A Preliminary Study of Stoicism as Psychotherapy

I. Introduction

This essay will consider the thesis that there is within Stoic philosophy, a distinct and interesting theory of human psychology which entails not only a normative account of human growth and development but also a corresponding theory of psychopathology based on that account. The theory also encompasses a system of therapeutic techniques formulated to expose and correct these pathologies. In sum, there exists what can only be described as, a unique and well-formulated system of Stoic Psychotherapy [1].

In fact, I would assert that Stoicism does not just contain a theory of psychotherapy as part of its larger philosophical theory, but that Stoicism itself is more accurately conceptualized as primarily a psychotherapy, albeit, with an extensive philosophical underpinning.

However, as this is not the major topic I wish to address, this position will go largely undefended save for the following material from Martha Nussbaum’s book, The Therapy of Desire: Theory and Practice in Hellenistic Ethics [2].

It is not true that there exists an art called medicine, concerned with the diseased body, but no corresponding art concerned with the diseased soul. Nor is it true that the latter is inferior to the former, in its theoretical grasp and therapeutic treatment of individual cases (Galen PHP 5.2.22, 298D=SVF III.471). (p.14)

They [the Hellenistic philosophical schools and the Stoics in particular] saw the philosopher as a compassionate physician whose arts could heal many pervasive types of human suffering. They practiced philosophy not as a detached intellectual technique dedicated to the display of cleverness but as an immersed and worldly art of grappling with human misery. (p.3)

Finding out how human beings are diseased and what they need is a prelude to, and is inseparable from, trying to heal them and to give them what they need. The connection is this close, first of all, because the conception of the philosopher’s task as a medical one makes compassion and love of humanity central features of it. Having understood how human lives are diseased, a philosopher worthy of the name--like a doctor worthy of that name--will proceed to try to cure them. The whole point of medical research is cure. So, too, the whole point of philosophy is human flourishing. The medical analogy expresses this basic commitment. (Emphasis added) (p.33-34)

And it is clear that the Stoics ... wish to claim that a philosophical art of soul-healing, correctly developed and duly applied, is both necessary and sufficient for attaining the highest ends of human life. ‘Be convinced at least of this,’ Cicero’s interlocutor declares, ‘that unless the soul...is cured, which cannot be done without philosophy, there will be no end to our afflictions. Therefore, since we have begun, let us turn ourselves over to philosophy for treatment; that we may be cured if we want to be’ (TD 3.13). (p.317)

Ms. Nussbaum’s entire book is an exploration of Hellenistic philosophy as a therapeutic endeavor and an extended defense of that position. She brings out an abundance of additional material in support of this thesis that cannot be included here. Suffice it to say, that what has been presented makes clear that the Stoics placed a high priority on their ethical theory and its application to practical living both as an individual, personal endeavor, and in a broader didactic context.
 
 

II. Outlining the System

Even if it is granted that within Stoic philosophy there are numerous techniques designed to aid one in the art of living, a collection of therapeutic techniques alone does not constitute a system of psychotherapy, Stoic or otherwise. Aaron Beck in his book, Cognitive Therapy and the Emotional Disorders [3] suggests that one of the characteristics of a system of psychotherapy, as distinct from simply a collection of techniques, is that its therapeutic approach be derived from and related directly to a comprehensive theory of psychopathology. Although not explicitly stated by Beck, it can be inferred that the theory of pathology also includes a normative account of human development. It is obvious that without the standard for healthy behavior, which such a theory would provide, there can be no determination of what constitutes pathological behavior.

Beck also suggests that a well-developed system of therapy should possess a detailed description of and guide to therapeutic techniques related to this model [i.e., the theory’s model of psychopathology]. [4] To this I would add that any comprehensive system of therapy should include a specific therapeutic paradigm or model (e.g., Ellis’ ABC Theory of Emotion or Bandura’s Social Learning Theory [5,6]) in addition to a broad theory of behavior change. I believe it can be convincingly demonstrated that Stoic philosophy possesses more than ample resources for constructing a uniquely efficacious psychotherapy based on the above criteria. The following material will present, in outline form, one attempt to do so.
 

