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Ask the expert
Development and process

Can a person who suffers from the impostor’s syndrome ever overcome it?

Impostor’s syndrome is a psychological phenomenon in which people are unable to feel worthy of their accomplishments. I think, as a psychologist, one of the advantages I have is that people tell me what they really think. And the most common response I give people, and it’s an honest one, is that their thoughts are completely normal. The truth is that we all have anxieties and self-doubts. But, because we can only read our minds and not the minds of others, we tend to think that everyone else who projects a very confident image is very confident. The truth is that they’re not.

So yes, I think that it’s really just an issue of self-confidence, and, in almost any therapy, all we really work on is self-confidence. I always say that, if there were a self-confidence pill, I’d be out of a job. So the impostor’s syndrome is really just an issue of self-confidence. Some of us have problem areas that we can work on. It doesn’t make us inadequate. I think we all have strengths and weaknesses and sometimes we can strengthen our weaknesses so to speak. More often than not we’re not very different from other people and I think it helps to understand that.
-Camillo Zacchia, Ph.D., Mini-Psych School 2009

I’ve heard that post-traumatic stress disorder (PTSD) lasts only six months to a year but also that it can last longer. Which is accurate?

First of all, PTSD should be distinguished from a normal stress reaction. Recovery from such traumatic events as the loss of a loved one, rape, or even a severe car accident varies from person to person, and so there is no standard. In true PTSD, the person starts to get better but then starts to relive the trauma and may start having nightmares or become debilitated from trying to avoid a recurrence of the event. This can last their entire lives if not treated. Normal stress and normal trauma will generally go away for most people. Only a small percentage will develop a more severe disorder.
-Camillo Zacchia, PhD, Mini-Psych School 2010

Can aggressive behaviour in teens also mask an anxiety disorder or drug abuse?

Sometimes, aggressive behaviour is simply aggressive behaviour. However, an anxiety disorder can influence patience levels and other behaviour. If people are very stressed, they tend to lose patience more quickly and become more aggressive than normal. There are of course people who develop drug problems, and we see a lot more dependence in anxious people than in the general population. This is often because they self-medicate because they feel bad or need medication as a crutch, i.e., a sleeping pill to go to sleep, a tranquilizer to calm down, or alcohol to lose their inhibitions. The tendency is therefore to have more problems, but not all drug problems are caused by anxiety.
-Camillo Zacchia, PhD, Mini-Psych School 2010

What are the physical symptoms of a panic attack?

Although people experience different things during a panic attack, some common symptoms are headaches, dizziness, and tightness in the chest. These symptoms are your body's response to stress—a response that can also be triggered by perceived stress. Focusing on a single body part can sometimes make the symptom worse. For example, if you feel tightness in your chest, you will try to breathe harder to calm down or get more air. The problem is that this reaction soon leads to hyperventilation, which in turn leads to panic. The paradox is that your efforts to calm yourself down will give you symptoms that are extremely scary.
-Camillo Zacchia, PhD, Mini-Psych School 2010

Is there more risk to develop post-traumatic stress disorder when the event is experienced versus witnessed?

There most likely isn’t a difference, and a person’s reaction will probably depend on the intensity of the trauma. Obviously if you are involved in the event, your experience will be quite intense; however, if you are very shocked just by witnessing it, you can certainly experience PTSD or develop it to the same degree.
-Camillo Zacchia, PhD, Mini-Psych School 2012

If people damaged by trauma shut down emotionally to be safe, how do they “turn themselves back on”?

It’s not necessarily a conscious thing; it can just happen over time. For example, people in lines of work that are potentially traumatizing (i.e., people who work with dead bodies) can have a “switch” that helps them deal with death. There may be events that turn this switch off, but turning it back on again may not require anything else but time and dealing with the issues or circumstances that triggered the trauma.

If this doesn’t happen naturally, then the person may have to seek treatment. For a lot of people, antidepressant medication is an effective treatment for anxiety disorders, including PTSD, because it tones down the intensity of the emotions so that you are more able to face your fears. The goal is always to face your fears in a less emotional state. This can be done through exposure therapy, with EMDR (Eye Movement Desensitization and Reprocessing), or with antidepressant medication to make the emotion less intense: it’s all the same idea. You need to gradually resume your life and face your fears.
- Camillo Zacchia, PhD, Mini-Psych School 2012

To what extent does “survivor’s guilt” play a role in post-traumatic stress disorder?

This is something that happens a lot, especially if the person you lost, perhaps in a car accident when you were driving, is a younger family member. This can make you feel partially responsible or completely responsible. Trying to convince people that it was just an accident and that it wasn’t their fault is very difficult. Unfortunately, a lot of people end up feeling bad, especially when the person was someone close and someone they loved. This is a common feature of PTSD and is one of the things that we deal with using a more collaborative approach to get people to face their emotions and fears and deal with their perspective.
-Camillo Zacchia, PhD, Mini-Psych School 2012

Why are we able to control certain fears (e.g., of snakes) but not when we see someone who reminds us a traumatizing event?

The fact is that fears are different for each individual. Some people are afraid of snakes, while others are afraid of spiders. What is medicine to one person is poison to another. It is also amazing how one person can be completely controlled by a fear but be unable to understand someone else’s anxiety. One person may be deathly afraid of taking the bus but can’t understand why someone else is afraid of needles. In general, these fears are a manifestation of our fear of dying, making a fool of ourselves or losing our minds.
-Camillo Zacchia, PhD, Mini-Psych School 2012

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