Q: Tell me a little about your story.
A: In a nutshell: I ran into a huge wall when I was writing my own PhD. I fell ill with Lyme disease (an infectious disease transmitted by a tick bite) and couldn’t work at all for over three years. Even so, I decided to finish my thesis after the worst of my illness receded. The second time around I was forced to do things differently: I was forced to handle stress differently, and to transform negative patterns that had me captured as best I could. It worked. I finished writing my PhD in a couple of hours a day.

Q: So, what exactly happened?
A: In the third year of the PhD programme I collapsed. Until then my PhD experience had been a mixed bag: some good, some bad, but definitely nothing stable. I had a great first year: I met lots of new people, made friends, I met my now-boyfriend and I was excited to be in Florence writing a PhD. I didn’t exactly know what my PhD topic would be though, and it took me a long time to figure it out, which was stressful and made me feel insecure. Supervision was also problematic: nothing about the supervision relationship worked. Later I found out my supervisor was a bully. I decided to switch supervisors at the end of the first year. 

The second year was lonely: many of my new friends and my boyfriend left Florence. I started to feel the pressure of having to write, but not getting enough done. The supervision change was a success, comparatively, although I still felt quite isolated. Both at work and at home I felt very little sense of connection and support. I did manage to come up with my first chapters that were well received. By now I had the first real outline of the PhD project. My ideas were coming together. In the third year, I finally got completely clear on what I wanted to do, and how I wanted to do it, and I started working hard in order to ‘catch up’. I was pushing myself too hard. And my supervisor pushed me with me. I wasn’t feeling well at all at this point (mentally/ emotionally, to some degree physically – I had already contracted Lyme disease unbeknownst to myself).

Towards the end of the 3rd year I fell ill for real. At first I thought I had just overdone things a bit, and that was the reason I was feeling so weird and emotional and spaced out. After all, I had been working for a couple of weeks without significant breaks. I booked a ticket back to Amsterdam to stay with my boyfriend for a week or two to forget about my deadline and to get some rest. But after two weeks of mostly lying in bed, unable to do much else, things got worse instead of better. My head felt like it had imploded. I couldn’t read: the letters were dancing on the page. I couldn’t watch TV, as it felt like an assault. Having a conversation was a real effort, and I didn’t really manage. I couldn’t manage going food shopping or cooking (something I’d always enjoyed). I felt so tired I could hardly move my body. In fact the only two activities that seemed to be accessible to me were sleeping and crying. It was absolute hell. After a couple of weeks, when it became clear that I wasn’t getting better, I relocated to my parents’ place where I stayed for 8 months while they looked after me. I was in a bad state. By now I couldn’t stand light or sound. Because my symptoms were so severe a neurologist checked whether I might have a brain tumour (although they never said these words out loud). They found nothing, and I was told it was probably ‘stress’. In the end it would take over six years before I got the right diagnosis. At that point and stage, there was no longer a cure or proven treatment.

Nevertheless I recovered somewhat with hard-core healthy living and self-care, but the process was slow. Very slow. It took me more than three years before I could even start thinking about returning to work on a very part-time basis. I had two major problems. The first: lack of energy – I could hardly do anything because I was always exhausted. The second: my nervous system was fried, and didn’t react well to stimuli, such as sound or bright light. These two combined meant I could hardly leave the house. I wanted to, but I couldn’t do it without meeting the man with the hammer. A ‘normal’ job, however part-time, was out of the question.

Q: Wow.
A: Yes. It was bad. So, after about three years of being ill, with no prospects of getting better, I decided I wanted to try to finish my PhD.

Q: You what? Why would you even think about trying to finish your PhD in that state? That’s torture.
A: Maybe so. But I couldn’t think of any feasible alternative. All I knew is I had to do something to not go crazy home alone with only my misery to entertain me. I was recovering some of my mental strength, and I caught myself thinking about my PhD project often. I was still interested. Why not give it another go? I couldn’t leave the house to find work, and this project I could work on by myself.

Q: OK. So how did it go?
A: When I started work I didn’t tell anyone – I was too afraid I wouldn’t succeed. So I worked without telling anyone, for about half an hour a day, a couple of days a week. That was all I had in me energy-wise. But I made a commitment, that no matter what happened, this time I would take excellent care of myself. I didn’t know how, and I certainly didn’t have a ‘plan’ of what I would change compared to when I was working on the PhD before. But there had to be a better way, and I was determined to find it.

To my surprise it wasn’t too difficult to get back to work. There were certain things I couldn’t do – read a lot of literature for example. Reading was a challenge, and I only read those articles I absolutely couldn’t do without (this wasn’t a bad strategy at all). But running my analyses and writing seemed to come relatively naturally. I say relatively, because I am not going to pretend it was easy. I struggled with my energy and other limitations every single day. But yes, somehow things were coming together. It is difficult to reconstruct exactly how things got done. But after just over half a year I had the first version of a new, large empirical chapter written. One year later, I had re-written the entire thesis and updated it with self-generated data. I had expanded some chapters, re-written significantly, sharpened my argument and made the thesis into a whole. It was ready to send to the committee.

