“Imposter syndrome” is a common label for feeling undeserving, fraudulent or close to being found out despite visible effort or achievement. It is not a formal diagnosis, and an online guide cannot decide what explains someone’s self doubt. The experience may sit alongside anxiety, perfectionism, depression, burnout, discrimination, difficult workplace dynamics, trauma, a new role, academic pressure, neurodivergence or a realistic uncertainty about an unfamiliar task. The pattern can be exhausting. Someone may discount positive feedback, attribute success to luck, prepare far beyond what is needed, avoid asking questions, struggle to rest, compare themselves constantly, seek repeated reassurance or delay submitting work until it feels impossible to improve. Another person may withdraw, turn down opportunities or feel detached from achievements that others can clearly see. These responses can make sense as attempts to reduce uncertainty, even when they become costly. Assessment led therapy begins with context rather than a label. What is happening at work, study or home? When did the self doubt become more intense? What standards are being used to judge the self? How are sleep, mood, concentration, physical health and relationships affected? Is there a history of criticism, exclusion, bullying or instability? Are workplace practices or a genuine skills gap part of the picture? The aim is not to persuade someone that every concern is irrational. CBT based therapy may be considered after assessment where appropriate. It can explore self criticism, assumptions about competence, avoidance, checking, reassurance seeking, overwork, comparison and the relationship between standards and wellbeing. It does not prove that someone is competent, secure a promotion, determine an employer’s responsibilities, provide legal advice or guarantee confidence. Workplace adjustments, discrimination, performance procedures and contractual questions may need an employer, occupational health, union representative, HR professional or employment adviser. Any behavioural work should be collaborative and paced. It is not a directive to expose yourself to public criticism, disclose private health information at work, reduce preparation abruptly or take professional risks without considering responsibilities and safety. A useful formulation can distinguish a value led ambition from a rule that makes every task a referendum on worth. Physical symptoms should not automatically be attributed to pressure or anxiety. Persistent exhaustion, sleep change, pain, palpitations, medication effects or a marked change in functioning may need medical advice. Urgent appropriate help is needed if someone feels unable to stay safe, has thoughts of suicide or self harm, experiences psychosis or has a sudden marked change in mental state. For related information, see anxiety support at lyceumclinic.co.uk/therapy/anxiety/, the guide to perfectionism and CBT at lyceumclinic.co.uk/guides/cbt for perfectionism/ and the guide to career transition anxiety at lyceumclinic.co.uk/guides/redundancy career transition anxiety/. You can enquire about current arrangements and whether CBT based therapy may be suitable for your circumstances.