A guest post from Rivia Mind presented by Dr. Shaheen Ali, MD.
Have you ever been told you apologize too much? Maybe you downplay compliments, not daring to believe they’re genuine. Or despite how much you achieve, you still feel like an imposter at work — a pattern often called imposter syndrome.
These patterns can feel like core parts of who you are. But think about it. Were they always there, or did they emerge in childhood as a way to navigate challenging circumstances?
Dr. Shaheen Ali, a psychiatrist who works with adults navigating the long-term effects of early experiences, sees this often. She explains that attachment trauma can show up in adulthood as difficulty trusting others, trouble being vulnerable, hypersensitivity to rejection, or even a tendency to avoid closeness altogether.
Dr. Ali takes a psychodynamic approach to therapy, exploring how formative experiences shape present-day patterns. She believes that when you can connect the dots, you’re better able to decide which patterns actually benefit you.
The Trauma Spectrum: Big T vs. Small t Trauma
You may think that to qualify as trauma, an experience needs to be earth-shattering. Sudden loss, abuse, or witnessing violence can all be considered traumas — what clinicians refer to as “Big T” traumas. But there are also more nuanced versions, called “small t” traumas. These might include a parent who was physically present but emotionally distant, households that overemphasized success and penalized failure, or families where emotions were downplayed or dismissed.
The Adverse Childhood Experiences (ACE) questionnaire, used in research and clinical settings to assess trauma, goes beyond the obvious. Alongside direct questions about abuse, it includes subtler ones: “Did anyone in your family make you feel loved or special?” and “Did your family look out for each other?”1
“Being misunderstood, being unrecognized, feeling invalidated,” Dr. Ali explains, “those are early childhood traumas that can get deep in the body and mind. They can be stored within patterns of defense.”
Small t experiences leave gaps in what you learned about connection, trust, and your worth. When those gaps go unrecognized, you fill them with unhealthy coping mechanisms: walling off emotions, overachieving to earn approval, making yourself small to avoid conflict.
The good news is that once you can see these patterns for what they are — adaptations that once served a purpose — you can start to decide which ones to keep and which ones you’re ready to leave in the past. Here are a few common ones to look out for.
Fraught Relationships
When early relationships teach you that closeness can lead to disappointment or hurt, your nervous system learns to stay alert. It develops a finely tuned radar to detect anything that might signal rejection or abandonment.
In adulthood, this shows up in ways that feel protective but actually create the distance you’re trying to avoid. A friend or partner gets close, and you pull back. Someone texts less frequently for a few days, and instead of assuming they’re busy, you prepare for them to leave. They express a need, and you hear it as criticism.
“The brain learns to respond from fear,” Dr. Ali explains. “And the alarm system becomes dysregulated.” Your mind was trained to anticipate and defend against emotional harm. The challenge is that even in safe relationships, the warning system keeps running.
You might notice this in specific patterns:
- Withdrawing at the first sign of conflict, even minor disagreements
- Feeling responsible for managing other people’s emotions
- Struggling to express needs directly, hoping others will intuit what you want
- Testing relationships to confirm whether people will stay when things get difficult
- Gravitating toward emotionally unavailable people
Relationship confusion often leaves children wondering what they did wrong. “That creates a lot of self-doubt and anxiety,” Dr. Ali says. “It makes sense that the brain would respond by trying to minimize that distress in any number of ways.”
Imposter Syndrome
Imposter syndrome can trace back to a childhood experience where you received mixed messages about your capabilities.2
Maybe you were praised for being “naturally smart” but struggled when things got hard, learning that needing effort meant you weren’t as capable as people thought. Or perhaps you succeeded in ways your family didn’t understand — the first to go to college, the one pursuing a career your parents couldn’t advise you on — leaving you without a reference point for what “belonging” in that world looks like.
In professional settings, imposter syndrome shows up as a persistent sense that you’re performing competence rather than possessing it. You might attribute success to external factors like timing, luck, or who you know, while internalizing failures as proof of inadequacy. This can lead to avoiding opportunities that feel too ambitious, turning down promotions because you think you’ll fail, or staying in roles where you feel overqualified but safe.
The challenge with imposter syndrome is that it feels like clear-eyed honesty about your limitations. But that “truth” was informed by early experiences, not your actual capabilities.
Unhealthy Perfectionism
Take someone who grew up with parents working multiple jobs, high academic expectations, and an undiagnosed attention deficit making it difficult to succeed in school.
“They may develop a compensatory sense of conscientiousness,” Dr. Ali explains. “I’m going to check my homework three times, not just twice. I’m going to work two extra hours every night to keep my grades up.”
