Open access peer-reviewed chapter

Beyond Pressure and Perfectionism – Student Struggles in Contemporary Denmark from the Perspectives of Educational Counsellors

Written By

Jeanett Bjønness and Margit Anne Petersen

Submitted: 24 August 2023 Reviewed: 20 November 2023 Published: 14 December 2023

DOI: 10.5772/intechopen.113962

From the Edited Volume

The Social Contexts of Young People - Engaging Youth and Young Adults

Edited by Patricia Snell Herzog

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Abstract

This chapter explores the struggles that high school and university students in Denmark experience and try to cope with, through the perspectives of study counselors. Scholars have lately described a relation between students’ felt pressures and an increase in diagnoses such as stress, anxiety, and depression as well as increases in the non-medical use of prescription pharmaceuticals for enhancement purposes. While counselors have a unique position in the educational system as someone who is there to support the students, they are also witnesses to the changes that student populations experience over time. The chapter is based on in-depth interviews with 36 counselors at different universities and high schools in Denmark and examines how counselors cope with new developments in the educational system as well as new kinds of student challenges and struggles that go beyond issues with performance and perfection.

Keywords

  • study counselors
  • students
  • educational structures
  • pressure
  • coping strategies
  • performance enhancement

1. Introduction

Many of our students just long for a gray Monday. There aren’t many completely normal days, where you as a student only attend classes and talk about the homework you have done for those classes (H5).

This chapter is based on in-depth interviews with 36 counselors at universities and high schools in Denmark. As the quote alludes to, counselors note that students often long for a ‘normal’ day with no pressures to perform or obligations to present themselves in specific ways. While students’ experiences are well-documented in research, experiences and perspectives from the point of view of educational counselors have been less explored even though these experiences would make an important contribution to understanding the pressures and struggles students face in current educational contexts. Counselors have a unique position in the educational system as they are there to help while at the same time not being part of the teaching system. Furthermore, counselors not only see struggles existing within student populations but also witness how these struggles might change over time, as well as how recent developments in the policies and practices that govern educational programs, also might influence students’ struggles. The chapter shows that counselors struggle with their role and possibilities to help students, and while the chapter mainly focuses on counselors’ experiences and views of students’ struggles with pressure and performance, we also describe how they deal with the fact that some students seek other solutions to their problems than asking counselors for help. As such, this chapter builds on the growing research interest concerning young adults and their overall well-being in the European and North American educational systems [1, 2]. It has been documented that as a result of an increasing focus on competition and achievement in Western Societies, many students feel highly pressured [3, 4] and several researchers have highlighted the relationship between the pressures experienced by students and an increase in diagnoses such as stress, anxiety, and depression [5, 6], and the increase in non-medical use of prescription pharmaceuticals for enhancement purposes among healthy college-students [7, 8, 9, 10, 11, 12, 13, 14]. This is also the case in Denmark, where several reports bear witness to increases in anxiety, stress, and a general lack of well-being among young people [2, 3, 15, 16, 17]. A tendency for young people to use and misuse prescription medicines as a way of keeping up and performing in the Danish educational system has also been noted [18, 19, 20, 21, 22].

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2. Theoretical background

An important theoretical point of departure for this chapter is that achievement seems to have become the ideal for a ‘good life’ and that the ideal self is an achieving self [2]. Even though modernity theorists [23, 24, 25] decades ago noted a growing space for individual self-construction and that the individual is less bounded than before, it seems that the poststructuralist self is not quite as ‘unbounded’ as these theorists have suggested [26]. On the contrary, a new kind of individual responsibility to construct self-hood seems to have developed. This kind of self has been linked to neoliberal societal values [27], that favor the predominantly active, efficient, and goal-oriented individual [15, 26, 28] and include an obligation to perform well.

In line with these more general sociological points, recent educational research also reports on an increasing focus on efficiency, performance, and accountability in educational policies in many Western societies. Devine et al. [29] suggest that this development places new demands on students, which again require a focus on competencies such as efficiency and goal orientation. According to recent Danish surveys, young people report decreases in well-being compared to a few years ago [17]. While young people’s mental well-being is affected by various factors, external as well as internal, and the causes for a lack of well-being are manifold, we suggest that the overall social focus on performance may be one of the major factors relevant to this development. A similar point is made by Sørensen & Nielsen [30] who analyze the self-construction of young Danes. The young people they have interviewed seem to experience no self-evident right to subjectivity, and to regard subjectivity as something they are obliged to earn and create themselves (Ibid: 44). This means, the authors suggest, that the obligation to perform a specific kind of self is strong and that young people, out of fear of becoming ‘abjected’, and thus ‘nobody’ (Ibid: 36), seem to be inclined to act close to the ideals. In line with, for example, Willig [31], Sørensen & Nielsen argue that this obligation seems to be hard for young people to avoid or eliminate (see also [16]), and they see this new demand to be a flexible, responsible, and self-realizing individual (see also Refs. [27, 32]) as different from the demands of modern societies. They argue that ‘the self’ used to be ‘closed’, in the sense that there were relatively constant rules to follow, while in contemporary Western societies, the self is ‘open’, and that it is the obligation of young people to ‘close’ it by choosing the right ways to present themselves. The educational system, the authors argue, is a central arena of this self-construction.

Furthermore, one domain that seems to be increasingly important in the lives of young people is the increasing influence of social media. While researchers increasingly associate the focus on performance and perfection in young people’s everyday lives, and especially in educational contexts, with their stress and dissatisfaction, several studies have recently focused on how social media might play a role in young people’s images of achievement and perfection [33].

