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CBT Psychotherapy Resilience

Short Guided Relaxation Exercise

Listen to this Audio Recording of my Fractional Relaxation Technique

NB: This episode contains a recording of a guided relaxation technique, which you should not listen to while driving. I created this recording for my psychotherapy clients, many years ago, but wanted to make it more widely available. It’s a short and simple exercise, about thirteen minutes in duration. This is the approach that I found to work best for the majority of people.

Short Guided Relaxation Exercise Stoicism: Philosophy as a Way of Life Podcast

NB: This episode contains a recording of a guided relaxation technique, which you should not listen to while driving. I created this recording for my psychotherapy clients, many years ago, but wanted to make it more widely available. It’s a short and simple exercise, about thirteen minutes in duration. This is the approach that I found to work best for the majority of people. Stoicism: Philosophy as a Way of Life is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Instructions* Lie down or sit in a comfortable chair, where you are free from distractions* Close your eyes, while you listen to the recording* If you want to fall asleep, it’s okay to listen in bed at night* Try to use this recording at least once per day for at least two weeks* Relax your body and your mind togetherThrough regular use, you’ll develop an association between the recording and the feelings of relaxation, which will make it much easier to relax more quickly, and more deeply. Thank you for reading Stoicism: Philosophy as a Way of Life. This post is public so if you found it helpful, please feel free to share it. Get full access to Stoicism: Philosophy as a Way of Life at donaldrobertson.substack.com/subscribe
Categories
CBT Interviews Podcasts Psychotherapy Resilience Stoicism

Podcast: Talking about Stoicism and CBT with Tim LeBon

In this episode, I chat with Tim LeBon, cognitive-behavioural psychotherapist, research director for the Modern Stoicism organization, and author of Wise Therapy: Philosophy for CounsellorsTeach Yourself Positive Psychology, and more recently, 365 Ways to be More Stoicedited by my wife Kasey Pierce.  

Topics covered include…

  • How Tim first got into philosophical practice and Stoicism  
  • The relationship between Stoicism and CBT in general
  • Stoicism and third-wave CBT — recent advances
  • What Tim has learned about Stoicism from his experience as research director with Modern Stoicism
  • What’s 365 Ways like?  How it differs from other Stoicism books  
In this episode, I chat with Tim LeBon, cognitive-behavioural psychotherapist, research director for the Modern Stoicism organization, and author of Wise Therapy: Philosophy for Counsellors, Teach Yourself Positive Psychology, and more recently, 365 Ways to be More Stoic, edited by my wife .  Topics covered include…* How Tim first got into philosophical practice and Stoicism  * The relationship between Stoicism and CBT in general * Stoicism and third-wave CBT — recent advances* What Tim has learned about Stoicism from his experience as research director with Modern Stoicism* What's 365 Ways like?  How it differs from other Stoicism books  Stoicism: Philosophy as a Way of Life is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Tim’s new book, edited by my wife, Kasey Pierce, is now available from all good bookstores.Thank you for reading Stoicism: Philosophy as a Way of Life. This post is public so feel free to share it. Thank you for subscribing. Leave a comment or share this episode.
Categories
History Hypnotism

James Braid’s Hanover Square Talks on Hypnotism (1842)

The Hanover Square Rooms in London, 1843

Editor’s Preface

This is possibly James Braid’s very earliest publication on hypnotism; his letter was dated March 7th 1842 and published in the March 12th edition of The Medical Times. In it he does not use the term “hypnotism”, though elsewhere he suggests it was already in use by him at his lectures. The anonymous report which precedes his letter mentions his use of the expression “neuro-hypnology”, albeit spelt incorrectly.

Indeed, this is one of Braid’s most interesting letters, providing a neat summary of his early theory and practice.  It illustrates how, from the outset, Braid’s work was independently reported, and publicly examined and endorsed by a wide variety of observers, including some of the most distinguished scientists and physicians of his day.  In his first booklet on the subject, published shortly after this letter, a frustrated Braid reminds his critics of the sincere and persistent efforts which he made in order to substantiate his views,

Had I not, moreover, stated the fact that impressed with the importance of the subject, I had, at great personal inconvenience as well as pecuniary sacrifice, gone to London, that my views might be subjected “to a rigid examination” of the most learned men in our profession, to propound to them the laws by which I consider it to act, and above all, to prove to them “the uniformity of its action” and its practical applicability and value as a curative agency, by [my] mode of operating. 

Satanic Agency, etc., 1852

This journalist’s report and Braid’s subjoined letter, show the extent to which, with the limited means available to him, Braid attempted to develop his theory in a credible manner.  In Neurypnology (1843), Braid comments on the role of Dr. Herbert Mayo, one of the most distinguished medical scientists of the period, at the meeting,

I am fully borne out by the opinion of that eminent physiologist, Mr. Herbert Mayo, in my view of the subject, that my plan is ‘the best, the shortest, and surest for getting the sleep,’ and throwing the nervous system, by artificial contrivance, into a new condition, which may be rendered available in the healing art.  At a private conversazione, which I gave to the profession in London on the 1st of March, 1842, he examined and tested my patients most carefully, submitted himself to be operated on by me both publicly and privately, and was so searching and inquisitive in his investigations as to call forth the animadversions of a medical gentleman present, who thought he was not giving me fair play; but which he has assured me proceeded from an anxious desire to know the truth, not being biased by having any peculiar views of his own to bring forward; and because he considered the subject most important, both in a speculative and practical point of view.

In his Electro-Biological Phenomena (1851) Braid describes a successful public demonstration delivered by him in Manchester, adding,

I was equally successful in operating upon a number of strangers together at a private conversazione, given to the profession in London, in March 1842, sixteen out of eighteen having passed into the sleep, simply by maintaining a steady fixed stare and fixed act of attention, whilst gazing at root of a chandelier.  Most of these had never been so tried before.  I never touched any one of them until their eyelids closed.  Mr Herbert Mayo, the eminent physiologist and surgeon, tested them, and ran a needle from the back to the palm of the hand of one patient without his (the patient) evincing the slightest consciousness of pain, or remembrance of it after awaking.

Dr. Mayo subsequently published his own favourable account entitled ‘On Mr. Braid’s experiments’, in the next volume of the Medical Times for 1852.

James Braid
Portrait of James Braid

[Report by Anonymous Correspondent]

Mr. Braid delivered two very excellent lectures on this subject last week, one on Tuesday the 1st of March, at the Hanover Square Rooms, the other, the following day, at the London Tavern.

The lecturer commenced by giving his audience a detailed explanation of the theory and phenomena of animal magnetism, and entered fully into the subject, illustrating the paper by physiological facts, and several interesting anecdotes.  He prefers the term “neuohypnology [sic., an obvious typographical mistake], or the rationale of nervous sleep,” to that of animal magnetism, and thinks that that term is more proper, inasmuch as the effect is produced through the medium of the nervous system. Several experiments performed after the lecture.

The first was a young woman, whom Mr. Braid directed to look at her own finger; in two minutes the face became flushed, the woman sighed, and the eyes closed. She was then requested to sit down, which she did; her arms were raised and also her legs; ammonia was placed under her nose, the galvanic battery applied, pins stuck in the forehead and legs, and without the woman evincing the slightest pain.  The second experiment was upon two deaf brothers, one of them was magnetised by looking upwards, and in three minutes the effect was produced.  Mr. Braid extended both arms, which remained so for some time; he then clapped his hands, and the boy instantly became de-mesmerised.  The experimenter stated that the hearing was increased twelvefold during the time the patient was under the influence of the magnetising process.  The elder brother was then subjected to the same process, and became magnetised in about three or four minutes; a percussion cap was fired at his ear when in this state, but no effect supervened.  It is a singular thing that [presumably at a different stage in the lecture] the pulse in this boy increased from 84 to 140[bpm], and Mr. Braid remarked that such was generally the case.  [Braid repeatedly makes this observation in his writings, which seems to be verified by the reporter.  The induction of rigid catalepsy seems to roughly double the pulse, raising it to a level more typical during intense aerobic exercise.]

