Integrating Stoicism into Modern Psychological Treatment

Introduction

Globally, roughly 1 in every 8 people are living with a mental health disorder, with anxiety and depression being the most common (World Health Organization). The prevalence of antidepressant prescriptions has increased in developed countries over recent years. This could be due to more variety and access to antidepressant drugs, more effective diagnosis or other factors. Despite this, depression and anxiety are still on the rise leaving many people feeling hopeless and seeking a way to alleviate their symptoms. While seeking the proper care is a healthy first step, a big question is: what are other alternatives for those who are hesitant towards prescription drugs?

There is no doubt that antidepressants can be an effective way to significantly improve one’s mental situation. Additionally, with the majority of people wanting quick and easy ways to find a solution, the process seems to be the most convenient. Go to the doctor, tell them how you are feeling, and they can have the prescription filled at your local pharmacy the same day. However, there are those who view modern day medicine as the last resort and may seek natural ways to improve their situation. Also, there are individuals who have tried antidepressants and it may not have been effective.

It is known that daily exercise, healthy eating habits and socialization can be essential ways to help those suffering depression. A proper therapist does not always hurt to try as well. However, what if I told you reading a book may be a valuable approach. Exploring the past and becoming open to the perspective of someone notable can aid in the way you approach day-to-day life. Specifically, Meditations by Marcus Aurelius. This book was a journal written between 171 and 175 C.E. by Roman emperor Marcus Aurelius who was not proclaimed to be a philosopher nor were his writings intended to reach an audience. His reflections are inspired by a branch of philosophy called stoicism. Stoicism is a practice that teaches self-control over negative thoughts and the overcoming of destructive emotions. This book is essentially ancient wisdom for modern minds and the benefits of spending your time reading this will be discussed throughout this paper.

Depression

Depression, also known as major depressive disorder, is a common and serious medical illness that negatively affects how you feel, the way you think and how you act (psychiatry.org). Symptoms can vary from feeling sad, gaining weight and even leading to attempts at suicide. Depression is also known to be genetic, which is inevitable in being passed down to your children. Treatment varies but typically results in medication, psychotherapy or natural ways to reduce symptoms such as getting quality sleep, eating healthy and regular exercise.

One’s chemical makeup of their brain may contribute to an individual’s depression; therefore, antidepressants tend to be recommended. However, it can take weeks to months for people to see any signs of improvement and if they do, there are side effects that people may feel to be not worth experiencing. Additionally, it may take trial and error of a variety of antidepressants until an individual can find one that works for them since everyone is genetically different. Despite antidepressants being an effective tool in treating depression, the majority of people may not want to rely on an antidepressant for the rest of their lives. This is where alternative ways to treat depression are generally explored to help solve the root of the illness.

Psychotherapy, also known as “talk therapy” is also recommended for those battling depression. Specifically, cognitive behavioral therapy (CBT), which is the most common practice of psychotherapy. CBT focuses on recognizing negative thinking habits. The overall goal for CBT is to change negative thoughts and behaviors to more positive ones. Medication and psychotherapy can be intimidating to some individuals, especially since both come at a price that may not be affordable, or an individual may feel shame in attending psychotherapy or taking medications. The majority of those with depression are desperate to find a solution. Generally, many people may attempt self-help ways for depression whether it is taking a walk or eating healthier. This is where the book, Meditations, may be an effective tool for those who are looking for a place to start. Marcus Aurelius faced immense personal and political challenges, and many would be pleasantly surprised by how relatable his writings are to today’s modern world.

Stoic Concepts Relevant to Depression

Dichotomy of Control

One key stoic concept is the dichotomy of control. This is the understanding of what is and what is not within our control. When you begin to understand that your own judgements, thoughts and actions are within your control and other external events are not, this is a steppingstone in a direction for you to realize what you can control. Marcus Aurelius writes,

“You have power over your mind – not outside events. Realize this, and you will find strength” (Meditations, Book 8, Chapter 47).

