Philosophical Premeditation & Cognitive Therapy

Aequam memento rebus in arduis servare mentem. (Horace)
“Remember to keep a calm and balanced mind in the face of adversity.”

Copright (c) Donald Robertson 2008.  All rights reserved.
This material is based upon the forthcoming book, Philosophy & CBT, due for publication in 2009 by Karnac.

One of the most fundamental techniques of classical philosophical therapy was the method known as premeditatio mallorum, which means preparing the mind in advance to cope with adversity.  For simplicity, we can refer to this notion simply as “philosophical premeditation.” 

      Essentially the technique of philosophical premeditation involves visualising a future catastrophe as if it were happening now and restoring emotional calm by repeating appropriate principles of living, i.e., positive affirmations.  These principles were usually called “dogmas” or “precepts”, but also referred to as maxims, formulas, sayings, etc.  They are symbolically described as the “weapons” of the Stoic warrior.  A well-known children’s fable of Aesop (c. 620-560 BC), who lived long before the first recorded philosophers, puts the notion beautifully well,

 A wild boar was sharpening his tusks against a tree when a fox came by and asked him why he was doing this. 

“I don’t see the reason,” remarked the fox, “there are no hunters nor hounds in sight.  In fact, right now I can’t see any threat at all.”

“True,” replied the boar, “but when danger does arise, I’ll have other things on my mind than sharpening my weapons.”

There are countless references to the concept of mental preparation in classical philosophy, poetry, and literature.  It is perhaps one of the most characteristic techniques of Stoic psychotherapy, although it’s common to other Socratic sects, even the Stoics’ great rival, the school of Epicurus,

I have anticipated you, Fortune, and entrenched myself against all your secret attacks.  And we will not give ourselves up as captives to you or to any other circumstance.  (Epicurus et al., Vatican Sayings, 47)

Indeed, the great Stoic teacher Epictetus goes so far as to define (practical) philosophy in terms of this ability, “But what is it to study philosophy?  Is it not to prepare yourself for future events?”  (Epictetus, 3:10). 

It is perhaps because of the centrality of mental preparation to classical philosophy that, in modern usage, the adjectives, “Stoical” and “Philosophical” can both be used to mean the same thing: “calm in the face of adversity.” 

      The Twentieth century French philosopher, Foucault, had a great interest in this area and discusses classical philosophical meditation at length in one of his last lectures.  He describes the premeditatio mallorum of the Stoics as a meditation divided into three distinct processes,

First, it is not a question of imagining the future as it is likely to turn out but to imagine the worst that can happen, even if there’s little chance it will turn out that way -the worst as certainty, as actualising what could happen, not as calculation of probability.

Second, one shouldn’t envisage things as possibly taking place in the distant future but as already actual and in the process of taking place.  For example, imagining not that one might be exiled but rather that one is already exiled, subjected to torture, and dying.

Third, one does this not in order to experience inarticulate sufferings but in order to convince oneself that they are not real ills.  The reduction of all that is possible, of all the duration and of all the misfortunes, reveals not something bad but what we have to accept.  (Foucault, Technologies of the Self, my formatting.)

By premeditatio mallorum we are able to employ our current mental resources, calmly meditating upon relevant maxims or affirmations, while anticipating a future event.

      As Foucault notes, the Stoics divided their exercises into meditatio, a word which can mean both “preparation” and “meditation”, and gymnasia, practical training through activity.  “While meditatio is an imaginary experience that trains thought, gymnasia is training in a real situation, even if it’s been artificially induced.”  (Foucault, Technologies of the Self).  A similar distinction is found in modern CBT where exposure to stressful events can be either in vitro (in the laboratory of the mind) or in vivo (in real life), i.e., in imagination or through behavioural assignments in the real world.  A person can confront a fear of enclosed spaces, e.g., first of all by imagining themselves in a place such as an elevator, and subsequently, when able, by placing themselves in certain confined situations in reality something which is normally done in progressive steps moving from the least to the most challenging types of situation.

      The philosophers, unlike most modern therapists, took this notion to the extreme.  As Foucault writes, “The meditation on death is the culmination of all these exercises.”  They reasoned that if they could overcome their fear of future events in this way they should focus upon conquering man’s greatest fear, the fear of death.   “The heart which has purged itself of the fear of death,” writes Seneca, “no dread dares to enter.”  Hence, the equally famous philosophical technique of the meditation on death (melete thanatou) can be seen as the archetypal form of the premeditatio mallorum. 

