Exploring psychological responses to climate change using an existential framework: What hurts, what helps, and implications for mental health services

Aims: This project explores psychological responses to climate change – specifically, the nature of the distress caused (what hurts); methods for alleviating distress (what helps); and how clinical services could support people in such distress. Background: There is a lack of conceptual clarity regarding the nature of distress caused by confrontations with climate change as an abstract or global, and not instantly threatening, phenomenon (distress often labelled ‘eco-anxiety’). However, existing literature suggests that existential themes – particularly around identity, life meaning, and ontological insecurity – might be relevant. Methodology: The project adopted a critical realist epistemology. In-depth, semi- structured interviews were conducted with 15 self-selecting adults. Data was analysed through thematic analysis, which utilised an existential framework in a theory-driven analysis of participants’ distress, but a more inductive approach in the analysis of alleviating factors and potential avenues of clinical support. Results: Participants’ expressions of ‘what hurts’ were conceptualised by 7 themes and 10 subthemes. Climate change was equated with loss and associated with guilt, anger, isolation and chronic uncertainty about what to do, as well with challenges to personal identity and meaning in life. Participants’ expressions of ‘what helps’ were conceptualised by 7 themes and 2 subthemes. It seemed that distress was alleviated principally by engaging purposefully with climate change, often as part of a collective, and in concordance with personal values. 8 themes were developed to conceptualise participants’ ideas about how a psychology service might help people distressed by climate change. These centred around support in forming relationships with likeminded people and in engaging in ecologically- protective or nature-based activities. Conclusions: The existential framework offers an appropriate tool for conceptualising distress about climate change. Eco-psychological theories, highlighting the importance of relationships between humanity and nature, also appear relevant. Implications are discussed for clinical formulation, intervention, and future research.