As a therapist who worked in Hong Kong through the fifth wave of COVID-19, I have seen how anxiety can arise in response to systemic, and collectively felt events such as a pandemic. Anxiety does not always come from an external source like this—the source might not be absolutely clear. However, this post focuses on anxiety-inducing circumstances that play out on multiple levels of society. This could be in response to the deterioration of our planet, discrimination based on sexist, racist, and/or homophobic attitudes/policies, or the breakdown of social/political systems.

I sometimes come across doubt about whether therapy can be helpful in these situations. I think the reason for this doubt comes from the way we view mental health. For too long, Western psychology has been focused almost exclusively on the reductive idea that mental health concerns are individually derived. In this view, people with mental health concerns are problems—both the source and the solution. I divert from this view to see problems as problems (source). To me, this means two things: the problem is likely much bigger than you, and any problem that is bothering you is a valid one to bring to therapy.

To be clear, I see this as a good thing—the bigger the problem, the more points of entry we have into deconstructing it and addressing its impacts. No matter what your concern is, it’s likely that in therapy, we’ll be talking about factors that exist outside of the room. The problem never begins and ends solely with you, and big systemic issues are not the only example of this. In Hong Kong, I notice that systemic issues are sometimes a safe way into discussions about mental health—everyone is familiar with the impacts of the protests and the pandemic, so perhaps there is less risk of feeling alienated or different.

Entering therapy because you’re feeling anxious about something that seems untouchable is not uncommon. Many problems feel that way—the loss of a parent, growing up within abusive family dynamics, enduring traumatic circumstances—none of these sources of pain can be touched, changed, undone, or fixed. Our work in therapy is not about fixing. Our work in therapy is about opening ourselves up to what hurts so that we can shift our relationship with pain. The field of psychology is slowly becoming more inclusive of these possibilities and much work is being done about the treatment of eco-anxiety, minority stress, racial trauma, and more.

Eco anxiety can be treated in therapy. — *When multiple issues are impacting us, it’s normal to feel anxious. This is a valid reason to seek the support of a therapist.*

I’ve compiled a few ways (through research & my own professional synthesis) that therapy can be helpful in the face of anxiety-inducing circumstances that feel bigger than us and are far outside of our individual control. Of course, each therapist/client partnership is unique and there are many different approaches to therapy. This list is intended to explore general possibilities that may help you clarify your hopes for entering into therapy.

Therapy is a space to openly acknowledge anxiety without judgment

There is still stigma and misconception about anxiety. This is true in Hong Kong, and other locations as well. Talking about it can feel vulnerable and we may worry that something is wrong with us for feeling anxious about systemic issues. When we don’t have a nonjudgmental space to openly acknowledge how we feel, that stigma can be reinforced. Therapy can be a space to acknowledge anxiety without being encouraged to change the way we feel. In my clinical experience, by simply identifying it, some of its power can be taken away. Your therapist may want to teach you a little bit about anxiety and how it works, showing you that it’s not your fault and that you’re having a common, normal, human reaction to something scary and stressful, or possibly even life-threatening. Therapy needs to be a safe space for you to feel whatever it is you feel—and your therapist plays an active role in safely supporting you to care for and contain that feeling.

Therapy can help you process the emotions underneath your anxiety

Where there’s anxiety, emotion is never too far. Anxiety is oftentimes what we name our experience when we’re feeling a lot different things, but it is difficult, unsafe, or overwhelming to parse out each individual emotion. I find that when people are experiencing anxiety in relation to systemic problems, grief and/or anger are often present. These emotional responses are not always deemed socially acceptable. Others may feel uncomfortable with our emotions and try to tell us it’s not something worth being upset about because we can’t change it. It can be very healing to have a trusted therapist affirm the validity of your emotions. It makes complete sense that we’d grieve the destruction of our environment or that we’d feel angry about the devastating impacts of the patriarchy. It also makes sense that when these emotions remain unprocessed, they can ramp up and exacerbate anxiety. In therapy, we can safely peer underneath anxiety and give permission for grief and anger to be there, so that those emotions can be processed and therefore, less anxiety-inducing. Emotions are a pathway to getting in touch with yourself and what matters to you.

