When Imposter Syndrome Becomes Rumination: Intrusive Thoughts, Fear and the Need to Figure It Out

A note before we begin: This article is not intended as clinical advice or as a treatment protocol. It reflects observations from my own clinical work with people experiencing imposter syndrome, social anxiety and performance anxiety, alongside established cognitive-behavioural ideas about rumination and intrusive thoughts.

Some of the concepts discussed here, particularly the distinction between ego-dystonic and ego-syntonic thoughts. are more commonly used in the context of obsessive-compulsive disorder (OCD). I am not suggesting that imposter syndrome is OCD, or that experiencing the patterns described in this article means that somebody has OCD. Rather, I have found some of these concepts useful for understanding why certain anxious thoughts are particularly difficult to disengage from when they concern things we genuinely care about.

The article also draws on ideas I have learned from Dr Michael Greenberg’s work on Rumination-Focused Exposure and Response Prevention (RF-ERP), particularly his conceptualisation of rumination as a controllable mental behaviour and the importance of disengaging from it. RF-ERP is a newer approach and does not currently have the same established evidence base as standard evidence-based treatments for OCD and anxiety disorders. It is better understood as an extension and refinement of principles derived from existing cognitive-behavioural and exposure-based approaches, rather than as an independently established treatment with a large body of clinical-trial evidence.

What follows is therefore an attempt to apply useful ideas from existing and emerging psychological approaches to patterns I repeatedly observe in my own work. It should not be taken as a substitute for individual psychological assessment or treatment.

Intrusive Thoughts & Imposter Syndrome

One pattern I have noticed repeatedly in my work is that people are often quite good at recognising intrusive thoughts when the content feels obviously irrational, bizarre or disconnected from who they are. They are much less likely to recognise them when the thought sounds like something they might genuinely think. This matters enormously in imposter syndrome which is closely tied to our sense of self and identity.

To be clear, I am using the definition of an intrusive thought here as: an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate.

In this way, the content is less relevant but more the unwelcome nature of the thought.

A thought such as What if I'm not actually as capable as everyone thinks? doesn't necessarily feel intrusive. Neither does They’ll see I don’t know enough, What if I mess up this presentation and everyone sees that I'm not as competent as they thought? or I’ve somehow scammed everyone into thinking I’m good at my job.

These thoughts feel relevant. They concern real things: your career, your reputation, your competence, your financial security, your place within a group. Because they feel relevant, we tend to treat them as problems requiring our attention. That is where rumination can begin which leads to a vicious cycle of anxiety.

Please note I am using rumination as defined by Greenberg: any type of mental engagement with the problem; shifting into problem-solving mode, including analysing, mental reviewing, mental checking, visualising, monitoring, and even directing attention toward the problem.

Ego-dystonic versus ego-syntonic intrusive thoughts

In OCD work, clinicians often distinguish between thoughts that are ego-dystonic and those that are ego-syntonic.

Ego-dystonic thoughts feel inconsistent with our beliefs, values, desires or sense of self. Because they feel alien, unwanted or weird, it can sometimes be easier to recognise them as mental events rather than useful information (however this is not the case in some cases of OCD in which the egodystonic thoughts produce fear).

For example, like many human beings, I occasionally experience completely random intrusive thoughts. Recently I was at the top of a very tall, 7 floor museum. I looked over the edge of the top floor balcony and my brain said: What if you jumped?

I don't want to jump off. The thought has no meaningful relationship to my intentions or me. I recognise it immediately as random mental noise, and so I don't sit down afterwards and analyse it. I just move on. Many people with imposter syndrome experience random intrusive thoughts of no relevance and do nothing about them in a similar way.

But imagine my brain gives me a different thought.

I care deeply about being a good therapist. I care deeply about doing a good job. I care about being a good person. I care about not being a bad person. As part of that I care about communicating mental health information responsibly, particularly because mental healthcare is an area where pseudoscience, misinformation and unregulated practice can cause real problems.

So my brain has much more activating material to work with. It could say: Something you’ve said publicly about social anxiety is wrong

And then:

What if someone notices?

What if people publicly criticise you?

What if you get cancelled?

