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Table 2 Thematic structure with illustrative quotes

From: Understanding the mental health of doctoral researchers: a mixed methods systematic review with meta-analysis and meta-synthesis

Higher order theme Subthemes Sub-theme detail and illustrative quotes
1. Always alone in the struggle
  Invisible, isolated and abandoned • Feeling invisible and isolated both within and outside the academic environment; ‘…you can go weeks without talking to anybody, even family’ [39] (p. 86).
• Friendships characterised by:
 ▪ Poor quality; ‘…[rarely extending] beyond self-interest and competitiveness and into a realm of personal exchange and interpersonal connectedness.’ [39] (p. 88).
 ▪ Competitiveness; ‘They’re all fighting amongst each other, thinking you're getting it a lot better than I am … and the effect is that none of these people are getting very much: they're scraping for crumbs on the table’ [36].
 ▪ Too shared a sense of experience; ‘…you share the same fears... they are too close to the problem.’ [39] (p. 78).
• Departments perceived as failing to support DR connectedness; ‘…when the department was going to create their web site, and there was a discussion about who should be listed. First, they said that the doctoral students shouldn’t be there because they don’t have permanent positions. It’s sick’ [37] (p. 103).
• Inclusion within departments is only fleeting or hollow; ‘…when they need people, then we’re included’ [37] (p. 103).
• DRs made sense of their isolation as being about their own ‘differentness’; ‘Most participants identified themselves as different from the norm, in the role of the other, in at least one meaningful way’ [74] (p. 20).
• The lack of inclusion reinforces broader messages about the nature of an academic career; ‘This lack of departmental community sent a powerful (unintended?) message that scholarly research is a solitary affair.’ [42] (p. 180).
• The sense of academia as isolated may lead DRs to opt out; ‘…this information may allow them to self-select out of a career in academia if they find that the department or faculty environment is not likely to provide the type of support they anticipate wanting during their career.’ [62] (p. 52).
• Isolation was also apparent in personal relationships, both social and psychological; ‘I’m very alone compared to my friends and family at home. Nobody knows what I go through, what I experience’ [74] (p. 24.)
  It’s not you, it’s me • DRs expressed a sense of sole responsibility for their PhD; ‘You just have to do your job alone without anyone to help you.’ [81] (p. 40).
• DRs felt responsible for finding ways to capture and sustain their supervisor/s attention; ‘I feel like a cog. I know she doesn’t mean to make me feel that way but she has other advisees who probably share more similar interests and some of them get more of her time.’ [74] (p. 20).
• DRs felt that they had to take full responsibility for their personal lives and prevent any personal intrusion into the professional; ‘…Ariunaa recounted a harrowing story of having spent three sleepless days and nights at the hospital with her son following a severe seizure. During that time she was unable to contact her husband or to eat because she had left her phone and wallet at home in her rush to meet the ambulance. Through her tears, Ariunaa explained that she had not told her supervisors this story—“Because that's just my life and I should … manage my life” (Ariunaa, 3, 2161).’ [42] (p. 183).
• DRs identified an archetypal DR and felt that they fell short of this ideal; ‘Mia spontaneously declared that she was not an “ideal doctoral student”’ [37] (p. 107), thus were not really for whom a PhD opportunity was intended; ‘…[the PhD is] something for the exceptionally gifted. The informants did not feel they belonged to this group’ [37] (p.100).
• DRs felt unsure about their capacity to do a PhD; “… insecurity about the doctoral students’ own capacity…expressed many times through reflections concerning internal and external demands (one’s own demands and those of others). Are my research results good enough? Am I good enough? Can I handle what’s expected of me?’ [37] (p. 107).
• DRs felt that their inadequacy was reflected back by supervisors; ‘…I worked hard, and read a lot of papers because of the fear of response of the supervisor… but unfortunately… I didn’t know the answers to his questions—and then he got more and more angry’ [41] (p. 235).
• Feeling that supervisors treated DRs as if they were inadequate was framed as a cue to work harder; ‘The only way to lower the anxiety is to get things done’ [76] (p. 79).
• DRs appeared to be continuously working toward but never achieving the DR ideal; ‘Say there are sixteen waking hours in a day. I should be working seventeen’ [76] (p. 64).
• The actual-ideal self discrepancy was associated with punitive self-talk; ‘It’s happened again. I can’t believe I’ve got myself in this position…. I got quite upset really, feeling like I’ve let everyone down again…I’ve just let things simmer rather than tackle this work as effectively as I could and there’s no-one to blame but myself.’ [38] (p. 128).
• Self-castigation appeared to be necessary but not sufficient attempt to motivate oneself to improve; ‘…it’s not enough to punish yourself or feel guilty, when you don’t meet a goal; you should notice the reasons for your failure to attain the goals in future’ [41] (p. 234).
