'Stoicism and Autism II'

Stoicism as a Means to Cope with Autism

Autism Awareness

    Ten years ago I was diagnosed with Autism Spectrum Disorder, which describes a range of conditions classified as neurodevelopmental disorders. These disorders are characterized by social deficits and communication difficulties, stereotyped or repetitive behaviours and interests, sensory issues, and in some cases, cognitive delays.

    Throughout my life I’ve had problems in social interaction and adapting to systems, at school and on the labour market. My dream to graduate in history at university was shattered as I couldn’t fully adapt to the academic system.  This led to a severe depression about ten years ago. Looking back on things, most of my life has been dominated by fear. Whereas most youngsters gradually develop a sense of self-confidence and self-esteem, my progress was hindered by traumas and debilitating fears.

    I rediscovered Stoicism by coincidence at a very difficult moment of my life. After being discharged from a psychiatric hospital I googled ‘cognitive therapy’. On a practitioners website Epictetus was mentioned alongside Buddha as the originator of cognitive therapy. This immediately struck a chord with me, as I had read briefly about Stoicism in Jostein Gaarders ‘Sophie’s world’ during puberty and heard in a philosophy class the professor tell admiringly about someone who reacted stoically in a car accident. From then on I became increasingly interested in this philosophy.

    In the early days my knowledge of Stoicism was very limited: I was basically repressing emotions and got tangled up in my thinking a lot of the time. Later on I read the several books and blog posts that provided me with serious knowledge to put the philosophy into practice. There are various interpretations of Stoicism, but the way I see it’s an antropotechnic system to deal with the human condition and thrive in challenging circumstances.

    Four virtues are put forward to strive toward goodness: courage, justice, self-control and wisdom. I find this a powerful antidote to the postmodern culture of ‘success’, limitless pleasure seeking and increasing nihilism. It is also refreshing to see other people in terms of brotherhood rather than predominantly as potential competitors or enemies.

    Seneca is definitely my favourite Stoic philosopher. He wrote a lot about self-knowledge, setting goals and making progress. He wrote this passage in Moral Essays:

“Your greatest difficulty is in yourself. You are your own biggest obstacle. You don’t know what you want. You’re better at approving the right course than at following it. You see where the true happiness lies, but you don’t have the courage to attain it.”

    The problem with some people in the spectrum is knowing what is good for oneself. Some people with autism reportedly struggle with finding a sense of purpose for most of their lives. Therefore it is comforting as well as inspiring to read Seneca’s advice: “As long as you live, keep learning how to live.”

   According to Tom Morris, author of ‘The Stoic Art of Living’, Seneca also affirms the importance of zeal, or passionate commitment, to making ongoing progress  in meeting our challenges and in living in our lives. He goes even so far as to say that, “the greater part of progress is the desire to progress.” Without a positive desire to animate us, goal setting, confidence building, and any efforts of planning can end up being no more than empty, futile exercises. A distinction can be made between the Greek passions (agitations of the soul contrary to reason and to nature) and passion (enthusiasm). Seneca insists that:

“The good stimulates the mind, and in a way, moulds and embraces what is essential to the body.”

    Something essential to learn in life is the importance of social relations. The people in our lives can make our existence better and cooperation is essential to survive. Seneca writes:

“Our relations with one another are like a stone arch, which would collapse if the stones did not support each other, and which is held up in this very way.”

    I used to mistake obscure knowledge for wisdom – which is sometimes the case with people who are in the spectrum. Epictetus advice on the importance of listening as well as talking could we be featured in ‘The power of introverts’:

“Nature has given to each of us one tongue, but two ears, so that we may hear from others twice as much as we speak.”

    I frequently use Stoic techniques: distinguishing between what is in my power and what is not, mindfulness, negative visualisation, the reserve clause, evening meditation and oikeiosis. Oikeiois is still a big challenge: you have to useful to yourself before all else in order to be useful to others in a sustainable way.

    To be honest: I’ve still got a long way to go in order to progress to the Stoic ideal. Finding a new job is difficult but necessary to get my own place. Loving disinterestedly is sometimes an issue, as is self-control. Cultivating goodness also means pushing my boundaries and creating new routines. Seneca encourages me to have basic confidence: “I don’t know whether I’ll make progress or not, but I should prefer to lack success than to lack faith.”

The author of this piece wishes to remain anonymous.

'Autism and Stoicism I' by Chris Peden

Autism and Stoicism I

by Chris Peden

“You are going to have to take some time off in eight months.”

That’s how my wife let me know that we were expecting our first child.  I can tell you where she was standing, how her feet were positioned and how her face looked when she told me.  It was one of those moments when time just stopped, and still one of the best days of my life.