      It is said that ancient Roman generals had servants who whispered memento mori (“remember thou must die”) in their ears to help them moderate their pride following a great triumph.  This phrase has become part of our common cultural heritage and is still used to describe a whole genre of artwork which is intended as a meditation on our own mortality, from the Vanitas paintings of the Renaissance to the preserved animal cadavers of Damien Hirst.  This does not intend a morbid or melancholic state.  The ideal of the Stoic Sage, exemplified by Socrates, was both to love life and yet be unafraid of death.  “A person who has learned how to meet his death,” writes Seneca, “has unlearned how to be a slave.”

Eysenck & Cicero

The psychologist Hans Eysenck, who has a claim to be one of the founders of behaviour therapy, explicitly referred to the precedent for “exposure therapy” in philosophical literature.  In his autobiography, Eysenck claims that a good case can be made for saying that the German author Goethe “not only used methods of behaviour therapy, but also stated the basic premise on which these are based in a quite explicit fashion.” (Eysenck, 1990, p. 136).  Goethe describes how he employed in vivo exposure therapy methods, facing his fear of heights, loud noises, and blood, until they troubled him no longer.  Eysenck quotes Goethe’s finding: “Such troublesome and painful sensations I repeated until the impressions became quite indifferent to me, and I have since then derived great advantage from this training.” (quoted in Eysenck, 1990, p. 137)  However, Goethe also attempted to generalise this achievement to a wider range of fears, 

But I sought to steel myself not only against these impressions on the senses, but also against the infections of the imagination.  The awful and shuddering impressions of the darkness in churchyards, solitary places, churches and chapels by night, and whatever may be connected with them, I contrived to render likewise indifferent and in this, also, I went so far that day and night, and every locality were quite the same to me; so that even when, in later times, a desire came over me once more to feel in such scenes the pleasing shudder of youth, I could scarcely force this, in any degree, by the strangest and most fearful images which I called up. (Goethe in Eysenck, 1990, p. 137) 

Eysenck comments, “The treatment procedures used by Goethe are currently known as ‘reciprocal inhibition’ and ‘flooding with response prevention’.” (Eysenck, 1990, p. 137).  However, he adds that the same techniques have a precedent going back several thousand years earlier and provides his own translation of a Latin text. 

These ancient theories were Greek in origin, but were voiced in their most convincing form by Marcus Tullius Cicero, in his Tuscularum Disputationum [The Tusculan Disputations].  In the first place he points out that ‘Ab earum rerum est absentium metus, quarum est aegretudo’: in neurotic disorders, anxiety is felt of things not present, the presence of which causes grief, or distress.  This suggests immediately a learning process by means of which the distress properly associated with the ‘thing present’ (the unconditioned stimulus, in modern parlance) is evoked when the ‘thing’ is not present; that is, through a conditioned stimulus.  Now if we can remove the distress reaction [to the thing’s real presence], then the neurotic anxiety [experienced in its absence] also will be taken away: ‘Sublata igitur aegritudine, eadem impendentes et venientes timemus.’  This of course suggests a method of extinction, whether through ‘desensitisation’, or ‘flooding’, or ‘modelling’. (Eysenck, 1990, p. 138)

Eysenck also finds in Cicero a precursor of his own theory of trait “neuroticism”, a general emotional instability and vulnerability to disturbance, which Eysenck considered to be largely genetically determined. 

Cicero finally caps his account by appealing to individual differences: ‘At qui in quem cadit aegritudo, in eundem timor; quarum enim rerum praesentia sumus in aegritudine, eadem impendentes et venientes timemus.’  Translated freely, this states that the man who is easily distressed is also an easy prey to anxiety and fear.  For when stimuli cause distress by their presence, we are also afraid of the menace of their approach.  In other words, people who have strong fear reactions to actual dangers and stressful situations also show strong learned anxieties in the absence of these stimuli.  We cannot follow Cicero into the details of his discussion, but the elements of our modern way of looking at neurosis are certainly contained in his account. (Eysenck, 1990, p. 138)

This occurs in Cicero’s discussion of Platonic and Stoic theories regarding emotional suffering and its cure.  Eysenck therefore makes it clear that he considers Cicero to be describing a theory and practice similar to his own and to those of modern behaviour therapists in general.

Rational-Emotive Imagery (REI)

Albert Ellis, the founder of REBT, developed an influential technique known as Rational Emotive Imagery (REI); this is the main imagery technique used by his school of therapy.  There are a number of variations of this technique.  However, the basic formula can be described as follows.