What if that causes so much stress you can’t work?

What if you lose your reputation?

What if that affects your income?

What if you can't support yourself?

What if everything you’ve worked and studied for is pointless?

Now the thought/s feels completely different. They feel real and like they need attention, because they are in-line with who I am and what I value. They feel like they’re helping me ‘be a good person’ or ‘make things better’. These are egosyntonic thoughts, and they often come with emotional and physical sensations. But, the crux is, they are often just as intrusive as other thoughts (such as what if you jumped?) but we don’t see them that way because of the content.

Anxious intrusive thoughts often attach themselves to what matters

We sometimes imagine intrusive thoughts as bizarre, dramatic thoughts that arrive completely out of nowhere. But intrusive thoughts can also involve ordinary fears.

Being exposed as incompetent. Losing status. Being rejected. Making a mistake. Being embarrassed. Discovering that you aren't as good at something as you thought. Other people changing their opinion of you. These possibilities technically exist.

But a possibility being real does not mean that repeatedly thinking about it is useful.

This is particularly relevant to imposter syndrome because imposter fears often attach themselves to deeply held values and identities.

If being competent matters to you, your mind asks whether you're incompetent. If belonging matters to you, it asks whether you really belong. If professional integrity matters to you, it asks whether you've done something wrong. If being respected matters to you, it asks whether people secretly don't respect you. If your career has become important to your identity or security, it asks what would happen if you lost it.

The thought therefore doesn't necessarily feel like anxiety. It can feel like analysis and like it is helpful. But it is often not.

Rumination is a cognitive behaviour

This is where I think it is useful to stop thinking only about what you are thinking and start looking at what you are doing with the thought.

Rumination is a behaviour. It just happens internally.

A threatening thought appears: I'm not actually good enough for this role

You give it attention. You start reviewing evidence.

Well, they hired me, but maybe I interviewed particularly well.

You search for certainty.

Would I know if I were actually incompetent?

You replay interactions.

My manager looked slightly unconvinced when I said that. Was that because what I said wasn't very intelligent?

You predict.

What happens if I get asked something in the next meeting and can't answer?

You problem-solve.

Maybe I should prepare much more than everyone else.

You compare.

Everyone else seems to understand this more naturally than I do.

And after 30 minutes of analysis, you are left feeling anxious and terrified. The important feature here isn't the first thought it is the cognitive behaviour that follows it.

Attention makes the threat feel increasingly real

When we repeatedly engage with a threatening idea, our emotional system responds accordingly.

Imagine spending an hour analysing the possibility that your colleagues will discover you're incompetent. Even if nothing has actually happened in the external world, your body has effectively spent an hour responding to professional and social threat.

You become activated. You feel anxious. Your attention narrows. You notice more potential evidence of rejection or inadequacy. After a while, sometimes the feeling itself becomes evidence.

Why would I feel this anxious if there was not really a problem? No-one competent feels this way.

You might prepare excessively, avoid speaking spontaneously, turn down an opportunity, procrastinate on something visible, repeatedly edit an email, seek reassurance, monitor people's reactions or avoid situations where your competence could be tested.

The original intrusive doubt has started producing real behavioural consequences, not because anything about your life has changed, but because you spent so much time responding to the possibility of it happening that your brain has begun to treat it as a real immediate threat. Except, it was just an intrusive thought. Just like any other random intrusive thought, except it was in-line with things you care about.

The thought can connect to reality and still be intrusive

This is perhaps the most important distinction.

Calling something an intrusive thought does not mean saying it could never happen. It means recognising that the spontaneous appearance of a thought does not automatically make that thought worthy of engagement.

Could I accidentally say something inaccurate publicly? Of course but also, I may not

Could somebody criticise me? Yes and no

Could you make a mistake at work? Yes and no

Could somebody decide you're not as impressive as they initially thought? Yes and no

Could you perform badly in an important meeting? Yes and no

The goal is not to construct an argument proving that these things are impossible. In fact, constantly trying to prove that they won't happen can become another form of rumination. Instead, we can begin recognising:There is that thought again that makes me uncomfortable, but I can choose not to solve it.

