Over the last several months, we here in the Modern Stoicism organization have published several posts about one of the perks for our Patreon supporters – discussions by our panel of experts on Stoicism on selected topics. We’ve been publishing the full set of contributions to the panel in the Patreon site, and one of the experts’ contribution in a short mid-week post here. This time around, we’re doing something a little different. Down below, you’ll find the full panel discussion on the topic of “Stoicism, Pain, and Illness”
Before that, there’s two other matters to bring to your attention – just in case you missed them when we posted about them earlier this year.
First, here are the two earlier posts on other important topics
Second, if you’d like to suggest a passage or topic for our expert panel to consider, we now have a link set up for that – Suggest a Quote or Topic for Discussion
And now, with no further ado, on to the expert panel for May. Here’s the question: What insights does Stoicism provide to help us cope with Pain and Illness?
Stoicism treats pain and illness as something that relates to your body. Your body nothing to do with the ‘true you’ which is your rational mind, your will. The mind is temporarily housed in the body, like a traveller in a hotel room. Pain and illness that affect the body have little to do with your mind which is forever unfettered and free.
Sickness is an impediment to the body, but not to the will, unless itself pleases. Lameness is an impediment to the leg, but not to the will; and say this to yourself with regard to everything that happens. For you will find it to be an impediment to something else, but not truly to yourself.Epictetus, Enchiridion 9
Pain and illness affect you only when you identify yourself with your body rather than your rational mind or will. While Epicurus argued all pain is bearable, the Stoics believed that the real you never suffer pain or illness. It is this lack of identification with the body that made them immune – not only to pain and illness but to death itself.
There is, I assure you, a place for virtue even upon a bed of sickness. It is not only the sword and the battle-line that prove the soul alert and unconquered by fear; a man can display bravery even when wrapped in his bed-clothes.Seneca, Letters to Lucilius, LXXVIII.21
Stoicism is a philosophy of life, not a magic wand. So if someone thinks that adopting a Stoic outlook means that he will suddenly be free of pain and illness, they should think again. And of course the same could be said for someone embracing Buddhism, or Christianity, or any other framework to live one’s life.
The fact is that it is not in our power to avoid pain and illness. But as Seneca says in the quote above, it very much is in our power to react virtuously to such circumstances. Indeed, the entire 72nd letter to Lucilius is concerned with this topic, and is excellent reading for any student of Stoicism.
Most importantly, I think, we need not to allow ourselves to use our illness as an excuse to be rude or unkind toward others, particularly those who are actually taking care of us. It’s more common than you think: a friend of mine has worked in a clinic for the terminally ill, and told me that they have a chronic staff shortage due to high turnover, which is caused in part by the fact that the caretakers are subjected to constant abuse by the people they assist. Even dying is an opportunity to show kindness to our fellow human beings. As Seneca puts it in the same letter:
There are times when just continuing to live is a courageous action.Letters, LXXVIII.2
Many of us suffer from pain and illness, some more often than others, and Stoicism can help us not only to endure these conditions, but also to reframe our approaches to them, so that we can realize them not to be the catastrophes that they readily appear to us. Of course, it isn’t so simple as just reading some Stoic texts, or repeating “bear and forbear” like a mantra – there are no quick fixes. But Stoicism offers us powerful tools for analysis of what really troubles us, and for changing the ways we look at those matters.
One aspect that adds additional suffering to those enduring pain and illness is a set of evaluative assumptions that often accompany those conditions. These have to do with one’s value as a person. And this dynamic extends much more broadly to other circumstances that we typically view as negative, for example, poverty, as Epictetus points out in Discourses 3.26. He asks the person who fears poverty what it is that they really feel fear over. One of the answers that his probing analysis reveals has to do with a loss or lessening of social status.
Is that shameful to you which is not your own act? Of which you are not the cause? Which has happened to you by accident, like a fever or the head-ache? If your parents were poor, or left others their heirs, or though living, do not assist you, are these things shameful for you?
It is quite common for those who suffer from pain, or illness, or poverty to get an additional troubling condition foisted upon them by society and its members. It’s very easy for people who are dealing with these sorts of matters to be looked down up, treated as less than a person, even by their own caregivers. In this Discourse, Epictetus not only suggests that we ought to determine what really is shameful – which has to do only with what we choose and do, not with what happens to us – but that we even push back against other people’s judgements about our value and what it derives from.
All too often, those who suffer from chronic pain or illness get the message that there is not only something wrong with their body – and that’s true – but that, because of that, there is something wrong with them – and that inference is false. It is easy and understandable for a person who is suffering, and consistently getting those sorts of messages, to internalize them, and then create more suffering for themselves by repeating them to themselves. Stoic philosophy and practice can help undo the damage caused by that dynamic, and restore some measure of psychological health in the process.
Stoicism can be a great help to those suffering from illness and pain. As a CBT-therapist working in the NHS in the UK with people suffering from “long-term conditions” I regularly incorporate what I call “Serenity Prayer Stoicism” into my work.
When people have long-term illnesses or pain, they can be helped by thinking carefully about what they can and what they cant control. For instance,
- “I can’t control the fact that I have this condition but I can control how I respond to it”
- “I can no longer gain pleasure and meaning in the way that I did, but that doesnt mean I can’t do so in other ways”
- “I can’t control the fact that I will experience some pain. but by “pacing” my activities to the right level I can influence how much pain I am in”
These can all be incredibly helpful Stoic ideas which can be incorporated into standard CBT. Working as a therapist, it is ethically problematic to try to persuade people to change their value system, which is what one would need to do if one were to ask people to fully embrace Stoicism fully.
In other contexts than therapy, if people do agree that virtue is what matters most in life, then clearly this can help enormously in coping with illness and pain, Feeling good now becomes at best a preferred indifferent, and so pain and illness are not an obstacle to eudaimonia. Indeed, being ill and in painprovide new opportunities to exhibit the virtues. One can show courage in how one deals with pain, self-control in not complaining or not over-doing things, justice in being a good role model for people with your condition and wisdom in prioritising the virtues and in focussing on what you can control.
When about to be captured by enemy forces, James Stockdale, author of Thoughts of a Philosophical Fighter Pilot, and Courage under Fire famously whispered to himself “I’m entering the world of Epictetus”.. When ill or in pain, we could all benefit from engaging whole-heartedly with Stoicism.
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