Considering the described general discursive and structural conditions and developments, we investigate how counselors understand students’ conditions, struggles, and coping strategies, as well as how they contemplate their role in relation to the students in contemporary Denmark. Our analysis of the counselor’s narratives is thus inspired by a poststructuralist perspective [34, 35], suggesting that counselors’ (as well as the students’) narratives are conditioned by and embedded in social and cultural notions and norms.

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3. Methods

The chapter is the result of the analysis and comparison of interviews with educational counselors. The interviews formed part of three different datasets from related but separate research projects which included interviews with 36 counselors and 100 students. All three projects were concerned with the overall topic of performance enhancement and student struggles, primarily with a focus on the perspectives of the students themselves [12, 18, 21, 22]. In this chapter though, student struggles are analyzed through the lens of the educational counselors, and it outlines how counselors experience students’ challenges and solutions, also in the cases where students handle their problems in other ways than asking them for help.

3.1 Sample

The interviews for the first two projects took place at Danish universities and high schools between 2014 and 2016, and the last interviews took place at Danish high schools in 2018 and 2019. All three projects have sought to construct a diverse sample of both high schools and universities, to include as many different experiences and perspectives as possible. This includes both urban and rural high schools, various universities as well and different study programs that attract different student populations, including both competitive and less competitive settings. That being said, we also relied on schools and universities’ willingness to participate, and we recognize that the more resourceful institutions may have been more inclined to participate and that we relied on willing doorkeepers [36]. While our sample may not be representative, it nevertheless still covers a variety of perspectives.

The narrative data in this chapter come from in-depth qualitative face-to-face interviews with 36 study counselors from five different universities (U) and seven high schools in Denmark (H), conducted by the authors. The interviewees have worked as counselors between two and 25 years, there is a majority of women in the sample, and more than half have worked as counselors for over 10 years. We did not notice any differences between the experiences of male and female counselors, the main differences had more to do with the amount of time they had worked as counselors. While the interviews have belonged to different research projects, their focus and content are similar, addressing the themes also paramount in recent literature regarding student pressure and performance [2, 30].

We were particularly interested in exploring how counselors’ views on students’ struggles could contribute to the overall understanding of what students face in educational contexts in contemporary Denmark. The interviews focused on their individual experiences as counselors, both regarding recent political and structural developments in the educational system, the public discussions of performance pressure in media accounts, the kinds of problems students presented to them, and their knowledge of students’ coping strategies including performance-enhancing substance use. The interview schedules were open-ended and participants were able to raise themes and issues that were not necessarily included in the interview schedule [37]. For example, the perceived changing role of parents and importance of social media were themes introduced by the counselors. All interviews were recorded and transcribed verbatim.

3.2 Analysis

The empirical material was coded with Nvivo, using elaborate code trees with main codes and subcodes. We used thematic analysis [38] and discussed the material across the codes to identify patterns. In the analysis of the data, we were attentive to the ways in which the attitudes of the counselors reproduced or diverged from themes in public discourse or the media about education, performance, and perfection, which may affect the work life and attitudes of counselors. Furthermore, we paid attention to how themes raised by counselors resonated with and differed from the themes raised by students [12, 18, 21, 22]. Across all our data, our analysis suggests that many developments and considerations are emphasized by both counselors and students and between the different universities and schools, regardless of socio-cultural contexts and geographical locations.

The projects have been reported to the Danish Data Protection Agency. Our data collection is GDPR compliant and the research projects to which the data belongs have been followed by research groups of competent peers at Aarhus University.

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4. Results

Overall, our analysis suggests that there are an increasing number of students who seek counseling. Counselors find that students seem to experience new demands concerning their study life, as well as regarding themselves as individuals, requiring new coping strategies. The analysis illuminates the ways in which counselors conceptualize and manage this development and illustrates that student everyday life, as well as counselors’ role in the students’ lives, have changed radically. Many of the counselors try to explain these new developments by pointing to not only increased pressures in the education system but also by alluding to changes in leisure time and family life, including parental roles [30]. Furthermore, counselors are concerned about the increase in diagnoses among young people in general, as well as about indications that more students than before use performance-enhancing drugs. Finally, they are concerned about the pressure that is born of the requirement to present oneself as a successful being on social media [39]. The counselors reflect on how recent structural developments also cause new requirements for their daily work with the students. Among other things, they assume a more caregiving role than they used to and thus find themselves involved in tasks that they think ideally should be taken care of by the parents.

In the first section, we focus on how counselors describe the students they meet in the light of new demands for self-realization through perfection and achievement. In the second section, we take a closer look at how counselors view the background and implications of the students’ challenges. Finally, in the last section, we present and discuss the counselors’ experience with different coping strategies that students employ to meet their described changes and challenges.

4.1 Perfection and achievement

When we ask the counselors to describe the young people they meet in their counseling practice, they all (across our data sets) tend to describe contemporary students as concerned with perfection and grades.

They want to… uhm… perform well. They are all very concerned about that and about their marks. That is what is important to them… they are very concerned about doing what they see as perfect (H5).

The university counselor in the following quote, sees a tendency among the students to focus more on performance and results and he relates this to the new demands placed on students:

Students can no longer take their time the way they once could. They are pressured to finish their studies fast, both because of limitations in the financial aid system and because they in a shorter time-span need to perform well if they want to get a good internship or a relevant student job, or perhaps get into an international study program (U1).

