Marcus also found it helpful to think of his pain as confined to a particular part of the body rather than allowing himself to become consumed by imagining it as more pervasive. Pain wants to dominate your mind and become the whole story. However, people who handle pain well usually view it objectively, as something more limited in nature, which makes it easier for them to see themselves coping with it in various ways. Indeed, elsewhere in The Meditations, Marcus adds a Stoic twist to Epicurus’s saying. “Pain is neither unendurable nor everlasting, if you keep its limits in mind and do not add to it through your own imagination.”13 The Stoics were typically happy to assimilate aspects of Epicureanism and other philosophical teachings, but they tweaked them to be more compatible with their own core doctrines. Marcus meant that pain is tolerable if we remember that our attitude toward it is what really determines how upset we become. It’s not our pains or illnesses that upset us but our judgments about them, as the Stoics would put it. This is one of the main therapeutic tools in the armamentarium of Stoic pain management.
Marcus also noted that most other forms of physical discomfort can be dealt with in essentially the same manner. He compares coping with pain to coping with difficulty eating and drowsiness, two problems we know he suffered from personally. He also mentions oppressive heat, bringing to mind the Cynic notion of learning to endure intense heat and cold. When faced with any of these discomforts, Marcus would simply warn himself, “You are giving way to pain.”14 Then he’d apply the same coping skills, whether he was struggling in a blizzard along the Danube or suffering fatigue from riding for days from his base at Aquileia in northern Italy to the legionary fortress of Carnuntum. Pain, discomfort, fatigue—they’re all just unpleasant sensations.
He was right. The skills people use to cope with pain—even very severe pain—are similar to ones that can be used to deal with other uncomfortable sensations. For instance, during ordinary forms of physical exercise, such as jogging or yoga, there are opportunities to practice essentially the same coping strategies. We can learn to tolerate the harmless sensations of fatigue and discomfort experienced while doing these sorts of activities. Taking cold showers also allows us to practice the same techniques. If we learn these strategies well enough, then we may be able to call upon them to cope with severe pain or serious physical injury in a crisis, even if we’re caught off guard. Everyday tolerance of minor physical discomforts can help us build lasting psychological resilience, in other words. You could call this a form of stress inoculation: you learn to build up resistance to a bigger problem by voluntarily exposing yourself repeatedly to something similar, albeit in smaller doses or a milder form.
Over time, Marcus observed many people around him afflicted by different illnesses and facing death in various ways. He also learned specific coping strategies and techniques from his Stoic teachers. Indeed, Marcus described several different Stoic strategies for dealing with pain and illness in The Meditations. The most important thing he observed in those individuals who coped well was their ability to “withdraw” or “separate” their mind from bodily sensations. We’ve already introduced this Stoic technique, which I’ve called cognitive distancing. It requires learning to withhold value judgments from unpleasant feelings, viewing them as morally indifferent, neither good nor bad in themselves, and ultimately harmless. This takes practice, of course, and an understanding of the underlying concepts.
It was mainly through the Stoic teachings of Epictetus that Marcus found a way to conceptualize this powerful technique. One of the most famous stories about Stoic endurance happens to be about Epictetus. He was originally a slave and came to be owned by Epaphroditus, a secretary to Emperor Nero. According to the Church Father Origen, Epaphroditus took hold of Epictetus in anger one day and cruelly twisted his leg. Epictetus didn’t react but remained completely composed. He merely warned his master that the bone was about to snap. Epaphroditus continued twisting it, and that’s exactly what happened. Rather than complain, Epictetus responded matter-of-factly: “There, did I not tell you that it would break?”
Epictetus alludes to his being lame in the Discourses but never mentions the cause. Instead, he uses his disability as an example to teach his students about coping with illness. Disease is an impediment to our body, he tells them, but not to our freedom of will unless we make it so. Lameness, he says, is an impediment to the leg but not to the mind.15 Epictetus was no more perturbed by his crippled leg than he was by his inability to grow wings and fly—he simply accepted it as one of the many things in life that were beyond his control. He viewed his lameness as an opportunity to exercise wisdom and strength of character. Later in life he gained his freedom and began teaching philosophy. Perhaps his master felt remorse. In any case, this story powerfully illustrates the famous indifference of Stoics to physical pain. If this story is true, Marcus would certainly have heard about it. HOW TO TOLERATE PAIN
It may seem natural to assume that pain is intrinsically bad, but the Stoics employ a barrage of arguments to persuade their followers that pain and pleasure are neither good nor bad. For instance, one way of illustrating the indifference of pain would be to point out that, like other externals, pain can be used either wisely or foolishly, for good or for bad. An athlete might learn to endure the pain and discomfort of extreme physical exertion. In that case, deliberately exposing themselves through hard exercise to painful, or at least uncomfortable, sensations might be something beneficial insofar as it helps them to build endurance. Of course, someone who avoids discomfort is probably going to avoid strenuous exercise. Pain and discomfort can become advantages in life if they provide opportunities for us to develop our strengths. It’s also true that many ordinary people, at certain times, exhibit indifference to pain—such as when they’re injured while saving their own life. Some people, of course, such as masochists, even enjoy the sensation of pain. Pain is just a sensation, in other words; what matters is how we choose to respond to it.
Epictetus tells his students how to cope with pain and illness several times in the Discourses. Like Epicurus before him, he believed that complaining and chattering too much about our problems just makes them worse, and, more importantly, it harms our character. Marcus agreed that collective whining is bad for the souclass="underline" “No joining others in their wailing, no violent emotion.”16 Modern cognitive therapists likewise find that distress escalates when people tell themselves “I can’t cope!” Their distress lessens when they begin looking at things more rationally and objectively and acknowledge various ways they can potentially cope now or have coped in a similar situation in the past. In part, this is an observation about the rhetoric of pain. We should be wary of telling ourselves “This is unbearable!” and so on, because that’s usually just hyperbole that adds to our sense of despair.
Epictetus tells his students that it’s one thing to have a pain in the head or in the ear, but they should not go a step further and say, “I have a pain in the head—alas!” They shouldn’t imply that the pain is some kind of catastrophe. He explained that he wasn’t denying them the right to groan, just that they shouldn’t do so inwardly by actually buying into the notion that they’ve been harmed. Just because a slave is slow in bringing them a bandage they shouldn’t cry aloud and torment themselves, complaining “Everyone hates me!” (“For who would not hate such a man?” he adds sardonically.) He summed up his practical advice by telling his students to respond to troubling events or unpleasant sensations by literally saying This is nothing to me. This perhaps overstates things. Stoics can still “prefer” to avoid pain and illness when possible. Once it’s already happening, though, they try to accept the fact with indifference.