Beyond Feel-Good Therapy

Why Ancient Philosophy Asked 'Is This Right?' Instead of 'How Do You Feel?

15th century painting of Epictetus debating with his student Adrian - engaging in philosophy as self-improvement

Today, there is increasing recognition of the importance of ‘mental health’. 

We have preventative tools for moderating our mental health, like exercise and socializing. Then if we struggle too substantially, we might see a psychologist. 

In this way, psychologists are the ‘doctors of the mind’ - and psychotherapy is their therapeutic method.

But thousands of years ago, this was the domain of philosophy.

The Stoics, for example, thought of themselves as ‘doctors of the mind.’

Chrysippus, the 3rd leader of the Stoic school, said that the Stoics must understand extreme emotions like anger, jealousy and fear because:

“Just as the doctor must have intimate knowledge of the illnesses (pathē) of the body, so also the ‘doctor of the mind’ must have intimate knowledge of a variety of conditions of the mind.” (Graver, Stoicism and Emotions, pg. 141)

People used to seek out philosophers for general advice and to help with acute crises. But the treatment was not always pleasant.

Epictetus, the slave turned philosophy teacher, said that:

“The philosopher’s lecture room is a hospital: you ought not to walk out of it in a state of pleasure, but in pain—for you are not in good condition when you arrive!” (Discourses 3.24.30)

Philosophy aimed to heal or improve the soul just like a doctor heals the body (the greek word for the soul is psychê - the same root for the contemporary word psycho-therapy). Sometimes healing the soul is difficult, sometimes it involves hearing what you don’t want to hear. 

As Seneca said:

“Our words should aim not to please, but to help ... A sick man does not call in a physician who is eloquent.” (Letters On Ethics, 75.5)

Today, (almost) no one seeks out a philosopher. But what has been lost?

The difference between philosophy and therapy

If psychologists are today’s ‘doctors of the mind’, then their methods are less painful: Primarily, contemporary psychotherapy addresses mental health by identifying and resolving unhealthy or damaging patterns of thinking, not by being prescriptive or giving direct advice.

The schools and approaches differ, but there is a shared ethos in contemporary psychology: Therapy tries not to be directive or prescriptive about your personal philosophy of life. It helps the participant discover things about their thought patterns and emotional life. It provides a set of tools to support their own mental health, like mindfulness.

But this is not what ancient philosophy tries to do. There is a gap between what contemporary therapy provides and what ancient philosophies like Stoicism aim at.

Αncient philosophy offers a holistic conception of a good life. It makes claims about what kinds of lives are best. It is comfortable being prescriptive, directive and providing advice.

Because of this, it also challenges people, calls them out, and pushes them.

I think this matters, and has been lost somewhere along the way in terms of how we think about mental well-being.

Το show what I mean, let’s look at a Stoic case study.

Stoic Therapy in Action

Epictetus - The slave turned Stoic philosopher thought studying philosophy should be like visiting the doctor’s office - painful but good for your health

In Epictetus’ Discourses 1.11, we can see the Stoic approach to the disordered mind. Epictetus meets a father, who, unable to handle the stress of having a sick daughter, has left home and abandoned her. They have the following conversation:

Father: But I am so very miserable about my poor children, that the other day, when my little daughter was sick and was considered to be in danger, I could not bear even to be with her, but ran away, until somebody told me that she had recovered. 

Epictetus:  What, and do you think you were right to act in such a way?

Father: I was acting naturally…All, or at least most, of us fathers are affected in the same way.

Epictetus: I do not deny the fact [that you acted naturally], but the question between us is whether it be right. For, if we are to follow your reasoning, we would have to say that tumours develop for the good of the body, because they do develop and even that errors are natural, because all or the most part of us are guilty of them. 

For a father that in a moment of stress abandons their daughter, the key therapeutic question might be: “What are you feeling” or “Why are you feeling this way?”. It may even be “Is feeling this way something you want or something that benefits you?”. 

Epictetus focuses on the key philosophical question: “Is this right? Is this something a father should feel?”. 

In the rest of the passage we get to see Stoic therapy in action.

The father offers a defence of his behavior: He acted this way because he loved her so much. Epictetus then engages in Socratic questioning to pull out the absurdity of this claim.

Epictetus: So was it right for you, when you were affectionately disposed towards your child, to run off and leave her? And has the child's mother no affection for her?  

Father: Yes; surely she has. 

Epictetus: Would it have been right, then, that her mother too should have left her, or would it not? 

Father: It would not. 

Epictetus: What of the nurse? Does she love the child? She does. Ought she then to have left her? By no means. And her attendant? Does he not love her? Father: He does.

Epictetus: Should he not also, then, have gone away and left her, so that in consequence the child would have been left all alone and helpless because of the great affection of you her parents and those around her, or would have died, perhaps, in the hands of people who neither loved her nor cared for her? Heaven forbid!

Epictetus takes the fathers argument to its logical conclusion: If love is a justification for abandoning your daughter, then no could ever be cared for by those they love. This is absurd. His conception of love is wrong, and harmful. 

Why we need philosophy

While the passage ends here - with the father understanding the error of his thinking - this is not the end of philosophical therapy. What matters most is if he follows through on the lesson, and changes his behaviour. 

But the difference in emphasis is critical: The father needs to help his daughter, not because he is hurting, or confused, but because he is wrong. He has a false view of the world. This is not how a father should love his daughter.

I understand contemporary therapy’s hesitation to say what is ‘right or wrong’, except in extreme cases involving immediate harm to the patient or others. To answer those questions, you need an answer to what a person ‘should’ be, and institutionalized medicine is probably better for having an open and broad view on that question. 

But ancient philosophy offers a prescriptive view of how people should live.

For the Stoics, it is with good character. For the Epicureans, in a way that maximizes what is pleasant. For Plato, it was to have a well ordered soul, where you don’t allow your more animalistic desires to dictate your actions.

Ancient philosophy sees these questions as being serious and necessarily related to the idea of psychological health. Health is about more than removing harmful or unpleasant ways of thinking. You can’t have a ‘healthy mind’ without a conception of the good life it is aiming towards. 

As Epictetus would say, it doesn’t matter if what you are thinking in the moment is pleasant, painful, harmful or beneficial. What matters is if it is right.