Abstract
Laura H. Choate demonstrates a disconnect between what female undergraduates are achieving and how they actually feel about themselves and their accomplishments; she suggests a variety of interventions to counterbalance the cultural pressures that undermine college women's overall self–esteem and mental health.
My daughter is currently 11 years old and in the 6th grade. If all goes according to plan, she will be entering college in the fall of 2023. As I think about the current campus climate, I wonder what her college experience will be like. On the one hand, I am excited about the potential for her future: today's college women have unprecedented opportunities available to them. According to the US Department of Education, 57 percent of students in higher education are women, and there are now more women than men who have earned bachelor degrees. Women also significantly outnumber men in graduate schools and are more likely to earn doctoral degrees.
On the other hand, as a counselor and university professor for almost 20 years, I have become increasingly alarmed at the numbers of high–achieving women I see with chronic, deeply entrenched problems that are difficult to treat. Many have been struggling with depression, disordered eating, anxiety, and self–injury since their early adolescent years. Others have already experienced sexual trauma, including sexual assault and relationship violence. This makes me stop and reflect: why is there such a disconnect between college women's successes and their struggles?
In addition to my concern about the large numbers of current college women who are achieving yet struggling, I also fear that these problems will only worsen by the time my daughter gets to college. The pressures for girls start early, even in the first years of girlhood. Never before have girls experienced so many pressures to live up to unrealistic, perfectionist standards of achievement. They learn they must be successful in all life areas and that it is never okay to be just average: they must achieve at high levels in school, athletics, and extracurricular activities while also attaining a thin and beautiful ideal and having successful relationships both in person and online. Indeed, there is an expectation for girls to achieve in all areas, and by the time they get to college, they feel they are spinning multiple plates in the air, yet they still don't feel they are measuring up to what is expected of them. Both Roni Cohen–Sandler, in Stressed Out Girls, and Ana Homayoun, in The Myth of the Perfect Girl, write about how this pressure to live up to cultural standards of perfection can contribute to high levels of anxiety, emptiness, and feeling overwhelmed as girls and women run toward achievement after achievement in order to feel acceptable.
If we consider these two trends—that current college women are excelling while also experiencing more mental health problems than ever before and that younger girls are already staggering under the burden of cultural pressures that so often lead to distress—then we might conclude that the future does not look very bright for tomorrow's college women. Therefore, I believe the urgent challenge for college educators is this: we need to continue to support current college women's wellness and overall development, but we also need to focus on the future. What can we do today to create a better future for tomorrow's women on campus? With the current cultural climate impacting girls so negatively, how can elementary students like my daughter be effectively prepared to stay resilient by the time they have to face the challenges of college life?
The Disconnect: The Achievements and the Anguish
As we look around on campus today, our college women seem to be thriving. Yet when you ask them, many of them don't feel like they are thriving; instead, they say they are struggling, and many are. A 2015 article by Robin Wilson in the Chronicle of Higher Education claims college students are experiencing an “Epidemic of Anguish.” The numbers from the 2015 American College Health Association's (ACH) National College Health Assessment tell the same story: during the past 12 months, most college women said they felt overcome by all they had to do—well over half described their level of anxiety as “overwhelming.” About half of college women said their academic studies had been “traumatic or very difficult to handle” and they had felt that “things were hopeless.”
I can confirm this disconnect from my discussions with students on my own campus: they seem to have fully internalized unrealistic cultural expectations as their own measure of self–worth. I have listened as many bright, accomplished college women express how stressed, anxious, and overwhelmed they feel about their current lives and their futures. They worry they won't be able to keep up their grades to get into graduate schools or that they won't ever find a job. They worry they will never be in a healthy relationship. They worry that they eat too much, they don't exercise enough, they don't look good enough, they can't keep up with all that is expected of them … that they simply aren't enough.
The Struggle to be Enough and College Women's Mental Health
This chasm between women's apparent successes and their self–imposed, culturally driven expectations can lead to a sense of emptiness and frustration, resulting in the onset of mental health problems. I believe this is one of the contributors to the sharp increase in mental disorders and problems that we see in today's college women. For example, one of the most intense pressures that college women face is the expectation of a perfect appearance. From an early age, they have received the message that they need to look “hot and sexy”—from toys, merchandise, and provocative clothing. They have learned that their worth is based on their appearance. When women internalize these pressures, they become overly focused on their bodies, weight, and shape, trying to measure up to exacting societal standards for beauty. This overvaluation of appearance often leads to body dissatisfaction and disordered eating practices like excessive dieting and exercise, binging, purging, or even the development of full–syndrome eating disorders.
