Healthily Psyched at Guy's

King's College London Health Psychology blog

Author: Elaina Taylor

This year, pay attention to your resolutions: The importance of automatic thoughts

Haunted by Pino Grigio

I decided to go t-total in January. As a person who enjoys a glass of vino regularly, I knew this was going to be a challenge. Now, one week into 2018, I feel like I am being haunted by Pino Grigio. Everywhere I look my attention seems to be grabbed by some tempting alcoholic beverage. I seem to have developed an attentional bias for wine!

I am not overly concerned as I know we all preferentially attend to information that is temporarily salient or personally meaningful. However, whilst this rather flippant example of attentional bias is doing me no real harm (other than testing my resolve), in certain situations attentional biases can and do become problematic.

Cognitive biases, anxiety and depression

A cognitive bias is the tendency to notice, interpret, or remember only certain aspects of the environment. For example, when speaking in a group, someone who is particularly socially anxious may overly attend to negative facial expressions (e.g., anger and disgust) rather than neutral expressions. They may also be more likely to interpret a negative facial expression as indicating a disapproval or dislike of them, rather than the context of their conversation. This habit of selectively attending (attention bias) and interpreting (interpretation bias) creates a vicious cycle in which an ambiguous world is experienced as threatening.

Several decades of research in clinical psychology has identified that these types of cognitive biases play a central role in the onset and maintenance of anxiety and depression. Clinical psychologists have led research in this field, developing computerized experimental methods to tap into how people implicitly process salient, emotive and threatening information. Researchers are now refining procedures to modify these cognitive biases –called cognitive bias modification (CBM) (MacLeod & Mathews, 2012).

CBM aims to modify the attention or interpretation bias, by repeatedly training attention towards more positive or benign information. CBM can test the causal relationship between cognitive biases and symptoms by experimentally manipulating the bias and measuring any associated change in symptoms.

Though CBM techniques are in their relative infancy, they have shown some promise as a clinical tool (Hakamata, et al., 2010) and as an adjunct to conventional forms of psychological interventions (Williams, et al., 2013).

Cognitive biases and health behaviours

Traditional health psychology models have largely focused on the role of reflective, intentioned action and beliefs (Sheeran et al., 2013), such as weighing up the pros and cons of my dry January. Attention (excuse the pun) is also now being paid to more habitual or automatic drivers of behaviour, such as my increased perception of alcohol cues.

For example, attentional biases towards food has been identified in eating disorders (Shafran, Lee, Cooper, Palmer, & Fairburn, 2007), for cigarettes in smokers (Ehrman, et al. 2002), and for, you guessed it, alcohol in alcohol use (Townshend & Duka, 2001).

Building upon this basic science research, a growing number of studies have employed CBM techniques to attempt to shift these cognitive biases. In addiction, there is some evidence that CBM may be effective as an ‘add-on’ to traditional, behavioural interventions. For example, a study of a CBM with people with alcohol addiction, called alcohol-avoidance training, found that trained alcoholic patients showed less relapse at one-year follow-up than control patients (Wiers et al., 2011). A further study replicated this result, and found that a shift in the attentional bias mediated this effect (Wiers et al., 2013).

Cognitive biases and symptom experience

Experimental research has also begun to explore the role cognitive biases may play in how people experience physical symptoms, such as pain. Research has shown that if a person is expecting pain or they are particularly fearful and catastrophic about the experience of pain, they have a lower threshold of perception for pain. Thus, vague, commonplace pains may more readily capture attention and may be interpreted as indicating damage or disease (Keogh, Ellery, Hunt, & Hannent, 2001; Keogh, Thompson, & Hannent, 2003).

These types of illness-specific cognitive biases have been identified in chronic pain (Crombez, Van Ryckeghem, Eccleston, & Van Damme, 2013; Schoth & Liossi, 2016), chronic fatigue syndrome (Hughes, Hirsch, Chalder, & Moss-Morris, 2016) and irritable bowel syndrome (Afzal, Potokar, Probert, & Munafò, 2006; Chapman & Martin, 2011; Tkalcic, Domijan, Pletikosic, Setic, & Hauser, 2014).

