Recently, US citizens have experienced multiple collective sociopolitical stressors, including and not limited to gun violence, hate crimes, increasing national debt, job loss and the overturning of Roe v Wade. Of the issues mentioned above, some are processed more often than others in therapy. Gun violence is discussed often in session and contributes to anxiety, fear, rumination and distress in the minds of many. Currently, the overturning of Roe v Wade has significantly impacted the mental health of many and has been the center of therapy sessions for weeks. While working with female identified and lgbtq+ identified folx, the overturning of Roe v Wade has contributed to increased emotional, cognitive and relational stress. This increase in stress on its own has contributed to changes in behavior, coping ability, communication style and relationship dynamics. For those living with mental health challenges such as anxiety and depression, symptoms have increased and coping abilities have become challenged.
The impact of the overturning of Roe v Wade on the mental health of those in therapy include and are not limited to the following:
Increased fear and hypervigilance. Recently, clients have appeared to session endorsing increased fear and hypervigilance related to the Supreme court's decision to limit access to abortion services. Specifically, clients have endorsed experiencing fear of not being able to access essential reproductive health services including abortion. Others have endorsed a cognitively intrusive fear of becoming pregnant. This has contributed to some individuals feeling internally pressured to seek out as many services as they can before "they are taken away from me." Conversely, other individuals have been too fearful post this decision to access any services for fear of them being discontinued. Fear and hypervigilance has also contributed to some individuals becoming hyper-aware of the news, changes in access and/or national political discord. Multiple mental health diagnoses include fear and hypervigilance as part of the symptom cluster that contribute to distress, overwhelm andor difficulty with aspects of daily living. When the additional fear and hypervigilance as discussed above occurs for those living with chronic mental health challenges, these individuals may become increasingly overwhelmed, irritable, mistrusting, ruminative and isolative.
Apathy and hopelessness. In the face of recent sociopolitical issues, many individuals have noted apathy and hopelessness as contributing to increased psychological distress. Apathy is characterized by a lack of interest, concern or enthusiasm. It is displayed in this specific therapeutic context as an individual's distress about the Roe v. Wade decision followed by a feeling of lack of ability to make change to the issue, or a lack of concern about how this decision impacts the individual. People mention feeling apathetic or hopeless regarding sociopolitical issues and noticing how it impacts symptoms of depression and anxiety they are already experiencing. The compounding of apathy and hopelessness on previously existing anxiety or depression symptoms may cause worry, rumination, fear, overwhelm, agitation, isolation, external locus of control and lack of motivation.
Relationship discord. In addition to increased fear, hypervigilance, apathy and hopelessness post-Roe V Wade, clients are endorsing relationship discord. More specifically, relationship discord resulting from discussion on the impact of Roe V Wade on the individual in the relationship who has birth-giving ability. Topics clients endorse are creating discord in their relationships include; plans related to fears of unplanned pregnancy, a desire to stop having penetrative sex for fear of pregnancy, desires for surgical intervention, processing anger that only the person with birth-giving ability is impacted by this ruling and a feeling of not being understood by their partner. Among those in relationships, the issues mentioned above contribute to disconnection, sadness, disagreement, and interpersonal reactivity.
What can we do about it?
While individual and collective levels of stress continue to rise due to this sociopolitical change, there are multiple interventions that can be practiced in order to best cope. Coping strategies that address the psychological and relational issues mentioned above focus on grounding, mindfulness, compassion and communication.
Skills involving present time awareness, physical grounding and mindfulness are best in order to address the physiological and cognitive aspects of hypervigilance, fear, hopelessness and apathy. These skills ask the individual to slow down, become present with their emotional and psychical experience and attempt to keep their thoughts in the present moment. As apathy, hopelessness, fear and hypervigilance are impacted and intensified by worrying about the future or sadness about the past, present time awareness helps its users reduce this worry by remaining in the present moment. Grounding skills can be best applied to those experiencing hypervigilance and fear. These skills ask the individual to orient themselves, reduce the reactivity of their central nervous system and experience control over their bodily responses to stress. Grounding skills that can be practiced anywhere including and not limited to; noticing the colors in one’s environment, deep breathing with a focus on the in breath and out breath, changing one’s body temperature, noticing the details of an object in one’s environment, etc.
Compassion and nonviolent communication skills can be used in order to best address the relational discord that can occur as a result of the aforementioned sociopolitical issues. Compassion allows each individual to engage in perspective taking and reduce heightened emotion. As much of the relational discord involves each individual feeling misunderstood or unheard, compassion allows individuals to understand more clearly what informs their partner’s perspective and soften their responses. Lastly, nonviolent communication (NVC) asks each individual to 1. Name an observation, 2. Express their emotions, 3. Name their needs, and 4. Ask for their request to be met. The elements of NVC help reduce heightened responses to conversations about difficult topics, name the emotional impact of the discord and ask its participants to name their needs. It acts as a great starting point for discussing difficult topics and can be a helpful tool for any issue creating relational discord.