The third experiment was upon his own footman [perhaps the young “man-servant” discussed in Neurypnology]. In this case he bandaged the man’s eyes and in three minutes he was asleep; he was subjected to nearly the same experiments as the preceding.  Mr. Braid then recovered him and directed the man to turn his eyes to the side; in a few minutes the eyes closed, and the most curious effect was produced; the man began gradually to turn round, a circumstance by no means uncommon with those who turn the eyes to the side (so the lecturer informed us).  [This phenomenon might be compared to Braid’s later observations on “muscular suggestion.”]

The fourth experiment was upon a young lady, whom Mr. Duncan [who had previously conducted lectures introducing Braid’s work to the London audience prior to his arrival] had been in the habit of experimenting on.  This was a very interesting case; after being magnetised, several objects were placed before her eyes (which were closed), and she distinctly names each article in succession [an illusory feat, later attributed by Braid to the ability to see through eyelids which are not properly closed]; she then walked about the platform, and knelt and arose at the request of the lecturer.

The last and concluding experiment was upon a young woman, who after going through nearly the same operations, finished by singing “off, off, says the stranger,” and it really seemed as if she were about to go off.

[Braid’s Letter to the Editor]

To the Editor of the Medical Times,

Sir,

I feel obliged by the kind note you have sent me stating your intention of honouring me by a report of my lecture.  I much regret you could not attend the conversazioni, but I shall furnish you with a brief account of what took place on that occasion.  When I had briefly explained to those present my theoretical views, and the ground on which I had come to such conclusions, I expressed my intention to exhibit the phenomena on some of the subjects I had brought with me; some stranger proposed that it might be still more satisfactory and convincing to all present, were I to operate on a stranger, to which I readily assented, provided any one present was willing to become the subject of experiment.  It was then announced that a person born deaf and dumb was present, and had come with the express desire to be operated on, and would now come forward if I chose to begin with him.  I assented, and the patient came forward accordingly.  He was totally deaf, was never known to have heard sound at any time in his life, and was 32 years of age.  In about eight minutes, I evinced to all present the most incontestable proof of hearing being restored.  I then operated on another stranger successfully, and on a third, who was one of my subjects; the varied phenomena intended, and expressed as meant to be exhibited by said patient, were all demonstrated, to the satisfaction of all present.  The next operated on was Herbert Mayo, Esq., so well known to the profession; afterwards my other subjects were operated on, exhibiting these varied phenomena, both mental and corporeal.  As the last experiment of the evening, eighteen were subject to their operation at once, and in ten minutes 16 of the number [89%] were all in a state of somnolency, and some in the cataleptiform state, with insensibility to pain, as tested both by myself and Mr. Mayo [who seems to have shoved a pin straight through his hand].  The other two did not comply with my injunctions.  For the correctness of this statement, I beg to refer you to Dr. [Archibald] Billing [a physician and medical author] and Mr. Herbert Mayo, who tested the patients, and neither of whom I had had the honour of knowing till that evening.  [In Hypnotic Therapeutics, 1853, Braid adds, that of this group, ‘twelve of whom had never been tried before’, the sixteen responsive subjects ‘went into the condition at same time, by gazing fixedly and abstractedly on the root of a chandelier.’]  I should feel obliged by your recording the fact now stated, in addition to what your reporter might see or hear at the public lecture.  In short, the whole of my experiments go to prove, that there is a law of the animal economy by which a continued fixation of the visual organ, and a constrained attention of the mind to one subject, which is not of itself of an exciting nature; a state of somnolency is induced, with a peculiar mobility of the whole system, which may be directed so as to exhibit the whole or greater part of the mesmeric phenomena.

The remarks of your talented correspondent, Mr. Barrallier, relative to Mr. Catlow’s experiments, are quite in accordance with my own views.  I had made experiments to prove this, and had come to the same conclusion as Mr. Barrallier before I was aware of his experiments, and have confirmed them many times since on different subjects.  Mr. C.’s cases on the sense of hearing, touch, taste, smelling, and muscular motion, were nothing beyond natural sleep, at any rate totally different from mesmeric sleep, unless in those cases where the patients had been repeatedly operated on in my way, or through the eye. After a certain time, and frequency of being operated on in this way, the brain has an impressibility stamped on it which renders the patient subject to be acted on entirely through the imagination, and this is the grand source of the follies which have misled Mr. C. and the animal magnetisers.  I feel most confident of this, and shall feel obliged by your publishing this letter to record what I believe to be the fact.

On my return home, I delivered a lecture at Birmingham on Thursday evening, 3rd inst. [3rd March 1842], when I exhibited a series of experiments which were quite conclusive on the subject.  I am to deliver another lecture in Manchester next Saturday evening, when I shall exhibit the same, and many more, illustrative of the imagined transposition of the senses [i.e., seeing with the stomach, and other supposed paranormal abilities called the “higher phenomena” of Mesmerism], and the magnetic power of attraction, a report of which shall be sent to some of our papers, which I shall correct if any mistakes should appear before I send it.

I beg leave further to state, that as I have operated successfully on the blind, it is evident it is not the optic nerve so much as the ganglionic or sympathetic systems and motor nerves of the eye, and state of the mind, which influence the system in this extraordinary manner.

I have the honour to be, Sir, your much obliged and obedient servant,

James Braid.

3, St. Peter’s Square, March 7th 1842

PS. I may add, that last night I was called to a lady suffering the most agonizing Tic Douloroux.  In five minutes by my mode of inducing refreshing sleep, I succeeded in putting this patient into comfortable sleep, from which she did not awake till Sunday in the morning, being five and a half hours, and was then quite easy. By what other agency, I now ask, could such an effort have been induced.

Categories
Psychotherapy Resilience Stoicism

How Stoicism Could Help You Build Resilience

Combining stoic philosophy and cognitive-behavioral therapy.

  • Stoicism is an ancient Greek school of philosophy that inspired modern cognitive-behavioral therapy (CBT).
  • Stoics like Epictetus taught that it’s not things that upset us but rather our opinions (cognitions) about them.
  • People identify with Stoicism as a philosophy of life, which may be more permanent than skills learned in CBT or resilience training.

Read the rest of this article on Psychology Today…

Categories
Books Philosophy Philosophy of CBT Psychotherapy Stoicism

The Books I’ve Written on Stoicism

I’ve published about seven books so far on philosophy and psychotherapy. People often ask about one book but aren’t aware of the others so I’ve put together a short article explaining what they’re about. If you’re interested, you can see more info on my publications, including journal articles, some foreign translations, and books on psychotherapy not mentioned below, on my Google Scholar, Goodreads, and Amazon profile pages.

1. Ancient Lives: Marcus Aurelius (in press)

This is a prose biography of Marcus Aurelius, which will be part of the new Yale University Press Ancient Lives series, edited by James Romm. This book is finished and should (I think) be published around Spring 2023. This was the third book that I wrote in a row about Marcus Aurelius. It focuses on how Stoic philosophy influenced his life, and his rule as emperor, and how his personal relationships shaped and reveal aspects of his character. For instance, the first chapter focuses on Marcus’ relationship with his mother. I’ll publish more details on social media as they become available.

2. Verissimus: The Stoic Philosophy of Marcus Aurelius

Verissimus Cover

Verissimus is a graphic novel, published in July 2022, by St, Martin’s Press. It tells the story of Marcus Aurelius’ life in comic-book panels, with a lot of emphasis on his study and application of Stoic philosophy, particularly how it helped him to conquer his anger.