CBM work in this area is just beginning. Several CBM studies in chronic pain suggest that training people to direct attention away from pain-related information (i.e. reducing an attentional bias) is associated with reduced anxiety and pain related fear (Carleton, Richter, & Asmundson, 2011; Schoth, Georgallis, & Liossi, 2013; Sharpe, et al., 2012). However, as yet, mediation has not been established in these studies.

Experimental health psychology

The potential for experimental research to contribute to health psychology is substantial.  CBM research can help establish if cognitive biases drive certain health behaviours or help maintain symptoms and distress in certain conditions. Our interventions may be optimized by targeting these implicit cognitive processes. For example, reducing attentional biases to food cues may in turn reduce impulsivity and thereby help regulate impulsive eating. There may also be a role for implicit processing in coping. For example, if survivors of breast cancer have persistent attentional bias for cancer related information and tend to interpret ambiguous information as cancer related, they may consequently experience increased anxiety and fear of recurrence.

Experimental research within health psychology is small but growing. However, in order for this research to be fruitful, experimental methods must be tailored and adapted appropriately for the population being studied. *For a guide to developing illness-specific materials for experimental research see Hughes, A. M., Gordon, R., Chalder, T., Hirsch, C. R., & Moss‐Morris, R. (2016). Maximizing potential impact of experimental research into cognitive processes in health psychology: A systematic approach to material development. British Journal of Health Psychology21(4), 764-780.

I hope this article encourages you to consider the role implicit processes may play in your area of research and to explore how you might conduct experimental research to assess these hypotheses. This post was written by Alicia Hughes and edited by Jowinn Chew. Thanks for reading our post. Hoping to leave you healthily psyched for more until our next edition in February.



Afzal, M., Potokar, J. P., Probert, C. S., & Munafò, M. R. (2006). Selective processing of gastrointestinal symptom-related stimuli in irritable bowel syndrome. Psychosomatic medicine68(5), 758-761.

Carleton, R. N., Richter, A. A., & Asmundson, G. J. (2011). Attention modification in persons with fibromyalgia: A double blind, randomized clinical trial. Cognitive behaviour therapy, 40, 279-290.

Chapman, S., & Martin, M. (2011). Attention to pain words in irritable bowel syndrome: increased orienting and speeded engagement. British journal of health psychology16(1), 47-60.

Crombez, G., Van Ryckeghem, D. M., Eccleston, C., & Van Damme, S. (2013). Attentional bias to pain-related information: a meta-analysis. Pain154(4), 497-510.

Ehrman, R. N., Robbins, S. J., Bromwell, M. A., Lankford, M. E., Monterosso, J. R., & O’Brien, C. P. (2002). Comparing attentional bias to smoking cues in current smokers, former smokers, and non-smokers using a dot-probe task. Drug and alcohol dependence67(2), 185-191.

Hakamata, Y., Lissek, S., Bar-Haim, Y., Britton, J. C., Fox, N. A., Leibenluft, E., Ernst, M., & Pine, D. S. (2010). Attention bias modification treatment: a meta-analysis toward the establishment of novel treatment for anxiety. Biological Psychiatry, 68, 982-990.

Hughes, A., Chalder, T., Hirsch, C., & Moss-Morris, R. (2016). Illness specific cognitive biases in chronic fatigue syndrome independent of mood and attentional control deficits. European Health Psychologist18(S), 696.

Keogh, E., Ellery, D., Hunt, C., & Hannent, I. (2001). Selective attentional bias for pain-related stimuli amongst pain fearful individuals. Pain91(1), 91-100.

Keogh, E., Thompson, T., & Hannent, I. (2003). Selective attentional bias, conscious awareness and the fear of pain. Pain104(1), 85-91.

MacLeod, C., & Mathews, A. (2012). Cognitive bias modification approaches to anxiety. Annual Review of Clinical Psychology, 8, 189-217.

Shafran, R., Lee, M., Cooper, Z., Palmer, R. L., & Fairburn, C. G. (2007). Attentional bias in eating disorders. International Journal of Eating Disorders40(4), 369-380.