But that joy turned into something else a few years later.  My son was not speaking as soon as expected, and was tied to very rigid routines and timetables that had to be met.  We enrolled him in a special preschool program to deal with the challenges.

And he was diagnosed with Asperger’s, and later Autism

Our second son came along, and he too had trouble speaking, and had problems with his fine motor skills.

Another son, another Autism diagnosis.

What is Autism?

So what does it mean to be autistic?  The answer really is “it depends”.  Since Autism is a spectrum, it is really hard to label certain people as autistic because their symptoms can vary.  However, there certain common characteristics that we have had to deal with that are common to those on the spectrum.  We have seen and dealt with the following:

1)      Rigidity in routines and expectations – everything has to happen according to a certain schedule and under certain conditions.  While this could extend to not being able to wear certain types of fabric, ours mostly were about making sure that we were home in time for a certain show to be on.  I would have loved a DVR back then.

2)      Lack of sleep – Most autistic people don’t produce enough melatonin, which is the chemical in the brain that helps you get go to sleep.  There were more than a few nights when we had to get up to comfort a child who woke up with a nightmare or just couldn’t sleep.

3)      Sensitivity to stimuli – Restaurants and public places were problems because everything happening around them overloaded their senses, resulting in the flight or fight response, with them either running away or having a temper tantrums.

4)      Violent outbursts – The temper tantrums are legendary.  We have had quite a few pieces of furniture broken, mattresses thrown down stairs, and even a flooded basement due to a temper tantrum as a result of small event that they couldn’t process.

5)      Bad days at school – The school system did the best they could, but sometimes the outburst lead to calls home to come pick someone up, or drive them into school because all the activity on the bus overwhelmed their system.

Put all this together and you have a pretty challenging situation.  The hardest part for my wife and I has been the isolation.  Taking the kids out for a normal outing to most places actually overwhelms their system, and we end up either finding a quiet place where they can recover, or just decide not to go out at all.  While it would be great to do what other families do on a daily basis without thinking about it, making sure they are safe and feeling secure has trumped everything we have done.

The question I get most is “how do you handle all of this?”  For a while, I didn’t really have a solution myself, and would be spending most every day frustrated and disgusted with life, cursing that life could do something so unfair not only our kids, but to me and my wife as well.  Why us, and how do we keep going?

Stoicism

I have always been a reader, and can’t tell you how many books I have read over the course of my life.  I somehow got introduced to Tim Ferris, and his posts how Stoicism has helped him live a better life.  The more I read, the more intrigued I became of the practices and how they could help my life.  I started to read more, and developed an appreciation for what stoics do.

I had always thought stoics were very unemotional robots who spent their lives not feeling anything.  They almost seemed like they had developed a detachment from any feeling whatsoever, and had suppressed any emotion they had.  These robots seemed to be able to avoid feeling anything at all.  I thought “that’s what I need to help me deal with everything happening.  Not feel any emotion at all.”

Boy, was I wrong about that.  The more I read, the more I found out that Stoics are not the dour persons they have been represented to be, but they changed their focus to eliminating holding on to of negative emotions.  They do feel emotions, just don’t let them rule their lives.  And they aren’t withdrawn from life, but actively engaged in it.  I learned about Marcus Aurelius, who as Roman emperor had the world at his feet, but was also a Stoic.  I have a feeling it helped him run an empire.

How the Practices Helped

So, how did I use what I learned?  There are a few practices that were very helpful to me as I moved along my journey.  The first of these was train my perception to avoid labeling something good or bad.  As Marcus Aurelius said “Choose not to be harmed and you won’t feel harmed. Don’t feel harmed and you haven’t been”. It is easy to feel as though your autistic children are fighting with you when they are having their temper tantrums, or refuse to do the simplest task they have been assigned, or even go into a restaurant for a fun family event.  However, when you open up your perception to see what is really going on, you stop labeling their behavior as “bad” and actually see they are overwhelmed or even scared.  Once that happens you are able to deal with the situation as it is, and aren’t spending time on what you think the situation “should” be like.

Another way this practice has helped is in dealing with the judgments and comments of other people.  There will always be people who will say something rude about your child, or how you are raising them.  It is going to happen.  By choosing not to be harmed by what they say, you take away their power to make you do what they want, which is react and show that they are the superior person.  In addition, when someone offers a constructive comment, you can judge how applicable it is to your situation without thinking they are saying something about you personally.

The second habit that helped in dealing with our situation was practicing misfortune.  Seneca once said that “Emotions like anxiety and fear have their roots in uncertainty and rarely in experience. Anyone who has made a big bet on themselves knows how much energy both states can consume”.  We have had several things that have happened that were the “worst thing that could have happened”.  However, when it was done, we were still standing, and were able to move on to the next event in our lives.

