Stoicism and Chronic Uncertainty by Jenny Horner

Stoicism and Chronic Uncertainty

Jenny Horner


For the last 16 years I have been living with a chronic, fluctuating health condition. Over the last two years this has placed me under a form of house arrest. I have constant but changing symptoms and how I feel is unpredictable from one hour to the next, which makes any form of planning ahead very difficult.

What does my future look like?

  • Future Present – I stay mostly housebound with fluctuating symptoms and pay heavily for odd trips out
  • Future Dystopia – I slowly (or suddenly) deteriorate, unable to get to the toilet or feed myself
  • Future Utopia – I slowly (or suddenly) get better and resume normal life but without pressure to return to work too soon.
  • Future Upward Trend – over time I improve and regain independence but with lingering problems.

To what extent do I have control over these outcomes? And how likely are they relative to each other? I don’t know. I believe my actions do affect the likely outcome but I think some of it is down to chance (or what some people would describe as Fate). Being a psychology graduate I know that this type of lack of control over life’s circumstances also places my mental health in jeopardy, as an additional consequence of my physical health problems. In order to prevent depression creeping in I have been practicing different forms of meditation and relaxation techniques (including mindfulness and yoga nidra). I also have a sense that although I can do very little at the moment I want to invest my time in something that will last in the future. You could call this virtue (this is big with the Stoics), wisdom or resilience: if I can get through years of being housebound and remain psychologically healthy and good natured I’ll have learnt skills to improve my future life too. This is the context in which I took part in the Modern Stoicism course in May this year.

Modern Stoicism

I found the course interesting, helpful and at times puzzling. At the time I was having significant difficulties reading the course material but I found that the team had created enough resources for me to pull together audio/visual content to understand (I still haven’t read any authentic Stoic texts, which you should bear in mind reading my interpretation). My impression is that the combination of ancient philosophy with modern psychological techniques does seem to have something new to offer to the chronic illness community in terms of practical wisdom.

What to expect: Modern Stoicism (as I encountered it on this course) involves meditations using ancient stoic ideas combined with modern psychological practices (such as relaxation induction) and some changes in routine thinking and actions. You can approach this in much the same way as mindfulness: some people engage in an occasional secular meditation practice other people may orientate their whole lives around it.

Helps with: Coping with adverse circumstances, such as chronic illness. However, Stoicism is not a cure for chronic illness and is not likely to relieve symptoms unless there is an indirect effect due to reduced stress (but it could help you be happier in spite of your symptoms).

Particular concepts which stayed with me:

What is important?

“Health, wealth, and reputation may sometimes be preferable in life but they’re not necessary to excel and flourish as a human being – all you truly need is virtue and strength of character.” Donald Robertson (?)

“Sickness is a hindrance to the body, but not to your ability to choose, unless that is your choice. Lameness is a hindrance to the leg, but not to your ability to choose. Say this to yourself with regard to everything that happens, then you will see such obstacles as hindrances to something else, but not to yourself.” Epictetus, Enchiridion

Chronic illness certainly challenges health, wealth and reputation and I found myself returning to this idea, forming my opinion on it.

Contemplating the cosmos

Thinking about the universe first thing in the morning helps in two ways. Firstly my problems seem insignificant in the greater scheme of things. Then secondly, and almost contradictorily, I get a sense that my mind is as vast as the universe because it is able to hold such concepts, which is very freeing because I’m physically constrained to the house.

Premeditation of adversity

I often find instructions for positive thinking have the opposite effect on me and the stoic principle of imagining the worst is useful. I find this works well as morning and evening combination. In the morning I plan what I’d like to do for the day which provides a loose structure. I also imagine what could go wrong and plan for that as well (usually just health wise as in reality the possibilities for ill fortune are infinite!). An example might be that I’d like to write a blog post today but I can’t completely plan how to use my energy as answering the door to the postman and an unexpected phone call or a sudden migraine might wipe me out too much to write, so I plan to listen to a podcast instead if that happens. At the end of the day, I review how my day went especially how well I respond to my plans being thwarted by circumstance (my emotional response is more important than what I physically get done).  I find I cope better with things going wrong if I do this.