This was the second of three books that I wrote about the life of Marcus Aurelius, and how it connected with his philosophy. The graphic novel format meant that it’s a very different experience, though, from reading a prose biography or a self-help book. I wrote this book for adults – it’s a graphic novel not a comic – but I have to admit that a lot of readers have said their kids were attracted to the cover design and artwork, and stole their copy!

3. How to Think Like a Roman Emperor: The Stoic Philosophy of Marcus Aurelius

How to Think Like a Roman Emperor (2019) is a self-help book. Most of the chapters begin with an anecdote from the life of Marcus Aurelius, closely based on the surviving historical sources. This is followed by a discussion of how Stoic philosophy can be applied in daily life, and then a comparison with techniques from modern cognitive-behavioural therapy (CBT), which draw on my clinical background as a psychotherapist.

When I first proposed this book the title and the idea of combining three genres (history, philosophy, and psychology) seemed controversial – like a bit of a gamble – but it worked. Roman Emperor is my most popular book. It was the number one bestselling philosophy book in the US in the weeks following its release and was reviewed in the Wall Street Journal. It’s since been translated into eighteen different languages.

4. Teach Yourself: Stoicism and the Art of Happiness

Stoicism and the Art of Happiness (2013) is part of Hodder’s popular Teach Yourself series. It was so popular that a revised second edition was published in 2018, which added an extra chapter on death contemplation. This is a self-help book, which provides careful instructions on how to apply Stoic practices in daily life. It also includes many comparisons with cognitive-behavioural therapy and other evidence-based psychological strategies.

The Teach Yourself series follows a strict and well-established format. Chapters begin with relevant quotes, and short quizzes, and include practical exercises, guides to terminology, key points to remember, examples, recommended reading, etc. It’s designed to make it easy to put the advice into practice in daily life.

5. Teach Yourself: Build your Resilience

build your resilience book cover

Build your Resilience (2012) was my first book for Hodder’s Teach Yourself series. It’s a self-help book about what psychologists call “emotional resilience training”, which is basically training in preventative strategies designed to reduce the risk of mental health problems in the future by making you more able to cope with stressful situations. Like Stoicism and the Art of Happiness, it follows a strict self-help guide format, with lots of info boxes, and practical steps described.

Resilience building draws heavily on cognitive-behavioural therapy but I mainly focused on recent “third-wave” approaches, particularly Acceptance and Commitment Therapy (ACT). There are also chapters discussing research on resilience and vulnerability, and evidence-based approaches to relaxation techniques, worry management, and problem-solving. This book contains a lot of practical psychological advice – I wrote it partly to be used by my own CBT clients and trainee therapists. However, it also contains a chapter on Stoicism and references to Stoicism are interspersed throughout, comparing Stoic concepts and techniques to the evidence-based psychological approaches employed in modern resilience training.

6. The Philosophy of Cognitive-Behavioural Therapy: Stoic Philosophy as Rational and Cognitive Psychotherapy

Philosophy of CBT Cover 2nd Edition

The Philosophy of CBT (2010) was my first book on Stoicism. I’d already been researching the subject, writing about it, speaking about it at conferences, etc., for over a decade before I decided to publish a book. So it contains a wealth of research on the history of philosophy and psychotherapy. My first degree is in philosophy (Aberdeen) and my masters was in philosophy and psychotherapy, at an interdisciplinary centre in Sheffield University. I then trained in counselling and psychotherapy, which became my profession. I wanted to do a PhD about Stoic philosophy and cognitive-behavioural therapy but couldn’t find a university department with a suitably qualified supervisor. So, to cut a long story short, I ended up just writing a book, instead of a dissertation, which was published in the UK by Karnac.

Karnac were later bought by Routledge, who commissioned me to produce a revised second edition in 2020, as the book had become so popular. The new edition contains an additional chapter focusing on more recent “third-wave” approaches to cognitive-behavioural therapy, and how they compare to Stoicism. I was surprised at its reception because it was intended as an academic publication, aimed at philosophers and psychologists – but very few of them read it! Instead, by accident, it somehow reached a “lay” audience, who embraced it as a sort of self-help guide to Stoicism. So I accidentally found myself making the transition from academic researcher and writer, to self-help author.

Other Books

I’ve also contributed chapters to several books on Stoicism.

  1. “The Stoic Influence on Modern Psychotherapy” in The Routledge Handbook of the Stoic Tradition (2016), edited by John Sellars
  2. Introduction to Marcus Aurelius’ Meditations: The Philosophy Classic (Capstone Classics, 2020), which I also helped edit
  3. Introduction to Seneca’s Letters from a Stoic: The Ancient Classic (Capstone, 2021)
  4. “Marcus Aurelius and Psychotherapy” in The Cambridge Companion to Marcus Aurelius’ Meditations (in press).
Categories
Psychotherapy Stoicism Videos

Video: Interview on Stoicism and REBT

Categories
Build Your Resilience Excerpts Resilience Stoicism

Stoic Philosophy in Build your Resilience (2012)

Excerpts from Resilience: Teach Yourself How to Survive & Thrive in any Situation

Copyright © Donald Robertson, 2012. All rights reserved.

My previous book The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy (2010) discussed the relationship between Stoic philosophy and modern cognitive-behavioural therapy in some detail, from an academic perspective. My new book, Resilience: Teach Yourself How to Survive and Thrive in any Situation (2012), is a self-help guide to psychological resilience-building, based on modern CBT. However, it contains many references to Stoic philosophy. The outline below is based on modified excerpts from the text, which is available for pre-order now from Amazon and other online bookstores.

Most of the chapters begin with a quotation from Marcus Aurelius, linking ancient Stoic practices to modern cognitive-behavioural approaches to psychological resilience-building. However, the final chapter, looks at perhaps the oldest Western system of resilience-building, the classical Graeco-Roman school of philosophy known as “Stoicism”, which is derived from the teachings of Socrates and influenced the development of modern CBT (Robertson, 2010). The Stoics are, in a sense, the ancient forebears of most modern resilience-building approaches. Indeed, Epictetus, the Stoic philosopher who has most influenced the field of psychotherapy, has been described as “the patron saint of the resilient” (Neenan, 2009, p. 21).

The Essence of Stoicism

So what practical advice do the Stoics give us about building resilience? Well, this is a philosophy that can be studied for a lifetime and more detailed accounts are available. An excellent modern guide to Stoicism already exists in the book A Guide to the Good Life: The Ancient Art of Stoic Joy by Prof. William Irvine, an academic philosopher in the USA (Irvine, 2009). My own writings, especially my book The Philosophy of Cognitive-Behavioural Therapy, have focused on describing the relationship between Stoicism and modern psychotherapy (Robertson, 2010; Robertson, 2005).

However, although, Stoicism is a vast subject, it was based upon a handful of simple principles. Epictetus summed up the essence of Stoicism as “following Nature” through the “correct use of impressions”. By “following Nature”, the Stoics meant something twofold: accepting external events as decreed by the Nature of the universe, while acting fully in accord with your own nature as a rational human being, living in accord with your core values. (Scholars capitalise “Nature” when referring to the nature of the universe as a whole, whereas lower-case “nature” means your internal human nature as an individual.)

Don’t treat anything as important except doing what your nature demands, and accepting what Nature sends you.

Meditations, 12:32

Reverence: so you’ll accept what you’re allotted. Nature intended it for you, and you for it.

Justice: so that you’ll speak the truth, frankly and without evasions, and act as you should – and as other people deserve.

Meditations, 12: 1

However, the basic twofold principle “follow Nature” leads on to an elaborate system of applied philosophy, which this chapter will explore in more detail.