There have been a few times when we got a phone call about something one of the kids did that put us into panic mode, and wonder how we were going to survive it.  However, after the problem was solved, the situation wasn’t as bad as the initial feeling made it out to be.  It really has helped us realized that by experiencing the thing that makes you scared, you find out that what happens is not as traumatic as you had thought it was going to be.  This has helped me as I have started my accounting and tax business.  I know that if I focus on taking care of my clients and do what is right, I can handle whatever the business throws at me.

Lastly, keeping in mind that everything is ephemeral is very helpful.  Marcus Aurelius once said:

“Run down the list of those who felt intense anger at something: the most famous, the most unfortunate, the most hated, the most whatever: Where is all that now? Smoke, dust, legend…or not even a legend. Think of all the examples. And how trivial the things we want so passionately are.”

The struggles that we are going through are not going to last forever.  They will pass.  This is harder in the new world of social media, where it is easy to get jealous of people posting their vacation photos, as well as pictures of what seems to be a perfect life online.

What would happen if we were to have those same things?  The vacations end.  The house gets dirty.  The car gets dinged.  Everyone has trouble with their kids.  Getting jealous of the achievements of others does nothing to bring peace to your life.  We need to set our own goals based on what really would make us happy in our own life, work hard to get it, but most of all enjoy the journey that comes with the pursuit.

I consider myself a Catholic Stoic.  I follow, and believe in, what I learned about my Catholic faith.  But learning about Stoicism has given me a perspective on life that has allowed me to look beyond what is happening in the here and now to see the deeper meaning in what is occurring.  By stepping back and seeing things for the way they actually are, I get to see the beauty in life, the joy in the struggles, and get one step closer to God.

Chris Peden is a CPA who not only helps people and small businesses with their taxes and bookkeeping, but has written articles for GoDaddy and the Intuit Small Business Blog that help small business owners understand the sometimes confusing topics related to accounting and tax. He is also the father of two autistic boys, and has used the teachings of Stoicism and his Catholic faith to better deal with the challenges that come from raising special needs children. He can be contacted at chrispedencpa@yahoo.com.

 

'Stoicism as Practised by the Seriously and Persistently Mentally Ill' by Ian Guthrie

Stoicism as Practiced by the Seriously and Persistently Mentally Ill

Hope

Ian Guthrie, BA

“My mother was driving me in today,” said “Adam” at the beginning of our men’s group session. “She was getting really frustrated by the morning traffic and people cutting her off. I was like, ‘There’s this book we are reading in group that you might really like! It’s by this smart guy named Marcus Aurelius and he was a Roman Emperor and a philosopher and he wrote a book called Meditations that is about controlling your emotions and not letting things that you can’t control bug you.’

“And she turned to me and said, ‘Are you getting smart with me?’”

We all laughed at the story, and I realized that it represented not only Adam’s understanding of what we were reading in Meditations, but an example of each member’s attempt to apply it to his daily life. In the previous article I wrote for this site (“Is Stoicism for the Mentally Ill, Too?”), I presented my perceptions of the effect of the clinical use of Stoic principles from the perspective of the clinician. This article is oriented towards the reactions of my clients, all of whom are diagnosed as seriously and persistently mentally ill (SPMI).

Recently, the group members shared what they were learning and taking away from the experience. Several individuals spoke up.

“I am learning to accept things that I cannot control, to not get angry and stuff,” said Adam. “I used to struggle with that a lot and let things affect me, but what is the point of getting mad about things that are going to happen regardless? This is helping me right now with my [terminally ill] grandmother. Sure, I’ll be sad when [her death] happens, but I think I’ll be able to accept it, because like we’ve been reading, death is natural.”

Adam is recalling passages from Meditations that address human mortality. “Death, like birth, is one of nature’s secrets” (iv. 5). He is reporting that his experiences with Stoicism have aided him in processing emotions more effectively than he was previously capable, and he anticipates that he will be able to do so in the future.

“Walter” announced that he found it interesting that Aurelius’ text is “from the old times, and it still applies today!” Aurelius speaks to the permanence of the world: “Everywhere there is change; and yet we need fear nothing unexpected, for all things are ruled by age-long wont, and even the manner of apportioning them does not vary” (viii. 6). The world in its essence does not change, and neither does the worth of Stoic principles.

Another client, “Henry,” told me that he has been enjoying the readings. “It points out how to successfully think…to change…and how to reason and consciously digest your day and your life.”

