Rey Sunglao in Grimes Glen Park. Photo Credit, Thompson Marinho.

Introduction

As promised, this is the third of a series with the above title.

• Part I focused on a growing awareness of the effects of Climate Change on Mental Health.
• Part II emphasized the positive effects on Nature on Mental Health.

This blog, Part III summarizes some of the things that we can be aware of to help ourselves, friends, family members, and neighbors with whatever concerns we might have about Climate Change. Throughout my 40 years of practice I always have said that nothing is really “wrong” with 99.8 percent of my patients are just good people with brains that work in a certain way and have developed defenses in order to survive in a traumatic and violent world.

This article is about unwrapping and releasing that goodness, and all are in preparation for our gala celebration on December 2. Hope to see you there!

Climate Change Anxiety: Is it Real?

Because climate anxiety is a relatively new concern, many questions still remain unanswered by researchers in the mental health field. The information below is adapted from two articles:

• Climate Anxiety: Trigger or Threat for Mental Disorders?
• Climate Anxiety Does not Need a Diagnosis of a Mental Disorder.

1. There is no consensus among researchers about the global incidence of climate anxiety. Some have put forth the argument that climate anxiety has a greater impact on lower-income countries in areas directly affected by climate change, particularly among the youth, who are at a greater risk due to their higher level of awareness and concern about climate change. Other researchers have contested this claim, arguing that countries with different average incomes have no substantial differences in their incidence of climate anxiety. These researchers have proposed that this issue has to do, rather, with impact visibility and adaptation capacity.
2. There is no consensus on the relationship between climate anxiety and mental health disorders. Some authors have put forth the bidirectional argument that climate anxiety may not only trigger mental disorders, but also can be more likely to be developed in individuals with pre-existing mental disorders. Other researchers have warned against the need to pathologize climate anxiety as a mental health disorder, arguing that “this conveys the wrong message that it is an individual’s problem […], requiring therapeutic intervention.”
3. There is no consensus on the need of therapeutic support for climate anxiety. While some researchers advise against treatments for climate anxiety due to the lack of evidence showing this anxiety as being excessive, others have encouraged therapeutic support to youth dealing with eco-anxiety.
4. There is consensus that climate anxiety plays a mobilizing role by acting as a catalyst to collective action. Climate anxiety is a very valid emotional response to the genuine threat of climate change, and as such, it has the potential of motivating individuals to recognize and promptly address threats to their individual and collective wellbeing. For many, participation in pro-environmental initiatives, especially in contexts of high collective efficacy, is likely to be a helpful coping strategy for climate anxiety.

Climate Change Acting Out: An Individual Perspective

Are There Really “Bad” People?

Q. How many psychiatrists does it take to change a light bulb?

A. Only one. But the light bulb has to want to change.

Another answer: Only one, but the psychiatrist has to want to change.

We always have new problems and have to find new solutions.    

It turns out that mental health counselors, social workers and therapists, psychologists, psychoanalysts and psychiatrists are becoming more aware of climate anxiety affecting our clients and patients, and we need to be prepared to assist.

Climate Change Anxiety Scenarios

Here are just a few possible presentations of climate-related challenges our fellows (and we) might face and seek help with:

• vociferous denial, and failure to take self-care measures;
• living in an area struck by a natural disaster (wildfire, hurricane, flood, drought, heat waves);
• grieving in all its forms for the catastrophic loss of wildlife (aka solastalgia);
• blaming others for complicity or causing the problems we face;
• hopelessness for the future;
• ambivalence about having children, distressing one’s spouse, or threatening the marriage;
• concern about how to address climate problems with children.

(The above and some of the content below is adapted from the last section of the presentation titled “Climate Psychiatry: What Every Psychiatrist Should Know”,  published in 2022 by the American Psychiatric Association (APA).)

We are lucky if people with such problems seek and find help, but unfortunately, there are a great many who might act out their trauma in destructive and even sociopathic ways.

We are the problem

As a psychiatrist, of course, I have been fully aware of the damage caused by other humans to my patients’ bodies, psyches, spirits, and interpersonal interactions.