In a 2007 article in Biological Psychiatry, James Hudson, Eva Hiripi, Harrison Pope, and Ronald Kessler found that eating disorders occur in a minority of students (10%). However, other sources indicate that up to 80% of college women report intense body dissatisfaction that also results in high levels of distress. This is concerning in that according to a 2013 chapter by Heather Shaw and Eric Stice in Eating Disorders and Obesity: A Counselor's Guide to Prevention and Treatment, eating disorders are often chronic problems marked by relapse; functional impairment; and risk for future obesity, depression, suicide attempts, anxiety disorders, substance abuse, suicide attempts, and morbidity.
When women's dissatisfaction with their bodies is regularly referenced as a normative discontent, it means that it is an expectation that women will always be working to perfect their bodies, that they can never accept themselves simply as they are. I have worked with college women who regularly starve themselves to keep their stomachs empty in hopes of a concave abdomen or a thigh gap (a goal widely promoted through social media). They have told me that the pressure for appearance is so intense that no matter what else they might accomplish, if they are not thin and beautiful enough, they believe they are not enough.
But the pressure for perfection is not just centered on appearance; it often generalizes to all life areas, resulting in problems like depression and anxiety, the two most common mental disorders in college women. Many women describe anxiety that stems from worrying about the future or that they can't get it all done and depression from believing they can't ever measure up, that they will never find the love and acceptance they crave, and that they will feel dissatisfied no matter what they accomplish. This distress among college women is pervasive, and generalized anxiety disorder—identified as the number one student mental health concern by David R. Reetz, Brian Krylowicz, and Brian Mistler in the Association for University and College Counseling Center Directors 2014 Annual Survey—is twice as likely to be diagnosed in women than in men. According to the 2015 ACH survey, about 19 percent of college women had a diagnosis or had received treatment from a professional for an anxiety disorder within the past year.
Similarly, college women are twice as likely to experience depression compared to college men. In 2007, the American Academy of Child and Adolescent Psychiatry stated that by age 18, up to 20 percent of girls have experienced a depressive episode, and not surprisingly, we see that these rates of depression continue during the college years, with 15 percent of college women diagnosed or being treated for depression. And most concerning, in the ACH study, almost 10 percent of college women reported that they had seriously considered suicide during the past year.
Another disturbing mental health problem that stems, in part, from the pressure that college women experience is the phenomenon of self–injury (e.g., cutting, burning, and scraping the skin). Approximately 15 percent of all current college students report a lifetime prevalence of self–injury, and it appears that women are twice as likely to report self–injury as men. As explained by the Cornell Research Program on Self–Injury and Recovery, these behaviors typically emerge in the mid–adolescent years (between the ages of 12 and 15) and can persist into adulthood.
A common part of the college landscape today, self–injury is frequently discussed on social media outlets. There are hundreds of “how to” videos on YouTube, and prominent celebrities such as Megan Fox, Johnny Depp, Demi Lovato, and Angelina Jolie have openly discussed their experiences with self–injury. In my experience, women describe their use of self–injury as a way to cope with all of their stress and pressure—either as a way to release psychological pain when their feelings become unmanageable, or as a way to feel something when they otherwise feel numb or empty. They say that self–injury is very effective because to them the physical pain of the cut or burn feels more focused and controllable than their psychological pain in that moment. Until they learn a more effective way of coping with pressures, they will continue to turn to self–injury as a viable option for anesthetizing their feelings.
The disorders and behaviors discussed briefly above involve college women and how they often internalize and react to stressors and societal pressures. In contrast, sexual violence is a crime directly perpetrated against women, which is rooted in and perpetuated by a culture that bombards us with advertisements, television shows, music videos, and videogames that link violence with the sexualization and degradation of women. It is no surprise that when boys and girls are exposed to these images and messages in their younger years, they learn to see girls and women as simplified types or objects, not as multidimensional people. When this happens, it becomes increasingly acceptable—even to women—to treat girls and women with less respect, compassion, and empathy and to act toward them in disrespectful and sexually degrading ways. We also see the lack of respect in relationships, where so many men and women report physical, verbal, and sexual violence in dating relationships.