The first few passages of the philosophical Handbook of Epictetus provide arguably the most authoritative summary of basic Stoic theory and practice. I’ve paraphrased the key statements below, to highlight the possible continuity with ACT, CBT and the approaches to resilience-building discussed in this book.

  1. The Handbook begins with a very clear and simple “common sense” declaration: Some things are under our control and others are not.
  2. Our own actions are, by definition, under our control, including our opinions and intentions (e.g., commitments to valued action), etc.
  3. Everything other than our own actions is not under our direct control, particularly our health, wealth and reputation, etc. (Although, we can influence many external things through our actions we do not have complete or direct control over them, they do not happen simply as we will them to.)
  4. Things directly under our control are, by definition, free and unimpeded, but everything else we might desire to control is hindered by external factors, i.e., partly down to fate.
  5. The Stoic should continually remember that much emotional suffering is caused by mistakenly assuming, or acting as if, external things are directly under our control.
  6. Assuming that external events are under our control also tends to mislead us into excessively blaming others and the world for our emotional suffering.
  7. However, if you remember that only your own actions are truly under your control and external things are not, then you will become emotionally resilient as a result (“no one will harm you”) and you may achieve a kind of profound freedom and happiness, which is part of the ultimate goal of Stoicism.
  8. To really succeed in living as a Stoic, you need to be highly committed, and may need to abandon or at least temporarily postpone the pursuit of external things such as wealth or reputation, etc. (Stoics like Epictetus lived in poverty while others, like Marcus Aurelius, tried to follow the principles while commanding great wealth and power – both were considered valid ways of living for a Stoic but Marcus perhaps believed his complex and privileged lifestyle made commitment to Stoicism more difficult at times.)
  9. From the very outset, therefore, the Stoic novice should rehearse spotting unpleasant experiences (“impressions”) and saying in response to them: “You are an impression, and not at all the thing you appear to be.” (Something that closely this resembles the basic strategy we call “distancing” or “defusion” in modern CBT.)
  10. After doing this, ask yourself whether the impression involves thinking about what is under your control or not; if not, then say to yourself, “It is nothing to me.” (Meaning, it’s essentially indifferent to me if it’s not under my control – I just need to accept it; although the Stoics did admit that some external outcomes are naturally to be preferred, despite lacking true intrinsic value.)

The Teach Yourself book goes on to describe the basic principles of Stoicism in more detail and, in particular, to elaborate upon some of the basic psychological strategies employed for resilience-building by the Stoic sages, such as acting “with a reserve clause”, visualising the “view from above”, and contemplation of the ideal Sage, etc.

Table of Contents

  1. Introduction: What is Resilience?

     

  2. Letting go of Experiential Avoidance

  3. Values Clarification

  4. Commitment to Valued Action

  5. Acceptance & Defusion

  6. Mindfulness & the Present Moment

  7. Progressive Relaxation

  8. Applied Relaxation

  9. Worry Postponement

  10. Problem-Solving Training

  11. Assertiveness & Social Skills

  12. Stoic Philosophy & Resilience

Categories
CBT Stoicism

Stoic Philosophy as Psychotherapy (2005)

This article was first published in the July 2005 edition of the BACP magazine CPJ (now Therapy Today).

Republished with minor amendments.  Copyright © Donald Robertson, 2005.  All rights reserved.


The philosopher’s school is a doctor’s clinic. (Epictetus, 1995: 3.23.30)1

There is currently [2005] a growth of interest in the “practical” or psychotherapeutic aspects of classical philosophy. Academic experts have long perceived “Late” or “Roman” Stoicism (c. 1st – 2nd Century AD) as offering the most explicit system of therapeutic concepts and techniques to be found in classical literature.  This article seeks to introduce some of the basic principles of Stoic philosophy to an audience of psychotherapists and counsellors. We have found that therapists are often surprised at how relevant to their practice and strangely familiar Stoic ideas actually are.  Indeed, we hope to demonstrate that many modern theories of psychotherapy, counselling and personal development are ultimately indebted to this age-old but virtually forgotten therapeutic tradition.

The Origins & History of Stoicism

Stoicism is an ancient European school of philosophy, which incorporates a comprehensive system of therapeutic exercises. Zeno of Citium founded the school in Athens, as a “Socratic” sect, around 300 BC. However, Stoicism was more than just a “philosophy”, in the modern academic sense of the word, it was a far-reaching and long-standing cultural movement. 

 The historical boundaries are controversial, but it is safe to say that the Stoic school of philosophy can be situated within a broader philosophical tradition of “practical philosophy.”  That movement as a whole lasted from around the time of Pythagoras of Samos (c. 6th century BC) –who may be considered the original philosopher-therapist– to the superseding of pagan philosophy by Christian theology well over 1,000 years later. Following the closure of the great pagan academies by the Christian Emperor Justinian in 529 AD, the therapeutic practices of Stoicism and other philosophical systems survived only insofar as they were assimilated into orthodox Christian theology, i.e., barely at all.

 As a living tradition of philosophical practice Stoicism’s time was over. However, some of its concepts survived in literature and experienced various revivals, most notably the so-called “Neostoicism” of the Renaissance period, explaining the traces of Stoic thought in the work of such influential figures as Erasmus, John Calvin, Rene Descartes, William Shakespeare, John Milton, and Michel de Montaigne, to name but a few.  Even the royals, Queen Elizabeth I of England and King James I of England (VI of Scotland), were considered admirers of Stoic philosophy. More recently, Tom Wolfe, author of Bonfire of the Vanities (1987), published a novel called A Man in Full (1998) in which one of the lead characters adopts a philosophy of life based on the ancient Stoic Manual of Epictetus. Hollywood director Ridley Scott’s epic Gladiator (2000) depicts the last days of the Stoic emperor Marcus Aurelius (Richard Harris) and briefly alludes to the cardinal philosophical virtues and the Stoic notion of ‘contempt for death.’ 

It is worth noting, in this context, that the English language still retains evidence of the therapeutic dimension of philosophy. The adjective ‘philosophical’, among other things, still clearly alludes to the ancient ideal of emotional calm (ataraxia) and self-mastery (sophrosyne). This usage of ‘philosophical’ has also become virtually synonymous with the modern, popular meaning of ‘stoical.’

 philosophical. adj. 3. Calm in adversity.

 stoical. adj. Having or showing great self-control in adversity. (OUP, 1992: ‘philosophical’, ‘stoical’)2 

Indeed, Stoicism’s influence over our thought and language, usually unrecognised, endures right down to the present day, so much so that people are often surprised to find that many familiar clichés and proverbs are derived from Stoic philosophy – I call this its “déjà vu factor.”

Stoicism & Modern Psychotherapy/Counselling

Stoicism is fundamentally a philosophy of life independent of any political or religious dogmas. Some have seen it as comparable to a “European Buddhism” or “Western Yoga”, similar in appeal to Oriental systems of thought. Yet it is essentially agnostic, naturalistic, and European in character. Though we shall focus on the therapeutic dimension of Stoicism, it does encompass the possibility of certain metaphysical and spiritual themes, which provide the basis for a sophisticated kind of rational mysticism. Indeed, historically Stoicism evolved into the high mysticism of the last great pagan philosophical school, Neoplatonism, which was in turn assimilated into Christianity.

However, Stoicism is also the forgotten ancestor of our own psychotherapeutic tradition.  The modern history of psychotherapy begins in the early Victorian era with the development of hypnotherapy as a medico-psychological treatment, from which Freud subsequently developed psychoanalysis. Yet thousands of years earlier, it was common parlance to refer to philosophy as a “physician of the psyche” and for philosophers to employ therapeutic aims, concepts, techniques, and styles of working. For example, it’s now known that Freud derived his concept of katharsis (psychical “purification”) from a superficial reading of Aristotle. However, as a classical scholar himself, he might have been aware that the word was more commonly used as a technical term to describe the separation of mind from emotional attachment to external, material things. This notion of the need to “separate” and “purify” the subjective (self) from the objective (other), so fundamental to Stoic practice, pre-empts the basic psychoanalytic concept of projection, which both Jung, and later Klein, inferred was among the most fundamental of all Freud’s so-called ‘defence mechanisms.’ 

