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Imposter syndrome and Public Involvement: How to make it easier to speak up

Rachel Temple

There is nothing worse than sitting in a meeting and feeling like you shouldn’t be there. That you aren’t good enough. OK, there is something worse – when all the attention is turned on you and everyone is waiting for an answer. Perhaps because you’ve been noticeably quiet and the chair of the meeting wants to include your views so they ask you a direct question:

“Do you have any thoughts to add, Rachel? What do you think?”

Say something Rachel. Anything! No, not that – that’s stupid!

As someone with social anxiety, I battle this internal monologue in every meeting. The idea that my opinions are worthless and inferior. It isn’t easy speaking up when you’re in a room full of people, all suited and booted and with more qualifications than you can count. When your mind is blank and people are expecting you to come up with some decent ideas, or at least to say something. It can feel incredibly uncomfortable. And awkward. Because it’s not like you don’t have any ideas – you just don’t want to share them. Or well, you do, but you don’t feel confident enough. How could your ideas possibly be valuable when there’s a room full of professionals who know what they’re talking about?

This feeling, often referred to as imposter syndrome, isn’t exclusive to socially anxious folk like myself. Many others also seem to worry that their opinions don’t belong in a room full of people who seem to know what they’re doing. For this reason, imposter syndrome can be a problem in the world of Patient and Public Involvement (PPI) – both for the individual who doesn’t feel confident to speak up and for researchers that are eagerly seeking the views of people with lived experience of the topic at hand. After all, how can you make the most of a meeting in which many don’t feel able to speak?

Why it’s a big deal

If people feel like aliens in the room, they probably won’t talk. This means that we, as researchers, don’t get their opinions on the research project that is being presented. Which means that we aren’t able to improve the quality of that research as fully as we might if we could gather the full diversity of opinions in the room. It’s a missed opportunity. Not only that but these types of opportunities (ones that require expressing ideas in front of professionals) aren’t likely to appeal to people who find it hard to speak up in the first place. Therefore, we could be losing out on reflecting a whole swathe of people’s opinions in our research altogether.

Having facilitated some meetings myself now, I’ve been able to consider this issue from both perspectives. With my chairing hat on, I can see the benefits of putting people on the spot and asking them directly to answer a question. Yet with my socially anxious attendee hat on, I can see why this would be someone’s worst nightmare. It’s also not the most effective approach, given that people are likely to agree for the sake of getting all eyes off them as soon as possible. And, because expressing anything that isn’t the majority’s opinion risks them feeling really stupid.

Despite this, there are things that we can do to reduce people’s insecure feelings and increase their confidence during meetings. Below are some things that we’ve explored at McPin:

  • Reinforce the idea that every voice matters equally  For every meeting that we hold, the golden rule at McPin is that every single person’s opinion is of equal worth. That includes the staff facilitating the meeting. Establishing this rule at the beginning of the meeting helps but it is also important to reiterate it  throughout. It is also something that can be emphasised  when advertising for any involvement opportunity in research. But remember, don’t just say it – mean it.
  • Establish ground rules As well as the fact that every voice matters, we have a general list of ground rules that we go through at the beginning of all involvement meetings. We remind people that no question is a silly question and we request that people refrain from using any jargon.
  • Think about how you dress for a meeting While it’s not always appropriate, sometimes it can really help to dress down for meetings. That way, you look less authoritative and more like you’re on the ‘same page’ as fellow attendees.
  • Separate, smaller meetings Invite fewer researchers to meetings when you’re trying to capture the view of people with personal experience of the topic. It’s simply less intimidating that way. Smaller group work activities can also help, for example, splitting the room in two or three. However, you may want to think carefully about the group dynamics. Placing quieter people together can sometimes help to bring them out of their shell – power in numbers!
  • Anonymous feedback or voting Have you got to make an important decision in a meeting? Allow people to vote in private (e.g. votes in a hat). It may be time-consuming but it’s more likely to lead to truthful opinions than, say, asking around the table one by one (i.e. ‘creeping death’).
  • Ask for feedback At the end of meetings, why not ask people for feedback on how the meeting went? You may learn more about how to make them feel more comfortable.
  • Option for feedback via email Meetings aren’t the only way of doing things and some people simply don’t thrive in that environment (myself included). Plus, the opportunity to reflect post-meeting can lead to stronger suggestions and input from people.

While these suggestions may not be perfect, I think they are a step in the right direction. Not all of them will be applicable to every single meeting and they won’t always be practical. But I do believe that this is the kind of stuff that we need to give more thought to. Because even when we are content that we are doing a good job in collecting people’s true opinions and ideas, I can guarantee that there was someone in the room that really wanted to express a thought – but couldn’t. That thought could have been a small suggestion or it could have been a ground-breaking epiphany. Either way, it matters.