• Dr. Susan Prieto-Welch, Director for Counseling and Psychological Services
• Dr. Heather Servaty-Seib, Assoc. Dean for Student Life, Honors College Prof. Counseling Psychology

Session Outcomes

• Learn some of the reasons why physical distancing is challenging for students.
• Learn how the broad concepts of loss and grief can be applied to students' experiences during physical distancing and the COVID-19 pandemic.
• Learn how to identify some of the signs of distress from students who struggle during physical distancing.

Impact of COVID-19

Susan:

Physical Distancing
We want to talk about the impact of the pandemic on not only students, but certainly on all of us, as we quickly had to adjust to help flatten the curve and contain this virus. One of the key features of doing this is being socially and physically distant from others. I am glad that we're using the term “physical distancing,” because fundamentally, it is about keeping ourselves healthy and safe but also not inadvertently being carriers for others. 

Disruption of Routines
When I think about how that impacts students, I think about how developmentally much of what happens in the way of growth and change during the college years as well as integration of a sense of yourself is relational in nature. We have the very clear, concrete practical disruption of daily schedules and routines, the way classes are handled, seeing people and moving about throughout our day. And then we also have the more embedded disruption in our interaction and in the way that we navigate our world, the way that we receive feedback and support from our world in all areas of life.

Asked to Quickly Change
We are being asked to transition and change very quickly. That's challenging for anybody, students included. I think one of the other impacts of this is that opportunities for social connection and religion are now severely limited. They're actually changed as well. It's about learning how to maintain some of what we can in the relational realm, but also experiencing what dimensions cannot be replicated and that leads to a sense of loss.

Lack of Control
One of the key features of this pandemic and the changes that we've had to implement is a sense of lack of control. And that very commonly results in fear, which is an emotional response to a real or perceived imminent threat. One of the things that I think is unique to this condition or this environment currently is that there's a very real sense of threat for people with this illness. We can speak a bit more to that.

Fear and Anxiety
Along with fear, a sense of intense anxiety for people can develop that can last over a period of time. Anxiety is distinguished from fear in that it is the anticipation of future threats. When I think about students, I certainly think about the illness. I think of concerns about family and friends, about jobs and internship opportunities, about school, performance and functioning. These are the elements that are highlighted for me as I think about COVID-19 and its impact on our students.

Heather:

Non-Death Losses
A large part of my research and my clinical focus is the idea of loss and not just death-related losses. We have these experiences within the midst of this pandemic, but we also have what we call non-death losses.

We have lost the ability to live our lives, which sounds almost too simplistic, but if we think about what that means for students and what it means for us, there is a whole range of very small, very large, very unique kinds of loss experiences. We often think about loss only in relationship to death. We need to broaden our understanding of loss and our understanding of grief to capture all of these non-death losses that are a part of our current living experience.

Student Losses
Students have lost the ability to live on campus, to be in physical community with one another in the same way that they had hoped, and that is very much a part of their expectations of how college would go. They have lost the ability to be engaged physically in their courses and some of that has to do with the content of the learning. There are certain courses, lab-based courses, skill-based courses that don't translate well to the online format. Those losses of learning are very real.

Unique Profile of Losses
The losses are unique for each student. It’s important to think about a profile of the losses that are significant for each student. We do not want to point out and highlight the losses they've experienced in a way that will bring them down. They're already down. This is a tremendously difficult process to cope with. Instead, the idea in highlighting is to help them gain insight about the broad range of losses they're experiencing, and it will be validating and quite normalizing for them.

Grief is Normal
Loss is normal. Grief is normal. And what we are experiencing now is a lot of normal, challenging responses to an abnormal situation. We can be in a place where we can start to question or judge our response, whether it's us or the students that we're working with. It is quite understandable. Related to that, every loss, all those combination and set of losses, will be connected with grief. And often, we again minimize how we look at grief in our US society.

Grief is Multidimensional
Grief is a multidimensional response—emotional, cognitive, physiological, social, and spiritual. It is all of those domains of our lives, which is why grief is so overwhelming. Use the language of loss to ask students, “It sounds like there are a lot of losses right now. What would you say are some of those key losses?” Allow them to have voice and space to articulate those losses to themselves, because you've asked that question and opened up that window, opened up that door for them to move toward those losses. 

Move Toward the Losses
Moving toward the losses will result in that sense of insight and deeper understanding of the extent of what they are experiencing. We need to encourage students to find the places of control. There's so much that we are not in control of right now. So we have to find those pockets of control. How can we still create a sense of structure in our lives, for example, if that is what we need. What does that look like for each of us? That will be very independent and very specific for each of us.