That work ethic becomes a strength. It helps the child succeed, earns praise, and creates a sense of control.
In adulthood, that can lead to unhealthy perfectionism. Checking your work three times becomes checking it six, driven by a persistent fear you’re missing something. Working extra hours becomes an exhausting baseline expectation you set for yourself. What began as a way to earn love and approval can become a rigid standard that’s difficult to meet.
“Traits are strengths,” Dr. Ali says, “when we figure out how to use them. That conscientiousness is a superpower, just like the attention deficit is. Processing the world in that unique way is quite useful once you learn how it serves you.”
People-Pleasing and Porous Boundaries
If you learned that your role was keeping others comfortable, setting boundaries as an adult can feel almost impossible.
This might develop in households where a child’s role was to manage the emotional climate by soothing a volatile parent, mediating conflicts between siblings, or not speaking up to avoid adding stress. The child learns that their worth depends on how well they can anticipate and meet others’ needs.3
In adulthood, this might show up as chronic over-apologizing and feeling guilty for taking up space or having preferences. You might find yourself absorbing blame that isn’t yours, working overtime to make sure everyone around you is happy, or feeling intensely uncomfortable when someone expresses disappointment.
Constantly prioritizing others’ needs over your own isn’t sustainable. It leads to resentment, exhaustion, and relationships where you’re never sure if people like you or just like what you do for them. Learning to set boundaries means unlearning the belief that your value comes from how accommodating you can be.
Self-Sabotage
Self-sabotage can look irrational from the outside: walking away from a nurturing relationship, procrastinating on a project you care about, or overcomplicating simple tasks.
If your early experiences taught you that good things don’t last, or success brings dangers like increased expectations, visibility, the possibility of a harder fall, then sabotage becomes a form of control. You’re not waiting for the disappointment to come. You’re creating it on your own terms.
This can develop in childhoods marked by unpredictable losses, achievement met with jealousy or increased pressure instead of celebration, or constant instability. The lesson absorbed? Don’t get too comfortable or trust good things to stay.
In adulthood, you might find yourself anxious when things are going well, unconsciously creating problems to restore familiar chaos.
Recognizing this pattern means you can start asking whether the threat you’re defending against still exists, or whether you’re safe enough now to let good things unfold.
Recovery Starts with Reframing
“Everything that happened has been for a purpose,” Dr. Ali says. “People behave the way they do because it serves them in some way. The patterns were successful for surviving, avoiding conflict, distress, fear, and pain, or for getting love, affection, or attention.”
A child who develops hypervigilance in an unstable home is learning a real skill — how to read a room, anticipate danger, and adjust accordingly. A child who becomes the peacekeeper has created a role for themselves where they’re needed and unlikely to be rejected.
“It makes sense that you learned how to deal with things in this way because of what you were handed,” Dr. Ali says. “It worked.”
These strategies, however brilliant they were in context, often outlive their usefulness. The workplace isn’t your childhood home. Your partner isn’t your emotionally unavailable parent. But the nervous system doesn’t automatically update its threat assessment. Sometimes we have to reboot it ourselves.
Moving On From Childhood Trauma
Change takes time.
Acknowledgment creates possibility, though. When you can see that your fear of vulnerability is a learned response, you can start to question it. When you recognize perfectionism as a survival strategy, you can begin to loosen its grip.
With that understanding, you can decide how you move forward. If imposter syndrome is the pattern you recognize most in yourself, this guide on how to overcome imposter syndrome offers practical next steps.
If these patterns sound familiar, you don’t have to figure out where they came from on your own. A Resource Specialist can help you find a therapist who understands childhood trauma’s lasting effects and connect you with the right support.
Shaheen Ali, MD, is a psychiatrist and psychotherapist at Rivia Mind with training in consultation-liaison psychiatry. She brings a trauma-informed, psychodynamic approach to her work with adults, grounded in science and attentive to the full complexity of each person’s life.
Rivia Mind is a doctor-owned private mental health practice that believes in evidence-based, whole-person care. Learn more at riviamind.com.
References:
- U.S. Centers for Disease Control and Prevention. About Adverse Childhood Experiences.
- Psychology Today. Imposter Syndrome and Adverse Childhood Experiences.
- Wells, M., Glickauf-Hughes, C., & Jones, R. (1999). Codependency: A grass roots construct’s relationship to shame-proneness, low self-esteem, and childhood parentification. The American Journal of Family Therapy, 27(1), 63–71. https://doi.org/10.1080/019261899262104
Photo by cottonbro studio: https://www.pexels.com/photo/woman-wearing-a-blazer-writing-7441095/
The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.
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