Is Ecopsychiatry a Specialty for the 21st Century?

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 Houston.

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! ▪