I admit that comment stunned me. Henry is diagnosed with schizoaffective disorder, a diagnosis known for hallucinations, delusions, and mood swings. Despite (or perhaps because of) his diagnoses, he values and places emphasis on the importance of being able to think clearly. He is not the highest functioning member of the group, though he does make great efforts to understand, to ask questions, and to interpret of passages as frequently as possible. Meditations encourages this level of evaluation, saying “if possible, make it habit to discover the essential character of every impression, its effect on the self, and its response to a logical analysis” (viii. 13).

Often my clients tell me that they wish they could stop taking their medications because they do not want to experience the side-effects that so many psychotropic medications have, such

as lethargy, weight gain, and impaired memory. Most have resigned themselves to the need for medications to keep their symptoms in check. Medication usage is a matter for clients to discuss with their doctors. My role as a Psychosocial Rehabilitation Worker is to help them increase their functioning by the development of coping skills, and in that capacity, I wonder what could a stoically-trained, yet seriously ill mind accomplish for itself?

Stoicism isn’t a treatment for mental illness, but it is a prescription for how to live life well. I’ve introduced my group to Stoicism in the hopes of giving them the tools necessary to begin using their innate human reason to conquer the irrationality that they experience. Every healthy human being experiences irrationality from time to time, but there are those of us who strive for higher functioning in order to further separate ourselves from “the unreasoning brute creation” (viii. 12). Those that experience irrationality to a diagnosable degree can have exactly the same goal and are capable of achieving levels of success.

As we concluded one session, “Charles” spoke up. He thanked me for teaching Stoicism to him and said, “I feel like I’ve matured since we started. When I was in my 20’s, I spent my time getting into drugs and it messed me up. This is the stuff I should have been learning!”

Ian GuthrieBA, is a graduate student pursuing licensure as a professional counselor. He is a psychosocial rehabilitation worker for a community mental health center in Kansas City, Missouri.

A Blueprint for a Philosophical CBT by Jules Evans

In this article, Jules Evans envisages what a ‘philosophical CBT’ might be like, and how it could work….

Imagine being able to practice philosophy through the NHS. The idea is not as far-fetched as it sounds. In fact, therapists and counselors in the UK are beginning to put together something called ‘Philosophical CBT’, which could radically change how people see philosophy and the wider humanities.

CBT, or Cognitive Behavioural Therapy, is now at the heart of the British government’s mental health policy. Successive British governments have committed a combined £580 million to a policy called Improved Access for Psychotherapies (IAPT), which hugely increases the availability of CBT through the NHS, and will train 6,000 new cognitive therapists by 2014. It is the boldest expansion of mental health services anywhere in the world.

While many mental health charities have welcomed this initiative, others in the mental health industry have fiercely criticized it. Therapists from other traditions say it has too much of a ‘one size fits all’ approach, and that 8 to 16 weeks of CBT only offers a short-term fix that ‘papers over the cracks’. Others have criticized CBT’s intense focus on an individual’s thoughts and beliefs rather than their socio-cultural and economic context.

Continue reading “A Blueprint for a Philosophical CBT by Jules Evans”

'Is Stoicism for the Mentally Ill, too?' by Ian Guthrie

Is Stoicism for the Mentally Ill, Too?

A Reflection on the Clinical Use of Marcus Aurelius’ Mediationsmental-illness-unemployment

Ian Guthrie, BA

In my own studies of Stoicism, I had come to recognize some similarities between the subject matter and certain counseling perspectives such as Rational Emotive Behavioral Therapy (REBT), founded by Albert Ellis, and Cognitive Behavioral Therapy (CBT), pioneered by Aaron Beck. The population I work with consists of individuals with a wide age range from young adult to elderly, who are considered to be seriously and persistently mentally ill (SPMI). The majority of these clients are diagnosed with bipolar disorder or a type of schizophrenia, and a smaller percentage experiencing other mental illnesses including anxiety disorders or traumatic brain injuries. Considering the benefits that individuals receive from CBT and REBT, I thought they might also benefit from understanding the ancient philosophies, so I began considering how to educate them in stoic philosophy.

I selected Marcus Aurelius’ Meditations because it provided short passages that could be broken up more easily and discussed within the time constraints of the sessions. The challenge hinged on my ability to translate Mediations into something accessible to this population of SPMI adults. I decided to keep the audience small: a weekly men’s group I had recently begun facilitating became the forum because it allowed more opportunity for each member to explore his thoughts as needed.

Our sessions progressed slowly. After each passage, the group would take time to explore where the information was coming from historically as well as how it could be applied to their contemporary lives. Early on, none of the members showed either great enthusiasm or an overwhelmingly negative response. Clients were quietly receptive but offering only occasional remarks. However, after we finished the first book and began the second, a new client joined the group. I asked if any of the more seasoned clients would like to explain what we were discussing. One of the clients, “John,” who suffered a traumatic brain injury, with resulting memory issues, spoke up. He described Meditations and recalled the brief biographical information about Aurelius I had given the very first day, with a minor embellishment. “And this Marcus Aurelius guy is one badass dude.” At that point, it was obvious that these clients had developed some personal investment.

