by Dr. Marc J. Shulman | Long Island Psychology | Self-Esteem, Anxiety | Updated September 2026
You’re the most prepared person in the room. You have the degree, the track record, the case history that proves you belong exactly where you’re sitting. And you spend the entire meeting quietly waiting for someone to figure out that you don’t.
If that feeling is familiar, it has a name. Imposter syndrome shows up constantly in this practice, especially among the lawyers, doctors, finance professionals, teachers, and executives who make up so much of the Nassau County workforce. Search volume alone tells you something: by a wide margin, this is the self-esteem concern people in this area go looking for help with most. Whatever it resembles on the surface, it isn’t humility.
What Imposter Syndrome Actually Is
Imposter syndrome is the private, persistent conviction that your accomplishments came down to luck, good timing, or someone else quietly picking up the slack, never your own ability. Running underneath it is a constant, low-grade dread of being unmasked. No edition of the DSM has ever listed it, but it is a well-studied pattern, it turns up across professions, and it tracks far more closely with anxiety and shaky self-esteem than with anybody’s real competence.
That last part is worth sitting with. Competence and this feeling simply don’t move together. Some of the most genuinely skilled people I see are the ones most convinced they don’t belong, while people with noticeably less ability walk into the same room feeling entirely certain. Whatever the feeling is measuring, it isn’t your actual skill.
Solid self-esteem tends to travel with something like an internal instrument panel: a reasonably accurate read on your own capabilities, paired with enough confidence to reach toward the top of that range without puffing the number up or talking it down. In imposter syndrome, that same panel breaks in one specific direction. Every outside gauge reads high, the performance reviews, the client outcomes, the résumé itself, while the internal dial just sits there and refuses to move.
It also runs against something else stable self-worth depends on, which is an internal sense that you’re capable of directing your own life. Attributing your outcomes to luck or timing isn’t merely inaccurate. It quietly hands authorship of your own success over to circumstance, which is precisely backwards from what genuine self-esteem requires.
Why It Clusters Among High Achievers
This part of Nassau County breeds imposter syndrome almost by design. Kids get sorted into competitive tracks early. Professional visibility starts young, and success here tends to happen out loud: announced, watched, compared, posted before the ink dries. In an environment built like that, being outwardly accomplished while privately braced to be caught isn’t a rare psychological quirk. It’s closer to the default setting.
The mechanism is fairly mechanical. The more externally impressive someone becomes, the wider the gap grows between the résumé and the internal experience, but only for someone whose sense of worth was outsourced rather than grown from the inside. Up close, that gap is just imposter syndrome under a different name: worth built on borrowed foundations, which is the same structural problem behind most of what shows up in self-esteem work generally.
This isn’t a fringe experience. A 2020 systematic review in the Journal of General Internal Medicine, synthesizing 62 studies and more than 14,000 participants, found prevalence estimates ranging from 9% to as high as 82% depending on the population and the measure used. It clustered consistently among high-achieving groups, and it correlated strongly with anxiety, depression, and burnout. The same review also found that no published studies had evaluated treatments specifically for it. That’s part of why we treat it as an expression of the broader self-esteem pattern rather than waiting on a dedicated protocol the literature hasn’t produced yet.
Imposter Syndrome Isn’t Humility
A common misconception, often held most firmly by the person experiencing it, is that this feeling is just modesty: a healthy check against arrogance. It isn’t. Humility doesn’t come with a racing heart before a presentation you’re fully qualified to give, and it doesn’t keep you up rehearsing a defense of your own competence for an audience that never asked for one. Imposter syndrome is competence wearing a fraud’s disguise, and what it produces is real anxiety, not appropriate modesty.
The Cost of Carrying It
Imposter syndrome doesn’t stay contained to the ten minutes before a presentation. Over time it produces exactly the behaviors that look, from the outside, like dedication: staying later than the job requires, over-preparing for meetings that don’t warrant it, saying yes to more than a reasonable workload because turning anything down feels like confirming the fraud. Colleagues see commitment. What’s actually happening is compensation, an attempt to out-prepare a feeling that no amount of preparation resolves, because the feeling was never about preparation.
Left alone long enough, this is one of the more direct paths into burnout we see in our Nassau County practice, particularly among attorneys and physicians whose fields already reward overwork. The exhaustion isn’t a separate problem sitting next to the imposter syndrome; it’s often the most visible symptom of it. It also overlaps heavily with the chronic self-criticism we treat as a closely related pattern.