A. Normative Psychology

The theory of oikeiosis (to be well disposed toward something) provides the Stoic account of normative human growth and development. It includes the motivational theory behind goal-directed behavior and specifies what constitutes appropriate (i.e., normal in a developmental sense) activity for man as a rational creature throughout each stage of the maturation process. Cicero 7], in De finibus iii.20-21 outlines these stages:

The first appropriate function of a creature is to maintain itself in its natural condition. The second, that it should seize hold of the things that accord with nature and banish those things that are the opposite. Once this procedure of selection and rejection has been discovered, the next consequence is selection exercised appropriately; then, such selection performed continuously; finally, selection which is absolutely consistent and in complete agreement with nature.

The motivating mechanism behind this process is oikeiosis. The term is variously translated as appropriate, well-disposed, endearment or self-endearment. Animals are constituted from birth so that they are well-disposed to themselves and as a consequence of this disposition have as their primary goal, or first appropriate function; self-preservation. As the animal matures it becomes well-disposed to additional functions, until in the final stage of development man, the rational animal, lives a life that is in complete agreement with nature; the eudaimon (happy or flourishing) life. [8]

Because the primary focus of this essay is not normative or developmental psychology but rather psychopathology and its treatment, this admittedly foundational topic will go undeveloped. An extended treatment of the subject is provided by Troels Engberg-Pedersen in his book, The Stoic Theory of Oikeiosis. [9]
 

B. A Proposed Therapeutic Model

Just as in cartography the map is not the territory, so too, in psychology the model is not the therapy. A model can, however, serve as a useful tool by providing an overview of the therapeutic process and by illustrating the interrelationships between the different therapeutic constructs. And just as there can be many different maps of the same geographical area, each depicting a specific feature of the landscape (e.g., elevation maps, road maps, etc.) there are a variety of ways to conceptualize what takes place in therapy. What follows is one such conceptualization; others are certainly possible.

It may prove helpful in understanding the role of models to compare and contrast the proposed Stoic model to that of another similar therapy. The Rational-Emotive therapy of Albert Ellis, mentioned earlier, will serve nicely in this effort.

Very briefly, this theory, the ABC theory of emotion, is as follows:

A is the activating event; what happens to the individual. B is the belief system of the Individual; how he or she interprets A. C is the emotional consequence the individual experiences.

Although most people believe that it is the activating event itself that leads to their emotional consequence, according to Ellis this is incorrect. In reality it is the individual’s interpretation of the event, that is, their beliefs about the event that actually produce the emotional consequence. Rational beliefs produce rational emotional consequences; irrational beliefs produce the opposite. Irrational beliefs are the pathological agents within this system and its therapeutic techniques are designed to dispute these beliefs and to replace them with new, more rational ones leading ultimately to new emotional consequences.

The ABC Theory of Emotion
 
 
 
 
 
 
 
 

The model that I propose for Stoic therapy is similar to that of Ellis though there are some significant distinctions that will emerge as the unique terminology of the Stoics is considered.

Appearances - The ability to make proper use of appearances (or representations) is the cornerstone of Stoic ethical development. “Epictetus repeatedly insists that an ethically good life is equivalent to making correct or proper use of representations (for instance, Discourses I.1.7, II.22.29, IV.6.34).” [10] The word rendered “representations” is from the Greek word phantasia. “There is no agreed translation of phantasia, and no single modern word is entirely apt. ‘Appearance’, ‘impression’, ‘presentation’ and ‘representation’ are the English renderings most commonly adopted.” [11] An appearance is more than raw sensory data. It is sensory experience put into propositional form. This experience may be either external experience perceived by the senses, or internal experience, for example, memories or imaginings.

