CBT and Stoicism

Here is a blog that I wrote on the New Statesman's website this week, http://www.newstatesman.com, which talks about how I overcame social anxiety with the help of Stoicism and CBT.

Not many people know about the link between CBT and Stoicism, but the one actually evolved from the other, as the founders of CBT - particularly Albert Ellis - happily admit.

How Stoicism Helped Me Get My Groove Back

I first read Stoicism when I was seventeen or so, and it immediately struck a chord with me. But it wasn’t until I was around 22, seven years ago, that I really started to apply it.

By that time my life had gone rather awry. I’d had a very easy first 18 years of my life, with success and good fortune coming easily to me. I’d then experimented somewhat recklessly with drugs, had some traumatic experiences on them, and been unable to accept those experiences.

This led to me developing an anxiety disorder, where I was plagued with panic attacks, constant feelings of stress and unease, and bouts of moodiness and depression.

At the root of it, perhaps, was an inability to accept what had happened to me, or that I had lost the happiness and good fortune of my youth. I was miserable over having lost friends and squandered my talents, and terrified of being a failure, or worse, being perceived by others to be a failure.

The psychiatrist, whom I visited when I was 22 or so, told me I had post-traumatic stress disorder and social anxiety. He said he could make me better simply by waving his finger in front of my face – a hip new technique called Eye Movement Desensitization and Reprocessing, or EMDR. It sounded too good to be true, and was.

Around that time, I bought a book called The Discourses, by the Stoic philosopher Epictetus. It was he who first declared that it was not external things, but our opinions about them, which caused us suffering. It was our own thoughts and opinions that imprisoned us and made us miserable.

But, uniquely among animals, we had the power of ‘meta-thinking’. This means we could become aware of our own thinking patterns, analyze them, and if necessary change them. Our mind could imprison us, but it could also set us free.

Epictetus declared that passions were the result of misconceptions about the world. Something happens to us (A), then we make an assessment of that event (B), then we attach powerful emotions to that event (C).

For example – you lose your job (A), you make an assessment of that event such as ‘this is an awful and intolerable event that proves I’m a good-for-nothing loser’ (B), then the powerful emotion of depression comes in and locks that assessment in place (C).

But a Stoic would look at (B), at your original assessment of the event. Is it really so god-awful to be fired? Does the fact that you have lost one job mean you are a complete good-for-nothing? Perhaps the circumstances leading to you losing your job were out of your control. In any case, you did your best, what’s the point beating yourself up about it?

A Stoic would actually look at the situation as a great opportunity to assert their inner freedom over external events. Epictetus would say that adversity is the cosmos sending us a sparring partner, something we can take on and try to conquer, in order to strengthen our inner detachment and mastery over our passions and conventional opinions.

Sure, sometimes we may lose and fall into a depression, but then we get back up, dust ourselves off, and get back in the ring. Each time we beat our conventional opinions, they get less and less power over us, and we become more and more masters of ourselves.

Above all, we can learn to accept what happens to us. Stoics accept external events because they believe they are part of the Logos, the divine law that guides all events. They believe the universe is rationally ordered, so we should accept whatever it dishes out to us.

Even if you don’t believe in the Logos, you can still use Stoicism to overcome negative emotions. Cognitive behavioural therapy (CBT) is a modern therapy that updates Stoicism and applies it to modern emotional disorders like social anxiety or post-traumatic stress disorder.

The founder of CBT, a New Yorker called Albert Ellis, was inspired by reading Epictetus when he was a young man. Ellis also asserts that it’s our opinions about things that cause us suffering, rather than the things themselves.

Ellis suggests that we wall ourselves in with ‘must statements’, such as ‘I must be successful’ or ‘I must be popular’, and when the opposite occurs, we beat ourselves up and consider ourselves complete failures.

CBT tries to make patients aware of how their own thoughts, their own ‘must statements’, are at the root of their depression or anxiety, so that they can challenge their own habitual thoughts and replace them with more rational or flexible statements such as ‘it would be nice if I was successful, but it’s not the end of the world if I’m not’.

So CBT uses the psychological insights of Stoicism, but without the cosmic faith in a divinely-ordered plan. For Ellis, bad things happen, and that’s just life. Shit happens, as he puts it. You can either accept it, or be miserable the rest of your life. It’s your choice.

CBT has been proven to be the most successful form of treatment for most emotional disorders. It’s now widely accepted by western medicine, and by a number of national governments such as the British government, which is putting millions of pounds into providing CBT for the mentally ill.

Speaking from my own experience, I can say that it proved very successful, and has helped me re-gain both my self-control, and my pleasure in life.

So CBT is a fairly unique case where western medicine has embraced the insights of a 2000-year-old philosophy.