Striving for perfection is not only a concern connected to grades and academic performance. Rather, it seems to reflect a more general tendency among young people to be concerned with perfection and achievement, not only to be the perfect student but also the perfect friend, partner, family member, intern, or whatever else they engage in [20, 21, 30, 40]. Furthermore, and related to the urge for perfection, according to the counselors, one of the main characteristics of the students is that they are goal-oriented. As a counselor at one of the central counseling offices for university students describes it, this ‘perfectionism’ may cause students to have problems handling situations they have not planned for:

I always tell them; ‘Yes, a truck can suddenly get stuck in the middle of your road. That is life. You have to learn that not everything will always be perfect. But this is very difficult for them to deal with. It is one of the challenges that we try to help them with (U7).

Some counselors also relate the focus on perfection and grades to another important change: they note that the ‘kinds’ of students that seek help have changed and that the students they meet now are in many ways more resourceful than the ones they met earlier:

Lately, after the progress reform, I get more students who have had a normal childhood, but who come with stress symptoms. So, there is a difference and I think we have just seen the beginning of it (U9).

But even if the students, who seek counseling, seem more resourceful than before, often, the students themselves cannot explain what is wrong, other than feeling stressed or unhappy. As one high school counselor notes:

Typically, they do not know what is wrong themselves. Some experience performance pressure which then triggers some anxiety. It is typically the girls who have anxiety, there are also boys, but it is especially the girls… It is clear that it is about having to appear perfect on a lot of parameters and at once and… that it triggers them… either panic anxiety or social anxiety, there are some contexts where (…) they cannot necessarily even say ‘that’s why I have anxiety’. But they can say ‘I feel pressured both in this and that and that area’ (H3).

As the previous quote illustrates, and this is especially so for young women (see also [18]), the range of different expectations the students have for themselves often somehow “gets in the way” of well-being. One high school counselor talks about several young women who collapse in a high-school gym class, and he relates this incident to the pressure to have perfect looks:

They are very preoccupied with the perfect look; it is important to look good to be good enough. Moreover, they come and tell me that it’s awful that they’ve only got B and not A in some subjects - they seek out the teachers and want an explanation of what they can do better to get an A. They are very preoccupied with those grades (H5).

Besides performing at school, the counselors experience that it is also important for young people, especially in high school, to perform in the peer group, and to be seen as popular, fun, or good-looking. Students who seek counseling often say that they are afraid of being excluded from the group and of being seen by peers as stupid or inadequate. This tendency to feel inadequate and insufficient is underscored by the following quote from a high school counselor:

We have many more than before who feel inadequate. They do not use the word ‘insufficient’, but they say, ‘I am not good enough’. And when I talk with them, it’s the fear of being stupid and of being outside the group that preoccupies them. What do the others think about me? (…) That is something we’ve talked about in the group of student counselors - this has become much more widespread! Many of our students miss a gray Monday (H5).

When asked, the counselor expands on the concept of a gray Monday, explaining that the students need “ordinary and predictable days, where they know what to do”. He thinks that many of the students find that the expectations are too high and that they meet (too) high demands for levels of reflexivity and independence.

Many of the counselors note that the demand to work independently and the pressure to be reflective is growing, and there is great pressure to constantly start new projects and meet multiple deadlines. They find that the pressure experienced by the students is very ‘real’, and they note the same tendency in their own work lives: “In our own schedule as study counselors - many more assignments come in” (H9).

Related to this, and regardless of where in the educational system they are working, almost all the counselors notice that one of the challenges that students face is the ability to structure their time. Having to navigate many different projects and subjects as well as social and extracurricular activities is in itself a difficult task, and with the added pressure to perform well it becomes even more difficult:

We did a little ‘study’ of our own, looking at what the main reasons for seeking help at the counseling office were. Apart from lack of self-confidence, time management was a major issue (U7).

Many counselors note that strongly related to the anxiety of wasting time is a growing goal-orientation among the students. A university counselor explains that the students who are in the phase of applying to schools or universities are very concerned about making the right choices:

One of the things I have felt most clearly during the 4 years I have worked here is that there has been more goal orientation among the students, especially those who seek us out: ‘If I start here, what opportunities do I have? What can I end up with? What choices should I make?’ (…) These are people who have not started at all yet (…) they make plans, and if at some point they have to deviate from this plan, then they feel that they have wasted their time in some way. And I think that is a pressure for them, to be sure not to waste time or resources or limited financial aid (U12).

Some of the high school counselors see it as their task to explain to the students that more than grades, it is important to focus on well-being and a curiosity to learn. But then, as one counselor explains:

Then the students smile at me and say ‘yes, but we know very well what reality is like - we must have an A in average to get into our dream study. So, it is worthless to focus on well-being’ (H5).

This seeming lack of confidence among students in their own ability to influence the general circumstances is something many counselors experience, and while it is more pronounced in the high school domain, several traits of it also exist within the universities. Furthermore, while there are some differences in how striving for perfection and focusing on achievement is challenging for young people, who seek counseling in high schools and universities, overall, they seem to experience many of the same kinds of problems in their everyday lives. This points to a more general problem that may be less connected to the specific level of education or type of situation a young person is in and more to a general societal and cultural phenomenon.

4.2 Recent reforms and changes in the study counselor role

Overall, study counselors are quite concerned with recent reforms of the educational system which is also described in research [39, 41]. They find that recent changes in Denmark, for example, the implementation of the ‘progress reform’ in 2005, has had a large influence not only on the educational pressure that students must deal with but also on their own role and ability to help students, who face difficulties. One high school counselor, who is also a teacher with nearly 20 years of work experience, reflects on this:

It is quite frustrating to have to live up to all these demands that come from outside the educational system. Things have changed a lot…with these reforms… I thought, great, we are going to get much more time with the students, more time to talk with them. But that was not the case at all. It was all about working more. In fact, we are getting less and less time. Both in teaching and in general (H2).