      REI helps the client to question the validity of negative cognitions.  An anticipated activating event (A) is pictured, as if happening now, while the client mentally rehearses changing his negative emotions and behavioural reactions (C) by swapping his negative cognition (B) for a positive one.  Ellis describes the technique in the following words in his advice to patients, 

Use rational-emotive imagery to vividly imagine unpleasant activating events before they happen; let yourself feel unhealthily upset (anxious, depressed, enraged, or guilty) as you imagine them; then work on your feelings to change them to appropriate emotions (concern, sadness, healthy anger, or remorse) as you keep imagining some of the worst things happening.  Don’t give up until you actually do change your feelings.  (Ellis, How to Maintain and Enhance your Rational Emotive Behavior Therapy Gains)

This is achieved as follows, according to some REBT practitioners, 

[…] the client is instructed to imagine a feared situation and simultaneously repeats very forcefully to herself (either aloud or internally depending upon the situation) a previously negotiated helpful coping statement.  This helps clients to experience less anxiety and prepares them for difficult situations or it can be used to help them deal with how they behaved in an earlier situation.  (Curwen et al., 2000: 119-120)

As with most techniques in CBT, subjective measurements are taken before, during and after the exercise to make sure it is being done effectively.  Lack of change on a SUD scale, e.g., might suggest that the coping statement needs to be discussed and possibly changed.

      The basic formula is sometimes expressed in the acronym “FEAR” by modern therapists: “Face Everything And Recover.”  Meaning that by patiently and systematically confronting our fears, and accepting the situation, anxiety and other negative feelings will usually recede.  The act of confronting fears in reality or in imagination is known as “exposure” therapy.  It leads to what behaviourists call “habituation” or “extinction”, i.e., getting used to the situation, which tends to take the form of “desensitisation”, i.e., a reduction in the level of nervous arousal.

      Another useful version of the acronym FEAR, which relates to cognitive more than behavioural therapy, is “False Evidence Appearing Real.”  This can be interpreted very simply, in CBT terminology, as “thinking errors appearing real.”  As most of our fears are the result of thinking errors, as described in the ABC model, it follows that the problem situation itself is seldom as inherently frightening as we assume. 

Russell: The Conquest of Happiness

The influence of the Stoic tradition can clearly be seen in the writings of Bertrand Russell, one of the most influential philosophers of the Twentieth century.  Russell wrote one of the earliest modern self-help books, The Conquest of Happiness (1930).  He describes a philosophical method of overcoming anxiety and worry, indistinguishable from the premeditatio mallorum.  He also provides, arguably, the most lucid explanation of exposure therapy that one could wish for, 

Worry is a form of fear, and all forms of fear produce fatigue.  A man who has learnt not to feel fear will find the fatigue of daily life greatly diminished.  Now fear, in its most harmful form arises where there is some danger which we are unwilling to face. At odd moments horrible thoughts dart into our minds; what they are depends upon the person, but almost everybody has some kind of lurking fear. (Russell, 1930: 60)

 Russell provides his own examples, but he emphasises that this technique is part of a very general one for overcoming fear of all kinds, 

Probably all these people employ the wrong technique for dealing with their fear; whenever it comes into their mind, they try to think of something else; they distract their thoughts with amusement or work, or what not.  Now every kind of fears grows worse by not being looked at.  The effort of turning away one’s thoughts is a tribute to the horribleness of the spectre from which one is averting one’s gaze; the proper course with every kind of fear is to think about it rationally and calmly, but with great concentration, until it becomes completely familiar.  In the end familiarity will blunt its terrors; the whole subject will become boring, and our thoughts will turn away from it, not, as formerly, by an effort of will, but through mere lack of interest in the topic.  When you find yourself inclined to brood on anything, no matter what, the best plan always is to think about it even more than you naturally would until at last its morbid fascination is worn off.  (Russell, 1930: 60) 

Russell provides the following explanation of the technique itself, 

When some misfortune threatens, consider seriously and deliberately what is the very worst that could possibly happen.  Having looked this possible misfortune in the face, give yourself sound reasons for thinking that after all it would be no such very terrible disaster.  Such reasons always exist, since at the worst nothing that happens to oneself has any cosmic importance.  When you have looked for some time steadily at the worst possibility and have said to yourself with real conviction, “Well, after all, that would not matter so very much”, you will find that your worry diminishes to a quite extraordinary extent.  It may be necessary to repeat the process a few times, but in the end, if you have shirked nothing in facing the worst possible issue, you will find that your worry disappears altogether, and is replaced by a kind of exhilaration.  (Russell, 1930: 59-60)

 Spinoza: Remedia Affectuum (Remedies for the Emotions)

In the Seventeenth century, the Dutch thinker Spinoza, whom Russell greatly admired and studied in depth, produced a hugely influential work of philosophical therapy, the Ethics.  Spinoza was greatly influenced by classical literature on philosophical therapy and has, with some justification, been called “more stoic than the stoics.”  He recommends that “rules of living”, effectively affirmations similar to the Stoic precepts, should be internalised.