Sharpe, L., Ianiello, M., Dear, B. F., Perry, K. N., Refshauge, K., & Nicholas, M. K. (2012). Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials. Pain153(3), 722-731.

Sheeran, P., Gollwitzer, P. M., & Bargh, J. A. (2013). Nonconscious processes and health. Health Psychology, 32, 460.

Schoth, Daniel E., and Christina Liossi. “Biased interpretation of ambiguous information in patients with chronic pain: A systematic review and meta-analysis of current studies.” Health Psychology 35.9 (2016): 944.

Townshend, J., & Duka, T. (2001). Attentional bias associated with alcohol cues: differences between heavy and occasional social drinkers. Psychopharmacology157(1), 67-74.

Tkalcic, M., Domijan, D., Pletikosic, S., Setic, M., & Hauser, G. (2014). Attentional biases in irritable bowel syndrome patients. Clinics and research in hepatology and gastroenterology38(5), 621-628.

Williams, A. D., Blackwell, S. E., Mackenzie, A., Holmes, E. A., & Andrews, G. (2013). Combining imagination and reason in the treatment of depression: A randomized controlled trial of internet-based cognitive-bias modification and internet-CBT for depression. Journal of consulting and clinical psychology, 81, 793.

Wiers, R. W., Eberl, C., Rinck, M., Becker, E. S., & Lindenmeyer, J. (2011). Retraining automatic action tendencies changes alcoholic patients’ approach bias for alcohol and improves treatment outcome. Psychological science22(4), 490-497.

Wiers, R. W., Gladwin, T. E., & Rinck, M. (2013). Should we train alcohol-dependent patients to avoid alcohol?. Frontiers in psychiatry4.


Christmas Special from Healthily Psyched

The Ig Nobel Prizes were developed in 1991 to reward improbable research, specifically research that makes people laugh and then makes them think. The awards focus on research that is unusual, imaginative and that helps satisfy people’s curiosity. As it is nearly Christmas, we thought we would use this Healthily Psyched blog post to share some of the most interesting (and vaguely Health Psychology related) Ig Nobel Prize winners:

Are night owls more likely to be psychopaths?

Night owls, or people who habitually stay up late, are on average, more psychopathic, more manipulative and more narcissistic than early birds, according to a study which won the Psychology Prize in 2014. Researchers surveyed 263 students on a series of personality traits and found those who habitually stayed up late were more likely to score higher on the Dark Triad (narcissism, psychopathy and Machiavellianism). The authors postulate that this is due to Dark Triad traits being adaptive for darkness, solitude and night time living. However, night owls need not worry too much about becoming a psychopath, as the correlations between personality traits and chronicity were all small (r=.13-.20)

How can anyone not like cheese?

christmas 1

In 2017, the Ig Nobel Prize for Medicine was awarded to Jean-Pierre Royet and colleagues for their paper entitled ‘The Neural Bases of Disgust for Cheese: An fMRI Study’. This study involved 15 people who liked cheese and 15 people who did not like cheese being exposed to both images and odours of cheese. fMRI results showed that certain parts of the brain (basal ganglia structures) were more activated in those who disliked cheese than in participants who liked to eat cheese. Whilst these results show clear differences in brain activation between cheese lovers and cheese haters, it fails to explain how anyone could not like cheese.

Ugly art and lasers

Some people may find that attending art galleries for hours on end is a painful experience, however they may change their minds after reading the following study. In 2014, the Art Prize was awarded to a study investigating the relative pain people suffered while looking at paintings rated ugly, neutral and pretty, while being shot by a powerful laser beam. Paintings viewed as beautiful produced lower pain scores in comparison to neutral and ugly paintings. This led the authors to suggest that pain can be modulated at the cortical level by the aesthetic content of distracting stimuli. In other words, beauty and ugliness exert a different effect on pain. We look forward to seeing the fascinating interventions which may stem from this study for chronic pain conditions, but it gives a whole new meaning to the quote, ‘art is pain’.