The counselors attribute the experience of teachers and counselors having less time with the students to the continual pressure from the government to change procedures. Especially the older, more experienced counselors underline the increased time pressure and the fact that more students demand their assistance only adds to the time pressure.

These changes have increased pressures both on counselors’ time and their performance. Some counselors also note that this development may relate to what has been described in recent literature, that academic education has become more of an ideal in the overall discourse on youth [2, 3, 6]. Many counselors believe that this development may lead young people to believe that performing academically is the only way to perform a successful youth identity:

I think many more young people choose and are admitted to university than used to be the case. Earlier, it was not for everyone, but now it seems that everyone is somehow pressured into getting a university degree, even if it is not really their thing (U4).

The counselors are concerned with the ways in which recent developments; reforms and an increase in the presence of students with diagnoses such as anxiety, depression, and stress, influence both the students’ lives and their own daily work as counselors. The more experienced counselors find that the students they meet often have other and more serious problems than the students who approached them before the reforms. In fact, sometimes, counselors find that helping students is beyond their ability as study counselors. The counselors reflect on these changes, and in the following, we describe the four main developments that counselors see as “game-changers” in their own work life: increases in students with diagnoses; parents’ changing roles; increasing loneliness among students; and the presence of social media in students’ lives.

4.3 Student pressures and an increase in diagnoses

The counselors experience that the combination of the performance-based ‘measurement culture’ with the increased time pressure creates new requirements and a more stressful situation for many students [12, 18, 20].

Many students experience that they are not good enough. And then there is a hassle in the family, and the boyfriend splitting up, or the housing situation is unsafe (…) These things have always been talked about, but what we’ve seen escalate over several years is about performance and perfectionism. This affects all students (…) Perfectionism is not just being very ambitious, but as something unhealthy, almost pathological, and you scold yourself because you got a B and not an A. (U6)

Study counselors, especially at high schools, suggest that increasing demands, while simultaneously having less access to face-to-face contact with teachers, may contribute to the problems experienced by students:

Many have a diagnosis…. A lot of them are anxious. We try to help them develop strategies that they might be able to take with them further on in their studies… our role as counselors has really changed. It used to mainly be concerned with electives and study requirements, and of course absence from school, which we still deal with, but then we talk about why they have been absent, and then all the problems surface (H5).

The more experienced high school counselors recall that, some years ago, they helped more with, for example, choice of subject and absences from classes, while now they increasingly help with problems such as vulnerability related to anxiety and depression. Especially high school counselors have noticed that particularly the youngest students over the last decade or so, have started to seek help from counselors regarding new kinds of challenges in the educational system:

I really like to feel that I make a difference for the students. Those who don’t really have adults in their lives, at least they have a study counselor in whom they can confide. Because it is important to have grownups who you can share your thoughts and problems with…. you know, the pressure has increased, and the students use me for more things than earlier on…I really feel that many of them are much more vulnerable than what we have seen before (H5).

As this last quote illustrates, one common concern about the growing vulnerability of students is that they seem to lack responsible adults in their lives.

4.4 The role of parents

Both high school counselors and university counselors underscore the importance of family support for the well-being of students, but quite a few of them hear from students that they feel that their parents lack interest and that they do not feel supported by them. An experienced university counselor (U13) cites a student he met in counseling: “Now I am a first-generation academic, a true pattern breaker, and there is no one in my background who understands me. I feel extremely lonely.” On the other hand, counselors also often hear of parents who, in the eyes of the students, expect too much from their children. This is sometimes when parents are very well educated, and the student feels pressured to live up to that. Finally, counselors mention that some students live with a single or vulnerable parent and may be afraid to bother them with their problems.

Quite a few of the high school counselors describe that students often experience distance in relation to their parents and that they lack an adult with whom they have a confidential relationship. Sometimes, when high school counselors invite parents to meetings, the parents have no idea what their child is struggling with:

Sometimes it comes as a surprise to the parents how big the problem is. And many of the students we see feel that their parents are not really present in their everyday lives (H5).

There is a general tendency that counselors are increasingly experiencing having to take care of tasks that they think of as parental tasks, such as care and recognition.

4.5 Loneliness

A growing problem that counselors struggle to help students with is the issue of loneliness and a sense of feeling different. In a recent study about Danish university students, one out of four participants described themselves as lonely in their study environment [42], and our interviews showed that this may manifest itself in many ways. One university counselor gives the following examples:

It can be: “Now I am a first-generation academic, and there is not anyone in my background who understands me. I feel that I am extremely alone with this”. Or: “I come from a home where both my parents have Ph.D. degrees and I think there is so much I have to live up to intellectually”. I might see slightly different versions of it depending on the background. But I might see it with all types of backgrounds (U5).

Although loneliness is a theme both among university and high school counselors, it is more upfront among high school counselors. Many of them are concerned with an increasing number of young people feeling alone and socially excluded:

Typically, they come to my office and say, ‘I want to change class’. And when you ask ‘why?’ You find that it’s not about the teachers, it’s not about them thinking they’re in the right school with the right subjects, but that they cannot identify themselves with their classmates. And that can seem somehow strange because 5-6 students can come to see me from the same class and say the same thing, right? They all feel alone and seem to think that all the others have someone to talk to (H3).