An impression, to be propositional, must already be an interpretation of some sort. At this stage, we may say that someone has an ‘impression of’ something (such as an impression of a cat on the mat). The next stage is moving--usually so quickly that this first stage isn’t even recognized by people--to having an ‘impression that’ something, such that there is a cat on the mat. The first sort of impression may be true. The black shape on the mat really does look like a cat. But the second stage may offer a different interpretation, such as having an impression that there is a coat on the mat (it wasn’t a cat at all!). The first stage is having an awareness of something or other: the second stage is a commitment to an interpretation that something or other is the case. In moving from an ‘impression of’ to having an ‘impression that’, one automatically applies an evaluation of whether this is something agreeable or disagreeable (and how much so)--or whether it makes no difference either way--(and why this is so)…[12]

Value System - The system of values offered by the Stoics is the essence of their moral philosophy and the very heart of Stoic therapy. It provides the standard against which appearances are to be evaluated. It is open to gross misunderstanding, very counter-intuitive, and even when thoroughly understood difficult for most people to accept. It is, however, the logical outgrowth of the Stoic view of what constitutes a eudiamonistic or flourishing life.

According to the Stoics, such a life consists of always obtaining those things that we desire and always avoiding those things we wish to avoid. So far, the thesis is unremarkable. It is hard to see how anyone could object to this as a specification of the “good” life. The problem, of course, is that this seems clearly beyond our reach in many instances, for we often do not have control over the things which happen to us. I may desire a healthy life, but as there are numerous conditions that impact on that desire over which I have little or no influence, my desired outcome cannot be guaranteed. To the extent my desires are fulfilled and the things I wish to avoid, avoided, to that extent I consider my life to be happy. Of course this places me at the mercy of a host of external factors and virtually insures a life of emotional instability.

The Stoic solution to this dilemma is to confine our desires to only those areas over which we have absolute control. [13] In this sense the philosophy is reductionistic. We gain control by reducing the sphere over which we attempt to exert control. Clearly, the less I desire to control, the less opportunity there is for my desires to be thwarted. Ultimately, we find that there is only one domain in which we are assured absolute control and that is the domain of our cognitions; how we judge matters, what we think, our beliefs and our attitudes; in a word, the use we make of appearances. But the ability to control our judgments is only one half of the equation; for if our judgments are in error it makes no difference that they are within our control; the eudaimon life still eludes us. Enter the Stoic position on values and the close relationship between Stoic philosophy and the various cognitive therapies. According to the Stoics, the proper use of appearances requires: (1) a correct truth assessment of the appearance and (2) a correct value assessment of the appearance. All appearances are viewed by the Stoics as being incapable of producing happiness (eudaimonia) or of detracting from it; they are ‘indifferent’ in this respect. Thus, to value the illness of a loved one as an evil is an error in judgment. Likewise, to value the recovery of a loved one from illness as a good is an error. Epictetus expresses the appropriate attitude toward appearances in a passage often quoted by cognitively oriented therapists:

It is not the things themselves that disturb men, but their judgements about these things. For example, death is nothing dreadful, or else Socrates too would have thought so, but the judgement that death is dreadful, this is the dreadful thing. When, therefore, we are hindered, or disturbed, or grieved, let us never blame anyone but ourselves, that means, our own judgements. (Handbook 6, trans. Oldfather)

To make value judgments accurately and consistently based is the second half of the equation in making proper use of appearances.

Consequences
The consequences of misjudging an appearance need not be immediately apparent nor are they confined solely to the realm of emotions; the impact to the agent is more extensive. In Ellis’ theory, to engage in irrational thinking is to experience unwanted or maladaptive emotions and it is these emotions that signal the need for therapy. On the other hand, an individual may believe that his or her new vacation house is a “good”, although according to the Stoic system of values the house would actually be an indifferent. As long as the house remains undamaged there are no negative consequences resulting from this misjudgment and thus, therapeutic intervention would not be appropriate within many systems of therapy including presumably, RET. Not so the Stoics, who would view the misjudgment itself as indicative of pathology regardless of the presence or absence of “emotional symptoms.” [14]

Although negative emotions may be one consequence resulting from the misuse of appearances, this does not define pathology in the Stoic model as envisioned; it is simply one of the by-products of that pathology. It is the development of maladaptive cognitive and behavioral habits, which are the long-term effects of judgments that are the targets of therapeutic intervention. Appropriate judgments result in positive cognitive and behavioral habits, inappropriate judgments in the opposite.