• Internalisation of perceived failure culminated in DRs making sense of their current and future performance through a lens of inferiority; ‘[DR]: There are some doctoral students at the department who have really been given a lot. Whenever they‘ve wanted something, they‘ve got it. They‘ve gone on a lot of trips, and after they‘ve defended their thesis, they‘ve been offered posts, posts designed specially for them […] I don’t think they‘re going to do that for me. [Interviewer]: Why not? [DR]: I don’t know. I suppose that once again it has to do with the fact that I think everyone else is much better than I am.’ [37] (p. 104).
2. Death of personhood
  A sacrifice of personal identity • Enmeshment of self-identity and PhD; ‘…this program and what I am doing is essentially my life and everything else revolves around me doing this [PhD].’ [59] (p. 10).
• Priority placed on PhD activities to the detriment of personal relationships; ‘When we went into our honeymoon cabin so to speak, he [the DR’s husband] carried in bags that were very heavy and he said, “What’s in here?” They were filled with books, and he was quite upset about it. But, you know, you have to.’ [76] (p. 61).
• DRs had a sense of never being free of their PhD; ‘…they felt that their research was always hanging over them and giving them a guilty conscience. This can be seen as the negative side of the freedom experienced when doing research…there is no clear dividing line between work and leisure time.’ [37] (p. 107).
• Time spent on non-PhD activities, even basic activities of living, was seen as indulgent; ‘A guilt trip about eating, the time it takes to cook your meals, the time it takes to eat’ [37] (p. 77).
• Self and PhD identity enmeshment is associated with identify conflict; ‘Priscilla feels “it's almost like having split personality for me” in balancing her spiritual and academic priorities’ [59] (p. 7); ‘…all of my worlds are colliding’ [59] (p. 10).
• Friends and relatives provided an uncomfortable reflection of the DR’s changing identity; ‘None of them have Ph.D.s and I don’t want to have that elitism. I certainly don’t want to have that interfere with my friendships.’ [74] (p. 24).
DRs engaged in selective pruning of personal relationships as deemed necessary for future in academia; ‘I moved away from the person I had been seeing for almost two years and did not maintain the relationship … definitely a personal sacrifice. … I mean it is a trade-off, being married or having a full time partner because it’s great financially and emotionally when you’re really down in the dumps, but it’s also really bad [if one gets pregnant or has relationship issues] … that puts strain, that can prevent you from doing your work. So, I’ve sacrificed so that I can stay on track and stuff, so everybody’s like ‘Oh, you do so much … you do it so well’. But, I also don’t have a personal life.’ [40] (p. 147).
• The DR identity perceived as unclear and confusing; ‘Sometimes I consider myself still as a student when it comes to doing research and sometimes I already perceive to be an expert in my area.’ [81] (p. 41).
  Self as parasitic • DRs conceived of themselves as hindering or harmful to others; ‘I'm just a hindrance to others’ [81] (p. 40).
• Problems within the PhD could lead to a feeling of punishing close others; ‘…it seems that because I haven’t done the work I’m punishing her or that we have to make the decision that we don’t see each other because I’ve got this work to do. I think sometimes there does become an overlap and my mood can kind of transfer from one situation to the next.’ [38] (p. 128).
• DRs expressed concern that they had sacrificed own and familial financial solvency; ‘Students’ qualitative responses sometimes indicated concern that their own educational debt load would become an intergenerational burden and that they wrestled with the pros and cons of spending resources now on their own education versus being able to plan for their children’s educational futures’ [49] (p. 171).
  Death of self-agency • DRs expressed feeling overwhelmed by their thesis, ‘…it is a world of information and we may be engulfed by its huge Tsunami waves if we do not know how to boldly dive through this ocean of information …but AH! Unfortunately, it seems I am engulfed’ [46] (p. 19), which had the power to overwhelm or destroy; ‘As a result, the influences and demands within her doctoral program are “sucking the life outta [her]” or cause “crumbling”’ [59] (p. 9).
• DRs expressed a lack of personal power within academia generally; ‘There’s not much of a role to take, if you are nothing but at mercy of others.’ [81] (p. 40).
• Powerlessness was specifically evident in relation to supervisors; ‘I think it’s very natural to feel inadequate’ [39] (p. 79).
• DRs felt that supervisors did not treat them as holistic people; ‘No one ever asks, “How are you doing,” not even faculty or your advisor. The dialogue with staff is always very academic-focused, like, “How far are you on your paper,” “How much have you gotten done.”’ [39] (p. 94).
• DRs reported that their supervisors and other academics prioritised their own will above that of DRs; ‘I was trying to run some analyses in another lab. The professor in charge of that lab was willing to help me out, however he requested collaborative work in exchange (i.e. to be co-author). My supervisor didn’t like the idea and the samples were not analysed… My dissertation director approved my chapter and later removed approval after another member of my committee did not like the chapter. I felt betrayed by his failure to stand up for me.’ [62] (p. 49).
