. I don’t have to know everything today, but the faster I know knee and shoulder, because that’s what I’m going to see every day, then the faster my confidence level’s going to go up in my own abilities. And that’s just going to have positive outcomes for everything in my life. Right. Cause less anxiety and stress. And you’ll just feel better about yourself.

Mike Reinold:
So I always kind of say it that way too, take an audit of your situation and your skillset and how those match and kind of figure that out a little bit, then you’ll know, like Dave, what courses to take, right. Or Diwesh, what to learn tonight. Right? Those types of things, you’ll kind of learn those things. So keep those in mind and just know that being in a service based industry, we put a lot of pressure on ourselves. Right. You need some sort of mentorship and some sort of guidance to help you. Especially some of those tricky situations where not even we can get them better. Right. Right.

Mike Reinold:
Lenny had an ACL reconstruction yesterday that re-tore his ACL Right. It’s not his fault. A lot of people would say that day one, right. Like, “Oh man, my patient didn’t do well.” There’s a million reasons why that go in there. Right. But as you get more confident in your ability, I think you tend to stress less about those things because you know that you’ve done your best to put that person in the position to succeed. Right. Makes sense?

Mike Reinold:
Awesome. All right. Great episode. I think that was good. I thank Eric, but he didn’t officially ask this. I just threw him in here. So thanks Eric for bringing this to my attention. I think this would be a good one. Hopefully it’s something that everybody can benefit from because I think it’s a pretty big topic right now. So appreciate you. If you have a question like Eric, head to mikereinold.com, click on that podcast link and fill out our form and we will hopefully see you on a future episode. Thank you so much.

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