Separation and Loss in University Mental Health Work*

Work with students in college or university mental health settings involves many aspects of separation and loss for both student and therapist. Most students arriving at college or graduate school are in the midst of dealing with physical and emotional separation from parents, siblings, significant peers, teachers and, in the case of international students, country. This separation or loss occurs at the very time when new and usually more rigorous academic and social pressures must be confronted. The emotional high of having been accepted by an academic institution of one's choice is quickly tempered by doubts about one's ability to cope with so many new challenges. Feelings of being an imposter (“the admissions office must have made a mistake”) are common. Many students find their way to the Mental Health Service during their first semester, often within a few weeks of arriving. Typically they present with symptoms of anxiety and/or depression, inability to concentrate and severe self-doubts. Initial exploration by the clinician often reveals concern about living in a strange and stressful environment, and loss of an important love relationship, usually a boy- or girlfriend. Further exploration may bring to light other losses: that of a parent by death or divorce earlier in life or about to occur; loss of youthful good looks due to weight concerns or illness; loss of financial independence so as to finance further academic study; loss of parental support when higher education is not understood or valued; loss of hope for a future when the nuclear threat is repressed and numbing has set in. The sudden death of another student by accident or suicide often precipitates