Consider Potential Gains
We also want to consider the windows and the moments when we might be able to offer to students the idea of considering potential gains that are a part of physical distancing. In my interactions with students over the last month, I have heard students talk about the losses in their very last semester of college, but who also articulate a sense of gained flexibility, a sense of being with a parent who will be deployed this summer and having those extra two months to interact and be close. The ability to interact with siblings, the ability to return to a hobby that they did not have time or opportunity to do when they were on campus. It's not as if though those gains overshadow the losses. My point is that we need to model and allow students to have the opportunity to hold both. That there are losses here. There is grief here. But there also may be gains, and can we allow ourselves to consider some of the gains that may be a part of this experience? 

How will Society be Changed?
I'm fascinated to think about as a society what might be some of the posttraumatic kinds of gains we may take from this pandemic, in terms of existential reflection, in terms of our care for one another, in terms of our ability to care for the planet more. It's going to be quite interesting to see how things unfold. But none of that downplays or eliminates the idea of the real losses. Both the death losses that our students will experience and so many of the non-death losses that they are experiencing and that we are also experiencing as we attempt to be helpers.

Signs of Distress that Require Referral

• Persistent, unrelenting sense of loneliness, sadness or anxiety
• Sleep/wake cycle persistently unbalanced. Significant disruption of self-care(eating, sleeping, hygiene)
• Sense of isolation that is not soothed by remote connection, communication and contact with others
• Persistent sense of lack of motivation/being unable to motivate
• Complete withdrawal
• Any mention or talk of feeling hopeless, "done", suicidal

Susan:

Persistent Behaviors
One of the things I look for when I think about somebody needing a referral is the sense of something being persistent. When fear, concern and anxiety persist over a period of time, there can develop a lack of flexibility and a lack of acknowledging the way in which things may lead to fear, sadness, an anxious feeling. We need to acknowledge the ways in which we do have some control, how to understand feelings and the interaction between how one feels and what one does, that is behavior, the actions that one engages in.

If we can move from a place of fear to a space of learning, that is indicative of having some energy to be resilient with the ability to move into different realms, if you will. When this cannot happen, or when somebody begins to feel a bit stuck. That is a time to think about what resources we marshal for them and a referral.

Lack of Self-Care is a Flag
I look at self-care. Do students have consistency in behaviors around eating and appetite, being able to sleep? Do they take care of themselves physically? Are they changing clothes? Are they exhibiting hygiene? When people start talking about inability to do these things and this persists for a while, that's a flag.

When Virtual Connecting is Not Helping

If people don't feel any kind of soothing as a result of connections with others through Facebook, FaceTime, Skype, whatever it might be, and there's a persistent sense of loneliness and isolation, which can lead to a feeling of helplessness or hopelessness, that's a flag, as well.

Lack of Motivation
Struggles with motivation are very common. Certainly not only our students, but a lot of folks are feeling that. That, in itself, is not a flag, but if it becomes persistent, and certainly if somebody completely pulls away, that is a prompter for reaching out and trying to find out what's going on.

Hopelessness
Certainly, if there is a mention of any sort of feeling significantly hopeless, wanting to not be here anymore, that is a prompter. Some students will flat out say, "I thought about killing myself. I thought about hurting myself." That is obviously a very clear flag for reaching out and trying to connect them with resources.

Heather:

Importance of Sleep

I highlight again the importance of sleep. We know much from recent literature that sleep is connected to issues of motivation and cognitive functioning. It's connected to the processing of stress and emotional challenge. So that ability to still have some consistent and positive sleep hygiene is very important to students, and can be helpful to highlight for them.

Connection Related to Well-Being
We know from the research in psychology that the most consistent predictor of well-being is relational issues and connection. So sleep and social connection are critical factors where we can make a difference in our communication to students.

We also want to be thinking about these issues for ourselves. If we think about our own lives, and think about how these issues are operating for us, we can be as present as we want to be and need to be for students.

Question #1: How can physical distancing heighten some of the mental health issues our students traditionally struggle with during this time in the semester? 

Susan

What we know about depression and anxiety, among other things, is that it does tend to worsen when we don't engage in activities that are enriching or reinforcing to us. And again, a lot of what is enriching and reinforcing generally for us as humans, but certainly during the college age years is relational in nature.

So there's a bit more of a barrier. A bit more of a roadblock during this particular time. Particularly for folks who may already struggle with feelings of depression or anxiety, generally speaking. It is important to try to figure out ways to engage in activities that are enriching and that you enjoy. Work with a student to try to help them think through this and rediscover. Hobbies that you may not have done for a while may be helpful. It's about how we continue to find ways to enrich our lives and engage in any way that we can with others.