Our sessions continued and they are currently ongoing. We are entering the ninth month and have only covered up through half of the fifth book. Different topics received varying levels of reception. For the purposes of brevity, I will highlight three topics, in no particular order, which seemed to resonate most with my clients.

The first of these topics is personal productivity and following through with natural duty. Meditations v.1 reads, “At day’s first light have in readiness, against disinclination to leave your bed, the thought that ‘I am rising for the work of man’.” The passage goes on to discuss that to love one’s self, one would “love your nature, and nature’s will.” This was a fairly long passage. The clients usually have difficulty comprehending what the longer passages are about, but this one resonated to such an extent that many of them needed no interpretation. They understood, and they summarized the message perfectly. One client, “Peter”, diagnosed bipolar I, spoke about how he had always struggled with motivation, but he always felt better after being able to work on something and be productive. Most of my clients have been judged unable to maintain employment and receive government support. However, each noted having the desire to contribute to society. So, we spent time discussing how each member could satisfy his natural duty. Some have since begun taking steps to follow through on their ideas, such as volunteering or pursuing hobbies.

The second Stoic topic that resonated with the group is self-regulation by rational thought. This is a topic that is mentioned frequently in Mediations and is a key concept in Stoicism. Several passages prompted lengthy discussions on the topic, such as the suggestion to “put from you the belief that ‘I have been wronged’, and with it will go the feeling. Reject your sense of injury, and the injury itself disappears” (iv.7).

Following this reading, there was a brief discussion that beliefs prompt emotions which can affect how we carry ourselves through our daily lives, when all that need be done to control the emotions is to regulate those beliefs with rational thoughts. The men began sharing previous experiences where they had been successful in practicing this, such as being able to control themselves when confronted with aggressive and irritating drivers, or unsuccessful and envisioning how they ought to have acted differently.

One client in particular, “Bruce”, diagnosed with paranoid schizophrenia, struggles greatly with paranoid delusions. When I read one of the passages relating to self-regulation, he immediately referenced his thought disorders, describing how hard it is to cope with from time to time. I encouraged him, in moments of particular paranoia, to consider his emotions and the thoughts that prompted those emotions and to embrace as reality only what he knew empirically. He has subsequently reported some small success in the management of his paranoia. As I have encouraged him to process his thoughts, he has begun to practice this on his own.

The third topic is that of understanding natural events, not as good or evil, but as indifferent. Having a mental disorder is something that I point to specifically when this comes up. Stoicism encourages us to view events, like having a mental illness, toward which some in the group have harbored resentment for limiting their opportunities, as a thing that does “neither elevate nor degrade; and therefore they are no more good than they are evil” (ii.11). Rather, they should hold the perspective of the headland being constantly assaulted by waves, to adopt the view, “not, ‘This is a misfortune,’ but ‘To bear this worthily is good fortune’” (iv.49).

When considering natural events, the idea of death is brought up, by both Aurelius and my clients alike. This is observably more difficult for some to accept than it is for others as a non-evil, natural indifferent. When mentioned as “no more than a process of nature” (ii.12), some clients did express some difficulty accepting this view. They described their experiences of friends dying at young ages and even some of their own brushes with death. In the Stoic sense, seeking death prematurely, such as is entertained in suicidal ideation, is in conflict with our natural duty to be productive members of society. However, in instances of a seemingly premature death (such as when a non-group member, female fellow client died suddenly of natural causes), Stoic philosophy would question the very idea of prematurity, “for the sole thing of which man can be deprived is the present” (ii.14). This usually prompts contemplation among the clients, and something I expect to discuss more as the topic is brought up in future sessions.

The following can be gleaned from these sessions. First, my clients seemed to have benefited, not just from the topics presented in Meditations, but also from the philosophical depth of ideas. They have been challenged intellectually and engaged in healthy thought. Second, Stoicism provides a blend of both simple guidelines and complex concepts which have allowed the men the opportunity to engage Stoicism at their own level. Third, Stoicism, in its embrace of the rational, has the potential to provide SPMI clients with intellectual tools to aid them in addressing a world which may appear, by virtue of their respective delusions, overly irrational. Take for instance, the example of Bruce and his paranoid thoughts that cause him to view the world in emotional context. He has been developing the tools necessary to separate his emotions from his view of reality. Further, individuals with bipolar diagnoses suffer mood swings which affect their approach to life. Through encouraging a thoughtful and rational approach, they may learn to lessen the impact that their moods swings have.