Many counselors experience that loneliness may be one of the most difficult problems for high school students to handle because there seems to be a kind of taboo attached to it. In contemporary Denmark, where the main requirement is to be active, goal-oriented, socially visible, and popular [2, 26], it may be especially hard to talk about feeling lonely:

In the last two or three years, I think loneliness has been an ever-increasing problem. Before that, they approached me with challenges like stress and assignments and… Now I think that loneliness, is definitely top one of things they come to me with (…) And it’s not because we do not have stressed students today, we certainly still have (H3).

Many of the high school counselors we interviewed are concerned about the degree to which loneliness preoccupies students and about how common it is. And they find it hard to handle:

If they say, ‘I suspect I have depression’ or if they talk about symptoms of anxiety, then it is pretty easy to say: ‘You need to go to your doctor’. But what do you say to a young person who is lonely? I actually think that’s harder, right? … There is not necessarily anything wrong. They just don’t thrive (…) Sometimes you can find some explanations… But often they are just not really happy, and they think it is difficult when everyone else has a lot more fun than themselves (H7).

In general, the high school counselors note that the feeling of not being popular is an important concern of the students they meet in counseling. The feeling of inadequacy is described by, among others, Alain Ehrenberg [43], who is concerned exactly with the distance between what societies expect, and what individuals can live up to. Bjønness [18] for example describes how students experience a discrepancy between what is expected from them as students and friends, and what they can do or perform. This discrepancy, according to the counselors, is made even more present for the students as a result of the increasing role of social media.

4.6 Social media

Counselors both at high schools and universities generally agree that much of the academic and social imperative for success, and the related stress and loneliness, may relate to the emerging culture of documenting and presenting oneself through social media. They note that the way young people interact has changed a lot and that platforms such as Facebook and Instagram are used to receive positive feedback from friends [44]. This creates an environment of comparison and competition, which, for some young people, may be hard to live up to [33].

Many of the counselors argue that social media may contribute to the feeling of being alone:

We have talked about in the student counselor group that… it is harder to be young today. Because there is a requirement that you must be on social media. You cannot just opt out. And it is 24/7 that you are on communities on social media. The phone must be switched off during teaching, but as soon as the break is there, they pick it up - because they must check if there is something they have to comment on (…), and that puts pressure on them (…) Fear of missing out, right? Especially among the group of students who want to perform well (H5).

Some counselors are concerned, that young people who feel that they are already marginalized may feel that social media amplifies their sense of marginality:

They typically have a class chat on Messenger or Facebook - and when they have written on the chat ‘Is there anyone who wants to join something’ and they get no answer - they can see that everyone has seen their questions and then of course they feel extremely humiliated to have asked and no one answers. And then maybe someone else asks something and then everyone answers all of a sudden (…)They know very well, intellectually, that it is a snapshot and that it is not necessarily the whole reality, but they still have the feeling that they are never in those pictures (…) those who are lonely, they also have a tendency to withdraw so they are not included in those class chats, they end up opting out of everything (H3).

Counselors at both university and high schools are concerned with the felt requirement among students to be on social media all the time:

We are more and more experiencing those “FOMOs” - fear of missing out - tendencies. It is rare that one simply experiences a student who takes the consequence and erases himself – it is mostly as if the mobile phone is being tattooed on their hand. It sits there constantly, and it must be on constantly. They are so scared of missing something. FOMOs are here to stay. One should preferably look like someone who is constantly in touch and constantly busy, all the time, fresh, and smart (U12).

Besides providing a means to become included, social media is also about promoting oneself, showing that one is both having fun and doing well in work and studies. Some counselors talk about certain students as ‘overachievers’, who want to show their success in all aspects of their lives [3, 21], but that even among the students, who do not fit into this description, there is a kind of tacit requirement to engage in this self-promotion. Several counselors find this hard to resolve, and many relate this hardship to the fact that their own youth experience was so different from what the students experience today. They find it difficult to fully understand and live up to technological changes and the student’s perceived need to constantly engage with social media.

We have until now described recent changes from the perspective of educational counselors, but the tendencies described above are also central in our interviews with students as described elsewhere [12, 18, 39]. In the next section, we discuss how the counselors understand some of the different coping strategies used by students.

4.7 The emergence of new coping strategies

Many students in both high school and university do not seek counseling [21, 39]. Such students often do not expect that counselors could be helpful in solving the struggles they deal with, and some students understand seeking help as admitting to not being in control of things. Students who do not seek counseling sometimes seek alternative strategies, outside the educational system [21]. However, counselors have noted that even though the students do not approach the counselor to talk through their problems, they sometimes ask the counselor’s advice about how to get a doctor’s note, a diagnosis, or a sick leave, to give space and time to deal with what they are going through:

Many students take sick leave or get a doctor’s note so that they can postpone their exams or papers. This is another way of saving time in the system (U3).

While the counselors acknowledge that these can be necessary solutions, several of them suggest that these strategies are sometimes used to deal with a situation that perhaps could have been helped in other ways:

With certain diagnoses, students get more time for an exam, and this can of course really help those who need it. But I can’t help wondering if some of the diagnoses that are made, might be strategies for coping with an educational system (U1).

The counselors seem to acknowledge that these kinds of strategies may be used as ways of dealing with an educational system that often does not encompass enough time and flexibility. In some ways, this might be understood as related to processes of (bio)medicalization [45, 46]. This is not necessarily because students and counselors see their problems as pathological or belonging to the medical realm but because they have figured out that medical documents and explanations may constitute a more legitimate and productive way to achieve help. As this university counselor notes:

Problems with non-wellbeing take up more and more space in our work (…) earlier on a diagnosis had negative connotations… today it provides access to various resources (U10).