• DRs felt they were used as a means of research production; ‘I had an idea for research. I told my supervisor…and we came up with some ways of testing it…He told me he decided to submit the manuscript as the only author…This experience has left me not trusting my supervisor and I will not share research ideas with him again… Incompatible sense of ethics; was tired of being lied to and directed to do unethical things’ [62] (p. 50).
• DRs felt that retaining their self-agency might be incompatible with maintaining a positive supervisory relationship; ‘…it wasn't of any point to keep arguing with him you know … when you're arguing with a professor … the truth is you really have a lot to lose … so I just compromised … and then sort of we started developing a relationship … (Jack, 1, 260–286). Jack considered the role his supervisor assigned him (division of labour) inappropriate and face threatening. However, conscious of the power dynamics at work, he chose not to resist. Instead, he lowered his sights (object) and chose to focus on ‘just finishing’ the PhD: I guess there was a lot of ambition, but … you just reach a point where you don't really care anymore what happens, all you need to do is just … try to see if you can have the results and try to finish. (Jack, 2, 902–913)’ [42] (p. 183).
• DRs appeared to accept issues in their supervision without challenge in a resigned fashion; ‘Mary’s goal of improving her English was thwarted by her supervisor's decision to communicate only in Chinese, yet her respect for her supervisor prevented her from objecting. …. Ariunaa's decision to suppress her anxiety about her son may have been prompted by observing the ‘care-less’ (Lynch, 2010) culture of the academy which ‘values … competitive … and individualistic practices’ (Bansel, 2011, p. 552). Unfortunately, the ‘culture of silence’ reflected in Jack, Mary, Dev and Ariunaa's responses militates against change occurring in the AS [activity system] of doctoral education. Anecdotal evidence from the researcher's network of (local and international) doctoral students suggests that the tensions experienced by the participants are common, as are their reactions. Their silence may have less to do with culture than power.’ [42] (p. 184).
• DRs shared litanies of supervisory issues but appeared to silence themselves from explicitly criticising their supervisors; ‘Emily felt stressed and anxious trying to decide how to sequence her co-authors’ names in a forthcoming article: E: …now my co-authors are giving very different amount of inputs … and one of them is trying to keep the work just between me and him [laughs]. And it's very clear, like—“Let's just work, I know they are saying that, I know they think like that, but let’s just keep it between you and I, we’ll continue just sending it back and forth … Ok? And I know they think differently, you think differently, but now this is what we're going to do.” [laughs] [R: How do you feel about –?] E: [laughs] So that’s the situation. (Emily, 5, 593-629) Emily’s evasive response to the researcher's question may indicate her reluctance to blame her stress on her supervisor's behaviour (Mesquita & Frijda, 1992).’ [42] (p. 182).
• DRs expressed a lack of self-agency in being able to curate positive life circumstances generally; ‘…and basically I have no friends. I mean my contact with the rest of my family is gone. And that I regret. I don’t think that’s healthy. And I want to change that, but I can’t… don’t have the energy or the time to do that just now.’ [76] (p. 101).
• DRs appeared to feel a lack of self-agency in relation to curating a positive future; ‘…without an overall goal I find it very difficult to motivate myself to work’ [38] (p. 127), which undermined their current self-agency and motivation; ‘…then I think the most stressful thing is to think [that] I am doing all this and … there isn’t any certainty of a reward at the end or of job security at the end.’ [40] (p. 146).
3. The system is sick
  Most everyone’s mad here • Some DRs emphasised pervasive impact of their mental health problems; ‘I suffer from depression and it is a hard thing to overcome … it is a negative influence on my research and as an individual because you need to fight with something constantly to feel better. It is something you have to overcome constantly. It is an ongoing battle that is never going to end; it is like a constant obstacle in your career and in your personal life. (Participant 173, Latina female)’ [50] (p. 208-9).
• Some DRs provided more implicit examples of experiences of mental distress:
 ▪ ‘I had never experienced so much stress and anxiety during all my life. All systems of my body were disturbed. I was always crying because, I felt… I’m dying’ [41] (p. 236).
 ▪ ‘I feel depressed, sometimes I cannot do anything even no feeling to go outside’ [46] (p. 20).
 ▪ ‘I just think sometimes your bed’s your safe place so the longer I stay in there everything else isn’t that real.’ [38] (p. 130).
• DRs described a PhD-specific numbness-hypervigilance response; ‘…a duality in the outcomes of exposure to doctoral-level stressors explaining, “the usual stress coupled with not enough sleep can really take a toll on one’s mental and emotional health;” however, “little stressors no longer weigh me down like they used to.” (Enzor, 2017, p. 85), “…but some students were experiencing debilitating panic attacks when they received emails from their supervisors, things like that.”’ [39] (p. 83).
