Exclusive CLIMATE CHANGE coverage
Part one of this article briefly reviewed the literature on climate anxiety, presented the clinical rationale for moving climate-distressed patients into engaged action in concert with others, and listed numerous varied means of action.1 In this article, particular clinical situations in working with climate anxiety are discussed. The realities of climate change call upon a range of our skills, including our psychotherapeutic skills. Climate is both a public health and a psychological issue and these aspects are intertwined.
Most Americans are worried about climate change, and climate change may come up in various ways in treatment.2 The patient may explicitly make reference to it, or it may be an obvious aspect of their situation, such as having lost a home to wildfire. Sometimes the references are explicit. However, often these references are made by the patient in passing. As with any difficult topic, like sex or spirituality, the patient may be waiting, consciously or unconsciously, to see if the therapist can handle the discussion. It is the job of the therapist to be listening for possible references and to open these subjects for exploration.
Patients may reference the state of the world, the news, a friend or relative dealing with fire, flood, or storm, or concern about their children’s future. Sometimes these references may be made quite dismissively or sarcastically, as though the patient is inviting the therapist to collude in ignoring the importance of our collective situation. It is important that the therapist not share in an unspoken assumption that climate is too big to talk about. When such references come up in treatment, the therapist should follow up: “I noticed you joked about the state of the world. Perhaps there are things about it that are frightening, so you don’t want to let yourself take them seriously. What is it like for you?” Then the therapist is in a position to explore the patient’s feelings and help him or her actively engage in response to his or her deepest concerns.
A discussion about climate involves a fresh appreciation of our relationship with the future. British psychoanalyst Rosemary Randall points out that we have defensively tended to split our appreciation for present and future, predicting future catastrophe while wrapping the present in gauze, as though the present is not connected to the future.3 She and Australian cultural researcher Lesley Head4 point out that some of this difficulty might relate to the enormously influential work of Kubler-Ross on grief.
Kubler-Ross was working with people who were dying, and therefore the final stage she described was an acceptance that did not include a future. As Leslie Head describes, in our current climate situation, we enter a future with necessary coexistence of grief and hope. She distinguishes hope from optimism, noting that optimism tends to push out negative feelings, whereas hope has room for grief also. Popular movements dealing with climate anxiety, the Good Grief Network, and Joanna Macy’s Active Hope Workshops emphasize this coexistence of hope and grief.
1. Lewis J. In the room with climate anxiety, part 1. Psychiatric Times. 2018;35(11):1-2.
2. Leiserowitz A, Maibach E, Roser-Renouf C, et al. Climate Change in the American Mind: March 2018. New Haven, CT: Yale Program on Climate Change Communication; 2017.
3. Randall R. Loss and climate change: the cost of parallel narratives. Ecopsychol. 2009;1:118-129.
4. Head L. Hope and Grief in the Anthropocene: Re-Conceptualising Human-Nature Relations. London: Routledge; 2016.
5. Weintrobe S, Ed. The difficult problem of anxiety in thinking about climate change. Engaging with Climate Change: Psychoanalytic and Interdisciplinary Perspectives. London: Routledge; 2013: 33-47.
6. Alame D, Truog RD. How should clinicians weigh the benefits and harms of discussing politicized topics that influence their individual patients’ health? AMA J Ethics. 2017;19:1174-1182.
7. Ekholm S, Olofsson A. Parenthood and worrying about climate change: the limitations of previous approaches. Risk Analysis. 2017;37:305-314.
8. Benedek T. Parenthood as a developmental phase. J Am Psychoanal Assoc. 1959;7:389-417.
9. Hugger L. Mourning the loss of the idealized child. J Infant Child Adolesc Psychother. 2009;8:124-136.
10. Whitmarsh LE. Scepticism and uncertainty about climate change: dimensions, determinants and change over time. Global Environ Change. 2011;21:690-700.
11. McIntosh S. Overcoming Polarization by Evolving Both Right and Left: How Polarity Theory Provides a Path to Political Progress. Boulder: Institute for Cultural Evolution; 2016.
12. Australian Psychological Society. Coping with Climate Change Distress, Information Sheet. www.psychology.org.au/getmedia/cf076d33-4470-415d-8acc-75f375adf2f3/copi.... Accessed December 6, 2018.