But while some students choose to cope with challenges such as concentration, time pressure, procrastination, motivation, and self-confidence via the official healthcare system, counselors note that others choose to acquire and consume pharmaceuticals non-medically [18, 20, 39, 47].

I have had a few students, in the last 6 months, who have said that it is difficult to get an appointment at the psychiatrist’s office and that many want to get an ADHD diagnosis because then they have access to the medicine. I asked one of them if he knew people who did that, and he said yes. He did not think it was because they felt they had ADHD, but rather in order to get access to the drugs (U7).

Using doctors as access to prescription stimulants for non-medical purposes corresponds with what previous studies have shown [48] and can be understood as yet another version of turning more general problems into medical ones [2, 15, 46]. Several scholars have pointed to the blurred boundaries between enhancement and treatment in the use of pharmaceutical enhancers [49, 50] and research has documented how the knowledge about such practices spreads fast in and beyond student populations through peers, as well as on social media [48, 51]. While there is not much survey research in a Danish context, a bi-annual survey focusing on student life and well-being shows that 7% of students use different substances to handle pressures, including caffeine pills, beta-blockers, prescription stimulants, and alcohol [19]. Many of the counselors are aware of the non-medical use of Ritalin and other ADHD medicines but, they have so far been more focused on cannabis use, particularly in high school settings, which seems to be somewhat normalized among Danish students. Most of the counselors do not seem to worry much about the use of cannabis, and they also meet students who thrive despite using cannabis. Jens (H19) says that some students may experience pressure, but in his view, that is not because they use cannabis. On the contrary, Jens says: “Rather smoke cannabis and be a part of a group, than be lonely”. Counselors may also experience cannabis use as a problem though, for example when it is used because the young student cannot afford to buy medicine for their conditions:

I have experienced some students who smoke some cannabis because they cannot afford their prescribed medicine, or who have forgotten to buy it. Maybe they just moved from their parents, and just can’t get it done (H8).

At universities, the use of pharmaceutical enhancers like Ritalin is a topic of concern, but most counselors think that there are more cases than reported, because they expect that students would not come to them and talk about such use:

Many students would be ashamed to use study drugs. When you read about the culture, for example in American universities, they are very open about their use of study drugs. But most of our students would feel that it was cheating. So, some students might do it, but they would keep it to themselves. They would not tell us (U 13).

Previous research confirms that, in a Danish context, students tend to keep their non-medical use of prescription stimulants a secret, also from counselors, because it is not normalized and accepted to the extent that it is in a North American context but also because most of the students do not conceptualize their use of such drugs as problematic [52]. While counselors recognize that using substances to manage student pressures occurs without them knowing much about it, they do not isolate this ‘misuse’ from other coping strategies, such as doctor’s notes, sick leaves, or, as this high school counselor points out, self-hurting behavior:

If not all, then at least a very high percentage of our students have found some strategies to either relieve their ‘pains’ or get a little recognition. And it is not only drug misuse. It can also be ‘cutting’. Or other kinds of self-inflicted pain. Eating disorders also. But probably the most common is drug misuse (H21).

Many counselors make a link between study reforms and the indications that more students use performance-enhancing substances, suggesting that the system pressures young people into ‘boosting’ themselves with substances:

One could imagine that progress means that one says: “Well, when we are now more pressured in relation to the fact that we have to pass the exam on the first attempt, I just take some Ritalin or an extra-large handful of caffeine pills to be able to handle it”. You may realize that we have a new phenomenon, but whether it means pulling the behavior in one direction or another, you do not know until you see it happen (U13).

But some counselors recall that substances were also used years ago when they were students themselves:

I remember we used caffeine pills back then. In a way, it is not that different from what students are doing now, but I guess there is a difference between caffeine and ADHD medicine. And there is a difference in how we felt back then, and how I see the students feeling now. When I was a student, caffeine pills were not even illegal (U1).

While what this counselor suggests implies that functional drug use [50] is not a new phenomenon, the particularities of the drug use may well be very different nowadays. None of the more experienced counselors recall such discourses on ‘mental well-being’ or ‘being the best version of oneself’ that currently dominates the focus among many young people.

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5. Conclusion

In this chapter, we have illustrated some of the common challenges that exist among Danish high school and university students from the perspective of educational counselors. While students often ask counselors for help with problems that relate to overall struggles with pressure and perfection, our study also reveals how recent changes in discourses about performance in Danish society, reforms of educational structures, as well as technological changes affect not only students’ lives, circumstances, and struggles but also how counselors are (and are not) able to live up to new demands and roles.

This illustrates, as some theorists argue, that individuals are less bounded than earlier [24, 25], but also that rather than unboundedness, it may be a matter of new kinds of boundedness. It seems that both students’ and counselors’ narratives confirm that rather than fewer boundaries for individuals, new ones are emerging. Both student’s and counselor’s narratives indicate that the main obligation is to perform well and to present, build, and promote oneself (also on social media) as an efficient, goal-oriented, and socially competent individual [10, 26, 28, 53]. These new requirements seem to create new challenges both for young people, especially the youngest students, in the Danish educational system, as well as for the counselors’ ability to understand and help. There is a concern among the counselors about the growing number of diagnoses and loneliness among students, and how this development relates to recent reforms in the educational system, and to the more general development towards ‘the performance society’.