I admit to having some reservations before electing to share Stoic philosophy in the form of Marcus Aurelius’ Mediations with my clients. This was not because I doubted the worth of Stoic philosophy itself, but because my clients, individuals diagnosed SPMI, have somewhat impaired functioning and reasoning. This entire endeavor might have proven to be an exercise in futility. Even if the clients could comprehend Stoic teachings, they may have had no interest in them. However, in light of our sessions and to supplement conventional psychotherapies like REBT and CBT, I fully intend to continue on with Meditations and beyond as long as my clients will listen, because they have reported Stoicism has had a beneficial effect on their lives.

About the author:

Ian Guthrie, BA, is a graduate student pursuing licensure as a professional counselor. He is a psychosocial rehabilitation worker for a community mental health center in Kansas City, Missouri.

'My Return to Mental Health with CBT and Stoicism' by James Davinport

My Return to Mental Health with CBT and Stoicism

James Davinport 

Editor’s Note: Over the month of April, the Stoicism Today blog will feature posts on Stoicism & Mental Health, from a wide variety of angles. The first post is by James Davinport.

A year ago my whole world collapsed. In hindsight, I can say that I should have seen it coming – the breakdown had been building up for years: month by month vestiges of my self were chipped away, until finally, it felt like there was not really a ‘me’ there that I could recognize anymore. At work, in the lower echelons of a high-powered business, I had driven myself down into the dust. I had worked seven days a week for years, often in to the early hours of the morning. By the end, nothing on the computer screen in front of me made any sense, nothing I read made any sense. I dreaded the regular presentations I had to make at work: I felt like each and every one I gave was a ‘failure’ (even though the peer-assessment I received indicated the exact opposite). I didn’t want to see people, and I lashed out at family and friends. One evening, I found myself kicking a chair in my living room for no reason. Luckily, my lodger was not in the room at the time! During the day, I would slip away from the office to cry in a nearby park. My head raced with negative thought after negative thought, many of which were so irrational, that it was upsetting just to have them. Often, in my mind’s eye, I’d see visions of myself crying out for help.

But it was the physical symptoms that made me finally shout ‘stop’: the dizziness, exhaustion, tender muscles that would suddenly seize up, the panic attacks, the inability to remember or concentrate, the heart palpitations, and digestive difficulties for months on end. Whereas the mental symptoms could not, sadly, curtail my self-destructive ways, my body, the health of which suddenly seemed so absolutely vital, was what finally forced me to reassess what I was doing.

So I did what seemed the unthinkable: I quit my job, gathered my savings, and set about recovering.

This article is about how I have made that recovery, and will, I hope, be of use to others who find themselves in similar situations to the one I found myself in.


At first, I had little idea what was wrong with me: I just felt that ‘everything’ was wrong with me. I wondered if I had ‘CFS’, the dreaded ‘Chronic Fatigue Syndrome’, and whether I would be condemned to years, decades possibly, of extreme tiredness. Being in my late forties, I worried if anything, realistically, could be done at this stage: I’d spent years doing the wrong thing, and now, how could I possibly expect any real change for the better? But, deep down inside me, there grew the greatest determination I have ever experienced to get better.

I had tried meditation for the first time a few months before my breakdownbutI was so anxious that, after each session of mindfulness meditation I was closer to a panic attack than before it. (Later, I learned that this was brought on by a rather curious form of OCD, or Obsessive Compulsive Disorder, I had developed, called ‘sensorimotor OCD’, which leads to high levels of anxiety as a result of paying attention to bodily sensations). The present moment hardly seems a joyful place when your head is racing with negative thoughts and turbulent emotions. It became clear to me that ‘accepting’ these thoughts and feelings non-judgmentally was not what I needed to do: I needed to change them.

Recovering with CBT

I’d long heard about CBT, or Cognitive Behavioural Therapy, but had never really considered it for myself. But early on in my determination to recover, when I was idly browsing the shelves in a London bookstore, I came across a Teach Yourself CBT book. I thought ‘Why not?’, and bought it. This was the best purchase of my life.  I was determined to commit wholeheartedly to what the book taught me, building on each lesson bit by bit.

CBT requires continuous training. Over the last months, I have learned many helpful techniques, but here I’ll just outline some of the most fundamental practices.

The first exercise was to ‘reframe’ the thoughts I had, and see them as something outside of myself which was ‘up for debate’. Thus, I would rewrite

‘I feel anxious that my future holds nothing good’,

as

‘Anxiety tells me my future holds nothing good’.

The process of doing this in itself gave me a huge sense of achievement: instead of letting Negative Automatic Thoughts (or NATs) ruin the day, I was capturing them at their inception and stopping them in their tracks. The process of writing the NATs down was important too – it is good to get such thoughts ‘outside of yourself’ and onto a piece of paper.