Rational Restructuring
Rational restructuring is the term chosen to describe the dynamics of Stoic therapy. In Stoic philosophy reason is the defining characteristic of the mature individual and is the standard by which appearances are to be judged and behavior and thought guided. [15] Epictetus makes this point vividly:

For what is a man? The answer is: ‘A rational and mortal being.’ Then, by the rational faculty, from whom are we separated? From wild beasts. And from what others? From sheep and like animals. Take care then to do nothing like a wild beast; but if you do, you have lost the character of a man; you have not fulfilled your promise. See that you do nothing like a sheep; but if you do, in this case the man is lost. What then do we do as sheep? When we act gluttonously, when we act lewdly, when we act rashly, filthily, inconsiderately, to what have we declined? To sheep. What have we lost? The rational faculty. When we act contentiously and harmfully and passionately, and violently, to what have we declined? To wild beasts. (Discourses 2.9.2-5, trans. Long)

The therapeutic process of Stoic Rational Restructuring is based on a two step approach to treatment comprised of an educational phase and an application phase. This approach can be outlined as follows:

A. Educational Phase: Value Restructuring - The Proper Use of Appearances

Instruction in the proper locus of control (internal vrs. external)

Instruction in the Stoic system of values
 

B. Application Phase: Cognitive/Behavioral Restructuring

Restructuring behavioral habits

Restructuring cognitive habits
 

Restructuring occurs in three areas; the maladaptive value system itself, and the habits, both behavioral and cognitive, which are based on this system. The emphasis on habit formation, maintenance, and change is one of the distinguishing characteristics of Stoic therapy and that which serves to distance it from the purely cognitive schools of therapy with which it is so often associated. [16] Successful outcomes are not produced simply as the result of changes in the client’s cognitions. Though adoption of the Stoic system of values is a prerequisite for change, the Stoics clearly recognized that this, by itself, was insufficient to immediately overturn years of faulty habituation. The process of value restructuring is a lifelong endeavor. (This fact emphasizes the need for continued “self-therapy” beyond the initial formal therapeutic session(s); a point that finds ample support in the Stoic writings [17]. It is one thing to know the Stoic position on values, another to accept its validity, and yet another to habitually apply it to all of one’s judgments. The Stoic therapeutic techniques are designed to assist the individual to do just this in a number of different contexts and under varying conditions.

Eudaimonia
The goal of Stoic therapy is not the elimination of the presenting problem (the issue or issues that prompted the agent to seek counseling initially); it is much broader, much more extensive. It is the eudaimonistic life. [18]. This is described as a smooth flowing life, a flourishing life, a life free from emotional disturbance.

The Stoic model of therapy, while similar in some respects to the RET of Ellis and to other cognitively oriented schools, is distinguished from these by at least three factors: its emphasis on a specific and well-defined theory of values, its more inclusive view of what constitutes pathology and subsequently, its more restrictive view of what constitutes cure.
 

Proposed Model of Stoic Rational Restructuring
 
 
 
 
 
 
 
 
 
 
 
 
 

C.  A Stoic Theory of Pathology and the Process of Change

Beck [19] lists five standards for evaluating different theories of psychopathology. Since the tenets of Stoicism are being presented in this essay in terms of a normative psychological theory along with an accompanying theory of psychopathology it seems reasonable that the theory should be expected to meet these criteria.

The theory should satisfy the requirements of any good scientific theory, namely, that it explain the phenomena within its domain with minimal complexity. (p.307)

Because the model of Stoic therapy suggested is structured along cognitive and cognitive behavioral models rather than the psychoanalytic theories of Freud, Jung, or other so called “depth” therapies, it avoids the complexities inherent in such systems (e.g., unconscious conflicts, dream analysis, the collective unconscious, etc.) It is essentially a common sense theory in which someone who is having difficulty quitting smoking, for example, is viewed as having a problem with their cognitive and behavioral habit patterns and is not fixated in the oral stage of their psychosexual development. As Freud himself said, sometimes a cigar is just a cigar.

