Has the time come for a revival of ecopsychiatry? Revival of what, you may
be asking, given that ecopsychiatry has received virtually no attention over
the past decade. "Eco" refers to ecology, and ecology generally
refers to the relationships of an organism and the environment. Human ecology
adds the interaction of people with spaces and buildings. Another dictionary
definition includes advocacy for protection of natural resources. In contrast,
social aspects of psychiatry refer to relationships among people.
Ecopsychiatry seemed to have its heyday in the late 1970s. At that time APA
convened a task force on relating the environment to mental health and
illness, coining the term "ecopsychiatry." It produced a
bibliography of resources in 1979.
At that same time, I was beginning my career. First serving in the Army in
Alabama, I was struck by how living in a rural ecological area influenced the
practice of psychiatry, especially the isolation, reduction of anonymity, and
consequent ethical challenges.
Right after that, I worked in academic community psychiatry in Houston, a
rapidly growing urban environment. The ecology of state hospitals was replaced
by that of community mental health centers and homelessness. Resources rarely
matched up with needs, and even transportation to appointments was a big
problem. I had a nascent sense of the interaction of weather and psychiatry.
Early on, the Sunday magazine of the local newspaper did a somewhat facetious
photo story, "Sweating out a Houston Summer," on my perceptions of
the heat and humidity. I had noted more irritability appeared unless one could
stay in air-conditioned settings.
Another psychological influence of the weather emerged in the 1980s with
the research on seasonal affective disorder (SAD). In the late 1980s, I moved
to Milwaukee, where I saw quite a bit of SAD in contrast to virtually none in
The final heyday of ecopsychiatry seemed to arrive in the mid 1990s. Ante
Lundberg chaired a symposium on the topic at the 1994 APA annual meeting and
followed it up in 1998 by as editor of the book The Environment and Mental
Health. Perhaps the prominence of biological psychiatry and the daily
challenges of managed care pushed ecopsychiatry, like some other areas, into
the background. The irony is that at the same time certain interrelated
environmental influences were beginning to escalate. One was the manmade urban
environment. The other was global warming.
There can be multiple psychological effects of urban ecology. Children may
have less exposure to nature. Neurotoxic substances such as lead can harm the
developing brain. Crime, trauma, and consequent posttraumatic stress disorder
are often increased, especially in minority inner-city areas. Increased noise
can cause irritability and poor sleep.
The industrialization that accompanies urbanization is the link to global
warming. There is now scientific consensus on the link between the increased
use of fossil fuels and dangerous levels of carbon dioxide in the air. This
puts human behavior as a root cause of global warming. Since human behavior is
in the realm of psychiatry, one would think that psychiatry would have become
concerned with global warming. But we have not. Perhaps that is due in part to
the major, sometimes overwhelming, problems we confront in our daily work.
Ah, but there is the psychological paradox of global warming. Our brain is
hard-wired from evolution to respond to immediate danger with a
fight-or-flight reaction. There is not any corresponding natural reaction to
dangers that may be years or decades in the future, dangers such as global
warming. Freud described how easy it is for the psychological defense
mechanism of denial to then prioritize and push unwanted issues aside.
There are other psychological connections to global warming. The psychology
of names suggests that such terms as global warming or climate change are not
likely to provoke much fear in anyone. Those in cold climates may like the
image of some warming! Then there are the health risks. The organization
Physicians for Social Responsibility, which has won a Nobel Prize, assesses
that the health risks related to global warming could become as significant as
nuclear risks. The likely psychiatric risks are the known association of
violence with hot weather and the anxiety of weather trauma.
So, yes, the time seems ripe for a revival of ecopsychiatry. Maybe the
biopsychosocial model should become the biopsycho-ECOsocial model! ▪