The second exercise focussed on applying what CBT calls ‘General Thinking Errors’ to each negative thought: was I thinking ‘in extremes’ with no shades of complexity or nuance? Was I ‘overgeneralising’ to assume that one bad incident should apply to everything else, forever? Was I ‘filtering out the positive’, only looking at the negative aspects of the situation? Was I ‘jumping to conclusions’, ‘mind reading’ or ‘fortune telling’? For another week, I methodically challenged each negative thought in light of these thinking errors, growing more and more in confidence each day.

The third exercise, which combines all of these together, was about replacing negative thoughts with more realistic, balanced ones, noticing the effect of doing this on my mood and feelings. Let me give a (made-up) example:

Thoughts: “I made a complete fool of myself at the party. Everyone thought I was an idiot.”

How much do I believe this? 74/100.

Feelings: Isolation, upset, like no one will like me.

Alternative thoughts: “Objectively speaking, there was only one real awkward moment in the party, and I’m probably blowing even that out of proportion. Other people had awkward moments at the party too, and they just laughed them off – I guess a bit of awkwardness is a part of life! The rest of it went quite well, and I actually got on particularly well with two new people. All in all, there were more positives than negatives to the evening.

How much do I believe this? 95/100

Feelings: Contented, a more balanced perspective, like one awkward moment doesn’t put people off liking me.

How much do I believe the old thought now? 0/100

I have practised this particular technique ever since. I have come to love the challenge of doing it. It feels rather like ‘gardening’, as if challenging negative thoughts is like clearing out weeds.What I also like about this method is that is not about replacing negative thoughts with ‘positive thinking’ for its own sake, but rather with balanced, more accurate thinking, which accepts nuanced understandings of situations. And the great thing is that, today, my thinking in general is more balanced in the first place, and reflects more accurately how the world works.

The Power of Underlying Beliefs

For CBT, the mind is like an onion: the thoughts we have are at the very outermost ‘layer’ and, that we have them at all, usually depends on some ‘underlying belief’. For example, if you feel panicky when in social situations, as I do, you might have the underlying belief that ‘I’m unlikeable’ or ‘Other people usually are judgemental and unfriendly’. And those kinds of beliefs feed into your behaviours: you find yourself avoiding others so as not to confirm your underlying beliefs. It’s a self-perpetuating cycle of negativity that needs to be broken.

As I uncovered my underlying beliefs, I began to detect certain overarching patterns in my thinking. After some research, it became clear that I had Social Anxiety Disorder (a deep seated fear of rejection and humiliation) and serious problems with Perfectionism (where one’s self-worth is dependent on achieving rigid, wholly unrealistic goals in one or two areas of one’s life). In addition, albeit in a more minor way, it also become clear that hypochondria, agoraphobia, PTSD and various kinds of OCD were also in the mix. Sometimes you have to have a sense of humour when faced with all your neuroses! But luckily, especially for someone new to CBT like myself, there were CBT books available for each of these problems. And let me tell you that that is a relief. When you need help with these kinds of issues, you need books that deal with the problems head-on, backed up by evidence. I took a long-term view and set about changing each of these areas systematically.

This process is still ongoing. Challenging these underlying beliefs takes time, but it is a process that one comes to value and take pride in. It involves a lot of behavioural experiments, in which you directly confront your fears and constantly re-evaluate the beliefs that fuel them. It also involves learning a lot about human psychology, and how behaviours feed into emotions and thoughts and vice versa. It’s a highly rewarding journey. But today, I can safely say that over the last few months the balance has tipped:

–       From being generally ‘on-edge’ and feeling scared when out and about, I have gone to love being out and about.

–       Whereas before, I would have quickly withdrawn into my shell in social situations and felt ‘isolated’,I’ve now become increasingly confident in meeting new people, and tend to focus on the positives of each event afterwards and not on a negative ‘post mortem’.

–       Now that I’m in work again, I don’t drive myself non-stop. Now, my self-worth is derived from the whole spectrum of my life, not just my work-related achievements. I can knock off without the slightest shred of guilt at not checking my email until 9 AM the next morning.

–       From being fearful that I had several kinds of serious illness, such thoughts now rarely cross my mind. In fact, these days I laugh on the few occasions I have those thoughts.

–       The panic attacks have simply disappeared.

 

A year ago ago all this seemed impossible even to dream of. Now, it seems hard to countenance the kind of fears I had a year ago: was that really me? Back then, it seemed like the world was a harsh and horrible place. But, in fact, the outside world has not changed – rather, my relationship to it has changed. And that I achieved myself.