• DRs described a complex nexus of factors that could increase mental health vulnerability; ‘The financial issues, different issues that really, you know, affect your health, that really come together to form like a nexus’ [36] (p. 234).
• The PhD itself was described as a crucible for the development of mental health problems; ‘I think a lot of people in my program have dealt with very serious mental health issues and problems that were either because of the program or exacerbated by the program. It got to the point where the faculty had to have a serious conversation with the students because they realized that half the students were in therapy’ [39] (p. 83).
• DRs felt lucky if they did not experience mental health problems during the PhD; ‘I can understand how people with a mental health history may struggle in grad school because of its many demands, but I’ve been very lucky. I’ve been able to maintain good mental health’ [39] (p. 80).
• Supervisors and the system were seen to promote an expectation of DR suffering; ‘Katie mentioned a “proactive” approach to stress on multiple occasions throughout her interview; unfortunately, however, her portrayal of the prevailing attitudes within the doctoral learning environment was significantly more negative. She explained “you’re going to go into this and it is going to be very hard and nobody is going to support you and nobody really cares... this is the expectation that we are to suffer,” she elaborated, “I can’t think of anyone who hasn’t suffered in some way through the doctoral process.”’ [39] (p. 87).
• Academics were perceived as uncaring with regard to the mental toll of doing a PhD; ‘… some of the professors could be more conscientious of the psychological toll it can take on their students…Caroline declared, “especially for a psychology program, they [faculty and staff] should be much more aware of the psychological issues that come with being in such a stressful program”’ [39] (p. 81).
• The cycle of indigenousness of mental health problems was maintained by poor mental health literacy and lack of mental health and support provision; ‘Caroline: “I think we are afforded them [mental health services], I just haven’t taken advantage of it, even though I probably should have. Things might have been easier for me had I sought out the services, but I didn’t.” Dana: “I don’t know if we have any programs that specifically focus on mental health within our doctoral program.” … Isabelle: “I’m not sure I’ve ever looked into it [mental health services]. I know we have them but I don’t know how to access them.”’ [39] (p. 93).
• DRs felt let down by the system; ‘…people (should not) feel as if they are losing their minds’ [59] (p. 8), feeling that there was widespread denial of DR mental health problems; ‘I just think that, like, doctoral programs in general just create a lot of anxieties in students who probably are thinking faculty could do more to help with that.’ [39] (p. 82).
• DRs felt that the systemic encouragement of unhealthy lifestyles was tantamount to abuse; ‘The abuse I experienced is hard to characterize, especially in a survey form. It took me a long time to understand what was going on because its style was so insidious - being told that to survive in this profession one had to sleep 4 hours a night, or give one’s whole life, 12-hour days at full speed to the profession’ [62] (p. 51).
  A performance of optimum suffering • DRs felt that they had to show the right amount of stress and distress or else be perceived as not taking their PhD seriously enough; ‘Some students felt they had to hide their personal lives from the faculty and other students. Taking evenings off, going to the beach, or spending an evening in a bar would be frowned upon by faculty. One man in a gender-balanced programme said: ‘I wouldn’t ever want to come back after a weekend with a tan or something. … That would be really uncool because it would mean that I was doing something fun over the weekend.’ [40] (p. 147).
• DRs felt that they should not present themselves as intellectually inferior:
 ▪ ‘…you don’t want to say, I have no idea, I don’t know the steps I’m suppose[d] to take, and I know I should know them, so, people don’t say that’ [76] (p. 83).
 ▪ ‘In some classes, it’s a very competitive atmosphere, right, you don't open your mouth unless you have something absolutely brilliant to say’ [36] (p. 235).
• DRs felt that they should broadly avoid showing vulnerability; ‘I do my best to pretend [my illness] isn’t a factor. But, there are times I am just tired, or not feeling well from the medication that was supposed to cure my other ailment. I’m not a whiner, but it’s not always easy to hide my illness. I don’t want people to view me differently—more differently than I already view myself.’ [74] (p. 25).
• Disclosure of mental or physical health problems was perceived as resulting in changed perceptions and potential disadvantage; ‘I feel a need to put on a grin and bounce around the department because I have seen things handed out to people on a silver platter and I want that too.’ [74] (p. 25).
• DRs felt that poor responses to mental health disclosures might reflect universities trying to dissuade these DRs from continuing in academia; ‘You’ve noticed that I’ve been depressed for two years, and you’ve noticed that I couldn’t handle that other stuff, so why are you—are you purposely trying to just weed me out?’ [74] (p. 23).
  Emperor’s new clothes • Supervisors often appeared to be the conduit for transmitting an academic ideal; ‘My advisor keeps telling me that [my family and I] should move for my job once I graduate because I will be the higher-earning spouse. But my husband is also successful. Yeah, I might make more money in my field, but my marriage has already suffered as a result of me pursuing my doctoral degree. I don’t think it can withstand a move that’s on me, for my career, regardless of how hard I’ve worked.’ [74] (p. 24).
