Stoic Resilience in Face of Illness

by Carmelo Di Maria

2015 didn’t begin well for me – the end of a sentimental liaison had caused me a lot of turmoil on the emotional front (lots of sleepless nights, crying, rumination, loss of appetite, chain smoking… you name it).  The bright side of it, though, was that in an attempt to make sense of it all, I started devouring self-help books, especially those about relationships and the insecure attachment style (me) and narcissistic personality disorder (him). Fascinating reading, I tell you.

And it was in this frantic pursuit of enlightenment and self-amelioration that I eventually landed on the shores of ancient Rome and got acquainted with the Stoics. I started reading a lot on their philosophy of life and it was music to my ears. For starters I’ve always been a fan of CBT and the idea that the Stoics could be considered the forerunners of this psychotherapy school made me immediately warm up to them. In addition, I was already used to stick on the fridge nice philosophical maxims, so their pocket-sized pearls of wisdom fitted the purpose beautifully. I also happened to love their pragmatism, the idea that you could do routine exercises – like the mantra-like repetition of maxims, the morning and evening meditations, the ‘view from above’ meditation, the pre-meditatio malorum (meditation on adversities) –  with the aim of training your mind in a sort of mental fitness regime. Through their reflective meditations you could practice being more mindful of your thoughts and emotions, reframing some aspects of reality, making sure that your actions fall in line with your values and above all that you have values in the first place and that they occupy a prominent place in your life, ultimately you could practice how to become a better person.

Personal development had always been a constant in my life (I had been struggling with self-esteem and an anger management problem for years) so in a sense the Stoics were speaking a language I could completely understand. It was a question of nodding all the way.  But there was one thing that for me represented a revolutionary new way of thinking, i.e. the idea that some of the things generally most valued in life have no intrinsic value, namely: money, health, reputation, and everything else that lies outside our sphere of control. These things fall under the category of ‘externals’, things deemed outside our control and therefore ‘indifferent’. What are instead of the utmost importance, the Stoics thought, are our thoughts, emotions and behaviour, in a nutshell whatever is under our control and can lead us to live life according to virtue.

Health was the one aspect of life deemed by the Stoics ‘indifferent’ that stood out for me. Here were some people who were saying that if you’re suffering from ill health, it doesn’t really matter, it’s your attitude that count: ‘The thing that matters the most is not what you bear, but how you bear it’ (Seneca, On Providence) or ‘Remember too on every occasion which leads thee to the present difficulty to apply this principle: not that this is a misfortune, but to bear it nobly is good fortune’ (Marcus Aurelius, Meditations). This was very refreshing and comforting to hear for a person with two chronic conditions. So from a feeling of inferiority and impotence and of being somehow ‘less than’ when compared to healthy people, I began to see my value as a person reinstated and judged according to different standards: my resilience, my strength, my dignity, my ability to reframe things. I must say if I was yearning for a CBT fix, the Stoics were providing me with one of epic proportions, taking reframing to a whole new level. Money? Health? ‘That is nothing to me!’ This is how Epictetus was inviting his students to address aspects of life considered external, indifferent. The idea being that the only thing that matters is your character, being the best you can be and be strong in the face of adversity. It may sound a bit of a radical statement at first, but you can clearly see its value especially for somebody who is currently facing adversity. And whether you are indeed currently facing adversity or wise enough to prepare for it, Stoics suggested the practice of ‘pre-meditatio malorum’: imagining that something bad may happen to you and by so doing reaching the twofold goal of preparing psychologically for it, i.e. getting rid of the element of shock and surprise that might otherwise overwhelm you, and secondly appreciating your current situation. There have been times when I have meditated on my health condition worsening or even on my own death as a practice. The Stoics’ invitation to remember that ‘thou must die’ or otherwise known as ‘memento mori’ is something else that resonates me. Gone is the taboo typical of modern societies which makes death even more morbid and scary and in is a healthy realistic acknowledgement of death as a part of life: as Seneca said, life is a constant dying, each day that goes by means getting closer and closer to death. And if you’re ever despairing about your health condition, feel overwhelmed by a sense of injustice and anger, and are inclined to think ‘why me?’, the Stoics, on the back of their cosmopolitan view of the world and a sense of brotherhood in humankind, would be likely to reply: ‘Indeed, why not you?’

In sum, it seems to me that people with chronic conditions would derive a lot of comfort and a renewed sense of pride by adhering to a Stoic philosophy of life and following its precepts. All you need to do is showing resilience in crisis, acknowledging that some things like health are not under your control, but your attitude towards them are, not cursing your lot and instead accepting it with equanimity and good grace (‘Don’t demand that things go as you will, but will that they happen as they do, and your life will go smoothly’), taking inspiration from role models, historical figures and contemporaries alike, who may have faced adversity with strength and dignity.

The meditative practice of ‘A view from above’ is yet another invitation to distance oneself from an egocentric view of the world and embracing one of connected humankind. Incidentally, it is only by seeing it in the context of a big human melting pot that your pain becomes smaller and doesn’t morph into suffering. It is only by looking at the big picture and considering yourself as an infinitesimal part of the universe, a tiny grain of sand, and viewing your difficulties as nothing compared to all the misfortune on the planet and across the centuries, that you have any hope to minimise your suffering.

Where so much in the health literature seems to point at how to best manage your chronic condition, and patch things up as it were, but never highlights the strengths and qualities which can be derived from it (something referred to as ‘post-traumatic growth’ in certain quarters), stoicism allows us to take a different stance. The only good in life is virtue and you can be proud of yourself if you show courage, resilience and wisdom in the face of adversity.

And if the Stoics place so much importance on the meditation of adversities and on the reflection of life’s transiency, a chronic patient’s brush with mortality puts him/her in a position of advantage for carrying out both practices. He/she can more easily contemplate a deterioration of his/her health for example or meditate on death itself. Likewise, a person living with a chronic condition can more easily savour all the things in life one can be grateful for. A rose smells nicer when you happen to have a more vivid sense of how transient life is. Finally, if you are ever troubled by the brevity of life, make every day count, as Seneca suggests in the following two quotes:

‘Show me that the good in life does not depend upon life’s length, but upon the use we make of it; also, that it is possible, or rather usual, for a man who has lived long to have lived too little’ (Seneca, On the Shortness of Life).

‘Begin at once to live and count each separate day as a separate life’ (Seneca, On the Futility of Planning Ahead).

Because if it’s true that the Stoics bang on about ‘memento mori’ (remember that thou must die), the inevitable corollary is a resounding ‘memento vivere’ (remember to live).

Carmelo Di Maria is an Italian living in London. Loves to smile and have a laugh.  Taurean to the bone. Has a soft spot for parmigiana and rugged men. Hopes to teach one day a blend of mindfulness and Stoic reflective meditation to people with chronic conditions. Best thing that’s ever happened to him: his mum. (I could go on but I edit things down for a living).