A modern-day example may be a coworker who fails to complete a task leaving you having to complete it. It may be easy to be upset and claim them to be lazy. Yet, the stoic teaching would advise us to take a moment to appreciate ourselves for being healthy and able to work a job. Also, suggesting to take a moment and understand that the coworker may be going through a tough time and they may be struggling; allowing us to be greatful that we can help. This guides us to shift our initial negative reaction into a positive one.

Negative Visualization

Another stoic concept is negative visualization. Negative visualization is visualizing the worst possible scenarios to mentally prepare oneself for the worst outcome. This allows one to build resilience which results in reducing the impact of actual negative events.

“When you kiss your child goodnight, whisper to yourself, ‘They may not make it through the night” (Meditations, Book 11, Chapter 34).

Allowing yourself to understand the worst possible scenario helps mentally prepare you for the possibility. In addition, this practice helps enrich your appreciation for what you have and how suddenly it can all be lost. This way of thinking is not meant to negatively affect you, instead, open your mind to a perspective to help you in the long term. Negative visualization can also be everyday practice. For example, waking up and telling yourself that you may face hardship, or unexpected problems will help you acknowledge that negative events may occur. Facing negative visualization helps you build grit and perseverance preparing yourself for that potential time. In result, if no hardship occurred that day, you may be more appreciative than usual.

Accordance with Nature

Living in accordance with nature is a key value in stoicism.

“Adapt yourself to the life you have been given, and truly love the people whom destiny has surrounded you” (Meditations, Book 6.39).

Natural order is a crucial part of existence and understanding the orderly system we are a part of within the universe. It is easy to compare our lives to others wishing our lives were different. Accepting that you are who you are and those you have surrounding you is a first step in enjoying yourself and the world around you. Next time you are thinking negatively about your life, take a moment to breathe and focus on positive events or people in your life. Accept that you are present and alive and take pride in that.

The interesting quality about Meditations or stoicism is that there is no contradiction between different key attributes. In fact, they all seem to interconnect with one another. Let us revisit the coworker example: “a coworker who fails to complete a task leaving you having to complete it.” The use of the dichotomy of control is prevalent in this scenario, but you can also use negative visualization. If you visualize prior to going to work that it may be a stressful day, or other coworkers may not be at their best work performance, this will allow you to expect the worst. Therefore, you may not be as distressed when that moment happens. Instead, you can accept it for how it is; how you imagined it prior. We can also connect living in accordance with nature in this scenario. Waking up and coming to terms with the life you are integrated into will also help you favorably welcome what is external to you, such as the job and coworker.

Modern Psychological Practices and Stoic Parallels

Cognitive behavioral therapy (CBT) starts with identifying troubling situations in your life. Identifying these troubling situations allows you to become aware of your thoughts, emotions and beliefs. Your own self-awareness encourages you to talk more in depth about your thoughts. The therapist observes your feelings, interpretation of meaning, beliefs and other conditions. As you continue the self-talk process, the therapist will help you recognize patterns of negative thinking and behavior. The goal of CBT is to reshape negative or unrealistic thinking, resulting in helpful thinking becoming a habit that you can utilize for the rest of your life.

This process varies, ranging from 5-20 sessions until you begin to see a positive impact. It takes effort and commitment to work towards bettering your wellbeing. It is important to remember that everyone has different factors such as the severity of symptoms, type of disorder, how quickly you make progress and more. Like CBT, Meditations offers parallels when it comes to reshaping your thoughts and behaviors. Both emphasize rational thinking and self-regulation to improve your condition. It is common to have false interpretations of a situation.

“If you are distressed by anything external, the pain is not due to the thing itself but to your estimate of it; and this you have the power to revoke it at any moment” (Meditations, Book 8, Chapter 47).

Marcus Aurelius highlights that it is not external events that disturb us, but rather our interpretation that causes distress. CBT also focuses on distorted thoughts that lead to emotional suffering. Learning to find a balance with our irrational beliefs is a goal within CBT therapy.

As stated before, the dichotomy of control shares parallels with CBT by focusing on what we can control (thoughts and behavior) and what we cannot (external events). Becoming aware of what is in control can help reduce stress in uncontrollable situations. Those who are suffering from anxiety or depression may find it hard to live in the present moment. Stoicism can help you understand the importance of focusing on the present moment rather than ruminating on the past or being anxious for the future. In CBT, mindfulness is often integrated helping the client to find balance living in the present moment with the goal of reducing anxiety or stress.