In the Report on the AAU Campus Climate Survey on Sexual Assault and Sexual Misconduct, written by David Cantor, Bonnie Fisher, Susan Chibnall and others, 23.1 percent of female undergraduate students across 27 universities reported experiencing sexual assault and/or sexual misconduct, while 10.8 percent of women reported completed rape. Often, sexual violence is perpetrated against women in settings where alcohol and other substances are being used. Recently, a study described by Dennis Thompson in an article in U.S. News and World Report made national headlines when findings revealed that 15 percent of women reported having experienced incapacitated rape (rape while the woman was too intoxicated to give consent for sexual activity) during their first year of college, with many of these experiences occurring during the first few months of school.
Just as concerning, incidents of sexual assault and rape often occur in high school, so that many young women arrive on campus having already experienced sexual violence. Notably, in a 2014 Youth Risk Behavior study compiled by Laura Kann, Steve Kinchen, Shari L. Shanklin and others, 10.5 percent of 9–12th grade girls stated they had already been “physically forced to have sex when they did not want to” during the past year.
Sexual and relationship violence can precipitate a host of negative physical and emotional reactions including posttraumatic stress disorder (PTSD) and associated anxiety, depression, and substance use disorders. Most individuals develop PTSD symptoms (e.g., flashbacks, detachment, problems with concentration, isolation, intense negative emotional reactions) within two weeks of a sexual assault; in fact, these are considered normal and expected reactions to this type of trauma. Even more concerning, Dean G. Kilpatrick, Ananda B. Amstadler, Heidi S. Resnick, and Kenneth J. Ruggiero report that between 17 and 65 percent of sexual trauma survivors will go on to develop full–syndrome PTSD, a condition that if left untreated can significantly interfere with a woman's long–term functioning and quality of life.
Bridging the Chasm: Educator Responses
As an educator on campus, you are probably not surprised about some of these problems, but it is still not easy to read these numbers and fully comprehend the levels of distress that our students are experiencing. Clearly, this is not the kind of experience we want for the college women of today, and it is certainly not what we want for generations of women arriving on campus in the future. Yet, as I noted throughout this discussion, these problems don't usually start during the college years; rather, many of them are already present in middle and high school girls. Unfortunately, if nothing changes, it seems likely that these concerns will only worsen as younger students like my daughter transition to college in the coming years. My experiences working with pre–college and college women over several years have revealed to me how complex and deeply nuanced the situation has become. Yet while the problems are complex, I want to offer some initial ideas for shifting the culture and supporting current and future students for their optimal growth and development.
Countering Climate and Culture
First, all educators in both K–12 as well as in higher education need to address the toxic cultural climate in which women are still primarily valued for their appearance and sexual appeal and in which disrespect is normalized. While it will require a major cultural shift, we need programs starting in the middle school through college years that provide positive peer mentors and information about relationships based on mutual respect, not power and control or violence and manipulation. Educators can encourage classroom discussions about gender norms and stereotypes and how to foster a culture of healthy sexuality. And, importantly, we can make efforts to create a culture of respect where students do not stand by when others are sexually harassing or assaulting women but are willing to speak up and intervene to stop the behaviors instead. National campaigns such as “If you see something, say something,” which encourages bystanders to speak up to stop crimes or violence when they see it, is a start in the right direction.
Creating New Perspectives on Success
We can also step in and help our female students learn to put success in perspective. To promote this process, educators at all levels can encourage self–reflection and identity development through class discussions, opinion essays, and one–on–one mentoring. We can become instrumental in helping women explore their passions and dreams so that their drive for achievement and accomplishment will stem from a desire to learn and to develop their potential, not just from their need to prove their worth by meeting an external formula for success. We can mentor women to follow what they want for themselves, not just what is expected of them by the culture, by helping them create identities based on the following questions and on their own terms: What is meaningful and important to me? What do I truly like and value? What do I want my life to look like? What brings me joy? How can I contribute to the world in a purposeful way? Through answering these types of questions, women can create authentic identities based on internally derived standards. As they learn to nurture their passions instead of their “numbers,” college women can become more balanced and focused on developing authentic, meaningful lives.
