I have worked with students for almost 10 years, both in a large, inner city university with a diverse social demographic offering a range of vocational courses, and in a high-achieving, performance arts conservatoire in London. I also work with students and postgraduates in private practice. So what are the defining features of counselling those in higher education, and why is it so fulfilling?

Counselling students is all about working with the emotional aspects of learning. The experience of studying at university can stir up all sorts of anxieties in a young person’s internal world, which may then interfere with the process of learning and creativity. Sometimes these anxieties can feel intolerable and the student may think of not attending or even dropping out. I see my role as offering a safe space in which a student can voice, often for the first time, any worries about being a young adult in higher education.


Lost in transition

The young person in the room is negotiating a period of transition and separation - from home to away; from school to higher education; and from childhood to adulthood. Whilst the new-found freedom of uni can be exciting, the change in lifestyle also involves loss. The usual support network of friends, family and perhaps sexual partner, and any medical/learning/psychological support has been left behind. Sometimes there’s culture shock to cope with, too – a move from a rural home to a city setting, for example, or from a home country far away. A whole new set of connections is having to be made. Now the student is living with strangers, managing their shopping, cooking and cleaning themselves, negotiating the university timetable, meeting academic deadlines … all this in addition to trying to make new friends. 

It’s no surprise, therefore, that the student may, at times, long for the security and familiarity of home. This longing may well be unconscious, and is commonly defended against with strategies such as drinking or drug-taking, manic socialising, promiscuity or, conversely, withdrawing to an isolated state in their room. 

For some, separation from home can trigger deeper, unconscious relational issues around separation or trauma from childhood or teenage years. When this happens, the student can find themselves feeling depressed without understanding why, and it can lead to more serious self-harming activity or suicidal ideation. Student wellbeing services are always aware of separation issues, and the student counsellor will be working with the lingering ‘child’ in the room.


Common defences

It’s worth thinking further about unconscious coping mechanisms, as they can easily be activated when university arouses fears of survival. The more common defences nowadays include self-harming (excessive drinking/smoking, taking drugs, sexual promiscuity, cutting), often accompanied by a general reduction in the ability to ‘mother’ themselves. I can often find a student is not bothering to eat healthy food, to get enough sleep or to exercise, and is sitting on a laptop til the early hours, all of which will directly affect their mental health. Exploring why this might be can lead to discovering helpful Student Services resources available, eg yoga, mindfulness, financial support, learning support and mentoring, and wellbeing workshops.


Dependency 

Developmentally, students are unconsciously striving for autonomy and omnipotence; yet this desire can clash with reality, because they are actually in a dependent, assessed situation at university. They are constantly reminded, rather painfully, of how much they still do not know (about their chosen subject as well as about life). And the gaze of the university, rather like that of the parent, is constantly upon them, assessing performance, expecting certain standards, setting work deadlines and pointing out mistakes.

The ability to depend on another person involves vulnerability, a dangerous concept for anyone who has not experienced good-enough parenting, for anyone with attachment issues, trust issues, or who has experienced trauma. Difficulties with dependency can affect a student’s ability to be playful and creative in their academic work; it can lead to a need to maintain control (in the form of obsessive behaviours such as perfectionism and procrastination on essay deadlines, for example); and to difficulties allowing intimacy in sexual relationships which can lead to loneliness, isolation and low self-esteem.  


Transference

The student’s transference to the university (and to me) will always be present in the counselling room. Is the organisation felt as a persecutory ‘parent’ or an encouraging one? How has the student engaged with the work, tutors, course colleagues so far? Is the student able to be playful in the room or do they appear rigidly bound by their own internalised rules and regulations, a judgemental ‘should’ voice inside them? Perhaps most commonly, I will look out for past experiences of sibling rivalry in their family which can then get played out with fellow students.


The university context

It’s important to think beyond the room to the student’s narrative of themselves within the wider university. From the first meeting, I will hold in mind what subject the student is studying and what might have unconsciously attracted them to this course? Have they had a gap year and learned something about independence or did they leave home a matter of weeks ago? Is this a mature student with a partner/children, returning to education after years in the workplace and feeling uncomfortably older than their peers? Whereabouts are they on their course (1st year ‘child’, 2nd year ‘adolescent’ or 3rd  / 4th year ‘grown up’?) and is their emotional experience of university mirroring their childhood experiences in some way? Whereabouts are they in the academic year? Perhaps they are approaching a change of year or the end of their course, in which case past experiences of endings/changes are perhaps being aroused.

The numerous anxieties triggered by university can lead to a temporary reversal to a paranoid-schizoid state involving splitting everyone and everything into good and bad, idealised and denigrated. All the capable, good qualities can be projected into others – friends are felt to be getting high grades, feeling confident in their bodies and their identities, and enjoying great social and sex lives. All the bad feelings are located in the self and the student can end up struggling with low self-esteem, body dysmorphia (focussing on perceived flaws in their own body), or suffering more aggressive wishes to self-harm or end their life.


Identity

Issues around identity, particularly around sexuality and, more recently, gender dysphoria, tend to arise in late adolescence. The counselling room provides an ideal space in which a student can begin to explore confusing feelings. It is a journey that may have to be continued after university has ended, but along the way, past relationships with significant people in their lives can be explored, all of which can help the student build a clearer picture of themselves in relation to others.

Increasingly, students are telling me about social anxiety, performance anxiety (from exams to sitting in the student bar) and body dysmorphia. These are painful issues to be experiencing. Although separate in many ways, what they share is a fear of how the person is perceived by others, and there will usually be a point in the counselling when the student’s fear of not being good enough can be linked to earlier experiences, eg being bullied, a judgemental parent/sibling etc. Social media, and the envy it invokes, can exacerbate these earlier fears, and the student’s use of it can usefully be explored.


Sexual healing

Sex is always in the room, but particularly with this age group. Issues around the student’s relationship with sex, often repressed during teenage years at school, can now be explored more freely in the non-judgemental environment of the counselling room. Sex is a useful outlet for aggression, and the student struggling either to maintain healthy sexual relationships, or with impotence/frigidity, or with feelings of shame around sex and intimacy, may resort to other, less healthy outlets (eg violence to self or others, even suicide) as as way of managing unprocessed aggression.


Breaks and endings

High demand for student counselling means that it has to be short term work (4-12 sessions). Much attention is paid to breaks and endings, as we have to work around individual timetables, exam periods, term times and holidays. Any sense of emotional impoverishment already present in a young adult can be stirred up by the loss of me in a break, and defensive feelings of envy, rejection or aggression aroused, as I’m now felt to be the original mother wth the full, but withholding (ie not constantly-feeding) breast. This provides rich material for exploration.


All change

Perhaps the developmental aspect of the student is the very thing that makes working with students so rewarding. They are young, their defences are less entrenched and their emotional landscape can change rapidly. I’ve lost count of the number of times I have encountered a monosyllabic, depressed student who is struggling to maintain any motivation to stay the course, both at university and in life; only to have them return, sometimes even a week later, animated by a tale, an experience, a new friend. Sometimes the simple experience of being listened to, having a space to express their thoughts, and having these feelings normalised, is enough to trigger new confidence and an openness to engage with themselves and, therefore, with others. 

In the end, the whole point of student counselling is to support and enable young people to get the most out of their time at university. Many students find a few sessions are enough to help them on their way, knowing they can return later on in their course if needed. If deeper, longer term issues arise, as they do from time to time, the student can be offered a list of low-cost external counselling options or referred into the NHS, as appropriate.