What This Looks Like in a Session
A composite of a pattern I see constantly: someone gets the promotion they’d been working toward for years, and instead of relief, the anxiety climbs. There’s more to lose now, and a bigger audience to eventually disappoint. They’ll describe, in detail, every reason the promotion doesn’t count. The timing was lucky. The field was thin that year. Somebody senior must have advocated for them in a meeting they weren’t in. One patient told me the news arrived on a Friday and she spent the entire weekend building the case against herself, then went in Monday and thanked her boss for “taking a chance” on her. What none of them do, unprompted, is credit their own work. That’s usually the real starting point in treatment: not convincing anyone the promotion was deserved, but noticing how automatically they rule out the possibility.
Where It Comes From
Imposter syndrome rarely appears out of nowhere. It’s frequently rooted in conditional praise growing up, approval tied tightly to grades or awards or being “the smart one,” and sometimes in comparison with a sibling whose achievements set the bar. Some patients trace it to a parent whose own anxiety about status got absorbed early and never examined. In psychodynamic terms, this is transference at work: the audience being performed for in your head, the one you’re certain will figure it out, is usually an old audience rather than your current colleagues.
For some patients it’s less about a critical household than a competitive one, where being good wasn’t enough unless you were also better than someone specific. That comparison structure doesn’t disappear when the sibling or the classmate does. It finds a new object to attach to, which is generally the next room full of accomplished peers.
What Changes
| Before | After |
|---|---|
| A win brings relief that you weren’t caught, rather than pride in the work | A win registers as evidence you’re actually good at this |
| Wins get filed under luck, timing, or someone else carrying the load | You can own your own work without it reading as arrogance |
| Every unfamiliar room feels like an exam you’re about to fail | New situations feel demanding, not like a referendum on your worth |
| Competence on paper doesn’t translate into competence you can feel | The felt sense of “I’m good at this” starts to catch up with the résumé |
How We Treat Imposter Syndrome at Long Island Psychology
Treatment tends to move on two tracks at once: interrupting the pattern in the moment, and understanding where it came from.
CBT
In practice this means writing down the actual evidence for a success right after it happens, before the mind can reattribute it to luck. Over weeks, that record starts to outweigh the automatic discount.
Psychodynamic therapy
Figuring out whose approval is genuinely being sought in a given moment, which is usually a more specific and more revealing question than patients expect walking in.
Dynamic Experiential Learning (DEL)
Developed here at Long Island Psychology by Dr. Shulman, this approach targets the felt sense underneath the belief, since knowing intellectually that you’re qualified rarely changes how unqualified you feel.
ACT
Practicing walking into the room with the fraud thought fully present, instead of treating “feeling ready” as a prerequisite for acting competently.
Positive Psychology
Building a specific, evidence-based list of genuine strengths that exists independent of the next deliverable, so there’s something real to stand on besides the last result.
Frequently Asked Questions
Does imposter syndrome go away once you reach a certain level of success?
Usually not on its own, and it can intensify as success becomes more visible, since there’s more at stake in being “found out.” The feeling doesn’t track with the accomplishment, so accumulating more accomplishments doesn’t reliably resolve it.
Is imposter syndrome more common in certain professions?
It clusters in fields with high visibility and constant evaluation, such as law, medicine, finance, and education. That said, we see it just as often in business owners, and in parents running a household that looks effortlessly handled from the outside.
Can two people with the same job have very different experiences of this?
Yes, routinely. Two attorneys with nearly identical résumés can have completely different internal experiences of their own competence, which is part of why the feeling correlates so weakly with actual ability. It’s tracking something else entirely.
What’s the first sign that treatment is actually working?
Often it’s small: crediting a specific success out loud, in the moment, without immediately qualifying it. Patients tend to catch that shift in themselves before we point it out.
Getting Help in Nassau County
That mismatch between what your résumé says and what you actually feel is genuinely treatable, and it’s a pattern we work with often in this community. Our offices are in Garden City and Rockville Centre, with telehealth available throughout New York State, including Great Neck, Manhasset, and the surrounding Nassau County communities. See our full list of Nassau County locations served here.
Contact us at lipsychologist.com.
ABOUT DR. MARC J. SHULMAN: Dr. Marc J. Shulman is a licensed psychologist and the founder of Long Island Psychology, a group practice with offices in Garden City and Rockville Centre, NY.
Sources cited in this post: Bravata, D. M., Watts, S. A., Keefer, A. L., et al. (2020). “Prevalence, Predictors, and Treatment of Impostor Syndrome: a Systematic Review.” Journal of General Internal Medicine, 35, 1252-1275. Full article; Clance, P. R., & Imes, S. A. (1978). “The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention.” Psychotherapy: Theory, Research and Practice, 15(3), 241-247. Full paper (PDF)
