UHS puts students on the couch

Like hamsters scurrying along the exercise wheel of life, many Princeton students follow exhausting but exhilarating weekly routines. A typical week includes some variation on the theme of precepts, papers, problem sets, rehearsals, practices, playtime and, occasionally, sleep.

What few people realize is that, in addition to this pattern of achievement, many students have another weekly activity in common — psychotherapy. During their college careers, one in five students will make use of the free-of-charge consultations available through McCosh Health Center's Counseling and Psychological Services. Despite the frequency with which students seek mental health care, many claim they were not aware of the free counseling service. Needless to say they are quite surprised to learn that it is used by so many of their peers.

What does the relative prevalence of mental health consultations say about our campus community? To the outside world, Princeton students present quite the impressive front. It seems that even within our own community, we have convinced each other that we are extraordinarily competent. Is this outward air of calm confidence made possible because we hide our anxiety behind weekly therapy sessions? Is our mental health struggling behind our quest for picture-perfect self-images?

Dr. John Kolligian, director of Counseling and Psychological Services, answers this question with surprising optimism. He said he believes the rising use of therapy on campus reflects a nationwide increase among adolescents and young adults. Most students schedule appointments to address "certain stresses that come up around making the transition to college — making adjustments around a much more demanding academic schedule, coping with relationship difficulties, continuing to negotiate the separations from old friends and family, and all that comes from being in a new place," he said. "Those sorts of problems are pretty consistent across different universities, when you look at national data sets."

Many students who have taken advantage of therapy at Princeton had also sought professional help prior to arriving on campus, following the general trend of earlier recognition of mental health needs.

In short, Kolligian does not believe that Princeton-specific stresses are primarily fueling this trend. Some students seem to think the environmental stresses of a topnotch university deserve more consideration, however.

Katie Fallon '09 said she believes the Princeton environment acts as a sort of negative catalyst for the typical type-A personality. "An issue bothering you may be something that you developed as a child because of your background and your circumstances, and then being here makes it manifest," she said. "Considering the type of person that we all are, you put us in this stressful environment and things just explode."

Another student, Jill, who requested that her name not be used to protect her privacy, voiced many of the same concerns. "Princeton is not at all conducive to allowing students to focus on their mental health," she said. "There's so much stress, so much pressure placed on academic and social achievement, that personal needs are often neglected."

Jill first began attending therapy as an extension of the family therapy she had undergone at home to support her sister's struggle with mental illness. Over the course of these personal therapy sessions, however, Jill found an outlet for some of her own concerns that — amid the stress of college life — she had perhaps failed to address.

"It's really refreshing to have someone once a week who cares about your wellbeing and wants to sit there and listen to you talk and give you objective advice," she said. "I think that it's healthy to check in with yourself in an environment that usually does not allow you to do so — it's also allowed me to better relate to other people's problems."

According to Kolligian, Jill's personal account of success is corroborated by the generally positive feedback he receives as director of the counseling center at McCosh, and he hopes the free counseling service will continue to help students to adjust to college life in the best way possible.

"We actively encourage students to come see us even if they think that their issue might not be that big of a deal instead of waiting until it gets out of hand," he said, emphasizing the wide range of issues brought to the counseling center. Though emergency services are provided, students need not be on the verge of breakdown to schedule an appointment.

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Kolligian expressed concern upon hearing that many students are unaware of the free counseling provided to the student body.

"It's important for students to realize that all of our sessions at the counseling service are free — there's no specific session limit," he said, but he acknowledged that scheduling constraints have not been entirely resolved. "We try to keep the wait for an appointment as short as possible, but we're walking that line of balance between students who have scheduled appointments and those who have more pressing, potentially risky situations."

This potential appointment backlog could be one reason why many students remain in the dark. Both Jill and Fallon said that during their therapy sessions at McCosh they were not informed of the unlimited counseling policy, which guarantees students an appointment anytime. Instead they were told that they would most likely be referred after a certain time.

Another possibility is that there is still enough of a stigma attached to counseling and psychotherapy to discourage students to share much about their individual experiences. Kolligian said he believes that these negative associations continue to diminish as time passes, but they have not disappeared yet. As much as we would like to think of ourselves as the modern, open generation, we still have trouble sometimes admitting that we need help and can't do it all on our own.

"There are different factors in your background that might play a role in increasing or decreasing your disinclination to seek out help, and I still think we have a long way to go," Kolligian said. "If there's one student who really needs mental health care and treatment and does not seek it out because he or she feels embarrassed about doing so, then that's a concern. I hope that my staff and I, as we continue to do outreach and raise awareness on campus, can continue to battle the negative effects of this stigma."

But perhaps the most important fact in putting this stigma to rest is simply the knowledge that therapy on campus is more common than it seems.