Fostering Resilience
As a result of developing more positive self–worth, confidence, and balance, young women can begin to grow more resilient and be better able to analyze and process the many messages coming their way. College students’ lack of problem–solving and coping skills, in general, is often discussed in the media and among educators. According to the Chronicle of Education article cited earlier, college administrators and faculty are becoming increasingly alarmed by students’ inability to handle life stressors and disappointments effectively.
In part, this lack of resilience may be due to parents intervening in their children's struggles; however, in their efforts to help their children feel safe and comfortable, parents can actually impede their children's ability to develop confidence in handling their own problems. It can be especially disempowering to girls when parents micromanage their lives during adolescence and into young adulthood. When parents do too much, young women receive the message: “I don't believe you are capable of doing this yourself, so I have to do it for you.” This only serves to underscore the cultural message for women: You don't have what it takes. You are not enough.
In my most recent work, I wrote a book specifically for parents of younger girls: Swimming Upstream: Parenting Girls for Resilience in a Toxic Culture. In this book, I discuss negative cultural pressures for today's girls and what parents can do to build their daughters’ resilience. I emphasize how parents can be active in raising their daughters to stand strong in the face of cultural pressures through promoting positive body image, healthy relationships, and a balanced approach to academics, and through instilling active coping and independent problem solving skills.
Like parents, educators can work to provide college women with ample opportunities to resolve their own life challenges. Recognizing that some students might have been overly protected from having to figure things out on their own, we can promote the critical thinking skills necessary for independent research and problem solving. We can encourage real–world experience and healthy risk taking through internships and volunteer work. Students can explore opportunities on campus not just for resume building but instead can find activities that help them take a stand on issues that are meaningful to them.
In addition, while we can certainly supply students with information about campus resources that will enrich their lives, we can encourage them to actually access these resources on their own. For example, in my own work as a faculty advisor, while I fully listen and validate my female advisees’ concerns, I encourage them to seek out information and make choices independently instead of requiring advice for every decision that arises. In other words, rather than overly protecting students from problems by giving them advice, educators can empower them to think independently and to lead a self–directed life, not only in college but also through life after graduation.
Furthermore, young girls need opportunities to learn to develop positive coping skills when they are upset or distressed, so by the time they get to college, they have developed the skills necessary to deal with life's inevitable problems and disappointments. I have worked with numbers of women who turn to binge eating to numb themselves when they have a fight with a romantic partner. I have also encountered women who feel an urge to cut their arms with razor blades when they don't know how to handle the intense feelings that emerge when they think about abuse from their pasts. I hear girls say they drink to get drunk so they don't have to experience painful feelings from rejection or failure.
To promote resilience instead of self–destructive coping, educators can model and encourage women to explore strategies for better self–care through spirituality, health, and overall wellness. Educators need to be aware that their campus mental health services provide not only treatment for client problems, but they also offer prevention workshops to teach effective coping skills. Educators can provide referrals to programs that help students learn emotion regulation (i.e., the ability to become aware of and regulate intense emotions) and distress tolerance skills (i.e., being able to tolerate a distressing situation when it can't be changed in the moment). When women learn to use effective strategies for managing stress instead of turning to self–destructive behaviors, they will become more active agents in determining direction and meaning in their lives.
The disconnect discussed throughout this article is real for our female students—despite the fact they are generally succeeding in college. Faced with what seems to be insurmountable pressure, many women struggle to maintain their mental health and overall well–being. As quoted in Sales’ 2016 book American Girls, Elizabeth Armstrong advises, “We need to puzzle out why women have made more strides in the public arena than in the private arena” (p. 21). Why indeed are so many women coming to college with serious mental health challenges? What is happening in girlhood that is contributing to the early onset of problems that continue into the college years? And how can we work to change negative cultural influences so that girls will be prepared for the college years and beyond?
While many questions remain, we all must recognize that these challenges to college women's well–being can't be ignored. Action is needed now. To promote women's well–being, we should continue to support the needs of all college women, especially those who are struggling with significant mental health concerns. Campuses must provide comprehensive mental health services that include prevention programs as well as individual and group counseling approaches tailored to women's needs. As educators, we serve an important role as models who can encourage young women to pursue their own passions, engage in positive self–care, and to seek counseling when necessary. As we take these steps—making referrals for counseling for women on campus, supporting prevention programming for students, and providing mentorship—college women will have more opportunities not just to survive but to thrive during their college years. It is my hope that with these changes, we will have paved a path for a brighter, more resilient future by the time my daughter arrives on campus in 2023.