PhDs in Therapy

• Academics and Mental Health
• Opening Doors with Online Therapy
• The First Session
• Shame in Academia
• The Work Continues

Academics and Mental Health

My online psychotherapy practice attracts PhD candidates from around the world. Young academics are passionate people—articulate, often self-aware, intelligent, and eager to learn. But one would not guess how much this population suffers from poor mental health, how exposed and fragile they can actually be.

Research on occupational stress amongst academics indicates that it is widespread, with younger academics experiencing more mental health issues than their older counterparts. A recent Belgian study suggests that PhD students are 2.4 times more likely to develop a psychiatric disorder than the highly educated general population.

Other studies show that as much as 50 percent of doctoral students leave graduate school without finishing; it is reasonable to imagine that mental health issues play a major role in such an attrition rate.

Young academics are often reluctant to disclose mental health problems to their universities out of fear of stigmatization and punishment in the highly competitive academic world. PhD candidates who do their fieldwork abroad are particularly vulnerable. Not only do they feel a high pressure to achieve their fieldwork, but they also lose their social support system and have to adapt to a different culture.

Opening Doors with Online Therapy

Online therapy can be a unique opportunity for postgraduates to get support and resolve some developmental issues.

This vignette illustrates such a case.

When Jane engaged in online therapy with me, she was in the third year of her PhD program from a top American University. She was studying literary theory, and her fieldwork had just brought her to St. Petersburg, on the trail of the Russian thinker Michail Bakhtin and his main object of fascination—Dostoevsky. This city, affectionately called “Piter” by the locals, happens to be the one where I grew up before leaving Russia in my late teens. A bit of nostalgia was triggered inside me.

Jane had arrived in St. Petersburg in November. It had greeted her with gale-force winds and freezing weather, even worse than what she had imagined after reading the novels of Pushkin, Gogol, and Dostoevsky. At first she had been excited to discover its canals and lightless courtyards (kolodzi or “well-yards” in Russian) hidden in the middle of buildings, but after the first months, her fascination with the place was replaced by a lingering anxiety that she was not yet able to understand.

For our first session, Jane connected from the room that she was subletting in a big kommunalka, or shared apartment. The room was dark except for a surprisingly green wall gleaming behind her back, where she sat barely illuminated by the Russian winter’s scant natural light. Jane was slowly plunging into depression, which was draining all joy out of her research and her life. The faculty members she had met at the local university had first seemed friendly enough, but now she was avoiding any contact with anybody who could ask her questions about her research progress or about anything else for that matter.

The only window in her room was facing the plain yellowish wall of another building. If at first this grim view on the bare well-yard had reminded her of Dostoyevsky, it now felt like a metaphor for her current life prospects—long, dark Russian winter, loneliness in this foreign place, and a very uncertain outlook for a career in academia.

The day before she reached out for therapy, Jane had found herself sitting on the windowsill, looking down upon the dirty snow, and imagining her body lying in the middle of the well-yard, covered with her quickly freezing blood.

Now we were starting our first session, and she greeted me in Russian:

“Zdravstvuite.”

After a few minutes, I could sense that she was struggling, looking for words to describe the way she felt. As is often the case with bilingual individuals, we spent some time in this first session exploring Jane’s relationship with her two languages. Her Russian had developed through academic work, becoming her language of organized thought; when she wanted to describe her feelings, we had to switch to English. This going back and forth between the two languages allowed us to make better sense of her experience.

Soon we settled into our linguistic routine, using either language according to the subject. As with many emigrants, this arrangement suited us both, letting our multiple selves into the encounter.

Jane spoke Russian the way linguists often do—with unnatural care and respect for its intricate grammar. Strictly speaking, Russian was her mother tongue, but her mother had always been emotionally disconnected from her, and preferred to speak to her daughter in a limited English, without nuances but enough to give orders or rebukes. In high school, Jane then learned proper Russian, a language that she had until then perceived as unsophisticated.

Her father was a Texan estate developer. He had met his wife during one of his visits to Kazakhstan, where he had high-risk-high-reward investments. Jane’s mother was at that time young and beautiful; her secretary job was just a step towards her glorious future, where she knew she would have a shiny red car and a penthouse with views on skyscrapers gleaming in the night.

When Jane was born, her mother had already experienced deep disillusionment with life in general and her husband in particular. Texas was nothing like she had imagined, except for the consolation of owning her shiny red car; she used to drive on the endless dusty roads with fury.