The theory should be elastic enough to allow for the development of new techniques without being so loose or complex that it obligingly dispenses a justification for any procedure a therapist might feel inspired to improvise. (p. 307-308)

Stoic therapy has the advantage of being grounded in an extensive philosophical system that acts to limit the type of techniques deemed suitable for use. Therapies such as Arthur Janov’s Primal Scream can be dismissed a priori as incompatible with the Stoic view on emotions. On the other hand, Stoic philosophy was historically viewed as an evolving body of thought which was continually being refined and developed. Any techniques which do not contradict the fundamental tenets of the theory and which enjoy a measure of empirical support should be considered for inclusion in the cognitive/behavioral therapeutic repertoire.

An important challenge to a scientific model is the degree to which it is based on verified evidence. A related attribute is the degree to which its assumptions, axioms and hypotheses can be tested through systematic investigations and experiments. (p. 308)

As there is, at this time, no existing body of research on Stoic therapy, per se, (due in no small part to the fact that there is no formally recognized body of Stoic therapy!) meeting this criteria will depend on future efforts. However, to the extent that the techniques employed in Stoic therapy correlate to those of other therapies (e.g., RET, Cognitive-Behavior Modification, etc.) whose techniques have produced strong empirical support, to that extent the criteria has at least, in part, already been met.

The theory of psychopathology should be closely related to its allied psychotherapy so that it is obvious how the psychotherapeutic principles are logically derived from the theory. (p. 307)

The theory should provide the basis for understanding why its derived psychotherapeutic techniques are effective. The rationale and mode of operation of the therapy should be implicit in the theory. (p. 307)

Throughout the Discourses, Epictetus repeatedly makes reference to “the proper use of appearances.” As noted, it is this ability that is the hallmark of Stoic moral growth and the lack of this ability that results in the manifestation of problems and their subsequent negative consequences. In light of this emphasis, Stoic psychopathology can be defined very simply as the habitual failure to make proper use of appearances. [20]

Accordingly, the goal of Stoic therapy is two-fold. One, to counter the maladaptive thinking and thought patterns that have resulted from the improper use of appearances and two, to provide training in the proper use of appearances and toward the development of adaptive habits of thought and thought processes. The therapeutic techniques of Stoicism are designed to facilitate this change from maladaptive to adaptive behavior. And it is change, in one form or another, which is at the heart of all therapies.

Donald Meichenbaum [21] in his book, Cognitive-Behavior Modification: An Integrative Approach, views the change process as occurring in three phases:

Phase 1: Self-observation. “Through heightened awareness and deliberate attention, the client monitors with increased sensitivity, his thoughts feelings and physiological reactions, and/or interpersonal behaviors.” (p. 219)

Phase 2: Incompatible Thoughts and Behaviors. “As the client’s self-observations become attuned to incipient low-intensity aspects of his maladaptive behavior, the client learns to initiate cognitions and behaviors that interfere with the maladaptive ones. The self-observation signals the opportunity for producing the adaptive thoughts and behaviors.” (p. 223)

Phase 3: Cognitions Concerning Change. “The third phase of the cognitive theory of behavior change is concerned with the process of the client’s producing new behaviors in his everyday world and how he assesses (or what he says to himself about) the behavioral outcomes.” (p. 225) That is, are the techniques employed working or not? If so, why? If not, why not?

It is interesting to note that some 2000 years ago the Stoics were already utilizing the three phases of change presented by Meichenbaum. In the Discourses, Epictetus writes,

I am inclined to pleasure. I will bend myself, even unduly, toward the other extreme, as a matter of training. I am averse to pain. I will strive and wrestle with these appearances, that I may cease to shrink from any such object. (Discourses 3.12.7 trans. Higginson)

Phase One: He recognizes areas requiring change; “I am inclined to pleasure... I am averse to pain.” Phase Two: He sets about to establish incompatible behaviors; “I will bend myself to the other extreme.” Phase Three: He establishes the criteria by which success in the change process can be measured, “I will strive and wrestle with these appearances, that I may cease to shrink from any such object [as causes pain].” (Emphasis added) If Epictetus finds that he continues to shrink from those necessary situations that cause him pain (as opposed to enduring pain needlessly [22], he knows that he has more striving to do. Note that the striving referred to is not physical striving (i.e., to endure the pain), but with the appearances concerning the pain. His desire is that he judge the pain appropriately; as an indifferent and not as an evil.