Heather

It's not a formulaic sort of process; it is individual to each student. What is it that brings them joy, that brings them energy, that fills them back up again? It could be something very small. We hear and see a lot about the need to be physically active, which I think is true. But again, it also does relate to each individual person around what will help them.

One of the things I love about a college campus is the consistency of things, it's the cyclical nature of things. As we come to the end of the semester, there are things that we anticipate and expect. They feel natural, and there is a sense of predictability. We're in a situation now where very little is predictable. It's such a paradox. I was having a conversation with my research team about it the other day, and it's such a paradox that everything seems to be unpredictable, and yet every day feels exactly the same. What a hard spot that is for us to be in right now. Both for us and for the students.

Susan

When you're a college student, you're developing a sense of who you are and what your routine and rhythm is. That seems to be really important to a lot of the students that we see at CAPS. Now, all of a sudden, that is uprooted. Maybe the student goes back to family, and that could be a good thing. That could have its own layers to work through. Or maybe the student is in another different environment. So not only is their rhythm different, but their sense of identity itself is morphing and highlighted in certain ways, but maybe also needing to change in other ways.

Heather:

I think about where they are developmentally. I've heard students say, "I've taken a step back here. I never planned to live with my parents again." I've heard some say, "And now rather than being independent and working towards my autonomy," which we know is so much a part of where students are developmentally, "I'm back living at home with my high school siblings and studying with them, which is not what I had hoped or wanted or anticipated."

It speaks again to identity development, and how they see themselves and how they can hold on to the sense of who they have become even in the time they have been in college, and then it doesn't have to feel like a complete step back.

Question #2: What is similar and what is different about the type of grief our students are dealing with now and the grief they would experience in a death loss?

Heather:

We never want to equate a death loss with non-death losses. Death loss has such permanency to it, such broad reaching impact for person and family and system. It's not an issue of comparing to say that the grief that we and students are feeling now is the same. It's the same in that we're grieving because there are losses. There are aspects of the grief that may be similar, which I can speak to. One of the elements that you highlighted is that death losses are misunderstood in our culture.

Grievers are not always well supported.
I would say grievers are not always well supported. But when we talk about non-death loss situations, like the ones that we're in now, it's very difficult for others to acknowledge and recognize those losses. We see some literature where students are being shamed or judged for the extent of loss they're experiencing and the grief that they're experiencing. We need to be mindful that we're not saying it's the same thing, but it is grief.

Whenever we are attached and connected, there is the potential for loss. Grief is actually the reflection of attachment and connection. So every connection point, every aspect of our lives that we were attached to will be grieved if it is no longer present. Some of that has to do with enfranchising the grief students may be experiencing that is disenfranchised by society because it is not recognized and acknowledged. We don't want to underestimate the power of validating and normalizing the grief that students are experiencing. Some of the similarities go along with how we think about how grief functions.

Grief is Not Stage Based
We hear a lot about stage theories in terms of how grief functions, and that is a myth. Grief is not stage based, it does not function or operate in a staged kind of way. But there are other sorts of theories and concepts that can be very helpful to us. Grief is often considered a meaning making, a sense making process. How do I make sense of my life with this or this experience or this loss in it? I read a quote today: Part of grief is loss and part of grief is remaking your life. It's both. It's grieving the loss, but it's also trying to determine how do I integrate, how do I synthesize this into how I view my life story and move forward from here, not moving on, but moving forward from here. And I think that's quite similar.

Avoidance—Least Effective Approach to Coping
We have theories of grief that talk about the loss and the moving and the coping sort of aspects and again, that's the holding of both. One of the ways that college students most often try to cope is avoid. We also know from the research that that's the least effective approach in terms of coping.

We know when students are able to look at the challenges that are in front of them, digest them, break them down, work to make sense of them, they function better, sleep better and are more motivated. When they feel acknowledged and recognized, they try to make sense of it in moving forward.

Susan:

Some Energy Needs to Go into Understanding the New

Everybody is working from home and expecting our productivity to be the same, our focus, motivation concentration to be the same. Yet, some mental and emotional energy needs to go into to trying to understand the situation, to figure out what it means for me, and what do I learn about myself, about my world, about my environment?

Heather:

Conversations are Needed
The space is needed. I hope students are able to have those conversations with each other around the ways they're experiencing losses differently, experiencing grief differently and that it will be unique and different for all of them. We as staff and faculty members are also having conversations about the gains and losses with each other. We're asking how our motivation is waxing and waning.

Question #3: How do we encourage motivation?