• DRs felt that valuing teaching was non-conformist and potentially dangerous; ‘While I do accept that research is important, I also believe teaching is equally so. But I can’t say it too much as it could jeopardize the chances of my contract being renewed.’ … One respondent mentioned the heightened anxieties that occurred due to a need to conform: Essentially, even when I don’t agree, I must comply or risk not finishing my program. As far as personal feelings, I live in a state of heightened anxieties, and need to conform to finish as quickly as humanly possible [55]. (p. 341).
• DRs reported a dissonance between their personal and wider institutional values; ‘I struggle with the combination of my passion and ability. I can do the research, but do I enjoy the research to the level I need to if my entire professional career and reputation is based on it? I don’t know. I am struggling with that very question. But, God forbid I actually admit my thoughts to anyone.’ [74] (p. 21).
• DRs reported feeling powerless and caught up in institutional values; ‘It’s easy to drink the Kool-Aid here, to buy into the mantra that I must aim to be a researcher in a top research university. At times, I find myself sucked into this. Other times, I feel resentful that the faculty in this department feel it’s their place to decide what we do with our lives.’ [74] (p. 21).
• Feeling inauthentic when acting in line with institutional values had a high psychological toll; ‘The need to get along with a supervisor, to conform and to support institutional values was clearly expressed, and the use of such self-presentation behaviours created feelings of frustration, heightened anxieties and role stress—all which contribute to emotional exhaustion.’ [55] (p. 341).
• DRs sensed disapproval when they acted in ways that could suggest values other than related to a research career; ‘I remember one telling me when I was pregnant that obviously I wasn’t taking it [her studies] seriously, and I thought, who the fuck is taking it more seriously? I mean, this is killing me.’ [76] (p. 93).
• DRs felt unable to challenge institutional myths, such as the perceived institutional denial of the level of financial struggle involved in a PhD; ‘Students repeatedly explained that expenses and costs of living are not adequately covered by scholarships, stipends, tuition remission, and fellowships. One student asked, “So, how do they think people live?” These concerns led to some very expressive reactions to leaders’ suggestions concerning financial and budget-management counselling. It was deemed a “very elitist sentiment” by one, coming from a position of privilege, and that it was disenfranchising. The responses indicated that the problem is not knowing how to handle one’s finances but that the resources, no matter how well managed, are just not adequate to cover expenses.”’ [49] (p. 170).
  Beware the invisible and visible walls • DRs felt that their success in academia rested on their ability to negotiate situational norms and rules; ‘…it was challenging to learn how to navigate the process, how to play the game.’ [39] (p. 87).
• DRs felt vulnerable to being caught up in institutional conflicts; ‘…[if a student] is not aware of this minefield of political interests in the department, they can be hurt, not because people intend to, but just as a fallout of how faculty relate to each other’ [36] (p. 236).
• DRs perceived academics and departments as poor at resolving conflicts; ‘…already during the postgraduate studies there are some things that could be thought of as ‘glass walls’ in the form of norms and values according to which the doctoral students learn to conduct themselves. This is demonstrated, for example, in how conflict resolution works in their own department. Most doctoral students did not think their own department handled conflicts in a good way. They mainly thought that conflicts were covered up and not properly aired. Sometimes they felt that there were unexpressed conflicts and unwritten rules with which they were unacquainted, and which had originated from old conflicts that were still present.’ [37] (p. 107-8).
• DRs reported ambient anxiety and confusion over their own behaviour in the context of norm transgressions; ‘At seminars things happen that are difficult to comprehend until you have left the seminar. We had a horrible event, when this guy was completely humiliated by the opponent […] It got worse and worse. Nobody said anything. Nobody did anything. When we left the room it felt like we‘d participated in slaughtering him, and in a way we had, because nobody said anything.’ [37] (p. 105).
• Gendered and racial micropolitics were evident; ‘So I think any student who wants to make a complaint or lodge anything formal, unless you're some white person who thinks or knows, hey, these institutions are here to serve me, then fine, let them go ahead. They are privileged to think that; I don't, because I know it'll be the opposite.’ [36] (p. 235).
• Women and people of colour felt excluded or disadvantaged in visible and invisible ways; ‘It’s kind of elusive; it’s more a feeling somewhere in my head, so I can’t point to any specific events. It’s hard to know if it’s because I have a low position in the hierarchy or if it’s because I’m a woman […] but I often get this vague feeling that if I’d been a man, they wouldn’t interrupt me the way they do.’ [37] (p. 105-6).
• It is possible to experience insider and outsider status simultaneously; ‘I am a[n African Canadian] man, these [faculty members] are European women’…she [the professor] and I went at it verbally in class… I didn't think it was worth the trouble [to make a formal complaint], and I thought that by virtue of being a man I was able to defend myself … She was stopped because I invoked male power’ [36] (p. 235).