Given the quite unison concerns in much research, as well as among counselors and students in our Danish context, we find that more attention should be paid to not only the consequences of the increasing pressures to perform which seems to influence the well-being of young people, but also to the political and cultural structures in which these pressures exist.

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Conflict of interest

The authors declare no conflict of interest.

References

  1. 1. Låftman SB, Almquist YB, Östberg V. Students’ accounts of school-performance stress: A qualitative analysis of a high-achieving setting in Stockholm, Sweden. Journal of Youth Studies. 2013;16(7):932-949
  2. 2. Petersen A. Præstationssamfundet. København: Hans Reitzels forlag; 2016
  3. 3. Sørensen NU, Pless M, Katznelson N, Nielsen ML. Picture perfect. Præstationsorienteringer blandt unge i forskellige ungdomslivskontekster. Tidsskrift for Ungdomsforskning. 2017;17:27-48
  4. 4. Brown W. Neo-liberalism and the end of liberal democracy. Theory & Event. 2003;7(1):1-19
  5. 5. Ford JA, Arrastia MC. Pill-poppers and dopers: A comparison of non-medical prescription drug use and illicit/street drug use among college students. Addictive Behaviours. 2008;33:934-941
  6. 6. Skagestad LJ, Madsen OJ. Man blir så redd for å gå glipp av seg selv - En tematisk analyse av depresjon hos unge voksne. Tidsskrift for Norsk Psykologforening. 2015;52(9):750-761
  7. 7. Boyd CJ et al. Adolecents’ nonmedical use of prescription medications and other problem behaviors. Journal of Adolescent Health. 2009;45:543-550
  8. 8. Hildt E, Lieb K, Francke AG. Life context of pharmacological academic performance enhancement among university students - A qualitative approach. BMC Medical Ethics. 2014;15(23):1-10
  9. 9. LeClair A, Kelly BC, Pawson M, Wells BE, Parons JT. Motivations for prescription drug misuse amongyoung adults: Considering social and developmental contexts. Drugs, Education, Prevention and Policy. 2015;22(3):208-216
  10. 10. Maier M, Schaub M. The use of prescription drugs and drugs for abuse for neuroenhancemnet in Europe: Not widespread, but a reality. European Pshychologist. 2015;20(3):155-166
  11. 11. McCabe SE, Boyd CJ, Young A. Medical and nonmedical use of prescription drugs among secondary school students. Journal of Adolescent Health. 2007;40:76-83
  12. 12. Petersen MA, Nørgaard LS, Traulsen JM. Going to the doctor with enhancement in mind–An ethnographic study of university students’ use of prescription stimulants and their moral ambivalence. Drugs: Education, Prevention and Policy. 2015;22(3):201-207
  13. 13. Rabiner DL, Anastopoulos AD, Costello JE, Hoyle RH, Swartzwelder SH. Prediction of nonmedical ADHD medication use by college students. Journal of Attention Disorders. 2019;13(2):144-153
  14. 14. Teter CJ, McCabe SE, LaGrange MSWK, Cranford JA, Boyd CJ. Illicit use of specific prescription stimulants among college students: Prevalence, motives, and routes of administration. Phamocotherapy. The Journal of Human Pharmacology and Drug Therapy. 2012;26(10):1501-1510
  15. 15. Brinkmann S. Diagnoser og patologier før og nu. In: Brinkmann S, editor. Det Diagnosticerede liv. Sygdom Uden Grænser. Århus: Forlaget Klim; 2010. pp. 15-31
  16. 16. Illeris K, Katznelson N, Nielsen JC, Simonsen B, Sørensen NS. Ungdomsliv. Mellem Individualisering og Standardisering. Frederiksberg, Denmark: Samfundslitteratur; 2009
  17. 17. Sundhedsstyrelsen. Danskernes Sundhed – Den Nationale Sundhedsprofil. 2017. Available from: https://www.sst.dk/da/udgivelser/2018/danskernes-sundhed-den-nationale-sundhedsprofil-2017
  18. 18. Bjønness J. Gendered aspects of Danish students’ non-medical use of prescription pharmaceuticals for enhancement purposes in the ‘performance society’. Drugs: Education, Prevention and Policy. 2019;26(4):309-318
  19. 19. Djøf. Djøf’s studielivsundersøgelse. 2018. Available from: https://services.djoef.dk/~/media/documents/djoef/d/dj-oe-f-analyse/studielivsunders-oe-gelse-2018.pdf
  20. 20. Krøll LT. Students’ non-medical use of pharmaceuticals to manage time in everyday life crises. Drugs, Education, Prevention and Policy. 2019;26(4):339-346. DOI: 10.1080/09687637.2019.1585760
  21. 21. Petersen MA, Ølgaard LJLD, Nørgaard LS. Contextualizing study drugs-An exploratory study of perceptions and practices among study counselors, general practitioners, psychiatrists and from student polls. Research in Social and Administrative Pharmacy. 2019;15(10):1204-1211
  22. 22. Bjønness J. Målrettethed og kontrol. Studerendes fortællinger om brug af præstationsfremmende midler for at trives og præstere under uddannelse. Norsk sosiologisk tidsskrift. 2019;3(6):394-410
  23. 23. Giddens A, Pierson C. Conversations with Anthony Giddens: Making Sense of Modernity. Stanford University Press; 1998
