Deep adaptation: ways to grow through dissolution

Alan Heeks, Chair, Hazel Hill Trust

Published in JHH 18.3-Shifting the paradigm

Deep Adaptation emerged in 2019 as a different way to engage with the climate crisis: since then it has proved a valuable map for meeting the pandemic too, and I believe it offers a valuable way for medical practitioners to reframe their work, and the system they work in.

Deep Adaptation is the term coined by Jem Bendell, a young Professor of Sustainable Leadership at Lancaster University. In 2019 he looked at the latest data on climate change, and realised the outlook was far worse than most experts, including the IPCC, were saying at the time. Events since then have shown how right he was.

The first key element in Deep Adaptation is to accept that the climate system is broken beyond repair. In other words, it’s too late to stop catastrophic climate impacts. Mitigating them, reducing emissions, is crucial – but alongside that we need to give much more focus to adaptation, how we live with increasing disruption to daily life, and even the collapse of essential systems.

From my work with doctors on resilience, and just reading the press, I see strong parallels here with the NHS. There’s a widespread need for remediation, but also an imperative to learn how to live with, function, stay sane, in a medical system that is increasingly chaotic, and may well collapse in places within the next few years. Deep Adaptation offers valuable pointers on how to do this.

The second key element in Deep Adaptation is accepting that the emotional impacts of the climate emergency are huge, and we have to process these, face them and learn to live with them, before we can move into any coherent practical responses. These emotions include terror, overwhelm, guilt and many more. Bob Doppelt, in his book Transformational Resilience (2016), believes that most people, and many institutions, are carrying unfaced, unresolved trauma, and I agree with him.

David Peters [JHH editor in chief], myself and colleagues have been leading woodland resilience immersions for doctors. These events are our ways of making a start towards helping medics face the intense and usually unresolved emotions their work involves. We have drawn on elements of the Work that Reconnects, a process for this purpose that Bendell endorses. Its originator, Joanna Macy, says that the catalytic element in this process is having your painful feelings witnessed and accepted by others. Naming your emotions to colleagues seems counter to the medical culture, but I suggest it’s a vital step.

‘…we have to face the huge emotional impacts of the climate emergency before we can move into any coherent practical responses’

David and I chose to run groups for doctors as residentials at a venue which enabled nature immersion because we believed a longer, catalytic experience in this kind of setting would help medics break out of habitual clinical mindsets and experience the spontaneous regulatory effects of being in woodland. A deeply evolved ‘biophilia’ may help explain why this is so, for I have found the same to be true for Deep Adaptation groups for a wide range of clients. I can highly recommend Hazel Hill Wood, near Salisbury, as an off-grid residential venue for this kind of work (

‘…how to function and stay sane in an increasingly chaotic medical system that could collapse in places within the next few years’

The Deep Adaptation network includes many helpful processes, resources, and online forums and support groups. One of the most used tools is Bendell’s four Rs, which I have summarised below, suggesting how medics might apply them.

Resilience: developing the key skills we need for this, including handling emotional impacts and the skills of autonomic self-regulation. I have found David Peters’ views on the neurophysiology of stress and trauma valuable.

Relinquishment: a letting go of beliefs, values, belongings, materials and technologies. For doctors, a major letting-go may be of the expectation of a perfect zero error, emotionally untouched, professional life, the illusion of objectivity and a culture of repressing emotions.

Restoration: this can include recovering values and behaviours eroded by our fast, technocentric, materialist culture. On our immersion groups, many medics have recognised how much benefit there can be in even brief moments of mutual appreciation, spontaneous acts of kindness, brief silent pauses before action, or a short time passed mindfully in nature.

Reconciliation: the stresses we all live in have led to increased scapegoating, othering, and abusive behaviour. Reconciliation invites us to recognise that we’re together in all our human diversity on the planet we must share in a time of deep crisis, and that we all need to give and receive compassion, tolerance and forgiveness.

Another element I value in Bendell’s approach is what he calls The Love in Deep Adaptation, a blog you can find at There he points up the huge focus in Western culture on individual needs and control, and suggests that in these uncontrollable times there’s an opportunity for a return to compassion, curiosity, respect and love. This seems to me to just as true for the NHS as for society at large.

For more on Deep Adaptation, see For more on woodland resilience immersions, see


Doppelt B (2016) Transformational resilience. Routledge.