• Female DRs expressed feeling greater pressure and obligation both within and outside academia; ‘In the present study some of the informants reflected upon a kind of social responsibility. This is expressed, for example by Sanna: It’s especially the case for us female doctoral students. We can’t work if someone in the next room is crying. Some of the guys can’t either, while others don’t care about anything. They simply close their doors and write their thesis and now they’ve finished. That puts me under great stress’ [37] (p. 105).
• Female DRs suggested they had to take on additional roles and responsibilities compared to males; ‘Different from males, we females are overburdened by house chores and other social life issues… When I try to compare myself, even though I have the capacity to do many things, I refrain from them as I have limited time to concentrate on my study. Even if I limited myself from other works which could have helped me get some more money, the time I have for my study is very much limited when compared to that of males’ [52] (p. 293).
• Examples of successful women were those who had adopted a more traditional male role; ‘I think women in this field tend to be different from women at large. You know … I think they share a lot of the same traits as the males who are in this field. They are very driven’ [40] (p. 144).
4. Seeing, being and becoming
  De-programming • DRs spoke of rejecting the belief they should sacrifice personal relationships and identities; ‘One student in a male-dominated programme said she was not impressed by her advisor’s boasting of having only taken Christmas day off when he first began his career. She did not consider neglecting a family for a career as admirable. She and other students, mostly women, did not think they could devote themselves entirely to the tenure-track lifestyle. A number of men also stressed that it was important and often more enjoyable to be with their families than to be singularly focused on work.’ [40] (p. 150).
• De-programming from prioritising academia above all was associated with greater confidence, career commitment and motivation; ‘…students reported the greatest confidence and motivation when faculty validated the importance of personal relationships and family matters, and helped students find a balance between their personal and professional lives.’ [40] (p. 152).
• DRs suggested it possible to de-program from preoccupation with the ‘invisible walls’ of academia; ‘Certainly there is the [Professor A] camp and there is the [Professor B] camp and I am aware of that. … Has it affected me? No, I did my business [and] I try not to get involved in any conflicts. I don't know, some people would say I had my head in the sand, but, I mean, you have to kind of do what [you have to do]’ [36] (p. 236).
• Interaction with people outside of academia was seen to scaffold de-programming; ‘It has been helpful to have this main girl [Caroline’s best friend] not be in my doctoral program so I can complain about it and she can give me an unbiased opinion’ [39] (p. 80).
• De-programming also manifested as challenging perfectionistic beliefs; ‘I didn’t try to be the best; I tried to get through’ [40] (p. 146), and re-framing goals; ‘…you’ve gotta have your hands in several baskets and deal with them simultaneously and accept that all the baskets aren’t going to be nicely wrapped up in nice packages and on the due date’ [76] (p. 94).
• Uncertainty can be re-framed as a privilege; ‘I have the right not to know yet…the privilege of asking questions and getting answers and supervision’ [81] (p. 41).
• The PhD can be seen as an opportunity rather than a test; ‘Different doctoral students experience the academic field in different ways. For some, it feels like an arena with constantly ongoing battles, while for others it more closely resembles a pasture—a kind of a pasture of knowledge.’ [37] (p. 108).
• Not completing the PhD can be re-framed as a viable life choice; ‘I know that I can go anytime that I want…Yeah it’s a coping mechanism [having “one foot out the door”]’ [76] (p. 81).
  The power of being seen • DRs described powerful benefits to being seen:
 ▪ ‘An important component in the scientific room has to do with being seen—particularly by important key persons, “significant others”—people of importance to the informants on their journey towards a PhD degree. In the academic world this could be expressed as, “I’m seen, therefore I exist”’ [37] (p. 101).
 ▪ ‘Sanna focused mostly on the second aspect of the concept of seeing. In that her supervisor said that her area of research was important, she therefore felt some kind of security because she was seen by a key person at the department.’ [37] (p. 102).
• Disciplinary communities could provide a needed sense of being seen; ‘Emily was the only participant, however, to speak about a strong sense of disciplinary community in Australia. By participating in conferences and co-authoring a journal article she obtained: E: … good feedback … it gives you this confidence and … I feel I'm being … taken care of in this [name of discipline] community very well in Australia. I don't know what happened where exactly it came but … I feel they … want to care about me. I don't feel it's everyone's case …I'm realising that … I'm in good hands and I have good people around me … they must—they believe in me, that's the thing.’ [42] (p. 180).
• Positive engagement with the academic community was scaffolded by a sense of trust in the supervisor; ‘[I see the relation with the community] as both responsible and challenging but on the other hand as safe, because I fully trust my supervisor’s ability to evaluate the quality of my work.’ [81] (p. 41).
• Spending time with peers could provide a sense of shared experience; ‘Betty continued, “We have been afforded this beautiful opportunity to walk beside each other through this program and that is something I don’t take for granted and neither does she.”’ [39] (p. 79).