Is it mentally hazardous to own a cat?

christmas 2

The 2014 Public Health Prize was awarded to a series of studies investigating whether it was mentally hazardous for human beings to own a cat, mostly due to the existence of the parasite Toxoplasma gondi which is transmitted from cats to humans. This parasite can change the behaviour of rats so that instead of fearing the smell of cat urine, they become attracted to it, thus making them more likely to be eaten by a cat and further spreading toxoplasmosis. This research compared people with and without toxoplasmosis on a series of mental health and personality related factors. Results showed that people who were toxoplasma-positive had lower guilt proneness and were less impulsive and less disorderly. Similar studies have drawn links between toxoplasmosis and suicide, depression and schizophrenia. Whilst this may signal bad news for some cat-owning members of the Healthy Psyched blog team, the NHS says we shouldn’t be too concerned about findings like these, and other large rigorous studies have shown no links between cat ownership and mental health problems.

Beauty is in the eye of the beer-holder

christmas 3

The results of this next study are useful to keep in mind at any forthcoming Christmas parties. In 2013, the Psychology Prize was awarded to Laurent Bègue and colleagues from the University of Grenoble. The study was conducted within a naturalistic setting (a bar-room) in which ‘customers’ were breathalysed to measure blood alcohol level, and rated how attractive, bright, original and funny they believed they were. Results suggested that the higher their blood alcohol level, the more attractive participants rated themselves as. In a further study, they found that participants need not have consumed any alcohol at all, but that the mere belief that one has consumed alcohol increases self-perceived attractiveness, thereby supporting dual-process alcohol models suggesting alcohol stimuli operate on implicit expectancies. Unfortunately, the first part of this study was correlational so it is not certain whether more attractive people drink more. Nor did it test whether intoxicated participants were in fact, more attractive.

How to take a good group photo

christmas 4Successful shot of the Healthily Psyched blog team.

In 2006, the Mathematics Prize was awarded to Nic Svenson and CSIRO scientist Dr Piers Barne, for determining how many photos you need to take in order to find one where no one is blinking. After determining that blinks are completely random and independent of each other, Nic and Piers calculated the average number of blinks per minute (10), the average length of a blink (250 milliseconds), and the camera shutter length (8 milliseconds). It was then possible to model how many shots you would need to be almost certain of getting a good photo. Results gave a useful rule of thumb for photographing less than 20 people: divide the number of people by three in good light, or two in bad light.

Other interesting Ig Nobel Prize winners:

  • Medicine Prize (2015): For discovering that some allergic reactions may be reduced following intense kissing or sexual intercourse.
  • Medicine Prize (2011): For investigating how decision making changes when people have a strong urge to urinate.
  •   Veterinary Medicine Prize (2009): For showing that cows who are nameless give less milk than cows who have names.
  • Economics Prize (2008): For the discovery that lap dancers earn higher tips when they are ovulating.
  • Aviation Prize (2007): For the strange discovery that Viagra aids jetlag recovery in hamsters.

This post was written by Zoë Moon and Elaina Taylor. If you have any further interesting health psychology related studies you’d like to share, we’d love to hear from you. In the meantime, thanks for reading our post and we hope to leave you healthily psyched until next year.









From MSc to PhD: question and answer session with Healthily Psyched PhD students

Pippa and Louise blog photoPippa and Louise graduated from the Health Psychology MSc in 2016 and are currently enrolled as PhD students in faculties at King’s College London. Louise is based at the Faculty of Nursing, Midwifery and Palliative Care researching chronic pain in inflammatory bowel disease. Pippa is based at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) investigating infant feeding practices among women who deliver large-for-gestational-age (LGA) infants. Together, we have teamed up to answer some of the frequently asked questions about making the jump from MSc to PhD, how we got here, and offer some friendly (and hopefully, helpful) advice for anyone interested in or about to make the transition.

1. Did you always know you wanted to do a PhD?
Definitely not! During my undergraduate degree (BSc Psychology) my academic supervisor strongly recommended I apply to do a PhD and I just remember thinking “that’s definitely not me”. She must have seen something I couldn’t see at the time, because fast-forward three years and somehow it is me.