The best thing then we can bring about, as long as we have no perfect knowledge of our emotions is to conceive some right manner of living or certain rules of life, to commit them to memory, and to apply them continuously to the particular things which come in our way frequently in life, so that our imagination may be extensively affected by them and they may be always at hand for us.  (Spinoza, Ethics, V.10.n.)

Again, like the Stoics, Spinoza suggests that we mentally prepare for the typical problems that people are likely to encounter in life, 

But in order that this rule may be always at hand for us when we need it, we must often think of and meditate on the common injuries done to men, and in what manner and according to what method they may best be avoided [through the appropriate rule].  For thus we unite the [mental] image of the injury to the imagination of this rule, and it will always be at hand when an injury is done to us. (Ibid.) 

Spinoza first of all addresses the problem of irrational anger, and the principles which help us to moderate it in this way, adding “if the anger which arises from the greatest injuries is not easily overcome, it will nevertheless be overcome, although not without a wavering of the mind, in a far less space of time than if we had not previously meditated on these things.”  From anger he proceeds to discuss the conquest of fear, 

We must think of courage in the same manner in order to lay aside fear, that is, we must enumerate and often imagine the common perils of life and in what manner they may best be avoided and overcome by presence of mind and courage.  (Ibid.) 

He concludes this section on emotional remedies with an encouraging word for the student, 

And he that will diligently observe what is said here (for it is not difficult) and make use of it, will be able in a short space of time to direct his actions for the most part according to the command of reason. (Ibid.) 

The Ancient Origins of the Premeditatio

It is possible that the philosophical practice of mental preparation began with the most ancient of Western philosophers, the Pythagoreans, who meditated upon short, symbolic phrases, called “acusmata“, meaning “things listened to.”  Some writers suggest that the Pythagoreans would begin each morning by mentally rehearsing the day ahead and preparing themselves with the ideas which would help them act in an enlightened way.  Pythagoras flourished around 500BC, however, a similar daily regime seems also to have been adopted by the Stoics, and to still be in use by them over half a century later.

      Seneca, a Stoic philosopher and one of the greatest and most influential essayists of all time, was a Roman politician at time Jesus Christ and his disciples purportedly lived.  He discusses the exercise of mental preparation many times in relation to distressing life events, 

[…] we need to envisage every possibility and to strengthen the spirit to deal with the things which may conceivably come about.  Rehearse them in your mind: exile, torture, war, shipwreck.  (Seneca, Letter XCI) 

With regard to such blows of fate, which were common risks during his lifetime, Seneca writes, 

Escape them you cannot, scorn them you can.  And scorn them you will if by constant reflection you have anticipated future happenings.  Everyone faces up more bravely to a thing for which he has long prepared himself, sufferings, even, being withstood if they have been trained for in advance.  Those who are unprepared, on the other hand, are panic-stricken by the most insignificant happenings.  We must see to it that nothing takes us by surprise.  And since it is invariably unfamiliarity that makes a thing more formidable than it really is, this habit of continual reflection will ensure that no form of adversity finds you a complete beginner.  (Seneca, Letter CVII) 

Plutarch, a Roman philosopher of the early second century AD, writes in his essay On Contentment, 

Whoever it was who said, “Fortune, I have made a pre-emptive strike against you, and I have deprived you of every single loophole,” was not basing his confidence on bolts, locks and fortifications, but on principles and arguments which are available to anyone who wants them.  […] a mind which trains and strains itself to use rationality to conceive an image of illness and pain and exile will find that there is plenty of unreality, superficiality and unsoundness in the apparent problems and horrors each of them has to offer, as detailed rational argument demonstrates.  (Plutarch, On Contentment, 476C) 

He adds, “distress can be avoided by the beneficial practice of training oneself to gain the ability to look straight at fortune with open eyes.”  Likewise, the Stoic emperor Marcus Aurelius opens his personal therapeutic journal with a record of his use of mental preparation.  He writes to himself, 

Begin each day by telling yourself: Today I shall be meeting with interference, ingratitude, insolence, disloyalty, ill-will, and selfishness […] 

After reminding himself of the possible challenges he will face, as Emperor and general, he proceeds to rehearse his coping strategies, the beliefs which will help him see things more constructively, 

[…] none of those things can injure me, for nobody can implicate me in what is degrading.  Neither can I be angry with my brother or fall foul of him; for he and I were born to work together, like a man’s two hands, feet, or eyelids, or like the upper and lower rows of his teeth.  (Marcus Aurelius, 2:1) 

Marcus makes it clear that his mental preparation involves having his principles “ready to hand” (procheira), 

Take no enterprise in hand at haphazard, or without regard to the principles governing its proper execution.  (Marcus Aurelius, 4:2) 

The principles of right action are clearly thought of as affirmations or autosuggestions, by repeating them and contemplating them deeply, the Stoic absorbs their meaning at an experiential level. 