• Friendship was seen to buffer stress and protect against mental health problems; ‘…an intimate, best friendship may function as a mental health protective factor due to the best friend’s capacity to recognize any emerging mental health issues of their friend who is immersed in doctoral study, even if they, too, are enrolled in a doctoral program, based upon the familiarity and camaraderie within the relationship. Such protective elements of having a best friendship were detailed by the participants through the following statements: [Allen]: “My best friend knows me very well, he knows my history very well”. [Betty]: “She is very consistent and faithful, she is very intentional and following up with things, she always asks me how I’m doing. She knows how to dig deeper and to get me to really open up and share my feelings.”’ [39] (p. 94).
• Designated physical spaces seem important to being seen; ‘In her story, Kim described a feeling of being deserted when she began her research. She said it took at least two years before she grasped what she was supposed to do, and that this had felt horrible. Gradually, however, the situation changed. Kim started to spend more time at the department and established a physical presence there—she took over an empty desk—and she began to be seen more. She established more contact with others at the department and started to meet her supervisor more often.’ [37] (p. 102).
• Peers within the university could provide physical embodiments of being seen:
 ▪ ‘Marianne, who initially had not belonged to a research group but who was now a part of a group, described different examples indicating that she now felt a sense of belonging. One example was when she had been on holiday, and found a sign saying ‘Welcome home’ when she came back.’ [37] (p. 104).
 ▪ ‘[Interviewer: I see a photo of cardboard boxes] Those aren’t cardboard boxes - that is a castle! Can’t you see the castle!? (laughs) It has the arms symbol over it. While I was away on vacation it was my birthday, and when I came back the next week they [lab mates] had built this castle for me for a birthday present..’ [50] (p. 204).
• Close others outside the university can support DRs’ authenticity; ‘She is someone I can be myself with and not being concerned with formalities or expectations.’ [50] (p. 205).
• Pets could support feeling seen without requiring the expenditure of too much energy; ‘Pets provided love and support to students, without charging them for their time and without excessive communication… Pets made students feel special and important, at times when they might have felt insignificant and unappreciated..’ [50] (p. 207).
• With sufficient self-agency, DRs can see themselves and render themselves seen; ‘Marianne had held a seminar concerning her research. She described her experience of holding a seminar as rather affirmative. At the seminar Marianne was seen; people showed interest in what she said, and relevant questions were posed.’ [37] (p. 104).
  Multiple goals, roles and groups • Multiple role and activities appeared essential for protecting against mental health problems; ‘We could all very well do nothing but our school work and worry about presentations and like conferences, but we would probably go crazy and you would never get out of this program because the stress and everything else would probably kill you.’ [68] (p. 50).
• Leisure activities appear to support mental health through promoting physical health, buffering stress, uplifting mood and offering multiple identities; ‘…one (112, Latino male) reflected, “A lot of DRs forget to take care of themselves; I see it a lot. Science is important, but your body is more important.” …Activities served as an emotional and mental release for many doctoral learners, using informal and formal activities, such as fitness classes, dance, and television as their forms of catharsis. … Representative comment included: I am actually a part of the dance company, a ballet company on campus, …. so I might be a scientist, but I’m also a dancer, and I need to have time to be able to do that (Participant 117, Asian/Latina female, describing a photo of dancers’ legs).’ [50] (p. 207).
• Competing roles could support psychological separation from the PhD by requiring physical separation:
 ▪ ‘I go home and I leave work…I have a family’ [59] (p. 10).
 ▪ ‘…pets gave students someone to come home to, and forced them to venture outside of the laboratory and embrace nature and obligations beyond their PhD program.’ [50] (p. 207).
• Enjoyable and self-care activities provided a sense of balance and normalcy:
 ▪ ‘I just can’t emphasize enough the importance of balance. That is probably the biggest lesson I’ve learned so far. Through balance you maintain good, positive mental health.’ [39] (p. 80).
 ▪ ‘…a work-life balance has to exist for your health and your sanity.’ [68] (p. 48).
• All DRs appeared to benefit from treating the PhD as only one aspect of life; ‘On the other hand, for Stephanie, who is “not currently romantically involved,” well-being was maintained when she participated in activities “as if I have a life outside of the work I’m doing.”’ [59] (p. 10).
• Additional roles and activities render not completing the PhD as less averse; ‘A woman in a gender-balanced programme with one child and a second expected said she was less stressed than others in her programme without families because she was ‘not putting all my eggs into one basket’.’ [40] (p. 148).