This three-fold analysis of change (assessment, cognitive/behavioral restructuring, evaluation) is a recurring theme in the Stoic writings and provides the framework for understanding and implementing their therapeutic techniques.
 

D. Therapeutic Techniques

Epictetus is well aware of the fact that representations often overwhelm people and constrain them to act without proper reflection. His discourses are packed with analysis--psychoanalysis one is tempted to call it--of the conditions under which this may happen, and of what may be done to resist such representations (cf. II.22.5, III.12.11, II.22.6). [23]

Rather than provide a laundry list of Stoic therapeutic procedures, I will confine my examination to only one section of the Discourses. However, I believe this section will be adequate to illustrate the extensive use Epictetus makes of these techniques and to demonstrate the possibility of a future “handbook of Stoic therapy.”

In Book III, Chapter 12 of the Discourses, Epictetus responds to a question concerning the appropriate sphere of moral training:

Not to be disappointed in our desire, nor fall into anything which we would avoid. To this ought training to be directed. For without vigorous and steady training, it is not possible to preserve our desire undisappointed and our aversions unincurred; and therefore, if we allow it to be externally employed on things uncontrollable by will, be assured that your desire will neither gain its object, nor your aversion avoid it. And because habit has a powerful influence, and we are accustomed to applying our desire and aversion to externals only, we must oppose one habit to another: and where the semblances [i.e., appearances] are most treacherous, there oppose the force of training. (Discourses 3.12.4-6, trans. Higginson)

In this passage the important point is made that there are two types of training involved in effective moral development: behavioral habits and cognitive habits. I take the reference to “habit as a powerful influence” and our being accustomed to applying it (i.e., habit) to “externals only” to be speaking of habits of behavior which must be countered by new incompatible patterns. However, in the next phrase, where Epictetus speaks of “the appearances”, the emphasis shifts to an internal, specifically cognitive perspective.

The practice of developing behavioral habits is well known but not often recognized (or, at least, not emphasized) as a significant component within Stoic training by contemporary commentators who tend to overemphasize the cognitive elements in moral development. This may be due, in part, to the fact that some writers see behavior that is the result of habit as somehow less than moral behavior. In discussing the problem of akratic action (i.e., weakness of the will) David Carr makes the following statement:

… if an agent who would otherwise have succumbed to weakness holds out under the influence of training, he acts from habit rather than reason, and is not therefore, on rationalist assumptions, acting as a genuine moral agent. [24]

Contrary to this, the Stoics share the view of R.S. Peters, that the palace of reason is entered through the courtyard of habit. [25] The importance of habit is constantly stressed in the Discourses. However, even with the preeminence afforded cognitive factors within Stoic philosophy by most, the role of habit as applied to thought processes seems to strike many as something quite out of the ordinary. This is unfortunate, as this is the hallmark of the Stoic sage who has so trained his or her mind that the proper use of appearances is automatic (i.e., habitual).

Epictetus continues his instruction by providing a detailed and individually tailored training regimen geared to address the specific needs of his students who are then encouraged to test their progress.

Afterwards [i.e., training] you will venture into the lists at some proper season, by way of trial, to see whether these semblances get the better of you as much as they used to do.

There are several interesting points in the above passage and what is to follow. Most notably, progress is viewed as incremental. The Stoic teachings are set forth and after an appropriate time for assimilation by the student, the application of those teachings are tested in the real world. Progress or the lack thereof, is then noted and presumably additional teaching is provided depending on the outcome of the test. Prior to this testing, however, Epictetus offers this caveat: “But at first flee from what is stronger than you.” This begs the question, what could be stronger than the power to make proper use of appearances, and why should it ever become necessary for the Stoic to flee anything? The answer is both surprising and instructive.