As Jane grew up, she only added to her mother’s disappointments: she was neither beautiful nor particularly gifted for any girlish activities. Her academic achievements did little to change her mother’s opinion that she had been thwarted by fate in her motherly aspirations.

By the time Jane turned twelve, her father had lost most of his estate investments. She could remember him drinking whisky and grumbling about taxes and politics, only to rouse when his wife would come back home and scold him, provoking a fight. They both seemed to enjoy fighting, often loudly and in front of their daughter or other unwilling witnesses.

When Jane was accepted into a top university, her parents seemed relieved at the idea that she would finally be “out of the way.”

The First Session

In our first session Jane seemed withdrawn and extremely vulnerable. I wondered whether it was best for her to meet a therapist online. It probably was not, but she felt unable to get out of her flat and make it through the snow to the practice of one of the few English-speaking therapists available locally.

Looking through the dark window in front of her, Jane told me that she felt lonely and homesick. The homesickness felt even worse because she did not have a proper home back in the States any more. This feeling of homesickness paradoxically associated with the experience of homelessness resonated with me.

Her college friends were spread all around the country, busy with their own research or jobs. During her first months in Russia, she had managed to maintain the illusion of contact with some of them through Skype or WhatsApp, but now the calls were becoming rare. Maybe they had lost interest in her; maybe they never had any genuine interest at all. She had started doubting everybody and everything. Her parents had not paid her a visit.

And for several months, her academic advisor had not even been responding to her emails. Jane felt hurt and humiliated by this lack of interest from someone who had initially seemed so supportive and enthusiastic about her research. Her advisor was a middle-aged woman known for her feminist views and a difficult character.

Jane complained that her advisor’s silent ghost seemed settled at the end of her desk, at the other end of the room. Jane had been unable to sit there for days, and preferred to connect for our sessions from her sofa bed, crumbling under books and printed papers that she was unable to read or remove, even though sleeping in the middle of this improvised library—“the den,” as she called it—was becoming tricky.

As Jane was lying low in her den, the ghost was comfortably occupying her desk—an ever disapproving and punitive presence. Each time she tried to formulate a thought and write it down, she could sense, almost physically, the imaginary advisor winking in distaste at her poor efforts; simply knowing that the results would never be good enough. This room that Jane seemed to share with her imaginary advisor was suffocating, but the anxiety she felt at the thought of getting out was even worse.

As Jane described her advisor’s malefic ghost, I asked how its presence made her feel.

Alienated, confused… little.

As we explored these feelings, Jane’s usually calm face changed. She looked like a young and very upset child.

Have you ever felt like this before?

She had; it was a strangely familiar feeling when she curled up in her den, sucking her thumb at times she confessed. This is how she used to sooth herself, alone in her childhood room, when her mother was annoyed with her for some reason, or busy exercising.

As a child Jane often secretly thought that she had been born to these particular parents by mistake: she had little or no affinity with either of them. Roald Dahl’s character Matilda resonated deeply with her.

Jane had had as little choice when an academic advisor had been allocated to her, as she had had in choosing her own mother. She actually resented both of them. The awareness of her dependence on her advisor was producing a deep anxiety—the same she used to feel when she was dependent on her mother. This time the advisor seemed to be failing her in the same way her mother had done before, and this resonance made Jane’s anger even more overwhelming.

I knew first hand how the supervisory relationship, not unlike the therapeutic one, has the potential to repeat earlier traumatic experiences.

Shame in Academia

This incident opened a door into what would become the most important part of Jane’s therapy: working with and through her shame, towards a better sense of self and higher self-esteem.

During her first steps in academia, Jane had quickly learnt that she had to justify her every word or thought. Entry into the academic environment can trigger a feeling of shame in newcomers. It is easy to feel small and under-developed when entering a community of seasoned academics that you look up to: a dwarf in the presence of giants.

Jane would spend hours imagining how her advisor and other committee members would “laugh in her face” as she presented before them. At night, she would stay awake picturing the most humiliating scenes of her academic fall made public.

As Jane was describing how little, insignificant and defective she often felt, despite her obvious academic success, it became clear that this was a familiar emotional experience for her. She had felt this way many times before. As a little girl, she idealized her mother—a beautiful, tall, elegant, and snobbish woman. She remembered how proud she had felt of her mother as her primary school mates were admiring her beauty and expensive clothes. But as she grew up, her mother lost interest in her; Jane’s awe was replaced by disappointment. Why didn’t her adored mom like her? Did it mean that something was wrong with her? A feeling of not being good enough, not likable, had put roots in her very nature. This shame was later exacerbated by the tough rules of the academic world.