Q: So if my calculation is correct, it took you 4,5 years of actual work to write the thesis. That’s not bad at all.
A: Yes. That’s correct. I surprised myself and everyone else. Even though I could only put in a couple of hours a day (or as I think now: maybe because I could only put in a couple of hours a day) my thesis came together pretty smoothly in the end. I arrived in Florence in 2004, I defended in April 2012. That’s seven years and eight months (ouch!). But if you count only the months I actually worked on my PhD, it’s even a bit under 4,5 years. It was quite shocking to find out I could still be productive even with a fried brain and nervous system, and no energy. But I could do this only because I changed the way I worked, and the way I thought about my work. My work was very well received, and the EUI nominated me to be their candidate for the 2013 ECPR Blondel prize. 

Q: It must have been great to see your work acknowledged.
A: Oh, yes it was! I was over the moon with the reports from the committee members, and the nomination that followed. I was so incredibly relieved. None of these people except my supervisor even knew something was ‘wrong’ with me. I didn’t want their sympathy based on my circumstances. I wanted them to judge my work for what is was.

Q: Why do you think your experience could help people who are not having to deal with an illness? It sounds like a pretty singular experience.
A: Well, I wouldn’t wish the hardship part on anyone, that’s for sure. But it forced me (and still does) to strip things down to the bare essentials. When you are having to deal with such a serious and painful situation it makes you examine your situation, and look at it critically. You become quite motivated to change behaviours and patterns that are self-defeating. It is illuminating in the most painful way possible. There is no other choice.

Q: How did you become interested in wellbeing, stress and academic performance?
A: I was told initially my collapse was stress-related. That part makes me roll my eyes a bit now, as it made me think my situation was somehow self-inflicted, and not that serious, while in reality I was up against a disabling neurological infectious disease. So for my illness it didn’t provide the answers (though reducing stress was one of the main factors that helped me recover to some degree). But it did provide the framework for me to finish the PhD: it helped me understand why I had been feeling so stressed before, and how I might respond better to acute stressors, and live well in stressful circumstances in general. Which writing a PhD is… Unlike extreme illness scenarios such as mine which are relatively rare, having to take time off from work because of stress-related illness or mental health problems happens to more people than you care to know at some point in their academic career. It’s a silent epidemic: no-one talks about it. I became all the more aware of these issues when I was searching for answers of my own.

Q: How prevalent is stress-related illness and/ or mental health problems among PhDs?
A: The overall picture doesn’t look so good. What we know from recent studies is that around 50% of PhD students suffer from ‘psychological distress’, while 30-40% is ‘at risk of common psychiatric disorders’ (think depression and anxiety). These figures are ridiculously high. Three studies: one at Berkeley, one in Flanders and one at Leiden University all show the same distressing picture. Causality is always a complex issues, but I would argue that high stress levels are a major component in explaining these figures. If we can figure out how to lower our stress levels, and respond better to stress, live with it in a different way, perhaps it will affect us less negatively. (Only talking about what we can do individually here. The real problems are structural and should be addressed by our universities…but that’s a whole different topic).

Q: What would you say were the major stressors when you were writing your PhD?
A: Where to begin? It is important to understand that academia is a high-stress and, even more importantly, chronic-stress environment. This isn’t necessarily about workload, although it plays a role. The more important factors for stress levels are a sense of not being in control of outcomes (think long-term projects, little control over publications, few short-term rewards, a highly competitive job market based on those elusive publications, financial pressures etc.) and feeling undervalued and unsupported (lacking supervision, destructive criticism, competitive environment). Stress is not about capability. Don’t believe anyone who tells you otherwise.

But there are always particulars. These were mine:

The directly work-related factors:

• The feeling of being ‘behind on schedule’ – always chasing my own tail. It took quite a long time before I got clear on my research questions and methodology, and I felt I wasted a lot of precious time. I was two years into the PhD programme before I got clear on what the hell I was doing. My supervisor reinforced this feeling of being ‘behind’ by stressing ‘I had a lot to do’ every single time we met (not that that was often, mind you). Strangely enough, no matter how much work I got done, this didn’t change either his or my own perception of my lagging behind. The last time I met him, the summer before I defended, he said he was concerned that although the quality of my work was high, my work was still a little too ‘slim’. I told him I had just done a word count and it counted over 80.000 words, and that was without the conclusion I still had to write. He immediately told me I should really make sure I didn’t add much more! Somehow he had an out-dated perception of my work, based on my output being very slim in the first two years of the PhD programme. He couldn’t see what I had actually done now, and kept projecting my slow start onto my current work. And I did the same to myself before I got ill. It felt as if my work was never good enough. And even if it was good, it was never enough. That’s a really whacked-out and destructive mind-set. (File under: not feeling in control, amplified by my supervisor.)
  
