Anxiety and distress about the climate, politics, & human rights deserve space in therapy
Relevant background: what therapists treat (and how they treat it) changes over time
When many folks think of therapy, they think about mental illness and diagnosable mental health conditions. If you’re familiar with the DSM (officially the Diagnostic and Statistical Manual of Mental Disorders which is on its fifth edition with a text revision), Anxiety Disorders is one of the chapters. (Depressive Disorders is another.) Overtime, what constitutes a disorder has changed, as has how the DSM categorizes disorders. For example, Post-traumatic Stress Disorder (PTSD) was included in the anxiety disorders chapter of the fourth edition of the DSM (and it wasn’t even in the DSM until its third edition). Now, Trauma- and Stressor-Related Disorders is its own chapter in the DSM, and PTSD can be found there. Among the disorders included in the current anxiety chapter are specific phobias, Social Anxiety Disorder, Panic Disorder, and Generalized Anxiety Disorder. It’s not surprising the DSM doesn’t specifically cover concerns like eco-anxiety, climate anxiety, climate change distress, political anxiety, or political stress. Though future revisions could feasibly consider these, it’s not pathological to worry or experience distress as a result of what’s happening in the world around us.
The pandemic changed therapy
Recently, I was speaking with another climate-aware therapist in Seattle, and I asked her what prompted her climate-aware practice. Her response (in summary) was that she cared and didn’t want to separate this part of herself from other parts. She reminded me how this differs from graduate school training: as therapists, we’re supposed to keep ourselves out of the therapy room. We’re supposed to focus on what’s happening for the client and the origins of that in the client’s past and how that impacts the client’s “here and now.” But the Covid pandemic changed to some extent how therapists had to think about therapy. Aside from the obvious change of switching from in-person therapy to seeing folks mostly, if not exclusively, online, therapists were now living through the same thing at the same time requiring the same life changes and producing the same anxieties as those they helped. And this is odd for therapists, as we’re taught not to work with folks who are experiencing problems similar to our own because we can’t be objective, because too much of us may come into the therapy room, because we may not have a handle on what we’re sharing with those with whom we’re working. Therapists hadn’t received training on living through a pandemic; we were experiencing the pandemic and its side effects (loneliness, uncertainty, despair) at the same time as the folks with whom we worked. I wasn’t aware of any continuing education on how to help others get through and cope with this massive upheaval the pandemic spurred. In fact, I was asking for help from my own therapist!
Along with the pandemic, other issues were coming up more broadly during these online therapy sessions. The deaths of Breonna Taylor and George Floyd ignited a racial reckoning that had been a long-time coming (given police violence against Black folks is nothing new). As a result, white people felt pressure they hadn’t previously felt to examine their whiteness and internalized racism. If you're white and were living in Seattle at that time, you may have had family members contacting you about the CHAZ in Capitol Hill and wondering if you felt safe. (Maybe the family didn’t realize you, too, were there and among the protesters.) Climate disruptions, caused by severe weather, continued. Here, in the Pacific Northwest, fire season continued to wreak havoc on our ability to be outside when the air quality tanked; ashes fell from the sky; never-before-experienced heat domes led to deaths of the most vulnerable humans. And plenty was happening in politics–or politics beyond race and climate, since these, too, are political issues. The increasingly polarized electorate, the absence of civil and rational debate, an unwillingness to find common ground, and the catering to those who are most extreme in political parties have led to desperation and despair and hopelessness. All these were topics on people’s minds during the pandemic when they spoke with therapists. Therapists, too, were experiencing these same events and cultural shifts.
Current events and our world can be sources of mental distress, including anxiety and depression
Therapists need to talk about people’s stress and anxiety about the climate crisis, politics, genocide, and all else that’s happening in the world as we enter another presidential electoral year. So many feelings arise from what’s happening around us. It’s hard to look at the photos of and hear the stories about people, destruction, and violence in Gaza and not feel horrified or extreme grief. It’s hard not to feel angry, disgusted, betrayed or any other number of feelings when you get the email update or look at your news source of choice and see there’s been another mass shooting with more deaths and more people wounded–and that the shooting was directed at children or LGBTQ+ folks or Black folks or Asian folks. And it’s hard not to feel worry or anger when you learn the latest regarding reproductive health, like the Alabama Supreme Court decision about IVF. You think back to when the Supreme Court issued the Dobbs decision (i.e. the one that overturned Roe v. Wade), and recall people forecasted what would happen in court decisions regarding reproductive health. You may have outlined your worries in June 2022 to others, and they didn’t think the repercussions would extend as far as we’re seeing them extend not even two years later; or you may have considered yourself “safe” in your blue state (Washington) since the Supreme Court said they were going to leave decisions up to the states only to be hearing about the possibility of a federal abortion ban if the Republicans were to gain control of the presidency and both houses of Congress in November. Stuff is fucked. And your therapist should be able to engage with you on this stuff and not try to bring you back to whatever the DSM thinks is an appropriate topic for discussion or to treatment goals that aren’t practical when day after day you’re hit with more bad news that triggers more anxiety or worsens your feelings of sadness.
Therapists, as a whole, don’t have problems acknowledging that families (specifically parents) impact a lot of how people act and behave. There are therapists out there who will try to tell you that something your parents did when you were two months old that you don’t recall may be the reason for the core beliefs you continue to espouse. When looking at how someone functions in the world, therapists often consider how mental health symptoms get in the way of someone’s relationships, their ability to focus in the workplace or in school, within their social frameworks, or with respect to their physical health. It makes sense then that the world, culture, and climate in which we live also impacts our mental health and thoughts and feelings and behaviors. People differ in how sensitive they are; they differ in how they process information; they differ in life experiences; they differ in their family histories and how those relate to what those in power (i.e. white people) were doing. So naturally, what’s going on in our world is going to impact some people more than others, acknowledging Black people, Indigenous people, and other people of color are always going to be impacted the most in the US. (Because that’s how white supremacy in this country works.) If you’re one of those people who’s feeling impacted or wanting someone to talk to, therapy should be a place where you can do that.
Talking about politics & climate change (specifically the climate crisis) is welcome!
I love talking about the current (messed up) state of the world. I’m the person who goes to a social gathering and wants to skip the small talk and instead talk about how messed up it is that our country isn’t funding this country or is instead funding that country. Or how another Black person was shot basically for living in an area where white people didn’t think they should be. Or how we’re each reconciling that we care about the climate and consumerism but still engage in practices that are less than ideal. I love talking about this stuff because the emotions that result from these things are real and provide invaluable information to us. Our world is uncertain, and we may not have complete control. We can choose to ignore information; we can choose to feel numb. Or we can grieve and despair. And vent as we feel our rage. And maybe get to the point where we can act and practice hope.
If any of this speaks to you and you want to connect, please reach out.