A few months into our work, Jane’s mother announced that she would be visiting her in Russia. Jane felt disorientated and anxious. She thought that her mother must have been bored with her Texan life. But I could also sense how the little girl in her craved her mom’s attention; Jane was still hoping that her mother might end up appreciating her.

She went to pick her up at the airport. The first comment her mother made brought back the past: the airport hall looked provincial and rather under-equipped for a city praised by all touristic guides for its “emperor glory.” When they reached the luxurious hotel her mother had booked and sat together in the bar, facing the straight line of the Nevsky Prospect, Jane was already dreading the days to come. Looking at the middle-aged heavily made up woman, Jane realized that, however familiar she appeared, she did not really know her. In her bright yellow jacket, her mother looked strangely foreign. When Jane tentatively switched to Russian, she did not seem to notice, and carried on talking in her consistently poor English: Jane’s hope for acknowledgement of her efforts and progress in her mother’s tongue were vanishing. A young waiter came to take their order and smiled at Jane; she could not avoid noticing how her mother’s face froze.

When Jane finally heard her mother talking in Russian to people in shops and restaurants, she was shocked by the poverty of her vocabulary and the unpleasant notes of a foreign accent—maybe consciously produced by her Americanized mother.

Later on, reflecting on our use of Russian in therapy, Jane acknowledged that communicating in her mother tongue within a warm and genuine relationship was a meaningful experience to her. For a long time she had been reading about literary characters’ feelings in Russian; to speak about her own feelings in Russian to somebody genuinely interested was new to her. Putting her childhood experiences of loneliness and hurt into words in Russian moved something deeper inside her: she was now able to express anger towards her academic supervisor, but also acknowledge the anger she felt towards her mother.

The Work Continues

We eventually survived the winter together. As the days got longer and the first rays of a shy April sun illuminated Jane’s room, her shame seemed to lift. She washed her sole window for the first time since she had moved in, and realized that she did not feel any desire to fall. The snow underneath was starting to melt, and she noticed a neighbor looking at her from a window on the opposite side of the yard. She had never noticed any signs of life in that window before. As their eyes briefly met, she felt strangely alive.

Spring brought its own anxieties. Jane’s academic clock was ticking, and she had only a few months left to complete her fieldwork. Even if she now saw her adviser in a much less grim light, the support she was getting from her was scarce and inconsistent. The White Nights kicked in, and Jane lost sleep again over her work. Researching contemporary Bakhtinian thought, she was trying to contact the academics who saw themselves as his followers. The risk she was taking in reaching out to this closed circle triggered familiar shame: Jane was convinced that these seasoned academics would never take her seriously, and her Russian was certainly not good enough.

We had a session just before she was due to present her research project to this group, hoping to convince them to participate. Jane kept picturing how they would look bored or even leave the room before she could finish. She was particularly intimidated by one of them. This older professor looked like Bakhtin himself—the same high forehead and the white beard. Jane was not sure whether this resemblance was a cultivated forgery or unconscious mimicry. When they first met, he had spoken so quickly and pretentiously that he made little sense to her.

Her mother’s constant absence, combined with the little interest she had shown in her daughter, had never allowed Jane to confront her.

It took us a while to reach a point where Jane felt ready to have a direct and honest conversation with her advisor. She learned that she had been grieving her husband’s recent death and was being treated for depression. After this conversation, her advisor’s ghost dwindled and eventually left her desk, making space for her own thoughts. Her research journal came back to life and Jane’s eyes sparkled again when she spoke about her work.

One day Jane did not switch her camera on as we began our session. She wanted audio-only. When I asked her why, she said she did not feel well enough to shower or brush her hair. Or in essence, she felt too ugly and too unfit to be looked at. As she shared this with me, she cried. What Jane was painfully experiencing at that moment was a deep sense of inadequacy resulting in feelings of shame. To let me witness her shame felt unbearable to her; she was terrified to recognize in my eyes the same disgust that she used to see in her mother’s gaze.

Eventually we agreed that she had to take this risk to dispel her shame. After a few minutes, she was able to switch the camera on: her face looked puffy from crying and very young.