More recently, existential and cognitive therapies have drawn explicitly upon similar themes from classical philosophy. When existential therapists, following Heidegger, discuss the importance of an “authentic being-toward-death”, e.g., they are perpetuating one of the central methods of ancient philosophical therapy, the melete thanatou or “meditation upon death”, dramatically portrayed in Plato’s dialogues on the last days of Socrates. The “here and now” philosophy of Gestalt therapy is a figure of speech translating the Latin “hic et nunc”, one of the key themes of Stoic psychotherapy: returning awareness to the present moment. Albert Ellis, the founder of REBT, openly acknowledges his debt to Epictetus, the author of the therapeutic Manual of Stoicism; hence many students of REBT are already partially apprised of its connection with Stoic philosophy. The “ABC model” widely used in cognitive therapy is simply another re-iteration of the perennial philosophical notion of philosophical katharsis, i.e., separating out our subjective judgements from the external events to which they give emotive meaning. In this regard, Cognitive therapists repeatedly cite the famous quotation from the Manual of Epictetus: ‘It is not things themselves that disturb people but their judgments about those things.’ (Epictetus, 1995: §5)1

Nowadays thinkers are freely developing personal development systems and eclectic psychotherapeutic techniques which, often unknowingly, re-introduce key concepts and techniques from classical Western philosophy. Indeed, the many ways in which modern therapists are indebted to ancient philosophy would fill a book by themselves. We only offer a few examples of this intellectual debt to emphasise the point that all therapists, for the most part unwittingly, operate in the shadow of a very ancient therapeutic model. We still speak the language and use the methods of an ancient therapeutics, whether we realise it or not. 

The Basic Concepts of Stoicism

The name “Stoic” simply refers to the stoa poekile, the “painted porch” within which Zeno of Citium, the school’s founder, delivered his lectures and training. However, Stoicism has a more descriptive name, it is also called the “Natural Life” or “Following Nature”, and many variations of this phrase are used to describe the basic orientation of the system. The ancient historian of philosophy Diogenes Laertius writes, ‘the end [of Stoicism] turns out to be living in agreement with nature, taken as living in accordance both with one’s own nature and with the nature of the whole [universe]’ (Diogenes Laertius: 1964, VII: 88).3  In this, Diogenes is alluding to the central Stoic distinction between (internal) human nature, and the (external) Nature of the universe.  In fact, this basic ideal was interpreted as applying at three levels, Diogenes could have added, ‘living in accord with the nature of all mankind,’ because the Stoics believed that the individual self can only be understand as one part, or rather a ‘limb’, of the community of all people. Hence, we have a system of coherence at three levels of ‘nature’:

  1.       Self.  Moral integrity, truthfulness, and personal authenticity
  2.       Mankind.  Empathic understanding, social justice, philadelphia (“brotherly love”)
  3.       Universe.  Being at one with life, with the All, with the totality of Nature

The Stoic Emperor, Marcus Aurelius, employs these three tiers of psychological relations in the therapy journal he kept, the famous Meditations, when he writes:  

Your own mind, the Mind of the universe, your neighbour’s mind –be prompt to explore them all.

Your own, so that you may shape it to justice [and authenticity]; the universe’s, that you may recollect what it is you are a part of; your neighbour’s, that you may understand whether it is informed by ignorance or knowledge, and also may recognise that it is kin to your own. (Marcus Aurelius: 1964, 9:22)4

Stoicism, therefore, is essentially a philosophy of being at one (homologoumenos), or in harmony with, the totality of life. As psychotherapy, it equates mental and emotional health with integration or a sense of “oneness” at these three levels of existence. This simple and intuitive threefold classification also provides the basic structure for applying Stoic psychotherapy, the ‘Threefold Rule of Life.’ 

The Threefold Rule of Life

Objective judgement, now, at this very moment [Logic].

Unselfish action, now, at this very moment [Ethics].

Willing acceptance –now, at this very moment– of all external events [Physics].

That’s all you need. (Marcus Aurelius: 2003, 9.6)5

The Stoics divided their philosophy into three branches: Logic, Ethics and Physics. It is important to realise that these words have now changed their meaning; indeed we will substitute “Metaphysics” for “Physics.” Greek philosophy in general also recognised four ‘cardinal virtues’: Truth, Justice, Temperance, and Fortitude.  These may correlate with the Threefold Rule, the disciplines of Judgement, Action, and of Fear and Desire, and with what we might term the three ‘Core Qualities’ of Stoicism: ‘Objectivity’, ‘Integrity’, and ‘Acceptance.’  Fortunately, for ham-fisted scholars trying to translate these ideas into plain English, we possess a beautifully concise and poetic expression of the Threefold Rule,

“The Serenity Prayer”

God,

Grant me the Serenity

to accept the things I cannot change;

Courage to change the things I can;

and Wisdom to know the difference.

This is the so-called “Serenity Prayer” of the Twelve Step Programme of Alcoholics Anonymous. Although the earliest records attribute it to the late Victorian era, it is so obviously consistent with Stoic philosophy that it is tempting to speculate whether it originates in a much earlier source. In fact, some writers claim that it is based upon the work of the early medieval philosopher Boethius, author of The Consolations of Philosophy, though I have been unable to verify this. 

This, in a nutshell, is the essence of Stoic philosophy; though precisely because of its simplicity it does not give full expression to the enormous breadth of ideas which that system contains. It expresses one of the most fundamental principles of Stoicism: ‘to know the difference between what depends upon me and what does not.’ The Stoics mean by this precisely the distinction we have made between that which is internal and directly subject to my will, and that which I must accept as external and beyond my immediate control, i.e., wholly, or even partially, contingent upon external events.

What, then, should we have at hand upon [challenging] situations? Why, what else than to know what is mine, and what is not mine, what is within my power, and what is not. (Epictetus: 1995, 1.1.21)1

The Threefold Rule of Life

The previous section considered the Stoicism’s history and its relation to modern psychotherapy and counselling. We explained that the grand maxim of Stoic therapy is ‘To follow Nature.’  The first logical step on this path being to distinguish between our own internal nature, the field of Stoic Ethics, and the external Nature of the universe as a whole, the domain of (Meta-) Physics; Stoic Logic aims to make this distinction objectively. This is the Threefold Rule of Life, the basic psychotherapeutic structure presupposed in classical Stoic literature.  Marcus, e.g., exhorts himself to: “Apply them constantly, to everything that happens: Physics, Ethics, Logic” (Marcus Aurelius: 2003, 8:13) 5  We now proceed to examine each of these therapeutic disciplines in turn.

Logic: The Discipline of Judgement

And progress for a rational mind means not accepting falsehood or uncertainty in its perceptions […]. (Marcus Aurelius: 2003, 8:7)5

We can equate the supreme classical virtue of ‘Truth’ with the core quality which I call ‘Stoic Objectivity’, the ability to separate internal from external nature.  In one sense, the heart of Stoic Logic is ‘know thyself’, the legendary maxim inscribed at the Oracle of Apollo in Delphi. However, such knowledge takes on a special character in Stoicism; true knowledge is seen as precisely this ability to clarify the boundaries of the inner self. That is, to continually distinguish, in the present moment, between internal and external nature, i.e., between mind and matter.  As Epictetus says, ‘And to become educated [trained in philosophy] means just this, to learn what things are our, and what are not.’ (Epictetus: 1995, 4.5.7). We can picture this demarcation as the drawing of an imaginary boundary, a circle around the limits of the true self. Indeed, the Stoics described the perfectly circumscribed mind of the ideal Sage as ‘fencing itself off’, an unassailable ‘inner citadel’, and a ‘sphere in perfect equilibrium.’