I started coming round to the idea of doing a PhD during the MSc – the course offered the opportunity to tailor quite a few of the assignments to fields of research we were interested in, and I had started to explore pregnancy health and breastfeeding. The more I read about the topic, the more interested I became and I found myself wanting to know more. For as long as I can remember I have been fascinated with pregnancy health, but I never considered the idea that I could have a career based on exploring it.

Completing a PhD is not essential to becoming a fully qualified Health Psychologist (more on ‘Routes into Health Psychology’ later), but it provides the opportunity to carry out in-depth, original research into a topic or specialty subject that you find particularly interesting. The MSc allowed me to find a research area I was really interested in and one that I knew I wanted to pursue further, but I didn’t feel like I had enough research experience to start a PhD straightaway. When I graduated I began looking for Research Assistant (RA) posts on projects related to breastfeeding and pregnancy health and was lucky enough to be offered an RA job on a project investigating ways to empower healthcare professionals to provide tailored breastfeeding support. Throughout my role I was able to develop my research skills in the area and simultaneously conceptualise the idea for my PhD to put forward for funding.

Louise: Not at all. Throughout my undergraduate and master’s degree I was really interested in the subject areas but knew in the long term I wanted have a clinical role, working face-to-face with people and amongst a team. During the MSc I took up a number of both paid and volunteering opportunities to gain experience and expand my skillset and network of contacts. These opportunities included being a student representative for the course and a couple of research assistant (RA) positions. The RA positions in particular allowed me to work closely with PhD students and gain a real insight into the day to day life of doing a PhD. It was then that I began to realise some of real advantages and interesting challenges of a PhD. Particularly in a Health Psychology-related subject, a PhD seemed to involve obviously extensive research and project management but also collaborative work with patients and healthcare staff, as well as other academics in decision-making. Although you focus on a specific subject area for a PhD, I realised that throughout the 3 years you take on a variety of tasks, from recruiting and interviewing patients, applying for ethics, going to conferences (sometimes abroad!) and writing up and critiquing papers. I also knew that even though I wanted to end up long-term in a clinical role, a PhD is a great opportunity to challenge yourself and widen your skillset for whatever career you go on to do thereafter.

2. How did you go about trying to find a PhD?
Pippa:  There are a number of options available for finding a PhD project to suit you and your circumstances (Funded vs. Unfunded (Self-funded) / Part-time vs. Full-time / Established project vs. Self-constructed project) and lots of different ways of sourcing such opportunities. When I had settled on the idea that I wanted to complete a PhD in pregnancy-related health and breastfeeding, I initially started looking for projects that had already been funded and were open to applications. I signed up to and and got daily and weekly updates on projects available. There were plenty of great opportunities being advertised and lots I could have applied for, but as time went on I realised none of them really hit the nail on the head in terms of what it was I wanted to investigate. So, I then started looking into applying for funding for my own research project. I had been told this was going to be a little more difficult than signing up to established projects, but I had taken the approach that I wasn’t going to sign up to a project I didn’t want to do 110%. I looked for PhD Studentships/Scholarships through Research Councils (Medical Research Council (MRC), Economic and Social Research Council (ESRC)), The Wellcome Trust, and various other charities focused on pregnancy and neonatal health. I eventually put forward for two pieces of funding from different organisations.

Coming up with my own idea for the PhD took time because it meant I had to establish a good understanding of the current literature in the area to justify the objectives of my research. When I had a stable idea of what I wanted to do, I started looking for academic supervisors whose area of expertise were aligned with my own interests. I approached people I thought would be interested to discuss my academic ambitions and to ask whether they would be interested in supervising the project going forward. Throughout the process of developing the research project, I also contacted multiple professionals in both academic and clinical settings to discuss the project and ask whether they had any advice or recommendations about the idea. Looking back, this was crucial to ensure that the research I was proposing to funders was justified academically and relevant to current healthcare initiatives. Finding relevant and feasible funding opportunities took time and patience but I’m glad I did it.