My natural response was to give Jane a hug, but the limitations of the online therapy added to the natural ethical concerns around touching a client. This time I was painfully aware about the physical distance between us.

Jane was close to cancelling but she did not.

The meetings of their little group were informal and usually held in the apartment of one member or another. She was kindly asked to bring a cake to go along with the tea. As she rang the doorbell, she was close to fainting. Once inside, she was greeted by a giant St. Bernard dog, which managed to lick her on the nose. The laughter reaching her from the sitting room and the familiar smell of the books lining the walls of the corridor reassured her. Bakhtin’s twin brother’s wife—a tiny woman with sparkly blue eyes (also a former ballerina as she would learn later)—accepted the expensive cake with an evident pleasure and led her into the sitting room. The place was warm and the academics looked like old friends enjoying a tea together.

After an hour, she felt an almost painful sense of belonging; for the first time she was part of a welcoming family. They listened to her presentation with genuine interest, asked questions, and ended up having a heated and mostly inspiring argument in which Jane was able to take part. She forgot about the imperfections of her Russian and was able to enjoy this simple warm connection with her senior colleagues.

The inclusion and warmth Jane experienced at that meeting gave her a new boost. On her way home, Jane bumped into the blond neighbour. He was walking his scruffy dog beneath her windows. She spontaneously invited him in for tea. In bewilderment, she found out that he was a PhD candidate too, but in physics. It was a long night; his dog turned out to be a real cuddler and accepted her as a new friend.

I continued meeting with Jane for another year or so. She moved back to the US and started writing up her dissertation. Bakhtin’s twin brother died suddenly a few months after their encounter, and she returned to St. Petersburg to attend his funeral. His ballerina widow gave Jane some of her late husband’s books, insisting that such had been his wish. Jane cried and felt like an orphan. Grieving for the friend and mentor she had found in this old Russian philosopher made her question her relationship with her father.

In the meantime, his drinking had got worse. Jane went to visit. She needed only one dinner in his company to realize that he did not seem able to listen to anything she attempted to say and was clearly craving another drink. Once she returned from this disappointing trip back home, we had to mourn her hope of having at least one “good enough” parent.

In the process she finished her thesis and started teaching. This activity brought back the familiar feelings of shame, but her genuine interest in her students and her revived passion for Russian literature helped Jane to eventually enjoy her work.

The therapeutic relationship we developed helped Jane survive the definitive separation from her parents; their absence in her life was not plunging her in despair any more. She has finally been able to thrive in other close relationships—with her friends, colleagues and, finally, with her first supervisees. In our ending session she talked a lot about how much our relationship meant to her, but also about her desire to be there for her students. This filled me with warmth and gratitude—towards her, but also towards my own supervisors who were genuinely and consistently there for me. Their presence has been a real game changer for my own academic journey.

The path towards a PhD is never easy. It takes a lot of work but also a lot of daring. As any transitional stage of life, it abounds with demons that we must tame.

Jane is actually a fictional character inspired from many stories of PhD candidates whom I work with in my online psychotherapy practice, or during the course of my own PhD. I admire their courage, hard work, and passion for knowledge. These qualities are a great asset in therapy, which is a natural and inspiring companion for such a journey.

Reaching out for therapy online can help young academics to get the much-needed support, even when they are far away from home.

References

Bozeman, B. and Gaughan, M. (2011) "Job Satisfaction among University Faculty: Individual, Work, and Institutional Determinants," The Journal of Higher Education, 82(2), pp. 154-186.

Kinman, G. (2001) "Pressure Points: A review of research on stressors and strains in UK academics," Educational Psychology, 21(4), pp. 473-492.

Kinman, G. and Jones, F. (2003) ''Running Up the Down Escalator: Stressors and strains in UK academics," Quality in Higher Education, 9(1), pp. 21-38.

Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J. and Gisle, L. (2017) 'Work organization and mental health problems in PhD students," Research Policy, 46(4), pp. 868.

Lovitts, B.E. (2001) Leaving the Ivory Tower. The causes and Consequences of Departure From Doctoral Study. Rowman & Littlefield.

Shaw, C. (2015) http: //www.th eguardian.com/education /2015/ feb/13/un iversitystaff-scared- to-disclose-mental-health-problems (Accessed on 23/9/2017).

Walsh, J.P. and Lee, Y. (2015) "The bureaucratization of science," Research Policy, 44(8), pp. 1584-1600.

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