The ancients generally defined the psyche in terms of activity, as ‘that which moves itself.’ Hence, for Stoicism, the essence of the self is the autonomous action of our freewill: our intentions, thoughts, and decisions. This is a deeply existential view of the self; man is essentially freewill in action, everything else is extraneous to the self. The attitude we call ‘Stoic Mindfulness’ (prosoche), then, means constant self-awareness of the movements of the mind, assuming full responsibility for our own judgements, actions, fears and desires. 

Mindfulness also entails owning our thoughts, re-owning our projections, and suspending all value-laden or emotive judgements. Our thoughts project meaning and form onto our perceptions, by separating the two we attain Truth and Objectivity.  Moreover, the key therapeutic slogan of Stoic Logic is: ‘It is not things that disturb people but their judgements about things.’ (Epictetus: 1995, §5)1  Hence, John Milton’s Satan boasts, ‘The mind is its own place, and in itself can make a heaven of hell, a hell of heaven.’ (Milton, :I, 254)6 As Shakespeare’s Hamlet exclaims: ‘There’s nothing good or bad but thinking makes it so!’ (Shakespeare, 1994, Act 2, Scene 2)7 Marcus Aurelius provides many practical examples of this principle in his therapeutic journal: 

[Remember that] this noble vintage is grape juice, and the purple robes [of imperial office] are sheep wool dyed with shellfish blood. […] Perceptions like that –latching onto things and piercing through them, so we see what they really are. That’s what we need to do all the time –all through our lives when things lay claim to our trust– to lay them bare and see how pointless they are, to strip away the legend that encrusts them. (Marcus Aurelius: 2003, 6:13)5

[Assent to] nothing but what you get from first impressions. That someone has insulted you, for instance. That –but not that it’s done you any harm. The fact that my son is sick –that I can see. But “that he might die of it,” no. Stick with first impressions. Don’t extrapolate. And nothing can happen to you. (Marcus Aurelius: 2004, 8:49)5

We ascertain the truth when we acknowledge and suspend our own prejudices and let the facts speak for themselves. This technique of stripping things down to their essence, phrased in a few words, is known by scholars as ‘essential analysis.’ Its goal is called ‘objective representation’ (phantasia kataleptike), to this alone the Sage’s judgement assents. 

At a practical level, the Discipline of Judgement was achieved by a variety of therapeutic methods. For instance, sophisticated rhetorical techniques and verbal formulae –i.e., language patterns– were used to reframe perceptions. Visualisation was employed, e.g., in imagining the presence of an ideal Sage, accompanying the student as a mentor and observer. Moreover, the therapy was conducted in three modes which happen to correspond to the main surviving examples of Roman Stoic literature.

Mode Format Example
SolitaryTherapeutic journalThe Meditations of Marcus Aurelius
One-to-oneMentor and studentThe Letters of Seneca to his student
GroupDialectical debateThe dialogues in Epictetus’ Discourses and Manual.

Although the Discipline of Judgement was the logical cornerstone of the whole therapeutic system, practical training began with the two disciplines to which we now turn. 

Ethics: The Discipline of Action

[Follow] your own nature, through your actions. Everything has to do what it was made for. […] Now, the main thing we were made for is to work with others. (Marcus Aurelius, 2003: 7:55)5 

Stoic Integrity means to act at one with one’s own innermost nature and the nature of all mankind. The cardinal virtue of ‘Dikaiosyne’ has a dual meaning, it translates as either ‘personal authenticity’ or ‘social justice.’ Likewise, the Discipline of Action involves taking responsibility for all of our actions and directing them toward the solitary goal of reconciling personal moral integrity with love for all mankind.  Our sense of identity determines self-interest and therefore Ethics, because ‘wherever “I” and “mine” are placed, to there the creature inevitably inclines.’ (Epictetus: 1995, 2.22.18)1 For the Sage, therefore, there is no conflict between self-interest and social-interest because he identifies his own nature with the nature of all mankind. This sense of existential kinship is exercised by deliberately practising ‘brotherly love’ (philadelphia) and ‘exploring the minds of others.’ The striking parallel with the core counselling qualities of ‘congruence’, ‘unconditional positive regard’, and ’empathic understanding’ espoused by Carl Rogers will be obvious to any counsellor.  Motivation comes by making an affirmation of the first principle of Stoic moral psychology: ‘The good man is always happy.’ They distinguish sharply between sensory ‘pleasure’ (hedone) which is superficial insofar as it depends upon external factors, and ‘happiness’ (eudaimonia) which comes purely from doing the right thing, i.e., Integrity.  

Your integrity is your own; who can take it from you? Who but yourself will prevent you from using it? When you are eager for what is not your own, you lose that very thing. (Epictetus: 1995, 1.25.3)1

Epictetus elaborates, ‘nothing is of concern to us except our volition.’ The Sage, therefore, renounces attachment to material possessions and invests happiness solely in what is always within his grasp, moral integrity.  However, the Stoics recognised this was an idealistic vision. For practical purposes they distinguish between the absolute value of internal acts and the relative value of external goods. For example, physical health is considered a natural thing to desire and worth having, however, its value is secondary and derivative. That is, physical health is worth having only insofar as it contributes to moral integrity. Yet the Stoics believed that in extreme circumstances even death could be a rational choice. The archetypal example being Socrates, who famously accepted forced suicide rather than accept the trumped-up charges made against him in court – choosing Stoic Integrity over life. This solitary existential decision made him a legendary martyr, and effectively guaranteed philosophy a place at the heart of Western civilisation for posterity.

Some of the Stoics’ ethical views may seem challenging, even radical. However, their “Ethics” was not about moralising, in the modern sense, but something more akin to a system of personal development. Classical philosophy in general predicated its ethics on a notion of enlightened self-interest, which aims for a state of personal fulfilment and happiness. Hence, Aristotle refers to ethics as ethike arete, the science of ‘character excellence.’ Our moral character (ethos) is constituted by the principles of action which we develop into habits.

[Philosophy is] doing what human nature requires. […] Through first principles. Which should govern your intentions and your actions.’ (Marcus Aurelius: 2003, 8:1)5 

The process of ‘essential analysis’ central to Stoic Logic also creates the pithy slogans typical of their Ethics, e.g., “Seize the day”, “Indifference to indifferent things”, etc.  Contemplation, repetition, and memorisation of such principles of action (dogmata) was a key psychotherapeutic technique, as can be seen from the journal of Marcus Aurelius. Hence, these statements were used as autosuggestions, or affirmations, composing a ‘principle-centred’ and inherently therapeutic Ethics.

Metaphysics: The Discipline of Fear & Desire

Reasonable nature is indeed following its proper path if […] it has desire and aversion only for that which depends on us; while it joyfully greets all that which is granted to it by universal Nature. (Marcus Aurelius: 2003, 8:7)5 

Stoic Acceptance means living at one with the external Nature of the universe. The cardinal virtue of ‘Temperance’ means mastering our desire for sensory pleasure, that of ‘Fortitude’ the conquest of our fear of pain and death. Hence, this discipline is about controlling pathos, or emotion. The Stoics believed that both fear (or emotional ‘aversion’) and desire result from excessive emotional attachment; the attitude of the Sage toward external things, therefore, is one of serene non-attachment. The primal and underlying fear which the Stoic seeks to conquer is that of death. ‘The breast from which you have banished the dread of death’, counsels Seneca, ‘no fear will dare to enter.’ (Seneca: 1997, 19)8. Contemplating the transience of life was a standard therapeutic technique of classical philosophy in general.  Indeed, Socrates famously insisted that all philosophy is preparation for death. In the wake of military victory, ancient Roman generals were followed by assistants whispering “memento mori” in their ears: “Remember you must die!” (cf. Discourses 3.24.84-8). Traditionally, many clocks and watches carried Latin inscriptions meant for the same purpose, typically the tempus fugit (‘time flies’), of the Roman poets.