Fortunately, I feel surrounded by goodness in the people I know and the land I tread. But still, among many miscellaneous learnings, thanks to my beloved frogs, I have further learned through trying to help them what to watch out for, which, as it turns out, are mainly other humans and destructive behavior. For example:

We have managed to outcompete all other mammals with our population in the billions. Here are some general Wikipedia statistics on the population size of three primate species (least populated, second most populated, and most populated).

• Hainan black crested gibbon: 20 to 50 (estimated at 2000 in the 1950’s); critically endangered
• Senegal bushbaby: 107,000,000;
• Humans: 8,009,000,000.

It also turns out that wild animals are more afraid of humans than of any other species.

With good reason. Humans spread Chytrid fungus and Ranavirus, carry on with unnecessary and harmful pet trade, introduce invasive plants and animals, ruin the water, land, and air, and wage devastating wars, all of which are wiping out entire populations of living beings, not only of people but of all life.  

We Are the Solution

The development of resilience cannot be done in a vacuum, but must involve individuals, organizations, and communities, and above all, a strong cohesion between them.  This is easier said than done, especially in light of enforced isolation related to, for example, the COVID-19 pandemic.

Climate Change Denial: Psychoanalytic Recommendations

How should we address climate change denial?

“It is important for people to bear their anxieties, because when they do not, their thinking deteriorates, and irrationality, lack of proportionality, hatred and narcissism are more likely to prevail.”

—Sally Weintrobe

In the third chapter of her book, Engaging with Climate Change – Psychoanalytic and Interdisciplinary Perspectives”,  Ms. Weintrobe suggests that anxiety about our climate is needed for individual and collective action.

Perhaps we should be more anxious, considering the clear direction of climate change. This is easier said than done, however, in that the guilt we feel for humanity’s contribution to climate change, along with the feelings of helplessness in the face of such a large threat causes us to put up our mental defenses, which we can retreat behind to avoid a painful reality.

Because climate change threatens both the narcissist and realistic parts of the psyche, it is easier for one to deflect this anxiety by projecting it onto others or denying the problem.

The growing burden of climate anxiety can be observed in the phenomena of climate change denial, where a culture has formed around refusing to acknowledge the evidence of a warming world. For individuals who feel anxious about their survival due to climate change, and know that there is no “quick fix” to the problem, outright denying the cause of their worry is a way to assuage their worries.

As an alternative to climate change denial, Weintrobe advocates for individuals to harness their anxiety around climate change, and emphasizes the importance of genuine emotional support in doing so, as it will promote positive action as opposed to disavowal.

Climate Change Dialectics:  Psychiatric Recommendations

The bread and butter of therapists is reducing ambivalence, the angst of extreme black and white thinking, and in the very well chosen title by Lewis, Haase and Trope, “…Holding Open the Space Between Abyss and Advance”  

Examples of Climate Dialectics or Dialectic Splits in psychotherapy are Climate Reality–Social Reality, Individual Agency-Collective Agency, Hope-Hopelessness, Certainty-Uncertainty, and Nature as Comfort-Nature as Threat.

Like Weintrobe, the authors agree that anxiety is a natural response to climate change, and rather than being treated pathologically, it should be encouraged in the direction of action. They emphasize that a focus on the containment and transformation of climate anxiety, rather than on its reduction, assists in aligning with new realities and in the reduction of distress.

They recognize that knowledge of climate change and its certain impacts is at direct odds with the slow-moving, structured norms of human social and economic system, causing cognitive dissonance, or a dialectic split.

While some may resort to inaction in the face of this split, others may take a highly individualist stance, and bravely attempt to tackle the issue head-on.

This approach can also be dysfunctional, however, as action is yielded as a shield against anxiety and reduces an individual’s ability to be vulnerable to climate-related fears. This avoided vulnerability is powerful, as it is what allows community building around such issues, which provides a more powerful and diverse response than what one could accomplish individually.

There are several responses to climate anxiety across the dialectic spectrum, but the central message is that we should attempt to guide climate anxiety towards adaptation that is conscious of the community as well as of the self.

Climate Change Interconnectedness:  Medical Recommendations

The best way to counteract our own destructive tendencies is to recognize and act as if we are all one, as has been taught for time immemorial in all the great religions, by all the great philosophers, by all enlightened artists, by brilliant agriculturists, and for mindfulness regarding our upcoming Thanksgiving, our indigenous populations.  

The authors of  “Reconnecting for our future: The Lancet One Health Commission”, by John H Amuasi, Tamara Lucas, Richard Horton, and Andrea Winkler in The Lancet, the most cited Medical Journal in the world, write:

“The evolution and sustenance of our planet hinges on a symbiotic relationship between humans, animals, and the environment that we share—we are interconnected. However, this past century has seen human dominance over the biosphere … The apparent dominance of the human species comes with a huge responsibility. Thus, in our quest to ensure the health and continued existence of humanity, consideration must be given to the complex interconnectedness and interdependence of all living species and the environment—the concept of One Health.”

Climate Change Interventions:  An Interdisciplinary Approach

As much as climate anxiety is primarily a concern among psychiatrists and psychologists, a group of researchers in the above referenced article has recently proposed an interdisciplinary perspective for coping with it.

As health professionals keep investigating the various causes of eco-anxiety and refining coping strategies, especially for high-risk groups, other disciplines like sociology and political science for instance, can contribute fresh perspectives, addressing societal structures and conflict resolution. I would add religion, art, even business, and particularly, environmentalists.

This interdisciplinary framework is rooted in four elements aimed at building collective learning and strategic communication:

(1) Motivational and actionable message framing: messages purposefully structured to increase human agency and facilitate climate action

(2) Storytelling for social and behavior change: translating current knowledge, accurate information, and effective coping strategies for eco-anxiety from academic and clinical research to mass media production.

(3) Knowledge sharing and linked resources: an interdisciplinary approach that breaks down the silos in individual fields through knowledge sharing, via a centralized platform, between mental health professionals and colleagues in media production, constructive journalism, and science communication.

(4) Positive deviance for complex problem-solving: every community has outliers who find better solutions for problems than their peers.  It is helpful and revealing to look for “positive outliers” (e.g., those who are most susceptible to eco-anxiety in terms of key characteristics, yet demonstrate significantly better psychological resilience through climate actions).

Climate Change Interventions:  Therapeutic Recommendations

Trauma Informed Caring

Trauma-informed care is a newer name for intelligent therapy which recognizes that any individual we encounter at any level, is likely to have a history of trauma.

This involves five R’s:

1. Realizing the commonality of trauma and adversity.
2. Recognizing different manifestations of trauma; it affects people differently.
3. Responding to support recovery.
4. Resisting re-traumatization (i.e. the trigger of feelings and reactions associated with the original trauma) by offering a greater sense of choice and control, empowerment, collaboration, and safety.
5. Relationship building.

Six Principles

The Substance Abuse and Mental Health Services Administration (SAMSHA) recommends 6 principles for helping others overcome trauma, which correspond to the last three R’s above.

Presencing Skills

Often psychological principles are borrowed by the business world, but the concept of presencing skills has been adapted by psychology from business. Presencing refers to an individual’s use of his highest self to sense, enact, and embody the future as it emerges. Presencing skills include personal self-regulation, cognitive awareness, coping skills, support systems, and connection to nature in an increasingly volatile, uncertain, complex, ambiguous (VUCA) world.

Purposing Skills

Another component of building resilience to climate disruption is a similar list for helping ourselves and others find meaning, values, hope, and self efficacy, referred to as purposing skills. These include courage, purposefulness, emotional intelligence, questioning and listening, connectedness, inclusivity, and of course, collaboration.  This conceptualization again comes from the business world. However, the author emphasizes that profit cannot be the end goal, but profit may be a side benefit of helping to provide solutions to the problems faced by people and the planet.

Call to action

Building Collective Learning and Strategic Communication

This article is a plea to myself and every person I might touch to practice empathy and sensitivity in dealing with the world and its life contained therein. We might even condense that down to the Golden Rule: “Do unto others as you would have them do to you.”  

Also, please to disseminate this information as broadly as possible via the internet and all other forms of connection with your community. Here is a practical poster that you can feel free to download and post on your fridge.

Other Informational Resources:

• https://www.climatepsychiatry.org/
• https://www.climatepsychologyalliance.org/
• https://www.cdc.gov/violenceprevention/about/copingwith-stresstips.html

Many thanks to Thompson Marinho and Rey Sunglao for their contributions to this article. And for a lively celebration of my husband Martin Fass’ and all life, great entertainment and scintillating conversations, please join us at our Gala on December 2.