  24. 24. Beck U. The terrorist threat: World risk society revisited. Theory, Culture & Society. 2002;19(4):39-55
  25. 25. Ziehe T. Debate article: School and youth—A differential relation. Reflections on some blank areas in the current reform discussions. Young. 2000;8(1):54-63
  26. 26. Willig R. Selvrealiseringsoptioner – vor tids fordring om anerkendelse. I. In: Willig R, Østergaard M, editors. Sociale Patologier. København: Hans Reitzel; 2005
  27. 27. Gershon I. Neoliberal agency. Current Anthropology. 2011;52(4):537-555. DOI: 10.1086/660866
  28. 28. Rose N. Neurochemical Selves. Society. Nov-Dec 2003. pp. 46-59
  29. 29. Devine D, Grummel B, Lynch K. Crafting the elastic self? Gender and identities in senior appointments in Irish education. Gender, Work and Organisation. 2011;18:631-649. DOI: 10.1111/j.1468-0432.2009.00513.x
  30. 30. Sørensen NU, Nielsen JC. Et helt normalt perfekt selv. Konstruktioner af selvet i unges beretninger om mistrivsel. Dansk Sociologi. 2014;25(1):33-54
  31. 31. Willig R. Kritikkens U-vending: En Diagnose af Forvandlingen Fra Samfundskritik Til Selvkritik. København: Hans Reitzels Forlag; 2013
  32. 32. Rose N. Livets politik. Biomedicin, Magt og Subjektivitet i det 21. århundrede: Dansk Psykologisk Forlag; 2009/1999
  33. 33. Kleemans M, Daalmans S, Carbaat I, Anschütz D. Picture perfect: The direct effect of manipulated Instagram photos on body image in adolescent girls. Media Psychology. 2018;21(1):93-110
  34. 34. Butler J. Gender Trouble. Feminism and Subversion of Identity. New York: Routledge; 1990
  35. 35. Butler J. Bodies that Matter. On the Discursive Limits of “Sex”. New York: Routledge; 1993
  36. 36. Bryman A. Sampling in qualitative research. Social Research Methods. 2012;4:415-429
  37. 37. Fog J. Med Samtalen Som Udgangspunkt: Det Kvalitative Forskningsinterview. København: Akademisk forlag; 1994
  38. 38. Braun V, Clarke V. What can “thematic analysis” offer health and wellbeing researchers? International Journal of Qualitative Studies on Health and Well-Being. 2014;9(1):26152
  39. 39. Bjønness J. Et udstrakt selv: Unges brug af medicinsk kognitiv forbedring for at trives og præstere bedre under uddannelse. Tidsskrift for Forskning i Sygdom og Samfund. 2018;15(28):87-111
  40. 40. Jørgensen CR. Danmark på Briksen: Et Psykologisk Perspektiv på Danmark og danskerne i det senmoderne. Hans Reitzel; 2012
  41. 41. Sarauw LL, Madsen SR. Risikonavigation i fremdriftsstormen: Når studerende oversætter fremdriftsreformen ud fra nye risikologikker. Dansk Universitetspædagogisk Tidsskrift. 2017;12(22):141-152
  42. 42. Djøf. Djøfs studielivsundersøgelse. 2019. Available from: https://www.djoef.dk/-/media/documents/djoef/d/dj-oe-f-analyse/studielivsunders-oe-gelse-2019.ashx
  43. 43. Ehrenberg A. The Weariness of the self. In: Diagnosing the History of Depression in Contemporary Age. Quebec: McGill-Queens University Press; 2010
  44. 44. Chua THH, Chang L. Follow me and like my beautiful selfies: Singapore teenage girls’ engagement in self-presentation and peer comparison on social media. Computers in Human Behavior. 2016;55:190-197
  45. 45. Clarke A, Shim J. Medicalisation and biomedicalisation revisted: Technoscience and transformations of health, illness and American medicine. I. In: Pescosolido BA et al., editors. Handbook of the Socioogy of Health, Illness and Healing. A blueprint for the 21th century. New York: Springer; 2011
  46. 46. Williams SJ, Seale C, Boden S, Lowe P, Steinberg DL. Waking up to sleepiness: Modafinil, the media and the pharmaceuticalisation of everyday/night life. Sociology of Health and Illness. 2008;30(6):839-855
  47. 47. DeSantis AD, Hane AC. “Adderall is definitely not a drug”: Justifications for the illegal use of ADHD stimulants. Substance Use & Misuse. 2010;45(1-2):31-46. DOI: 10.3109/10826080902858334
  48. 48. Vrecko S. Just how cognitive is “cognitive enhancement”? On the significance of emotions in university students’ experiences with study drugs. AJOB Neuroscience. Nov/Dec 2013;4(1):4-12
  49. 49. Coveney C, Bjønness J. Making sense of pharmaceutical cognitive enhancement: Taking stock and looking forward. Drugs: Education, Prevention and Policy. 2019;26(4):293-300
  50. 50. Bancroft A. Drugs, Intoxication and Society. Chichester: John Wiley and Sons; 2009
  51. 51. Petersen MA, Petersen IL, Poulsen C, Nørgaard LS. # Studydrugs–persuasive posting on Instagram. International Journal of Drug Policy. 2021;95:103100
  52. 52. Petersen MA. Study drugs som vennetjeneste, ordineret medicin, eller stoffer til salg: Om anskaffelsen og brugen af ADHD lægemidler til optimering. Tidsskrift for Forskning I Sygdom Og Samfund. 2018;15(28):133-153
  53. 53. Hjortkjær C. Utilstrækkelig. Hvorfor den nye moral gør de unge psykisk syge. Klim. 2020

Written By

Jeanett Bjønness and Margit Anne Petersen

Submitted: 24 August 2023 Reviewed: 20 November 2023 Published: 14 December 2023