“Confine yourself to the present” (Meditations, Book 7, Chapter 29) says Marcus Aurelius.

Practical Applications

After reading Meditations, a common question is: How can I apply these teachings into my life? Some will tell you to read a few passages then sit and meditate on what you have read. You soon will then realize how impactful one of the passages has been on your everyday life. There are many passages discussing revenge, fear, mindfulness and other virtues that exist day-to-day. Specific quotes from Meditations may uniquely stand out to you, whereas others may not. If you are struggling with procrastination, one quote may have a deeper meaning to you, such as,

“You could be good today. But instead, you choose tomorrow” (Meditations, Book 8, Chapter 22).

The next time you are struggling to start a task, you may think of this quote, boldly within your thoughts. If you choose to apply it to your life, you may feel inspired to start the task you had been putting off. The beauty in it is that everyone is different and may interpret different quotes derived from Meditations differently. You must remember that Meditations was never intended to be published since it was a journal with quotes of thoughts from one single person. Many often view it as a guide, enabling you to choose what you take from it.

Testimonials

This paper was inspired by a series of testimonials written by people online when the topic of the video or forum thread was Marcus Aurelius, stoicism or Meditations. Some people described how the book Meditations has helped them cope with grief:

“Lost my mother at 22, and my baby sister now at 28. Marcus and his teachings have been keeping me sane since”

written by one user in the comment section of a YouTube video titled “Marcus Aurelius: The Man Who Solved the Universe.”

Another user commented,

“When my dad died, the following day I went out to a little forested peninsula near my house with a bag of sunflower seed, listened to Meditations on audiobook, and fed Chickadees from my hand. Best thing I think I could have done. I’ve been handling the grief 10x better than I expected to. It’s not frozen or suppressed grief, it’s processed.”

The comments continue with other individual’s unrequested opinions on Meditations and how it has helped them. Many people are surprised by how relatable Meditations is, and a lot of what Marcus Aurelius has written are thoughts we may have already contemplated throughout life.

“I recently got into stoicism, and one thing that shocked me about reading Meditations, was how natural it all was. Most of what Marcus said I had already contemplated when thinking about myself and the human condition.”

There are 7,083 comments on that specific video, so you can imagine how much more is written in discussion of stoicism and Marcus Aurelius. Concluding, Meditations has clearly touched people in positive ways as well enlightening the way people think.

Limitations

Reading Meditations is not a cure-all nor is it meant to be advertised as a way to replace therapy or other modern psychological treatments. However, it can be a first step into one’s journey of alleviating suffering from mental illnesses like depression or anxiety. It is important to note that we do not understand an individual’s full situation in their online testimonials. They may participate in therapy and/or take antidepressants while feeling hopeful after reading Meditations. However, the fact that a book written during a different time can be relatable to one’s life and shape how they perceive their thoughts and behavior for the rest of their lives is undoubtedly unique. Even if you do not suffer from a mental illness, reading books like Meditations can inspire your way of thinking, leave you with insightful questions and overall educate you on the history of a man who simply is, human.

Conclusion

To conclude, more research is required to have a better understanding of the impact stoicism has. However, stoicism could be complementary with modern psychological treatments. After all, much of philosophical questions or ideas helped build the framework for modern psychology. Exploring more in depth how stoicism or other philosophical ideas can be integrated within modern psychology would be interesting to see in the future.

References

Aurelius, M. (1862). Meditations (G. Long, Trans.). George Bell & Sons. (Original work published ca. 170–180 CE)

World Health Organization. (n.d.). Mental disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders

American Psychiatric Association. (n.d.). What is depression? https://www.psychiatry.org/patients-families/depression/what-is-depression

Horses. (2023, February 18). Marcus Aurelius: The Man Who Solved the Universe [Video]. YouTube. https://www.youtube.com/watch?v=tv6W0Nv5ev0&t=6s