Louise: Similarly to Pippa, I also signed up and to receive weekly updates on any PhD roles. But I also approached my supervisors and a couple of lecturers on the course to discuss that I was increasingly interested in doing a PhD. Some of the time, these individuals will know of PhD opportunities in the pipeline, so if you voice your interest (particularly to supervisors who you can see yourself working well with) then it gives them the opportunity to think of you when they come available.

That is how I eventually got my PhD. My MSc thesis supervisor informed me of an opportunity that was going to be available (and shortly advertised on these PhD career websites) for a PhD on chronic pain in inflammatory bowel disease. Applying for the PhD felt very much like any other job opportunity; I applied (by both emailing the supervisors personally and formally online), provided a cover letter and then went for an interview where I had to give a short presentation. I was fortunate enough that I didn’t have to apply for my own funding, as all of the funding and arrangements had already been put in place.

Look out for more on ‘Tips on applying for PhD funding’ in our follow-up blog post next year!

3. Do you have to be passionate about a particular subject to do a PhD on it?
This is a tough one – yes and no. Throughout the year of the MSc there were particular things I was more interested in, so I had a general idea of the sorts of topics I wanted to do a PhD on. There were also some particular long term conditions I was more interested in, and felt more passionately about making a difference in. But at the same time, I also felt quite flexible, and knew that as long as the PhD project involved having an impact on patient care, and/or working with healthcare professionals, I didn’t mind.

I have always thought the ‘go with your initial gut instinct’ is fairly reliable. But when I was informed of the PhD on chronic pain in inflammatory bowel disease (IBD), I had mixed feelings. I had always been really interested in the area of pain and psychological influences on pain, but I had no clinical experience in pain and hardly any knowledge of IBD. But after some research both into the PhD and the specific condition of IBD, it felt like a really interesting project. I am now over a year into the PhD, and find IBD a really fascinating and complex long term condition. I still have lots to learn!

Pippa: I agree with Louise – this is a tricky one. When I was looking for opportunities I was told countless times “Don’t do something you’re not 100% interested in – it will be difficult, so you want something you’re really passionate about”.

Because I have always been naturally interested in pregnancy and neonatal health, I never had a difficult decision of what area to study. But it wasn’t just the topic or research question that was important. There were plenty of projects advertised investigating infant feeding and pregnancy-health that I didn’t want to apply for. Just because I am passionate about the topic, didn’t mean I was willing to investigate anything in the field. I signed up to do the PhD I’m doing because it is in the right location; in an institution that has a strong reputation for empirical research in my academic area of interest (Health Psychology in the context of Midwifery and Women’s Health); means I have two incredibly supportive and expert supervisors; access to academic and clinical collaborations among KCL institutes and allied health partners; and that my project investigates the bigger picture of how to improve perinatal support for women.

While I think it’s helpful to be passionate about a topic, you don’t need to be infatuated with an idea. When you find the right opportunity, you know when you know it’s the right one.

4. What’s the jump like from MSc to PhD academically?
I think we’ve been quite lucky in that the MSc programme we completed was able to provide us with fundamental academic skills needed to undertake a PhD. A lot of the training we completed as part of the MSc has been crucial to the tasks I have completed in the first 6-months of my studies: Protocol writing, conducting a systematic review, critical appraisal of evidence, synthesizing and summarising existing literature, submitting ethics applications. I think it becomes slightly more challenging in the jump from MSc to PhD research when you’re transferring research fields, moving across disciplines, or having to move country to pursue your studies. Knowing what kind of support the University offers has been helpful to know where to go for support and information i.e. Library services, academic skills training courses, seminars and induction sessions.

One of the biggest adjustments I’ve come to terms with is that time is very much your own. Unlike a taught postgraduate programme, there isn’t a stream of (seemingly) endless short-term deadlines that organise when to prioritise your work for you – you have to create the deadlines and priorities yourself. This also means that instead of work being sequential (e.g. do the essay due first and hand it in before starting on the next one) you have to juggle multiple pieces of work all at once and divide your time in your day/week/month accordingly. This might come easy to some, but I’ve found it quite difficult to be continuously switching between pieces of work throughout the day/week. Breaking my ‘To Do’ lists down into the smallest possible components has really helped with staying on top of things on a week-to-week basis!

