Therapist Patricia Hasbach practices in a crunchy West Coast town that’s forever appearing on lists of Top 10 Places to Live. With its generous social services, thriving art scene, and easy access to forests, rivers, and mountains, Eugene, Oregon, is the kind of paradisiacal college town that, for many of its inhabitants, provides a verdant buffer to stress. But lately, Hasbach’s noticed some fraying of Eugene’s protective magic.

Among her clients and psychology students, she’s seeing an uptick in anxiety, depression, and anger that can’t be explained away with the predictable pressures of school, early trauma, or today’s oft-cited culprits of digital immersion, loneliness, and disconnection. Something more is happening. When given a nudge, a number of clients and students are admitting to an overwhelming concern about the news of today’s warming world, and with the fragility of life itself.

Take Sarah, a marketer in her early 30s who’d gotten married over the summer. Unlike some new brides who find their way to therapists, Sarah wasn’t questioning committing to her husband, Jack. She loved him and had long wanted them to settle down together. But soon after they’d wed, the United Nations’ Intergovernmental Panel on Climate Change released a dire report, saying that without radical worldwide action between now and 2040, the planet will warm so quickly that ramped-up wildfires, killer droughts, more powerful storms, and greater flooding from rising seas will likely become an unalterable fact of life.

It had led Sarah to a difficult dilemma only a few months into the marriage, and she needed Hasbach’s help to deal with it.

Eco-Anxiety and Environmental Melancholia

Sarah was stricken. She not only couldn’t stop thinking about the dystopia of the future, but couldn’t imagine condemning a child to live with all the unknowable dangers of a dying world. Beyond the physical changes she’d been hearing about for years were newer predictions—that a warmer world will bring with it a host of severe mental health issues for those trying to cope with the consequences of climate change.

Given all of this, she was right that they shouldn’t try to get pregnant, wasn’t she? And if so, what was the best way to convince Jack that they shouldn’t have children who’d have to endure such conditions? Mostly, she was worried that he’d still want those kids, no matter what.

Over the years, Hasbach has seen her share of cases of “eco-anxiety” like Sarah’s, and includes ecotherapy techniques in her eclectic clinical toolbox. She’s also noted, as the climate has degraded, a strain of depression that environmental psychologist Renee Lertzman calls environmental melancholia—a combined sense of primal loss and paralyzing powerlessness.

To address Sarah’s issues, Hasbach opted for a three-pronged approach. First, she helped her reframe the couple’s differing feelings not as a sign of a permanent impasse, but as part of a conversation that could become an ongoing dynamic in their relationship. Next, they talked practically about the conundrum, discussing whether she and Jack not creating a biological child would be the same as never having one. “Might he consider alternatives like adoption or fostering children?” she asked Sarah. “What about having strong relationships with your nieces and nephews?”

Finally, Hasbach encouraged Sarah to take her problem to its ultimate source. She prescribed heading out into Eugene’s bountiful nature and, as she walked, exploring her quandary about children while surrounded by the ebb and flow of life in the environment that she’s so concerned about. “Note the dieback that’s happening to the trees—as well as the rebirth,” Hasbach told her.

She prepped Sarah to take this walk “with intention” and discussed creating ritual and using meditation to help approach her dilemma differently. “We discussed creating a threshold to cross over, taking the time and space—without technology—to just be with her thoughts, concerns, and questions in nature, and then crossing back over the threshold, perhaps with some clarity or new insight,” Hasbach says.

Several days after the exercise, Sarah got up the courage to sit down with Jack and revisit the subject of having children. In the end, Hasbach says, “They recognized that they’ve been through a lot of change, and the stress of a wedding, and decided to put that question on hold.” Sarah told her that they’d agreed to revisit the subject in a year: time enough for another season of dieback and rebirth in the natural world that still surrounds them.

Taking Clients from Denial to Action

“Right now, people are feeling that they’re not safe,” Hasbach says. “Where we are today truly is different than where we were 10 years ago. Climate change is harder to deny. I find one of the most important things to do for clients with eco-anxiety is to help them feel validated about having these concerns. When they’re invited to explore it, a lot comes up. Often, along with anxiety and depression, come feelings of shame, of being complicit.”

Hasbach says she wants clients to feel free to share these feelings and even includes questions about their relationship to nature as part of her intake process. Sometimes she’ll meet with them outdoors, or, as she did with Sarah, prescribe nature walks between appointments. She says introducing the natural world into the process in these ways creates room in sessions for clients to both engage with their true feelings about it and, if eco-anxiety or depression is one of their presenting problems, make empowering changes in their lives.

In 2017, the American Psychological Association (APA) sought to prepare practitioners for addressing clients’ concerns about the environment by publishing Mental Health and Our Changing Climate, a guide that delves into the psychological impact of today’s grim environmental realities on clients and communities.

The APA says that in addition to cases of eco-anxiety and depression, therapists should expect to deal with increased levels of helplessness, fatalism, suicide, and aggression as natural disasters increase. There’ll be more PTSD and more substance abuse. To try to counter these, APA echoes what many ecopsychologists and therapists believe is sound treatment for today’s climate-change grief: let clients acknowledge their sorrow and fears, and then help them find empowerment through action. Sometimes that action can mean adding a lens of eco-awareness to their choices—as Sarah was doing in her own way—and sometimes it means joining with conservationists or environmental activists in their communities.

Thomas Doherty contributed the clinical section to the APA report. He’s past president of APA’s Society for Environmental, Population and Conservation Psychology, and founding editor of the journal Ecopsychology. He believes therapists ought to help clients identify which specific issues “activate their unique vulnerabilities or personal worries,” and then help them develop a plan of action that begins to give them some sense of control.

This may mean having to do some footwork in your own community. He says, “Don’t assume that people know where to turn,” either for resources after an event, or to find ways to volunteer for environmental causes that could help them become more empowered. But before therapists give clients the number for Greenpeace or their local community garden, it’s essential that clients have time to formulate their own, individual response to these issues.

“While having a stress response, it’s difficult to move out of a place of reaction to pro-action,” Doherty says. “But it’s important for all of us to understand that the pace of the universe is slow. There is still immense peaceful energy to tap into. We don’t want clients to be in denial but to slowly, carefully, and mindfully take in the issues. Then we can prioritize. What’s most urgent? Are there any true emergencies? Where are their skills? This can help them establish their own environmental identity. Ultimately, we want them to reclaim their nervous system and then become more empowered. The danger is people rush into action and then are less likely to be successful.”

Doherty also explains to clients affected by climate change reports that rather than keep pace with the frenetic publication of frightening news stories and social media, it’s healthier to read more balanced books on the topic. He’ll encourage them to take in art, poetry, photography, and naturalist writings instead—and to understand that, though it may feel like things are spiraling out of control and no one’s paying attention, thousands and thousands of people all over the world share their concerns and are working every day on these issues.

Preparing for an Uptick in Disasters

Doherty likes to remind clients that most every city and town in the United States already has a climate change action plan. One of those action plans is now in place in American Samoa, where in 2009, a magnitude 8.1 earthquake triggered a tsunami that inundated the islands, along with neighboring Samoa and Tonga, killing 173 people and injuring hundreds more.

Berkeley, California, therapist Jenny Freeman—who counseled children and families after both 9/11 and San Francisco’s 1989 Loma Prieta earthquake—was part of a psychosocial response effort led by an indigenous team in Samoa. The Samoan tsunami may or may not have been climate based, but some scientists are now predicting that rising sea levels will mean that powerful ocean waves—smaller tsunamis, generated from time to time by offshore earthquakes—could soon reach farther inland and create big tsunami-like conditions more frequently. The community Freeman counseled is living in such a sea-level-rise danger zone.

Freeman spent a lot of time in 2009 helping children and families recover from the wave in Samoa. The kids were naturally given to telling stories about the day, but instead of focusing on their trauma, she says, “We’d ask them what kept you alive, what strengths kept you aloft? And I’d hear stories of them feeling like they were drowning and then sensing a grandmother and her strength and getting a surge of energy. Others talked about diving back into the water to save elders or babies. The stories were about these kinds of connections to others. Many of them felt spiritually grateful for their survival.”

Freeman saw that, rather than take the Western approach of isolating a survivor in an office and focusing on personal grief and trauma, the indigenous responders helped engineer a collective response to the disaster. “We collaborated with local communities on many kinds of support, from kids’ camps to ritual group healings. In community settings, in celebration of being alive, there was traditional ceremony, food, dancing, singing, and gifts for the kids.”

Freeman’s hope is that as climate conditions worsen and disasters become more commonplace, less cohesive communities will find ways to draw on people’s connections with each other to create such healing support. Without such coming together, populations more divided by wealth and access to resources, as in the States, could find climate disasters all the more traumatic. Divisions of money and ethnicity could ultimately be exacerbated when the waters recede, or the fires are finally out.

“Practitioners need to keep in mind that how helpless or resourced people feel will affect their level of trauma,” Freeman says. “Fires burned up lots of homes up here [in Northern California], but recovery isn’t equal. What do Latinx people face in those communities? If they’re undocumented, are they afraid to seek support? Wealthy families with resources, like insurance, are already rebuilding. But those without such resources cannot as easily put their lives back together, and may still be crowding together in trailers. Let’s bring forth these issues and collaborate with folks on healing approaches that are culturally consonant.”

Susan Clayton is a social psychologist who heads the Society for the Psychological Study of Social Issues. She was a lead author on the APA report. She encourages therapists to pay attention to how people’s sense of place and relationship to environment, community, and location may soon be affected by climate change. Even if ruinous disasters, like those that Freeman responds to, haven’t hit, clients may still be coming in with underlying fears around the threat of dislocation or disconnection.

“If someone’s sense of identity is tied to location—and for many of us it is—then how might that feel when the location becomes degraded or somehow different? How might that threaten their sense of self and stability?” Clayton asks. Take for example, she says, the potential impact of a warming ocean on coastal communities tied to fishing, or on the lobster industry in a state like Maine. “How do all the people who for generations have associated their state and livelihood with that industry cope with any degradation of it? What sort of community would it be if no one could catch lobsters off their coast? What does that do to their sense of who they are?”

Stay “Blissed Out and Amazed by the Universe”

Of course, clients aren’t the only ones who’d rather not confront the uncomfortable realities of climate change. But Clayton says that for therapists, it’s professionally important “to be conscious of these threats and the broader form they may take. Because they have a responsibility to the mental health of clients, they must recognize that protecting their well-being means staying aware of the larger society.”

For some, like psychologist and author Mary Pipher, it’s meant becoming a very public environmental activist. She helped organize responses in her state (Nebraska) to the Keystone XL pipeline, and was inspired to write the book The Green Boat: Reviving Ourselves in Our Capsized Culture after struggling with her own forms of denial and climate-related despair.

She told listeners of the radio show Living on Earth, “No matter where we live, no matter who we are, we are the first generation in the history of the world to be faced with a planetary crisis which we must deal with rapidly and everywhere. And we all know this, even when we claim we don’t.”

For Pipher, action became the antidote to despair, but she acknowledges that she can’t guarantee that the action she takes, or all the action that’s going on across the world, will ultimately save the planet. She’s convinced, however, that action can help us increase our imagination, be kinder to others, and find ways to be “blissed out and amazed by the universe.”

If you’re doing the hard work of treating clients and taking action on social and climate issues, Pipher says it “needs to be balanced by lots of experience in which you’re just having a wonderful time—looking at the stars, or sitting by water, or enjoying your fresh-grown tomatoes with your friend, because whether or not we can change the world, I guarantee you that will change us.”

Not all therapists may have Pipher’s verve, or they may be juggling too many plates to imagine adding the threat of dystopia in our own lifetime, but the reality today is that no practice, no school of psychotherapy, can shield us from the here-and-now struggles of our clients’ lives. We’re profoundly interconnected with the natural world, and that world will continue to penetrate therapy’s bubble.

Hasbach thinks it could be time for all therapists to enlarge the scope of practice to include shining light on feelings about the “long emergency” of climate change—and to make therapy a place where people can find guidance and hope as they face the forbidding challenges ahead—risks that all of us, therapists and clients alike, are still trying to fully comprehend.



Lauren Dockett

Lauren Dockett, MS, is the senior writer at Psychotherapy Networker. A longtime journalist, journalism lecturer, and book and magazine editor, she’s also a former caseworker taken with the complexity of mental health, who finds the ongoing evolution of the therapy field and its broadening reach an engrossing story. Prior to the Networker, she contributed to many outlets, including The Washington Post, NPR, and Salon. Her books include Facing 30, Sex Talk, and The Deepest Blue. Visit her website at