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Helping Patients Cope with Emotional Reactions to Climate Change: Advice for Mental Health Clinicians

  • April 17, 2023
  • APA Leadership, Treatment

Climate change is not easy for humans to understand. It has qualities — like its enormous scale, complexity and uncertainty — that make it hard to comprehend. Greenhouse gases are invisible, and what is happening on one part of the planet is not happening on another. Because we can’t “see” it we are prone not to believe in it and more likely to have the kind of paranoid anxiety about it we have to other dangerous and invisible forces like toxic gases or hidden enemies.

Climate systems and human systems affect each other in so many ways that it is hard to make progress on one part of climate change without creating problems somewhere else. We call something like this a “wicked problem,” because there are no perfect solutions and goals must constantly be adjusted. Climate change is also terrifying. It is the largest existential threat that humanity has had to respond to in recent history. It threatens death not only for many of us, but for billions of living beings affected by our behavior.

It is no wonder, then, that people have feelings about climate change. In recent surveys, Americans have said they feel curious (60%) fearful (57%), anxious (56%), angry (55%) and even optimistic about climate change (32%).1 A quarter of the American population describe themselves as alarmed by climate change and another quarter concerned.2

climate change headline

When it comes to younger people ages 16-25 years, 84% feel at least moderately worried about climate change. More than half (59%) feel either very worried or extremely worried. A large majority of young people also feel angry and blame older adults for not caring for the planet. They feel other things too: shame, hurt, grief, despair, and guilt.3 Such feelings are a natural and understandable response to what is happening, and likely do not reflect a psychiatric problem.

Existential anxiety about climate change is triggered by fears of traumatic death —  ideas like being wiped out or annihilated. Such existential fear is also connected to feelings of being invisible, insignificant, or having failed to live meaningfully, ethically or fully. Sadness about climate effects can come from grief over the loss of species and habitats, losses of treasured landscapes, legacies and imagined futures for one’s offspring.

Anger and betrayal may arise when elders and leaders have not acted to protect younger generations and the planet. Those who are victims of climate injustice feel angry because they live in neighborhoods or countries suffering climate effects that they have not themselves contributed to. Scientists who have devoted themselves to climate research only to have their voices distorted and dismissed may feel angry and betrayed.

For many Americans, climate distress may also be accompanied by a sense of disconnection and unease. The social realities of our carboniferous lifestyle make us often complicit in worsening the climate crisis, and yet we love nature and its inhabitants. Many of us find our deepest and most meaningful experiences outdoors. This leaves us often with the pre-conscious anxiety that accompanies the defense of disavowal — knowing but acting as if we do not know. Underneath are shame, guilt, and impacts on our self-esteem because we are not acting with integrity. In relationships, different levels of concern about climate change can lead to relationship failure, and intergenerational, individual and couples’ distress over child-bearing decisions and issues of one's legacy and protecton of ones' children.

Because of the overwhelming nature of climate change, it is important to find meaningful ways of containing one’s reactions to it and maintaining equanimity. There are a number of actions that can be recommended as ways of containing climate emotions, including spiritual processing, taking action, participating in nature-based and climate-related rituals, joining a climate group, or reframing narratives about life and therapeutic goals through creative endeavors or in a therapeutic supervisory group. Equanimity — mental calmness in a difficult situation — can be cultivated through mindfulness techniques such as meditation, breathwork, time in nature, and so on.

Therapists and others can use a variety of techniques to cultivate a sense of safety, creativity and hope as we work through the climate crisis together. To work more deeply on climate distress, it is critical the therapist consistently process their own climate emotions. With patients there are many therapeutic approaches that can be helpful. One can apply techniques from acceptance and commitment therapy to help patients find transformational resilience and adapt to new realities. This can include sitting deeply with the realities of collapse and loss, and using meaning-based coping to find new ways of responding. The conceptual approache should view humankind as part of the web of life, not in hierarchical relationship to it. Cultivating secure attachment to nature should be a focus of therapeutic assessment and effort. Use of dialectical thinking, such as holding together our social reality and our climate reality, or looking at a problem from the opposite emotional perspective, can also generate creative responses to the climate crisis.4

The universe is an emergent system, defined by complex, creative, chaotic and unpredictable outcomes. This possibility for creative evolution is an opening, a space for hope and creativity, in which to consider fixed maladaptive positions and consider what can be relinquished and restored to live in a new way.


  1. Speiser, M., Hill, A. N., Catalano, K. (May, 2022). American Climate Perspectives Survey 2022. Vol II. Part II. Climate Change Sparks Emotional Responses. ecoAmerica. Washington, DC.
  2. Leiserowitz, A., et. al. (2023). Global Warming's Six Americas, December 2022. Yale University and George Mason University. New Haven, CT: Yale Program on Climate Change Communication.
  3. Hickman, C., et al. (2021). Climate anxiety in children and young people and their beliefs about government responses to climate change: A global survey. The Lancet Planetary Health, 5(12), e863–e873.
  4. Lewis, J. L., Haase, E., & Trope, A. (2020). Climate Dialectics in Psychotherapy: Holding Open the Space Between Abyss and Advance. Psychodynamic psychiatry, 48(3), 271-294.


Elizabeth Haase, M.D.

Chair, APA Committee on Climate Change and Mental Health
Steering Committee Member, Climate Psychiatry Alliance
Medical Director, Behavioral Health, Carson Tahoe Regional Medical Center

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