The contest between a fascinating women and a young man just initiated into philosophy is unequal. The brass pot and the earthen pitcher, as the fable says are an unfair match.

It is instructive to note that in this analogy philosophy is likened to an earthen pitcher; clearly of less value than that of brass. But, is this really the point that Epictetus is making? The answer is both yes and no. To the neophyte Stoic the answer is yes. The allure of a fascinating woman may indeed have more motivating force than his limited “cognitive” training can overcome. And what is the solution to this shortcoming offered by Epictetus? Not more instruction. Not an exposition on the Stoic theory of values to the effect that the woman is simply an indifferent and in this specific instance apparently a dispreferred indifferent. No, Epictetus has a very simple, very straightforward and very behaviorally oriented recommendation: Flee. This emphasizes once again, not only the common sense approach to therapy that the Stoics advocated, but also their recurring acknowledgment of the pervasive strength of habit.

This brief passage captures some of the essential features of Stoic Rational Restructuring. The chapter opens with a discussion what is and is not in our control, moves to a consideration of specific individual problems areas, and provides suitable training and testing guidelines for those areas. And it concludes with behavioral strategies for contending with particularly difficult situations.
 
 

III. Conclusion

The idea of Stoic philosophy as therapy is not new. Several previous contributors to this journal have offered insights into Stoicism’s therapeutic nature. The most recent of these, by Elen Buzare on “Stoic Spiritual Exercises” sets forth the role of meditation in bringing about inner transformation. My goal has been to attempt to show that practices such as this can be incorporated into a broader psychotherapeutic framework. I am under no illusion that what has been presented in this brief essay is anything more than a first tentative step toward that end. Although it is clear that much work remains to be done, I hope that I have, at the least, demonstrated the feasibility of such a project.

My apologies to the reader for not adhering to the guidelines of Epictetus.

A book will always be read with more pleasure and ease, if it be written in fair characters; and so everyone will more easily attend to discourses likewise, if ornamented with proper and beautiful expressions. (Discourses 2.23.1, trans. Higginson)

My thanks to Dr. Seddon for reviewing this essay and for the clarifications offered concerning some of the finer points of Stoic philosophy.
 
 

Endnotes

1. Psychotherapy can be broadly defined as the application of various psychological (as opposed to medical or neurological) techniques directed toward improving or eliminating maladaptive emotions and behaviors. It will become evident, in what follows, that this is not an adequate description of Stoic therapy. Likewise, what constitutes psychopathology (the study of mental and emotional disorders from the psychological perspective) in the Stoic system is considerably more inclusive than in other therapies. I will be using the terms therapy and psychotherapy interchangeably, as well as pathology and psychopathology.

2. Martha C. Nussbaum. The Therapy of Desire, Theory and Practice in Hellenistic Ethics. Princeton University Press, 1996.

3. Aaron T. Beck, M.D. Cognitive Therapy and the Emotional Disorders. International Universities Press, 1976.

4. Beck, p. 307.

5. Albert Ellis, Ph.D. Reason and Emotion in Psychotherapy. Citadel Press, 1977.

6. Albert Bandura. Social Foundations of Thought and Action: A Social Cognitive Theory. Prentice Hall. 1986.

7. Cited in A.A. Long. Hellenistic Philosophy. University of California Press, 1986.

8. “Oikeiosis determines an animal’s relationship to its environment, but that to which it is primarily well-disposed is itself (D.L. vii 85). Its self-awareness is an affective relationship, and all behavior can be interpreted as an extension or manifestation of the same principle. Thus the direction of an animal's impulses is determined both by what it senses and by its innate capacity to recognize things which belong to itself.” Long (1986) p. 172.

