Extract from Eureka Street
- Leo Mares
- 29 October 2020
Among the chaos and contention surrounding the 2020 budget, one particular decision was met with fairly resounding approval. Mental health and suicide prevention were highlighted as a ‘national priority’, with the government pledging a massive $5.7 billion to be spent on mental health in 2020-21.
Part of this includes extending the allowance of Medicare-funded psychologist sessions from 10 to 20 per year and expanding the headspace network, which continues to be a particularly critical service for provision of youth mental health. There is no doubt that such a move is commendable, however, I wonder if allocating further resources to treatment is really going to be enough to stem the growing crisis, particularly among young people.
It’s worth considering that the most common psychotherapeutic paradigm that is practised and endorsed in Australia is Cognitive Behavioural Therapy, or CBT. It is based on the idea that the way we think about, or ‘appraise’ situations has a powerful influence on the way we feel about them. Correspondingly, psychopathological symptoms are thought to be caused by a tendency toward unrealistically negative appraisals, which then in turn produce negative affective states, such as a depressed mood or anxious rumination.
CBT aims to break these negative thinking patterns through Socratic-style dialogue. But how helpful are therapies like CBT really going to be for dealing with the issues faced by my generation? One thing I’ve noticed among friends and acquaintances that are also in their early twenties is a pervasive sense of dread regarding the future, with catastrophic climate change being often cited as a cause of prospective chaos and destitution.
For example, one of my housemates was recently lamenting the fact that they couldn’t access their super early: ‘Civilisation will collapse before I’m 50 anyway, so I would prefer to just have the money and be able to enjoy it now’, they said. Sardonic humour like this is particularly common among people my age, and although it’s fun, I can’t help but feeling like it’s a way of coping with real possibilities.
Seeing as clinical psychology is a career path that I’ve thought about pursuing, I’ve often thought about how I might respond to such concerns within a CBT paradigm. If a patient told me they were experiencing anxiety at the prospective of mass food shortages caused by climate change, I would find it difficult to prompt a more adaptive and realistic belief. ‘Yes’, I could say, ‘but starvation shortages won’t impact you — a university educated person living in an OECD country — as much as it will people who are already living below the poverty line’. Their anxiety would be promptly replaced with guilt about their own relative privilege, and dread about the humanitarian crises that the future holds. Another successful day in the clinic, right?
'Concerns about climate change can obviously be debilitating, but can they be considered maladaptive? After all, a degree of pessimism actually seems like a rational and ultimately fairly "sane" response.'
Interestingly, the phenomenon of climate anxiety is something that’s being increasingly observed by mental health clinicians — particularly among young people. I wouldn’t be surprised if it is added to the next edition of the Diagnostic and Statistical Manual of Mental Disorders, or ‘DSM’.
However, I still find it hard to imagine how CBT could be used to treat this kind of condition. And although I’m personally more of a proponent of psychodynamic treatments — the kind that draws on ideas about formative childhood experiences and unconscious processes — I have to admit that they face a similar criticism. I can’t imagine that uncovering a patient’s childhood memories is going to be helpful in alleviating their climate anxiety.
New research is being done all the time, and so of course there are contemporary treatments (most often variants of CBT), which can be used to more effectively tackle climate anxiety. Despite this though, I feel like this is an issue for which better treatment can only get us so far, as most anxiety treatment aims at correcting ‘maladaptive’ beliefs and affective responses, often through an appeal to a more rational outlook. Concerns about climate change can obviously be debilitating, but can they be considered maladaptive? After all, a degree of pessimism actually seems like a rational and ultimately fairly ‘sane’ response.
One thing that can be done though is taking more action on climate change. The government has been relentlessly negligent on the issue, often taking steps to exacerbate rather than counteract it, through continued mass deforestation and further attempts to subsidise new coal-fired power plants. Although Australia only contributes a certain amount to global emissions, we lead the world on a per capita basis. What’s more, as a country we are particularly susceptible to increases in adverse weather events — something that proved all too real during the bushfires early this year.
Such a profound lack of action from our own government on an existential issue of this magnitude certainly doesn’t inspire hope. So when it comes to climate anxiety as a clinical issue, this is not only a risk factor, but also a barrier to treatment.
No doubt, the allocation of resources to mental health services is a good thing. However something about it feels akin to a local council attempting to improve the health of its inhabitants by opening more clinics, while simultaneously refusing to acknowledge that the nearby power plant is continuing to leak radioactive waste and making everyone sick. This is, of course, a crude analogy, but I still think there’s something to be said for the fact that any health spending should not only focus on treatment, but also on prevention.
Climate anxiety will only continue to become more common, and I don’t think that simply having more sessions on the couch will be enough to address it. So, perhaps next year’s mental health budget could involve splashing out on some cleaner energy as well.
Leo
recently graduated from undergraduate studies in Psychology and
Philosophy, and currently interns as a research assistant in a cognitive
neuroscience and a social psychology lab at The University of
Melbourne. He is interested in issues at the intersection of
psychotherapy, neuroscience, and politics. 
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