Louise: I agree with Pippa, it has been a huge advantage for me coming straight from the MSc. A lot of my PhD colleagues in my office in the Nursing and Midwifery department have either had quite a few years out of academia or their previous degrees where in a completely different subject. A lot of the assignments that you do for the MSc are the same for a PhD, such as a systematic review, study planning and recruitment, and writing up a research paper and working on feedback. Moreover, the fact that you do both quantitative and qualitative courses in the MSc really sets you up for your PhD; you go in with some level of confidence about analysing and presenting research data (again, a lot of my colleagues felt quite worried about this).

The main jump for me however, is that the quality of your writing and how you are presenting your research data has to be at a higher standard. Ultimately, you are generating new and interesting findings that your supervisors will want you to share with the academic world! Whether this is in poster presentations for conferences or submitting papers for publications to highly cited academic journals. This is a little bit daunting, because you need to be thorough and professional with your research conduct and presentation of findings. However, if you have a good set of supervisors who support you and give you good feedback with your writing, then this jump is manageable.

5. What are the biggest challenges moving from MSc to PhD?
Pippa: Your PhD will be a marathon, not a sprint. Having long-term goals to work towards (e.g. Write thesis) can easily become overwhelming, and you can sometimes feel like you’ve not achieved very much over time. I’ve found having specific, individual aims and objectives for the week/month that I can tick off as I go along really encouraging – especially on an ‘off’ day when I look back and can see a list of things I’ve already done!

A PhD is a form of academic training; it’s very individual and can involve a lot of lone working. Because you don’t always have someone there to get answers from (like a programme leader or module supervisor in an MSc), you have to learn to be confident in decision making about your work. What do I work on now? Are my search terms okay? What measures should I use? Is this questionnaire helpful? Your supervisors will be there to guide you in the right direction on your decisions and offer expert advice, but a lot of the time there’s not a ‘right’ or ‘wrong’ answer so it’s ultimately your decision. Having such a high degree of autonomy over your work is great – it just takes a little time to get used to!

Louise: I also agree with Pippa. A PhD involves a lot of planning and decision-making, and ultimately you will be the one who has to decide. For example, when you are critiquing models or deciding on suitable questionnaires, you have to develop your own way of thinking and be confident in your decisions. In the world of academia you are surrounded by influential people with strong opinions, and it’s important to learn how to reach a decision with your supervisors. Sometimes I felt like the more reading and research I did the more confused I got when making decisions, because I would read more and more stances on a particular viewpoint and lose track. In this process, it’s fundamental that you can back up your decisions with evidence – what does the research on the whole tell you? If someone challenged you on your decision, how would you back yourself up? Think ahead to those pesky examiners in your Viva and how you would justify yourself.

Another obvious answer to this question, but it’s important to say it anyway, is time management. Although you have a main task to carry out for your PhD, throughout your PhD you will also be exposed to a wide number of opportunities, whether it’s teaching, collaborative work or service development. A PhD is great at allowing you to build up your CV but it’s important to remember to distribute your time effectively, so that you are getting your work done effectively whilst taking up opportunities.

6. What does your day-to-day look like?
Louise: As the tasks throughout your PhD vary so much, your day-to-day can vary considerably depending on what stage you are at. For example, in the depths of recruitment, you may not see your desk for a few days at a time, if you are going into hospital sites or arranging meetings with the clinical team. However for the majority of the time, I am working at my desk in a big postgraduate office. I treat my PhD very much like a working job, working Monday-Friday unless the volume of work means I need to do the odd weekend here and there. I seldom work at home, and really enjoy sitting amongst other PhD students who will frequently be able to answer your questions if you are struggling with an ethics query for example.