•  A strained relationship with my supervisor. There were a number of reasons that supervision wasn’t as great as I had hoped. In a nut-shell: I felt pressured by my supervisor, but I hardly got any feedback on my thesis. He was absent, evasive. The feedback I did get often felt either dismissive (‘It’s fine’ or, the way I translated it: ‘I didn’t have time to read it properly’) or critical of minor details while seeming to miss the main point of the chapter (‘You should use different colours in your graphs. They are difficult to read’ Or, the way I translated it: ‘I didn’t have time to read your work and really reflect on what you have done, so I’ll just nit-pick about any obvious imperfections’). Often the feedback was mostly pressure to work harder, rather than substantive. My supervisor was a bit of a political science superstar, interested in my topic, and knowledgable on parts of it, but it wasn’t really his field. Combine that with him being overcommitted and stretched for time, and you can see why the feedback I received wasn’t always as elaborate as I’d have liked.In the last year of my thesis his behaviour became inexcusable. I had to wait for months (four to be precise) for feedback on the first chapter I finished after I got back on track after falling ill. It made me feel like I wasn’t worthy of his time and attention, and he didn’t really care whether I finished my thesis or not. Similarly, when I flew out to Italy to meet up to discuss my progress for the first time after four years of absence, my supervisor hadn’t read my work. The lack of feedback and engagement, combined with his continuous remarks that I should ‘work hard’ and ‘had so much to do’ were a serious stressor.My own part in these dynamics: I wasn’t very assertive when it came to ‘cornering’ my professor, a practice I now highly recommend when dealing with overcommitted and evasive professors (shouldn’t be necessary, but often is). I also didn’t have realistic expectations of supervision, and didn’t really know how to get the most out of the supervision relationship. Being clear on what you want and need is so important. That said, it’s not always easy to be assertive, especially when power is skewed in a relationship. (File under: feeling undervalued. I felt unsafe.)(Interestingly, in the Leiden study mentioned above, ‘satisfaction with the supervisor’ is a significant predictor of mental health problems – hmm food for thought).
• Insecurity about what I was doing. I don’t have a background in political science, which made me insecure about my work. For this reason I spent far too much time ‘underground’, not sharing my work or asking for feedback. I didn’t quite believe in myself and in my work yet. Big mistake. Second-guessing yourself continuously is the fast track to stress and feeling depressed, deflated and depleted. At the same time the academic environment can be intimidating and competitive, which isn’t conducive to openly sharing your still shaky work… (File under: not feeling in control.)

The non-work related factors:

• Being in a long-distance relationship doesn’t help. I am all too familiar with the two-body problem. It was a major stressor.
• Inability to relax at home. I shared a flat with three Italians. The first two years or so were great. Italian Sunday lunches around the kitchen table, the best homemade tiramisu, the kitchen filled with family and friends! What was not to love?Things changed when a flatmate moved in I didn’t get along with. I realised the novelty had worn off, and I was no longer enjoying the Italian-style, ‘family over privacy’-living arrangement. Still, I did not take this discomfort seriously enough to put my work on hold for a week or two to find a new flat and move.
• Inability to relax outside the house. I was a young blond woman in Italy and I got a lot of grief. Nice compliments too, mind you, but I got groped regularly, when I was waiting for the bus or walking home. In the end I didn’t enjoy leaving the house much. It didn’t feel care-free.
• Lack of a social life. I did have a handful of friends in Florence, but my life was very work-centred. And so was the life of my friends and colleagues. It was strange. I cannot explain why, but somehow my social life was arid. The EUI is a place where people come and go all the time, that definitely had something to do with it.

Q: Let’s talk about how you finished your PhD. What did you do differently the second time, when you re-entered the programme?
A: There was no ‘grand design’, but I knew I had to do things differently.

• In hindsight I think the most important change I made was to prioritise. I had to work with severe energy limits, which forced me to ask myself: what is the most important thing I can do today to move my work forward? I had to forget about the rest, because there was no energy for ‘the rest’. Dealing with these limitations was extremely frustrating. I didn’t want to do one small thing a day. I wanted to do ten big things! But I couldn’t. It was out of the question. So everything that was remotely unnecessary or that could get me side-tracked went out of the window. No energy to waste: on with the important core activities! To my surprise this new approach didn’t lead to cutting corners. On the contrary, by focusing only on the very important issues, my work gained in focus and clarity.
• The second most important thing was that I stopped second-guessing myself. I had all the odds stacked against me, and I simply couldn’t deal with another obstacle in the form of self-criticism. I felt lousy enough without all of that. It was a profound decision to get out of my own way. From then on, when I felt insecure about some element of my work or if I felt I could have done things ‘better’, I would not make matters worse by criticising myself. Naturally, I didn’t always succeed, and I didn’t become a glowing confident scholar overnight. But in the end, most notably at my defence, I realised that I felt comfortable and confident discussing my work. I owned it. And I had earned every bit of it.
• Thirdly, I started working in intervals, alternating between focused bursts of work and periods of relaxation. It speeded me up (even if it didn’t feel that way) more than anything else.
• Fourthly, I set up many practices to balance work and recovery. I found a yoga class I loved, I worked with a physical therapist to improve my fitness level, and I also went to see a wonderful shiatsu massage therapist occasionally to relax and let go. In addition I had a therapist I really trusted. My visits to her became less frequent over the years, but I knew I had someone to talk things over with if I needed to.

There were many more changes, but this is the top four.