The Good Life is in your Head

Chronic illness can leave you feeling fairly useless and unfulfilled. In Stoicism, virtue (self worth and morality) is based entirely upon your response to your circumstances. Initially I was concerned that this missed out social justice, but activism can be the outworking of your intellectual/emotional response if that is within your control, as long as you remember that the outcome of your action is not within your control. I can also be doing nothing in bed and potentially be more virtuous than a charity volunteer, if my response to events is exemplary.

Difficulties with Stoicism

I would not describe myself as a Stoic, as I do have some hesitations with the stoic outlook. Some Stoic concepts can be hard to accept and confusing, so I ended up spending too much mental energy thinking about them. For example:

Locus of Control and Fate

Nowadays we see that the distinction between what we can and can’t control is complex, so that very little is either completely in our control or out of our control. For example, genetics may predispose you to a health condition but your behaviour and uncontrollable environmental factors decide whether it is triggered. There can be a mind-body dualism in stoicism that is hard to accept in our world of PsychoNeuroImmunology and the science of gut microbiome influencing neurotransmitters which then effect our mood etc. Similarly, if you don’t believe in fate or destiny, it can be harder to accept your situation because potentially you could influence change in everything and nothing has been preordained. I found it confusing to distinguish what was in my control, although this was an interesting exercise and I do have plenty of time to think.

Coincidentally I got into modern stoicism at the same time as using a heart rate monitor to limit activity and found I was amalgamating these two very different approaches. An example of my daily rhythm was:

  • take my morning resting heart rate
  • use the stoic morning guided meditation to plan my day, initially based on my morning heart rate as well as planning for setbacks if my symptoms are bad or heart rate unusually high for standard activities
  • have the mindfulness bell go off every hour or two and do the Right Now activity to quickly assess how I’m doing fatigue wise and remind myself of my Stoic plan for the day
  • use the afternoon meditation to get my attitude in line
  • use the evening stoic meditation to assess my pacing through the day and make journal notes on my heart rate through the day.

Stoics are very into separating out what you can control and what you can’t. What would Seneca, Epictetus or Zeno do with a heart rate monitor? Obviously the ancient Stoics didn’t have access to this technology but I found myself thinking about what it could offer their practices. I don’t completely agree with their ancient idea that the only things you can control are your own thoughts and emotions (not your body) and I think that Seneca with a heart rate monitor would become quickly convinced that his heart rate was indeed within his control. It could be influenced by strong emotions and physical actions. Would the heart rate would be taken on as a Stoic measure of control over emotions and self discipline in exercise? This is a playful thought experiment but it illustrates a bigger point that Modern Stoicism needs to take into account recent research/technology as well as ancient philosophy.


I have found exploring stoicism intellectually interesting, but more importantly, some Stoic practices are now shaping and enhancing the structure of my daily life. I have yet to achieve ongoing, self-controlled serenity in the face of adverse circumstances but I am gaining self awareness of the processes necessary for this.

This post is adapted from previous blog posts, you can read more on Tips for ME [link]

About the author:

Jenny Horner lives in a small terrace house in England with her partner and Miniature Schnauzer. She is currently economically inactive and her in/activities mostly involve watching Netflix, tweeting Tips for ME and using relaxation resources. You can read more about her experience of navigating chronic illness at and contact her on @TweetTipsforME or

Links to Jenny’s blog:

2 thoughts on Stoicism and Chronic Uncertainty by Jenny Horner

  1. Archie says:

    What you can control is simply your will and intent. So, for example, with the heart rate monitor; if a gun goes off beside you unexpectedly, you likely cannot stop your heart rate from increasing. You can intend to meditate, or use some form of relaxation to calm your heartbeat, but too many things beyond your control, can interfere with getting the result.

  2. tipsforme says:

    I guess here I am questioning the Stoic orthodox view that all you can control is your will and intent. IF your gut is influencing your will then you are not actually in control of your intent (despite the perception that you are). If you can control your heart rate that is an example of something other than your will which you can control (although I see your point that this can be traced back to the intent to control heart rate).

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