‘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.

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