9. Troels Engberg-Pedersen. The Stoic Theory of Oikeiosis. Aarhus University Press 1990.

10. A.A. Long. Stoic Studies. Cambridge University Press, 1996. p. 275.

11. Long (1996) p.268, Footnote #10.

12. Personal communication with Keith H. Seddon Ph.D.

13. “Remember that desire demands the attainment of that of which you are desirous; and aversion demands the avoidance of that to which you are averse; that he who fails of the object of his desires is disappointed; and he who incurs the object of his aversion is wretched. If, then, you avoid only those undesirable things which you control, you will never incur anything which you avoid; but if you [wish to] avoid sickness or death or poverty, you will run the risk of wretchedness. Withdraw aversion, then, from all things that are not within our power, and apply it to things undesirable, which are within our power.” Epictetus Discourses and Enchiridion. Walter J. Black, Inc. 1944. p. 332, #2.

14. This is not to suggest that the Stoics would advocate intervening in such a situation: “We must confine Mr. Smith to the Stoic Center for Value Restructuring until he is cured!” It does, however, illustrate the broader perspective the Stoics take regarding what constitutes maladaptive behavior.

15. “The central and guiding attitude of Stoic therapy is its respect for the dignity of reason in all human beings… Reason is not just the most important thing about humans: it is something that is fully their own, in their power to cultivate and control.” Nussbaum, p.15. What I intend by the label, Stoic Rational Restructuring, should not be confused with the specific technique of “systematic rational restructuring” developed by Goldfried, Decentece, and Wienberg which is essentially a stress reduction strategy.

16. “All their [the Stoics] therapy is cognitive, and cognitive therapy is taken to be sufficient for the removal of human diseases.” (Nussbaum, p.335) I must respectfully disagree with Ms. Nussbaum on this very important point. While it is true that Stoic philosophy has a large cognitive component in its therapy; Epictetus is at pains to emphasize that this alone is inadequate to overcome the influence of years of maladaptive cognitive and behavioral habits. It is possible to know the Stoic theory of values and to know the areas over which we have and do not have control and still fail in living a virtuous life. As Epictetus said, habit has a powerful influence.

17. “The patient must not simply remain a patient, dependent and receptive; she must become her own doctor. Philosophy’s medical function is understood as, above all, that of toning up the soul-developing its muscles, assissting it to use its own capabilities more effectively (Sen. Ep.15).”  Nussbaum, p. 317-318.

18. “Eudaimonia, as its etymology indicates, is the name for a ‘blessed’ or ‘god-favoured’ condition, a condition in which a person’s lot or daimon is good. The term is normally and correctly translated ‘happiness’…” Long (1996) p. 181.

19. Beck, p. 307-308.

20. “On the one hand, Epictetus says that a good life consists in using one’s representations correctly, and that this is a faculty that human beings possess. This thesis suggests that we are able to take stock of our representations, interpret their content, and accept or reject courses of action that they propose. It implies that responsibility, praise and blame, rest not with our representations but with the use we make of them. On the other hand, Epictetus also says that people cannot fail to act in accordance with their representations of what is dominantly in their interests.” Long (1996) p. 278.

21. Donald Meichenbaum. Cognitive-Behavior Modification. Plenum Press, 1977.

22. Epictetus makes it abundantly clear in the opening lines of this chapter that there is no need for physical training that does not contribute to the proper understanding of those things that are within our power and those that are not. “We are not to carry our training beyond nature and reason; for in that case we, who call ourselves philosophers, shall not differ from jugglers. For it is no doubt difficult to walk upon a rope, and not only difficult but dangerous. Ought we to for that reason make it our study to walk upon a rope, or balance a pole, or grasp a statue? By no means. It is not everything that is difficult or dangerous but such things as are conducive to what lies before us to do. ‘And what is it that lies before us to do?’ To have our desires and aversions free from restraint.” Diogenes was known to train himself for hardship by grasping snow covered statues.

23. Long (1996) p.276-277.

24. David Carr. Varieties of Incontinence: Toward an Aristotelian Approach to Moral Weakness in Moral Education. Philosophy of Education. 1996.

25. R.S. Peters, Ethics and Education (London: George Allen and Unwin, 1966) p.314.