Your mind will be like its habitual thoughts; for the soul becomes dyed with the colour of its thoughts.   (Marcus Aurelius, 5:16) 

Positive affirmations such as these, however, have to be constantly reinforced, 

Principles can only lose their vitality when the first impressions from which they derive have sunk into extinction; and it is for you to keep fanning these continually into fresh flame.   (Marcus Aurelius, 7:2)

These are just a few of the comments found in classical authors which clearly relate to this theme of premeditation as a psychological and therapeutic exercise.  The analogies with modern psychotherapy are very apparent, as the remarks by Eysenck and Ellis show.  However, a great many other links can be found, or forged, between ancient and modern thought with regard to the therapy of the soul.

Marcus Aurelius on Empathy

(Excerpt from Marcus Aurelius, The Meditations, Book 11 §18, translation by D. Robertson (c) 2009)

When offended by other people’s actions,

1. Remember the close bond between yourself and the rest of mankind…
2. Think of the characters of those who offend you at the table, in their beds, and so on. In particular, remember the effect their negative way of thinking has on them, and the misplaced confidence it gives them in their actions.
3. If what they’re doing is right, you’ve no reason to complain; and if it’s not right, then it must have been involuntary and unintentional. Because just as “no-one ever deliberately denies the truth,” according to Socrates, so nobody ever intentionally treats another person badly. That’s why these negative people are themselves insulted if anyone accuses them of injustice, ingratitude, meanness, or any other sort of offence against their neighbours -they just don’t realise they’re doing wrong.
4. You yourself, are no different from them, and upset people in various ways. You might avoid making some mistakes, but the thought and inclination is still there, even if cowardice or egotism or some other negative motive has held you back you from copying their mistakes.
5. Remember, you’ve got no guarantee they’re doing the wrong thing anyway, people’s motives aren’t always what they seem. There’s usually a lot to learn before any sure-footed moral judgements can be made about other people’s actions.
6. Tell yourself, when you feel upset and fed up, that human life is transient and only lasts a moment; it won’t be long before we’ll all have been laid to rest.
7. Get rid of this, make a decision to quit thinking of things as insulting, and your anger immediately disappears. How do you get rid of these thoughts? By realising that you’ve not really been harmed by their actions. Moreover, unless genuine harm to your soul is all that worries you, you’ll wind up being guilty of all sorts of offences against other people yourself.
8. Anger and frustration hurt us more than the things we’re annoyed about hurt us.
9. Kindness is an irresistible force, so long as it’s genuine and without any fake smiles or two-facedness. Even the most stubborn bad attitude is nothing, if you just keep being nice to the person concerned. Politely comment on his behaviour when you get the chance and, just when he’s about to have another go at you, gently make him self-conscious by saying “No, my son; we’re not meant for this. I’ll not be hurt; you’re just hurting yourself.” Subtly draw his attention to this general fact; even bees and other animals that live in groups don’t act like he does. Do it without any hint of sarcasm or nit-picking, though; do it with real affection and with your heart free from resentment. Don’t talk to him harshly like a school teacher or try to impress bystanders but, even though other people may be around, talk as if you’re alone together in private.

Keep these nine pieces of advice in mind, like nine gifts from the Muses; and while there’s still life in you, begin at last to be a man. While guarding yourself against being angry with others, though, be just as careful to avoid the opposite extreme, of toadying. One’s just as bad as the other, and both cause problems. With bouts of rage, always remind yourself that losing your temper is no sign of manhood. On the contrary, there’s more strength, as well as more natural humanity, in someone capable of remaining calm and gentle. He proves he’s got strength and nerve and guts, unlike his angry, complaining friend. Anger’s just as much a sign of weakness as bubbling with tears; in both cases we’re giving in to suffering.

Finally, a tenth idea, this time from the very leader of the Muses, Apollo himself. To expect bad men never to do bad things is just madness; it’s asking the impossible. And to let them abuse other people, and expect them to leave you alone, that is arrogance.