But isn't some analysis useful?

Yes, there is a level of reflection, planning and analysis that is healthy and necessary.

If I am writing an article about a clinical topic, I should check my sources. If you have an important presentation, preparing for it is sensible. If your manager gives you constructive feedback, reflecting on it may help you improve.

The distinction is not thinking versus not thinking but problem-solving versus anxiety-driven rumination.

Useful problem-solving tends to have an identifiable problem, relevant information and some form of endpoint. You consider the information available, make a decision or take an action, and move on.

The other day another therapist described doing EMDR (a therapy I also deliver) in a way that I do not do. I immediately thought ‘Am I doing it wrong?’. It was an intrusive thought.. but part of being an ethical therapist is to make sure if you become aware of mistakes or issues, you fix them. You don’t just continue blindly.

I took a moment, thought about the EMDR I’m delivering, how I follow what I was taught, that I attend supervision regularly, and how it’s true that many therapists use different techniques in EMDR so it’s normal to have variation. That was it. Nothing more to figure out. It was a level of analysis that was helpful and then stopped.

But because it’s in line with something I care about, and my identity as a therapist, it could have escalated into: but what if I’m doing it wrong? Am I going to be ‘found out’ for having done it wrong this whole time? Will someone complain? Was I incompetent this whole time?

Rumination tends to demand something reality cannot and will never provide: complete certainty.

But how do I KNOW I'm good enough?

How do I KNOW nobody thinks I'm a fraud?

How do I KNOW I won't embarrass myself?

How do I KNOW I've never said anything wrong?

How do I KNOW people respect me?

There is no amount of thinking that can permanently answer these questions, so the mind keeps going.

Disengaging from imposter rumination

This is why part of working with imposter syndrome, or even social and performance anxiety, may involve learning to recognise certain thoughts as intrusive even when their content feels personally meaningful.

That can initially feel irresponsible.

Your mind may tell you:

But I need to think about this.

I'm trying to solve it.

I'm preparing myself.

If I stop thinking about it, I'll become complacent.

Surely successful people analyse their weaknesses.

Sometimes they do, but hours of circular thinking are not necessarily making you more competent, prepared or self-aware. In fact, you are likely making yourself more anxious, stressed, and more likely to not be able to do the things you want.

Disengagement requires accepting something surprisingly uncomfortable: I do not need to figure this out.

Not I have proved that the thought is false.

Not I now know that everybody thinks I'm competent.

Not I have finally established that I deserve to be here.

Simply: I do not need to do anything about this.

That is uncomfortable and not easy, particularly when the thought is egosyntonic and feels in-line with who you are, your values and life. But you may already be doing it with egodystonic thoughts.

You don't have to resolve every doubt your mind produces

For people experiencing imposter syndrome, this can represent a significant change.

Instead of constantly trying to establish whether you are competent enough, impressive enough, knowledgeable enough or deserving enough, you begin allowing those questions to remain unanswered.

Perhaps you are brilliant, or not. Perhaps somebody is better than you. Perhaps you will make a mistake. Maybe you are not as competent as you think.

When you receive information that proves or does not prove something, you can respond. But you do not need to spend hours mentally rehearsing every possible version of it beforehand.

Many people say, but I can’t stop thinking about it. If so, I would encourage you to read further work by Dr Greenberg here on mental behaviour.

The aim is not to eliminate intrusive thoughts. Human brains produce thoughts constantly, including strange, threatening and uncomfortable ones.

The skill is learning which thoughts actually require your attention. And sometimes, the thoughts that feel most important to solve are precisely the ones you need to practise leaving alone.

References

Clark, D. A., & Purdon, C. L. (1995). The assessment of unwanted intrusive thoughts: A review and critique of the literature. Behaviour Research and Therapy, 33(8), 967–976.

Greenberg’s work on RF-CBT: https://drmichaeljgreenberg.com/articles/

Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3(5), 400–424.

Purdon, C., & Clark, D. A. (1994). Obsessive intrusive thoughts in nonclinical subjects. Part II: Cognitive appraisal, emotional response and thought control strategies. Behaviour Research and Therapy, 32(4), 403–410.