Therapy can help you identify what matters to you & encourage action where possible

Once you have identified the feelings underneath your anxiety, your therapist may invite you to consider what these emotions are telling you. Emotions contain intent. They are sending us an important message, and these messages can reveal a lot about our values, our character, and what matters to us. For example, someone who has started to do the work of acknowledging eco-anxiety, then permitting and processing their underlying grief might ask themselves, what does this grief help me to see or understand about who I am? They may discover that this grief is an expression of care or sensitivity, a commitment to justice or personal transformation, or simply a deep love of nature. From this place of identifying personal values, therapists can help clients discover actions that support a sense of purpose and connection. Acting intentionally in accordance with what matters to you can reduce the impact of anxiety.

Therapy can help you create safety and resilience within yourself and your community

Moving through the above three processes in therapy takes a great deal of careful, well-paced inner work. It takes courage and strength to acknowledge, process, and identify with the emotional weight of anxiety. Through the process, your therapist can reflect back to you the inner resources and strengths that they notice you utilizing to do this work. They might offer some new coping strategies too. This can help you to see yourself as someone who is capable of responding to anxiety in helpful, adaptive ways while staying connected to the things that matter to you. If you’re someone who likes to seek support in connection with others, you may share this strength (and learn new ones) with others in support groups, community gatherings, or online advocacy spaces. A sense of connectedness with other people is a way to cope with anxiety because when we’re part of something bigger than us, we feel safe and protected. Your therapist may be able to help find people and spaces in which to come together and grow resilience around shared experiences.

Therapy can help you reposition the way you see yourself in the world

In the process of therapy, we often gain perspective and insight into ourselves and who we are in relation to others. A therapist does not usually tell you this, but rather, it happens naturally as you learn to be more curious and open-minded toward your emotions and your experiences. When it comes to anxiety brought on by systemic issues, discussions with your therapist might revolve around the nature of the issues that are impacting you and your community. If your therapist is informed about the issues that affect you, they can help you to differentiate between the internal, social, and systemic dimensions of the issue. You may begin to recognize how the issue shows up beyond just you, but also in your community, and in higher levels such as local laws or societal attitudes. For example, you may discover how painful it is to recognize how little is being done by big corporations to ease climate change, especially when they put the onus on consumers to drive change. It can be helpful to see where your influence can extend as an individual, but also the ways in which undo responsibility is being placed on you. From this kind of exploration, you might be able to identify emotional weights which are in fact not yours to carry. This does not make the pain disappear, but rather, the pain is placed within a larger context which gives it a more complex and accurate meaning.

I intentionally did not include a section about adopting positive mindsets about the problems we face as a society. While this may help us feel better, and could be a very important coping strategy for some folks, I believe we need robust, long-term, and transformative therapeutic approaches to these problems. I do not see therapy as a space to shift us away from the reality of these problems by encouraging clients to think more positively. Instead, I see therapy as a potentially liberatory space. To me, that begins with acknowledging how we authentically relate to the problems we face, then harnessing this into purpose and action when possible. My perspective is that through this process, we will find ourselves more naturally connecting to hope, joy, and optimism in ways that keep us focused and active in our pursuit of both internal and external change.

Finding a therapist who you connect with and whose experience aligns with your concerns is a hugely important factor in successful treatment. If you’re feeling anxiety due to large, systemic problems like climate change, COVID-19, racial injustice, misogyny, ableism, etc, it would be more than fair to ask your potential therapist if they have experience guiding people through these concerns.

Many of my clients bring these concerns to therapy, and I’d be happy to have an initial consultation with you (free of charge) if you think we might align. Please visit my booking/contact page if you’d like to get in touch.