Stoicism, the original cognitive therapy

Here's a piece I did for the latest issue of Psychologies, on the therapeutic benefits of Stoic philosophy:

Stoicism: the thinking cure

As a young man, Jules Evans was plagued by panic attacks and anxiety until he discovered an ancient philosophy that gave him back his peace of mind

You never forget your first panic attack. Mine was at a party, shortly after I turned 18. I suddenly found myself the centre of attention, and for some reason this triggered a wave of adrenalin, making my face turn white and my heart pound. I was terrified that others would notice my fear, and this only increased the panic. I felt like a rag-doll, picked up and shaken by irrational forces beyond my control.

It was the first of many such attacks. I came to dread social gatherings, and to avoid them, or drink to get through them. I didn’t understand what was happening to me, or whether I would ever get better. I felt an exile from the human race.

But what finally helped me return to health and happiness was not a lifetime of anti-depressants or expensive treatments, but a 2,000-year-old philosophy called Stoicism, which forms the basis of cognitive behavioural theory today.

This philosophy first emerged around 350 BC in Athens where the Stoic philosophers would teach (among the Stoa, or colonnades of the marketplace). Their immensely practical teachings aimed to cure the soul of emotional suffering. When we think of being stoic today, we think of stiff upper lips and emotional avoidance, but the philosophical truth is different.

Stoicism is about learning to understand and control our emotions, rather than simply stifling them. It is about learning to feel in control again, when our negative emotions seem to overpower us. For example, I didn’t choose to have a panic attack at that party, it just happened, making me feel helpless.

Stoics try to show how these negative emotions are actually in our control. They don’t just ‘happen’ as responses to external events. Instead, they arise out of our interpretation of external events. As the Stoic philosopher Epictetus put it, ‘it’s not events, but our interpretation of them, which cause us suffering’.

Our interpretations or opinions can make a bad external situation a whole lot worse. For example, what caused my panic attack was not the whole room looking at me, but the thoughts racing around in my head, saying ‘oh my God, everyone is looking at me, if they notice I am anxious they will think less of me, I will make a fool of myself, and that’s completely unacceptable…’

Stoicism helped me get better because it made me realise that what was causing my anxiety was not some burnt-out synapse in my brain, but my own beliefs. Specifically, it was my belief that other people’s opinions of me were all-important, that I must get on with everyone I meet, which was causing me suffering.

Stoics teach us that negative emotions often arise because we have become mentally attached to something external, such as the good opinion of other people. External things are always, to some extent, outside of our control and subject to change. If we build our happiness on externals, we will never feel secure or content. We will always be the slave of external circumstances, always feeling paranoid about what others think of us.

Instead, Stoics advise us to concentrate on what is under our control – our own thoughts – and to focus our efforts on learning to accept ourselves, and to control our thoughts. This is a much more important and worthwhile project than spending our whole life trying to make a good impression. If we follow the Stoic path, we can slowly become masters of ourselves, rather than the slave of externals.

Stoicism is very much an inner philosophy, which emphasizes intensive training of one’s mind, and a lofty disregard for externals. The Roman emperor Marcus Aurelius, who is one of the most famous Stoic philosophers, spoke of making your mind an ‘inner citadel’ from the vagaries of the external world.

In part, this emphasis on inner freedom rather than the outer life was a product of the era in which Stoicism grew up. It developed in a time of tremendous political upheaval, when the Greek city-states were being conquered by foreign empires like Rome, when dictators were imposing their bloody will upon populations, when daily life was uncertain and sometimes brutal.
Stoicism gave people a way to survive in such uncertain times. If the city-state fell, the true philosopher could maintain his equanimity, because he was not just a citizen of Athens or Sparta, but a citizen of the universe, a Cosmopolitan. The universe, Stoics believe, is governed by a universal law, which they called the Logos. When we cultivate acceptance of change and indifference to externals, then we live in harmony with this divine law.

This idea of living in harmony with the ever-changing universe could be compared to the eastern philosophies of Buddhism and Taoism. There are marked similarities – the Buddha also spoke of making one’s mind an ‘inner citadel’ – and some academics wonder if Stoicism was influenced by Indian philosophy after Alexander the Great invaded India.

Stoicism was also a marked influence on Christianity, which would claim that Jesus was ‘the Logos made flesh’. Stoic philosophers like Seneca were considered so close to Christianity that they were all but canonized by Christian philosophers in the Middle Ages.

The Stoic creed of accepting externals in the name of the Logos has attracted its critics. The philosopher Isaiah Berlin famously called it a philosophical example of ‘sour grapes’ – you are too politically weak to alter your environment, so you claim that true virtue lies in accepting the status quo. But shouldn’t we struggle to change the world, rather than accept it?

In fact, Stoics were anything but politically apathetic. There is a distinguished history of Stoics standing up to tyrants – Cicero gave his life trying to defend the Roman Republic against imperial tyranny, as did Cato, while the proto-Stoic Diogenes made a career from ‘speaking truth to power’. And the Stoic idea of natural law led directly to the revolutionary 18th century doctrine that if governments didn’t obey this natural law, then their population had the right to revolt.

But the most enduring influence of Stoicism is on psychotherapy. Today Stoicism is enjoying a huge comeback through cognitive behavioural philosophy (CBT), which is the most widely accepted form of psychotherapy for emotional disorders like depression, social anxiety or post-traumatic stress disorder.

I spoke with one of CBT’s founders, Albert Ellis, shortly before he died last year, aged 93. He told me: ‘The main inspiration for my therapy was the famous saying of the Stoic Epictetus: “it is not events, but our opinions about them that cause us suffering.” This is a tremendously powerful tool for understanding the human mind.’

Like Stoicism, CBT helps us become aware of our negative thoughts, and trains us to challenge those thoughts and replace them with more rational thoughts.

CBT uses many of the same techniques which Stoicism proposed 2,000 years ago, such as using a ‘thought journal’ to track one’s mental habits and bring them to awareness; or training oneself to keep one’s mental attention in the present, rather than worrying about the past or the future.

The British government has put CBT at the centre of a new ‘National Mental Health Service’, which it hopes will halve the number of people with depression and anxiety in the UK. And it has also introduced CBT techniques into the national curriculum, to help young people cope with emotional disorders. So Stoicism is having a real influence on millions of people’s lives today.

Some people complain that CBT has stolen the techniques of Stoicism, but ditched the metaphysics, and the Stoic idea of the Logos. But in today’s secular society, that was inevitable. The NHS could never subsidize a therapy that demanded you believe in the Logos.

And CBT has proved that you can still use Stoic techniques even if you don’t fully accept all the principles of Stoicism. Even if you don’t believe in the Logos, Stoic techniques can help you to overcome even the most powerful and terrifying emotional disorders. In the dark helplessness of mental illness, it can give us back our power, our sovereignty, and our health.