Recovering with Stoicism

Early on in my journey with CBT, I encountered Epictetus’s key idea, from Handbook §5, that ‘We are not disturbed by events but by our opinions about events’. As is well known, and as I found out, this was a key idea behind CBT. This fact made me curious about Stoicism, and, after some research, I read some books and used some online materials (including those on the StoicismToday blog). As a philosophy, it really resonated with me.

But, I’ll be frank upfront. Had I picked up a book on Stoicism a year ago, rather than CBT, I don’t think I would have made the great strides of progress that I have made. I’d probably have made some progress, but only a fraction of what I have made. Why? Because Stoicism was not developed specifically to tackle Social Anxiety Disorder, Agoraphobia, Perfectionism or Hypochondria! The idea that Stoicism is a ‘Therapy for the Soul’, and the key saying within Stoicism by Epictetus which I just quoted above, of course, make it seem similar to CBT. But that doesn’t make it psychotherapy, in the modern sense, which is concerned with treating specific problems. In contrast, Stoicism is ‘psychotherapeutic’ in the sense that is concerned with developing ‘good flow of life’, based on coherent ethical values, rather than a more turbulent ‘all over the place’ kind of life with suspect or ill-thought-out values. It is also psychotherapeutic in the idea that certain value-judgements (such as ‘I need money to be happy’) can lead to psychological disturbances that can be removed with shifting to value virtue instead. In other words, Stoicism is essentially different as it is about ethics. And, the key thing is that having Social Anxiety Disorder or Hypochondria are not ethical failings. When someone wants help with recovering from panic attacks, help them to recover from panic attacks but don’t ask them to define ‘virtue’!

So how, you might ask, did Stoicism help me to recover? CBT is immensely helpful up to a point. It does its job wonderfully but it is necessarily defined in relation to removing something negative. Whilst this process in itself can lead to more positive things – self-confidence, and the enjoyment of parts of your life that once made you feel fearful, CBT does not give any advice on how to live your life in an overarching way, or on what you should value in life in general.

As I cleared out all the ‘negative weeds’ bit by bit, I found that there was a certain hole, or absence, within me. And the question that was emerging was: what is the mast, or rock, by which I can live my life? And that’s where Stoicism came in: it filled up the space that had been created by rooting out the negative weeds.

Although my journey with Stoicism is in its early days, there are three key things that I have taken away which have started forming the bedrock of my life:

  1. The focus on ‘what is up to me’: for me, this is about understanding that the most important thing in life is valuing keeping your integrity in how you go about things. You don’t need external events to be like this or like that – purpose comes instead from valuing retaining your integrity in response to those events.
  2. The Examined Life: Every evening, I practise the evening philosophical review. I praise myself for what I did well, and highlight areas that need to improve. No longer is my day just one seamless ‘blur’. Now I have sense of my ‘overall life narrative’, of what I’m seeking to do, of certain ethical precepts, as simple as the importance of valuing friends and family, which can guide me each day. In the evening, I become, as the Stoic Week 2013 Handbook puts it, akin to a ‘Philosophical Counselor’ to myself.
  3. Happiness through cultivating philanthropy: The Stoic idea that we should seek to cultivate affection towards others has been a powerful influence on my life. Hierocles’ circles have been especially helpful in doing this. It has led me to prioritize cultivating relationships, friendships and community, and to the realization that in those areas, it would seem, is indeed where happiness can be found.

 

There is more to delve into with Stoicism – I still couldn’t define ‘virtue’ if you gave me a million dollars! – and possibly other philosophies, but, for the moment, the values by which I will live my life are slowly, but surely, coming together. Whilst CBT gave me my life back, by removing the negative things that had been obstructing it, Stoicism is providing reflection for the meaning or basis of my life as a whole.


Of course, there still are some bad moments. I am only one year into my recovery. But I recognize those moments much more quickly now, and know what to do. When I look back at the kind of thoughts that used to plague me not so long ago, I have visible proof of how far I have come in so short a time. Physically, I am much better too. So many of the symptoms I had experienced before have simply disappeared, thanks, I believe, to having a much calmer mind and to having the time to commit to a sensible exercise regimen. And, in case you are wondering, I now practice mindfulness meditation again, and it does not leave me anxious! It has once more become an important part of my life.

I hope that, in writing this piece, if there is someone out there who finds himself or herself in a similar position to the one I was in a year ago, that they can know that it is possible to change. The simple fact that it is in one’s power only to tend well to certain parts of your life – thoughts, intentions and actions – might seem limiting.

But I know now, firmly from my own experience, that focussing on those things is the most powerful thing you can 

More about the author:

James Davinport is a pseudonym. He lives and works in London.