This philosophical theme spawned a vast genre of the same name in the history of art. Examples of memento mori are countless, from the human skulls and wilting flowers of classical Vanitas painting to the animal cadavers of Damien Hirst, all confront us with coolly dispassionate reminders of our own mortality. That most iconic of all Shakespearean images, black-clad Hamlet contemplating the skull of his jester Yorick, affectionately parodies the philosophical practice of meditation on death. The practice of non-attachment and conquering death-anxiety is basically the application of Metaphysics. The original Stoic Metaphysics was wedded to pagan theology, however, belief in God is not essential to Stoicism. As a system of psychotherapy it stands apart from any particular religion or set of spiritual beliefs, and is easily adapted to modern agnostic or even atheistic perspectives. Nevertheless, the early Stoics were mainly pantheists who believed that the totality of the physical universe is simply the Body of God, and the object of His eternal meditation. The aim of their mysticism is simply union with the Mind of God (‘the One’). Hence, it was natural for them, like many earlier philosophers, to infer that by visualising the universe (‘the All’) they attained a Godlike point-of-view. From this God’s-eye perspective, the key concepts of Stoic Metaphysics became more apparent; namely, the unity, transience, and interdependence of all material things. 

The world as a living being –one nature, one soul. Keep that in mind. And how everything feeds into that single experience, moves with a single motion. And how everything helps produce everything else. Spun and woven together. […] Time is a river, a violent current of events, glimpsed once and already carried past us, and another follows and is gone. (Marcus Aurelius: 2003, 4:40-43)5 

For the Stoic, the universe viewed in its entirety is objective reality. Our normal, embodied and earthbound perspective necessarily distorts reality because it is confined to a tiny corner of the universe. Hence, ‘the All is One’, and the totality is the only authentic reality.

Modern scholars call this meditation exercise the ‘View from Above’, and variations of it abound in ancient literature. Sometimes it entails contemplation of the entire universe as though contained in a sphere. Typically though, philosophers attempted to visualise the Earth seen from outer space, a technique which created profound emotional detachment and tranquillity.  Support for this ancient therapeutic intuition comes from the numerous observations of astronauts, who describe the actual experience of seeing the world from space in remarkably similar terms. General Thomas Stafford, commander of the NASA Apollo 10 project, reports:

[From space] you have an almost dispassionate platform -remote, Olympian- and yet [seeing the Earth from up there is] so moving that you can hardly believe how emotionally attached you are to those rough patterns shifting steadily below. (Kevin W. Kelley (ed.), 1988)9 

Marcus Aurelius writes of the ideal Stoic attitude in identical terms: ‘To be free of passion and yet full of love.’ (Marcus Aurelius, 7.9)5 Coincidentally, this meditation exercise may well have evolved out of attempts to visualise the same perspective, of Zeus looking down from Mount Olympus, that General Stafford metaphorically alludes to.  This attitude of serene affection is the goal of the Discipline of Fear and Desire. It is for this reason that Stoicism viewed the practice of pre-scientific, or ‘phenomenological’ physics as a therapy of ‘fear and desire’ in its own right.

Conclusion

[After training in Freudian analysis] I gradually turned more and more to accumulated wisdom in the fields of philosophy. After all, philosophers have been thinking of some of the same issues that we have for the past 2,000 years and I’ve drawn a lot from philosophical insights. (Dr. Irvin Yalom, interviewed in the CPJ, July 2004: 8)

Why does this philosophy stuff matter so much to so many therapists and counsellors?  First, many people simply prefer the stylistic beauty and philosophical depth of classical literature over modern alternatives. Stoicism has demonstrated a perennial appeal enduring more than two millennia. For example, former US President Bill Clinton recently named the Meditations of Marcus Aurelius as his most treasured read. 

Second, many therapists feel the need for a broader philosophical framework. Psychoanalysis, perhaps Marxism, and to some degree religions such as Buddhism and Christianity offer an established ideological basis for therapy practice. Stoicism, on the other hand, offers a viable philosophy of psychotherapy which is not inherently wedded to religious or political dogmas. Ironically, in relation to modern, brief psychotherapy Stoic philosophy proves significantly more relevant than traditional Freudian theory.

Third, the Stoic system contains basic therapeutic principles and techniques not found in modern therapy, which are still relevant and applicable today. Indeed, we have only scraped the surface of Stoic psychotherapy in this article. In particular there are a number of rhetorical strategies and therapeutic interventions –visualisation techniques, etc.– which are not discussed here but which we have found of considerable use in working with clients and workshop participants.  Hence, we would encourage those with an interest in this area to research the primary texts themselves. There is still a great deal to be learned from the ancient forebears of psychotherapy. 

References

1 Epictetus The discourses, the handbook, fragments. London: Everyman, 1995.

2 Oxford University Press The Oxford Dictionary of Current English. Oxford: OUP, 1992.

3 Laertius, Diogenes Lives of the philosophers. H.S. Long (ed.) Oxford: OUP, 1964.

4 Aurelius, Marcus Meditations. London: Penguin, 1964.

5 Aurelius, Marcus Meditations: living, dying and the good life. London: Phoenix, 2003.

6 Milton, John Paradise Lost. Oxford: OUP, 2004.

7 Shakespeare, William Hamlet. London: Penguin:, 1994.

8 Seneca, Lucius Annaeus Consolation to Helvia, in Dialogues and letters. London: Penguin, 1997.

9 Kevin W. Kelley (ed.) The Home Planet. Boston: Addison-Wesley 1988

 

Categories
CBT Philosophy of CBT

Introducing The Philosophy of CBT (Karnac Blog)

Stoic Philosophy as Rational & Cognitive Psychotherapy

Philosophy of CBT Cover 2nd Edition

Blog article for Karnac.  Copyright © Donald Robertson, 2010.  All rights reserved.  This article includes adapted material from The Philosophy of Cognitive-Behavioural Therapy.

The Philosophy of Cognitive-Behavioural Therapy (CBT) is a new book about ancient philosophy and modern psychotherapy.  Professor Stephen Palmer, author of Brief Cognitive Behavior Therapy and several other books on CBT, has kindly contributed a foreword in which he observes that a thorough discussion of the historical roots of modern cognitive-behavioural therapy (CBT) has been lacking.  He adds,

This book takes us on a historical journey through millennia, and highlights the relevant philosophies and the ideas of the individual philosophers that can inform modern cognitive-behavioural therapies.  This book also contains some therapeutic techniques that seem to be modern, yet were developed and written about many years ago.

This is the essence of The Philosophy of CBT.  It’s a book about the practical relevance of ancient philosophy to modern psychotherapy, most especially the relevance of Stoicism to modern CBT.  

Stoicism had more of a psychotherapeutic orientation than most modern psychotherapists are probably aware of – it was essentially a psychological and philosophical therapy in its own right.  CBT is also more indebted to it than is widely recognised.  Epictetus, one of the most important Stoic philosophers, went so far as to say that the philosopher’s school is a doctor’s (or therapist’s) clinic (Discourses, 3.23.30).  In 1979, Aaron T. Beck and his colleagues wrote in the first major CBT treatment manual, Cognitive Therapy of Depression, ‘The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers’ (Beck, Rush, Shaw, & Emery, 1979, p. 8).  These comments echo earlier remarks made by Albert Ellis, the founder of Rational-Emotive Behaviour Therapy (REBT).  Most CBT practitioners will be familiar with the famous maxim of Epictetus, from the Stoic Enchiridion (Handbook), that states,

It is not the things themselves that disturb people but their judgements about those things. (Enchiridion, 5)

This ancient philosophical precept is widely-quoted in introductory texts on CBT and in the writings of Beck, Ellis, and other leading authors in the field.  It serves to highlight the fundamental link between ancient Stoic therapeutics and modern cognitive therapies.  However, this link is never explored – at least not in much detail.