  Finding hope, meaning and authenticity • Finding hopefulness and meaning in the PhD can scaffold purpose, enjoyment, and authenticity; ‘The background is chaotic, right? Chaotic, a lot of motion, and then in the foreground is a caravan moving through the desert and everything seems serene and ordered, and you see the stars and so much beauty. And I think this is how I would describe myself, that I am on a pilgrimage, like the caravan in the desert, and I strive to be at peace and have a sense of order in the midst of a world that is very chaotic and seems to be moving around seemingly without purpose. And I think I strive to be an example of the fact that we do have a sense of purpose and we are moving toward it very slowly but with purposefully and with great peace and serenity. (Participant 190, Asian male)’ [50] (p. 210).
• Hopefulness is predicated on identifying a goal; ‘Stephanie states, “I can see myself walking across the stage” which gives Stephanie a larger view of her actions in a positive light that affects her well-being in a positive manner.’ [59] (p. 11).
• Hopefulness is enhanced by breaking tasks down into small steps; ‘…if I bit off little chunks of the elephant, as my mum says, bit by bit, it won’t seem as big an obstacle’ [38] (p. 128).
• Meaning manifested as passion in action; ‘But nothing’s as good as the high of ideas’ [76] (p. 103).
• Meaning also manifested as DRs feeling that they were living in accordance with their values and had a sense of purpose; ‘Makaila stated, “There are bigger things out there.” This would suggest that she under-stands her purpose is a larger than just her doctoral studies and would encompass more. Makaila also stated “attend to the family” as a way to balance her well-being, but it also displays her placing importance of having a larger life than just her graduate school aspirations.’ [59] (p. 11).
• Feeing that supervisors believed in them scaffolded DRs sense of self-agency and motivation; ‘Journey explained that his supervisors’ trust in his ability had given him the confidence to begin writing: J: when … you are a person from an environment that is not really value publication as it is here, and then you come to this place – R: – to compete on an even footing – J: Yes … I was very happy that my supervisors yeah they trust me, tried to motivate me – ‘Yes you can, you have experience’ and … when we discuss content-based knowledge, ah maybe they said – ‘Yeah … you have’ R: Mmm J: Then ah one of them at that time started to ask me to write a paper. I guess it's a kind of recognition that you … can do that. So, yeah that's part of things that strengthened myself that I … could do.’ [42] (p. 181).
• Other people could motivate DRs to finish; ‘Jenny: “Even when I wanted to quit, even though she was sympathetic and understanding, she quickly told me, “No, not on your life.”’ Katie: ‘To be perfectly honest, if it were not for my best friend, I probably would have either dropped out or failed out of my program. I could only get through this with him and that is essential.’ [39] (p. 92).
• Meaning appeared scaffolded by contribution, belonging and mattering:
 ▪ ‘Through his PhD, Journey hopes to convince his Indonesian colleagues that they too can participate in international research: I should communicate … with them … remind them that it's all about efforts, it's all about ah commitment … maybe come up with failures, but you have to try. … So I've done my part, though it's small and shows us that yes we can! (Journey, 6, 1036–1044)’ [42] (p. 184).
 ▪ ‘I use encouragement as a way to invest in other people and I feel like I’ve received that too. Words and encouragement like, “You’re not alone in this,” are very meaningful and helpful.’ [39] (p. 79).
• DRs could use agentic action to source a community for collective authenticity; ‘…if you want to be cutthroat and hateful to people then you can be, but if you want to have an engaging, enriching educational experience, there are people out there who want that same thing.’ [39] (p. 88).
  The PhD as a process of transcendence • The PhD acted as a forge, testing and remoulding DRs into something greater; ‘…[my supervisor’s] office is a little bit intimidating to go in there, but it is also a very challenging and intellectually stimulating place, and it is where a lot of really good conversations happen, and it feels like you are really pushing your limits every time you are in there having conversations with him. (Participant 24, American Indian/White female)’ [50] (p. 202-3).
• The struggle caused DRs to have a greater sense of their capacities; ‘…this semester it was like everything else was thrown at me, and I feel like I have stood tall, and nothing at this point can really deter me from my goal of getting my PhD (Participant 64, Black male)’ [50] (p. 210).
• A trusted supervisor aids in the process of transcendence; ‘He has really been there for me to go through the growing pains of learning how to think and learn differently.’ [62] (p. 49).
• The PhD could allow DRs to transcend personal tragedy; ‘Regarding mental health, from the outset of my program, academics became a productive outlet through which I channelled personal stress and frustration; … I recently described my doctoral experience as “merely a former coping mechanism that has evolved into an oasis of creativity and scholarly enrichment.”’ [39] (p. 88).
• The PhD could serve as a transformative selection process for social relationships; ‘It is good to test a relationship,’ he asserted, ‘Challenges, I believe, validate our relationship.’ [39] (p. 84), with some relationships cast aside, ‘It is good to test a relationship,’ he asserted, ‘Challenges, I believe, validate our relationship.’ [39] (p. 84), and some forged anew; ‘…many of my best friends went through the program with me and I feel much closer to these friends than my other friends who were not in the program because of the bonding experiences we have shared.’ [39] (p. 85).