Amy Lemley, 46, has spent most of her life feeling like a fraud. She remembers debilitating performance pressure even as a young child. When she believed she wasn’t strong in a subject, such as science or math, she’d avoid it, once refusing to do homework for months.

Later, as a marketing copywriter, Lemley felt her anxieties surfacing again. She began worrying obsessively about how she came off to coworkers and clients. Was she being taken seriously? Did that person think she knew what she was talking about? A few times she forgot to bill her clients, and when she realized the mistake, was too embarrassed to send the bill late.

She didn’t like being put on the spot either. She screened her calls and preferred email to knocking on a colleague’s door. Mostly, she says, she was so consumed with perfectionism that she constantly felt she’d be “found out” for her weaknesses.

Lemley says her workplace anxieties crippled her, costing thousands in lost earnings and missed opportunities, professional relationships and personal wellbeing. She recently collaborated on a book, Work Makes Me Nervous, with Jonathan Berent, a psychotherapist and business performance consultant.