Once a week I will attend an MDT meeting at the hospital near my office, as this allows me to keep a relationship with the clinical team and listen to discussion of interesting patients cases on complex medication regimes. During recruitment periods, this meeting also gives you the opportunity to locate any suitable participants. I also do a bit of teaching when I can during my PhD. I teach as a TA on a statistics course which I do weekly in the autumn term, and occasionally do blocks of weekly teaching throughout the year in a secondary school (as part of a charity scheme), where I teach my research to high-achieving students in deprived schools.

Doing a PhD forces you to be organised, so I find it helpful writing a list at the beginning of the week and keep a physical diary to have everything down that I am doing. Although no one is keeping tabs on you to clock out at the end of the day, being able to tick off your lists of tasks gives you a structured way to carry out our day and ensures you don’t fall behind on anything.

Pippa: I come into the office every day Monday – Friday because I find it almost impossible to work from home. I also work more efficiently later in the day, so tend to come in and leave a little later than the rush hours.  Usually I have three or four tasks for the day that I aim to tick off and start with the one that will take the most time, leaving smaller tasks or ones that require less brainpower (like collecting search results from systematic review searches) for the afternoon. I save tasks that need the most brainpower until my optimal ‘thinking’ hours and if I’m in flow I tend to run with it until my brain/body tell me it’s time to lock up and go home! At the moment I’m working on two systematic reviews, a protocol for a cohort study and writing a background chapter justifying why I’ve included the measures I have included. I am also part of a parent support group and a local neonatal unit which I attend one lunch time a week, and attend monthly family support MDT meetings there. In the lead up to setting up my cohort study I have also had the opportunity to attend an antenatal clinic specifically for women with diabetes. Observing clinicians in the clinic has given me insight into the feasibility of recruiting women for the study and (hopefully) means I will be prepared for any challenges that lie ahead.

Our ‘Ten Top Tips’:
1. Network– when getting a PhD idea together, starting on a project, or putting a study together, use all the resources available to you to discuss your ideas and ambitions and get feedback from professionals in the area.  Ask them what they think, if they have any recommendations, and if they’d like to be involved moving forward.

2. Your supervisor(s) are key – Making sure you have good mutual expectations and a clear and open dialogue will mean you are able to get the support you need academically.

3. Treat it like a ‘9-5’ – Although you might still be referred to as a ‘Student’, for all intents and purposes your PhD is your full-time job so make sure to treat it like one. Find your optimal working hours, if you’re an early bird or night owl, and try to set your work around that but still be available during normal work hours.

4. Don’t compare yourself! – Every PhD is unique and every student has a different style of working, so comparing yourself to other PhD students around you isn’t going to be helpful a lot of the time. There isn’t a set structure or timeframe of tasks to adhere to so as long as you’re meeting the targets you have set, you’re doing okay!

5. Don’t be afraid to ask for help – Colleagues, Post-docs, former PhD students, academic support staff, PhD students ahead of you, supervisors, Institutional support (e.g. Library services, counselling services). They all want to see you succeed and are happy to help at every step along the way. Better to reach out earlier than wait until it’s all on top of you.

6. Break down your to-do lists – Having smaller achievable goals for your day or week will really help to organise your work and keep you moving forward. Being able to look back at last month and seeing all the things you achieved will also help keep up your motivation!

7. Support network – Having a good support network both personally and academically is crucial. There will be highs and lows so making sure you have people to celebrate with and pick you up is important.

8. Make the most of your time – Spend some time seek out other opportunities relevant to your work that can help you build up helpful skills. This could include teaching opportunities, volunteering positions in clinics or even getting involved in student representative boards at King’s.

9. Be confident with your decision making! Being surrounded by so many academics and other PhD students – it’s hard to know which is the correct way of doing things. As long as you have done your research and have a good argument to back up your decision-making, go with it and be confident with your supervisors. They won’t want you to rely on them.

10. Enjoy the ride! Sometimes it can feel a bit daunting having such a large amount to accomplish when you are mindful that you have limited time. But enjoy each stage and the new skills you are learning.


This post was written by Louise Sweeney and Pippa Davie who are PhD students at King’s College London. You can find out more about their research here. We hope you’ve enjoyed this article and that we’ve left you healthily psyched for more.