Climate Dialectics in Psychotherapy: Holding Open the Space Between Abyss and Advance

Author:

Lewis Janet L.1,Haase Elizabeth2,Trope Alexander3

Affiliation:

1. Clinical Assistant Proffessor of Psychiatry, University of Rochester.

2. Associate Professor of Psychiatry, University of Nevada School of Medicine at Reno; Medical Director, Outpatient Behavioral Health, Carson Tahoe Regional Medical Center, Carson City.

3. Senior Resident Physician, UCSF Department of Psychiatry, San Francisco.

Abstract

The complexity, uncertainty and charged nature of climate change make it a unique stressor that is irreconcilable at an individual level. This experience of impossibility leads to splitting of reactions into polarities, or dialectics, which must be contained to reduce climate distress and held open for generative use towards climate adaptation. We present a dynamic model for addressing climate change material within psychotherapy, wherein these climate dialectics are identified, explored, and held open. Clinical vignettes* illustrate therapeutic work with the particular climate dialectics of Climate Reality–Social Reality, Individual Agency-Collective Agency, Hope-Hopelessness, Certainty-Uncertainty, and Nature as Comfort-Nature as Threat. Situations of climate anxiety, solastalgia, disavowal, and the climate dismissive patient are addressed, as is the therapeutic use of the wordlessness that accompanies our relationship with the natural world. We explore and emphasize how 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. Use of a developmental stage metaphor, attention to climate-specific counter-transference enactments, and emphasis on authentic action are central to this process.

Publisher

Guilford Publications

Subject

General Medicine

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