Moreover, there are many practical therapeutic strategies and techniques to be found in the literature of classical philosophy that have good “face validity”, appear consistent with CBT, and may well deserve empirical investigation in their own right.  Hence, some of the key points of The Philosophy of CBT might be summarised as follows,

  • The origins of modern cognitive-behavioural therapy can be traced, through early twentieth century rational psychotherapists, back to the ancient therapeutic practices of Socratic philosophy, especially Roman Stoicism.
  • The notion of Stoicism as a kind of “intellectualism” opposed to emotion is a popular misconception.  Stoicism has traditionally attempted to accommodate emotion, especially the primary philosophical emotion of rational love toward existence as a whole.
  • Ancient philosophy offers a clear analogy with modern CBT and provides many concepts, strategies, and techniques of practical value in self-help and psychotherapy.
  • The contemplation of universal determinism, of the transience or impermanence of things, including our own mortality, and the meditative vision of the world seen from above, or the cosmos conceived of as a whole, constitute specific meditative and visualisation practices within the field of ancient Hellenistic psychotherapy.
  • Contemplation of the good qualities (“virtues”) found in those we admire and in our ideal conception of philosophical enlightenment and moral strength (the “Sage”) provides us with a means of role-modelling excellence and deriving precepts or maxims to help guide our own actions.
  • The rehearsal, memorisation, and recall of short verbal formulae, precepts, dogmas, sayings, or maxims resembles the modern practice of autosuggestion, affirmation, or the use of coping statements in CBT.
  • The objective analysis of our experience into its value-free components, by suspending emotive judgements and rhetoric, constitutes a means of cognitive restructuring involving the disputation of faulty thinking, or cognitive distortion.  By sticking to the facts, we counter the emotional disturbance caused by our own “internal rhetoric.”
  • Mindfulness of our own faculty of judgement, and internal dialogue, in the “here and now”, can be seen as analogous to the use of mindfulness meditation imported into modern CBT from Buddhist meditation practices, but has the advantage of being native to Stoicism, the philosophical precursor of CBT, and to European culture and language.
  • The enormous literary value, the sheer beauty, of many of the classics with which we are concerned marks them out as being of special interest to many therapists and clients, just as it has marked them out for many thousands of previous readers throughout the intervening centuries.
  • Socratic philosophy has a broader scope than modern psychotherapy, it looks at the bigger picture, and allows us the opportunity to place such therapy within the context of an overall “art of living”, or philosophy of life.

Philosophers and psychotherapists have a great deal to talk about, and a better common ground is required on which the two traditions can meet each other and exchange ideas.  I hope that this study of the philosophical precursors of modern cognitive-behavioural therapy will help to clarify and strengthen the basis for further dialogue between philosophers and therapists in the future. 

The book is divided into two parts.  The first explores the historical and theoretical relationship between Stoicism and CBT.  However, the discussion extends to other schools of ancient philosophy, such as Pythagoreanism and Epicureanism, and other 20th century schools of psychotherapy, precursors of modern CBT, such as the rational persuasion school of Paul Dubois, etc.  The second part of the book focuses upon the practical strategies and techniques of Stoic therapeutics in relation to modern CBT.  For example, the role of specific mindfulness, visualisation, autosuggestion, and semantic techniques in ancient Stoicism are explored in some detail.  Appendices provide examples of a possible Stoic daily routine and a complete script for modern practitioners to employ in groups or with individuals, based on the Socratic meditation termed “The View from Above” by modern scholars.

Table of Contents

  • Foreword by Prof. Stephen Palmer
  • Introduction: Philosophy & Psychotherapy
  • Contented with Little

Part I: Philosophy & Cognitive-Behavioural Therapy (CBT)

  • The “Philosophical Origins” of CBT
  • The Beginning of Modern Cognitive Therapy
  • A Brief History of Philosophical Therapy
  • Stoic Philosophy & Psychology
  • Rational Emotion in Stoicism & CBT
  • Stoicism & Ellis’ Rational Therapy (REBT)

Part II: The Stoic Armamentarium

  • Contemplation of the Ideal Sage
  • Stoic Mindfulness of the “Here & Now”
  • Self-Analysis & Disputation
  • Autosuggestion, Premeditation, & Retrospection
  • Premeditatio Malorum & Mental Rehearsal
  • Stoic Fatalism, Determinism & Acceptance
  • The View from Above & Stoic Metaphysics
  • Conclusion: Fate Guides the Willing
  • Appendix: An Example Stoic Therapeutic Regime
  • Appendix: The View from Above Script

The Philosophy of CBT, now in its second revised edition, is available from Routledge, and all good booksellers.

Categories
CBT Excerpts Philosophy of CBT Psychotherapy

Foreword by Prof. Stephen Palmer

The Philosophy of Cognitive-Behavioural Therapy (2010)

Cognitive behavioural therapies are at the cutting edge of modern psychological therapeutic interventions. They are evidence based and therefore are underpinned by much research. In The United Kingdom (UK) the National Institute for Health and Clinical Excellence has recommended cognitive behavioural therapy for depression and anxiety-related disorders such as panics, obsessive compulsive behaviour, body dysmorphic disorder and post traumatic stress disorder (e.g. NICE, 2004, 2005; 2006; 2009). It is no surprise that this interests stakeholders wishing to provide cost-effective psychological therapies to their customers, ie the public, in order to improve wellbeing and reduce financial expenditure. In the UK the Government has taken the next logical step and funded cognitive behavioural therapy training as part of the Improving Access to Psychological Therapies (IAPT) programme. Stressed, depressed and anxious citizens cost countries billions of pounds according to the research data, and understandably reducing absenteeism from work due to psychological illness is an attractive target to focus on. An effective IAPT programme can benefit both the country and the individual.

Cognitive behavioural therapy has become one of the main approaches for dealing effectively with a wide range of psychological disorders and this has led to a large increase in the training of health professionals in this approach especially within the UK. Key handbooks available to trainees based on Dr Aaron Temkin Beck’s Cognitive Therapy (Beck, 1976) or Dr Albert Ellis’ Rational Emotive Behaviour Therapy (REBT) (Ellis, 1958) only briefly, if at all, cover the historical roots of these therapies. Dr Albert Ellis in his publications is often more explicit about the early origins of REBT in comparison to the books on Cognitive and Cognitive-behavioural therapy. 

Yet, for many of us something is missing from most of the literature. What has been needed is a book that covers the underlying philosophy of the cognitive behavioural therapies in much greater depth. This book on the Philosophy of Cognitive-Behaviour Therapy by Donald Robertson provides us with the missing link between the theory and the philosophy. This book takes us on a historical journey through millennia and highlights the relevant philosophies and the ideas of the individual philosophers that can inform modern cognitive behavioural therapies. This book also includes some therapeutic techniques that seem to be modern yet were been developed and written about many years ago. It is a fascinating read. The Philosophy of Cognitive-Behaviour Therapy could be considered as either a prequel or a sequel to the standard textbook read by a trainee or experienced cognitive behavioural or rational emotive practitioner who wants to understand these approaches to therapy within an historical framework.

Professor Stephen Palmer PhD  FAREBT  FBACP

Director of the Centre for Stress Management, London, UK