Therapeutic work in the Anthropocene: an interpretative phenomenological analysis of clinicians’ experiences.

Introduction: The current global conditions may trigger a latent state of worry or even pre-traumatic responses which may not be exclusively exhibited by patients. Exposure to unpredictable changes in the shared environment might challenge the inherently hopeful nature of therapy, altering our practice with unforeseen technical, ethical and/or pragmatic dilemmas that often pertain to themes of climate (social) justice. Since the term ‘eco-anxiety’ made its entrance into the field of psychopathology, several explanations on its unconscious value have been proposed; yet efforts to collect information on clinical work under climate change are vague, and little is known about the use of one's own eco-anxious response as a resonance tool to attune to patients' coping mechanisms in a shattering world. Methods: Fifteen therapists living in urban and suburban areas were interviewed on how they work with patients considering the current state of the climate crisis, their conjectures about eco-anxiety as a psychological construct, and other personal reflections on how the non-human environment affects psychological well-being. Data was analyzed using Interpretative Phenomenological Analysis (IPA). Results: The findings shed light on the sense of inadequacy that may arise in those who struggle to provide a sense of safety, due to the ever-worsening conditions of our social-ecological systems. Some interviewees reported a difficulty in modeling and/or promising a better quality of life due to the expected outcome of climate change in the next decades. The meaning of eco-anxiety as a construct and its use in clinical practices not only differed based on the participants’ residential location and personal sensitivity to the subject, but also on the epistemological stance of the interviewees. Discussion: The climate crisis, gathering unpredictable social changes, generates a new set of collective anxieties (eco-anxieties) that may intertwine with a person’s underlying psychopathology, and must be understood in the light of their history, functioning and biological disposition. As therapists may face resistance in recognizing or explicitly addressing the unthinkable anxieties made more salient by climate change, insight on countertransference for a climate-aware clinical practice seems pivotal for a good therapeutic alliance.