Susan:

Listen and Reflect
One of the important first steps is to listen and have students feel heard. “I don't feel motivated right now” can mean many different things. What does that look like for them? Engage in conversation and listen, reflect back, normalize what they're experiencing. What are the ways in which this makes a great deal of sense? 

Spend a good amount of time and energy being still, listening and reflecting back. Ask, “Are there things that you can rediscover or things that you would have wanted to explore, but you didn't have time? So how do you spend some time on that?

Heather:

Don’t Judge the Lack of Motivation or the Grief
I think about the meta level and the importance of working to not get stuck in that cycle. To not judge the lack of motivation, to not judge the grief. I often find that grievers are more stuck because they're judging their grief rather than just experiencing what is natural for them. Ask, "What is the least aversive task that you could do right now? You have this whole array, you have this whole process, pick the one that is least aversive." Because what we often find is that the first 5% and the last 5% are the hardest. “Can your goal be 5%? And what can it be that is the least aversive in it?”

Question #4: What signs should we be aware of with students who may not be dealing well with isolation?

Susan:

I have heard from faculty with concerns about students who might typically log in or do certain kinds of activities, but then start not doing so. Some students are straightforward, and they might indicate in assignments that they are struggling. They may not say a ton about it, but they may indicate that they're struggling.

Look for withdraw and changes in behavior. In some ways, it's a little bit awkward for us currently, because we're trying to figure out what is baseline or typical behavior in this context. And this context is so very different. Don’ be afraid to reach out and say, "Hey, how are things?" If you get any kind of inkling that something might be going on, reaching out and engaging in a conversation, opening it up, sometimes that is all a student needs to be willing to talk a bit about what's happening, which allows you then to think about where to go with it.

Heather:

We want to create a sense and culture of care within our units, and to be repetitive about that in terms of our desire to still be in connection and communication with students, to try to lower barriers. It's interesting to think students may have lower barriers to help seeking in this virtual world. In some ways, it can be harder. In some ways it could be easier. What opportunities are there for allowing them to be in connection with one another? And how creative can we be about providing those opportunities?

In the Honors College, we've created anonymous google docs for certain subgroups of students to be able to share and to read comments from others around certain issues. One was for seniors to think about what they would be losing this semester, being in the virtual world. We created one this week for juniors talking in terms of the experiences they will be losing this summer. They took advantage of it. They wrote to each other, they shared and said, "Wow, I'm feeling something very similar to that." There are a variety of ways that we could, without too much work, create spaces for students to be connected with one another and to not feel so alone.

Question #5: How can we help students through their grieving process?

Heather:

Allow students the opportunity to share what it is that they're experiencing for better or for worse. With grief, people need others to be present. They need them not to be afraid of their grief. And that can go a really long way.

If you are fully present with the student, say in a virtual call or a phone call for 10 to 15 minutes, without trying to fix or without trying to problem-solve, you can help them shift in terms of what they can do. They will be more able to think with you about how to move forward in a challenging situation.

It can also go a long way to say to students, "I've been struggling with motivation. This isn't just you." Share your own personal experience, which can be helpful for grievers. If you do come across students who are grieving death losses, the Actively Moving Forward group on campus is still functioning. They're having online gatherings, and they have more students coming now that we're in the virtual world than we did when we were in person. It is a peer-led support opportunity, and they're doing good work in the virtual space.

Question #6: How can we help our college students returning home when they didn’t expect to?

Susan:

Without being at all Pollyanna-ish, this is a great opportunity to get to know your child and who they are right now. Have conversations. They don't need to be long, but ask how this situation is different for them? Yes, you have house rules, which of those house rules can be a little more flexible to meet their developmental stage and where they are, which of them cannot?

There may be some lovely surprises about who your child has become in ways that you wouldn't necessarily know otherwise. You may have some discoveries, and they may have some discoveries as you share what's important to you and what's important to the household and why.

Heather:

We're not used to having conversations about how we interact and how we function with one another. But this is one of those times where we need the very direct and explicit conversations. It may be that you start by saying, "Okay, this might feel a little odd..." But we have to talk directly about these issues in order for us to function and move together as a unit. We're going to have to talk about these things in a very open and specific kind of way, maybe more than we ever have before.

Question #7: What are some resources for students, even though they are not on campus, to support them with mental wellness? 

• CAPS: Online Resources (purdue.edu/caps/services/digital-resources/index.html)
• COVID-19 Resources (purdue.edu/caps/covid-19/index.html)
• Speak with a clinician—call 765-494-6995...also for crises
• ODOS: call 765-494-1747 for support and information (purdue.edu/odos)
• Recreation and Wellness (purdue.edu/recwell)

To join the conversation and learn more,
use the hashtag #PurdueStepstoLeaps on social channels: