Tara came to see me for psychotherapy due to postpartum depression. She was 39 when she got pregnant. She never thought she would want to have kids due to “the bleak future she would be leaving them with” given climate change. However, when she had an unplanned pregnancy, given her age, she felt this was her last chance to have a child. This made her realize that there was a part of her that did not want to lose this opportunity to become a mother. After the baby was born, she was filled with guilt and ambivalence around her decision to have a child. Bonding with this “helpless, delicate human”, she felt overwhelmed that she could not “shield” her child from a future fraught with the effects of climate change. At one of our sessions, she tearfully said, “What have I done?”

Climate change is increasingly affecting people’s mental health. Six out of ten people are likely to suffer from some form of climate distress1. Yet clients do not often bring up climate change in therapy, and even when they do, few therapists receive training on how to address it2. Psychological theories have historically derived from an individualistic culture that is focused on the self, personal problems and relationships. The climate crisis is a global and collective problem that challenges the current individualistic psychological frameworks3.

The current framework of psychology is unsustainable and insufficient in addressing the challenges posed by the changing climate and environment. We cannot view psychotherapy as merely focusing on individual issues; it must consider societal and ecological powers that will affect every aspect of the psychological experience4. Psychologists have tried for decades to awaken their colleagues to the idea that psychological theory and psychotherapy are exactly where responses to the climate crisis should be considered, explored and processed5,6. Even as far back as 1960, renowned psychoanalyst Harold Searles7 proposed that we need to acknowledge the role of the non-human environment in the development and shaping of human psychological life. If you ask people to think of an image that calms them down, most will respond with a nature scene, or a place, rather than a human image. When you ask someone to envision their childhood home, neighbourhood or town, it will stir up emotions — negative, positive or both — but rarely will they remain emotionally neutral towards such memories. Clearly, we are affected and attached to more than just human objects. Ecosystems can play similar roles to familial relationships; they can often be referred to as a family member who will always be there, eliciting a sense of connection or safety, or offering perspective. Loss of such places can trigger emotions of grief or devastation, much like the loss of a human object8. Therefore, it is no wonder that many descriptions of humans and nature are so entangled, such as ‘human nature’ or ‘mother nature’. There needs to be space for this non-human attachment in therapy.

Apart from lack of sufficient theory and training, it is imperative that therapists are aware of their own defences around climate change. It will be a great disservice to clients who do bring up climate change in therapy if therapists conceptualize their responses in ways that reduce climate distress and grief to displacement. Responses to climate change can be amplified and should be recognized for the way they interweave with other psychosocial trauma in one’s personal history9, but therapists must never negate the climate crisis as a thing in and of itself10.

With anxiety disorders, our goal is the reduction of anxiety. As the mental health impacts of climate change continue to emerge, one approach is to validate and contain the anxiety, rather than attempt to fix it. Pathologizing climate anxiety is invalidating and contributes to the denialism we are facing in both society and the field of psychology4,11. We want clients to engage with their anxiety, so that they can mobilize that anxiety towards action and resilience building, and, hopefully, experience growth. While growth can come in many forms, in this Comment I will focus on growth through connection, resolution and hope.

Connection

Working with the psychological and emotional effects of the climate crisis can be difficult for any single therapist–client dyad to adequately contain. Therapy can be considered by therapists as the initial entry point, but not necessarily the final destination in regard to the client’s work around climate emotions. With the aid of therapy, the destination can be to link the inner world with outer action. However, this action can never be done in a vacuum. There are a variety of resources for both therapists and clients to make connections, build holding communities, work through difficult emotions and take action (Table 1). At the same time, therapists must also encourage clients to balance action with limits to personal responsibility. It is important to remember and be humbled by the fact that no one can bring about such tectonic change on their own.

Table 1 Climate-aware mental health resources for professionals and clients
Full size table

Resolution

Most clients are likely to present in the crisis phase of climate distress when initially reaching out for therapy. This phase can be characterized by considerable destabilization, disillusionment and a sense of urgency8. The goal of therapy is to reach a resolution phase around the climate crisis. Climate resolution can be different for different people, and it can be different from a resolution of an individual problem or a personal intrapsychic conflict. A variety of psychological models emphasize that climate resolution does not imply eradicating painful emotions, but acquiring a greater ability to stay present with the feelings8. Resolution is about becoming more effective in dealing with climate adversities by learning to tolerate difficult emotions, take self-care, and find meaning, direction or hope. Some of the ways we can reach transformational resilience are by taking action and having a sense of ‘we’ as opposed to ‘me’12.

I have noticed over the past several years an increase in active discussion around topics such as how we may start to consider climate change as a teacher, or force, that has begun to interrupt life as we know it, requiring us to reconsider our thinking, our relationships with each other and nature, and our priorities around what creates meaning in our lives. Allured and Easterlin13 talk about the need to reframe. Changing our lifestyles to be more aligned with climate limits may indeed require many adjustments, but maybe this change in lifestyle can offer something that is better than our old ways of living, in ways we cannot yet fathom.

Hope

Negative emotions are necessary to move people away from inertia and a reluctance to change their comfortable lifestyles. Yet without some measure of hope or sense of meaning, negative emotions can lead to resignation and paralysis. Hope can mean different things for different people. Hope is not thinking that you will not be impacted by the effects of climate change, or that somehow everything will be okay. That is not hope, that is an illusion12. Hope can be accepting the irreversible losses of biodiversity, habitats, food supplies and more, due to climate change, yet hoping one can still make a difference by saving what can be saved, or finding meaning in a new world order. Hope can be ‘radical’, such as having no hope for a viable sustainable future, yet having a sense of doing what is right and finding meaning in activism by virtue of commitment14. Hope is also dynamic. Macy and Johnstone15 talk about active hope as something we do rather than have. It involves exploring what we hope for and then playing our role in the process of moving that way. We all move along a continuum of hope. We can expect anyone dealing with climate change to oscillate between hope and hopelessness, as well as between optimism and despair. If therapists cannot understand and tolerate clients’ hopelessness and despair at times, they will lose their therapeutic function as a container. Therapists should acknowledge that anger, too, can be a constructive derivative of hope, as we have witnessed with movements such as Black Lives Matter and Me Too that ignited much-needed change in unacceptable cultural norms.

We can encourage hope while simultaneously acknowledging uncertainty about outcomes. Hope can be cultivated precisely because the outcomes have not yet been determined for this crisis13.

Going back to Tara, I applied this arc by first just listening and offering a safe space for her concerns, despair and guilt around her child, without making her feel judged, belittled or as if she was “making too much of a big deal out of this climate thing”, as her parents and some friends had told her. At times, we made some connections to past traumas, but that was not ultimately our single focus, and we did so gently so as to not invalidate climate change as a reality and trauma in and of itself. We explored if there were ways that could make her feel more connected to others who shared similar concerns. She found a climate change mothers group, where she was able to connect with other mothers who shared and validated her emotions. The group also provided a place where she could feel she was taking action, and not just experiencing learned helplessness, as they embarked on several climate initiatives. She is still concerned for her child’s future. But she feels less guilty when looking into their eyes, knowing that she is “doing her best” to protect them. By finding a community of like-minded mothers, she feels less isolated and a little more hopeful.