In addition to the maxim of Epicurus, Marcus mentions many Stoic strategies for bearing pain and illness by viewing them with studied indifference. Most of these strategies were influenced by the Discourses of Epictetus.
1. Separate your mind from the sensation, which I call “cognitive distancing,” by reminding yourself that it is not things, or sensations, that upset us but our judgments about them.
2. Remember that the fear of pain does more harm than pain itself, or use other forms of functional analysis to weigh up the consequences for you of fearing versus accepting pain.
3. View bodily sensations objectively (objective representation, or phantasia kataleptike) instead of describing them in emotive terms. (“There’s a feeling of pressure around my forehead” versus “It feels like I’m dying—an elephant might as well be stamping over and over on my head!”)
4. Analyze the sensations into their elements and limit them as precisely as possible to their specific site on the body, thereby using the same depreciation by analysis that we used in the previous chapter to neutralize unhealthy desires and cravings. (“There’s a sharp throbbing sensation in my ear that comes and goes,” not “I’m in total agony.”)
5. View the sensation as limited in time, changeable, and transient, or “contemplate impermanence.” (“This sensation only peaks for a few seconds at a time and then fades away; it will probably be gone in a couple of days.”) If you have an acute problem like toothache, you’ll have forgotten what it felt like years from now. If you have a long-term problem such as chronic sciatica, you’ll know it sometimes gets worse and so at other times it must be less severe. It makes a difference if you can focus on the notion that this shall pass.
6. Let go of your struggle against the sensation and accept it as natural and indifferent, what is called “Stoic acceptance.” That doesn’t mean you shouldn’t take practical steps to deal with it, such as using medication to reduce pain, but you must learn to live with the pain without resentment or an emotional struggle.
7. Remind yourself that Nature has given you both the capacity to exercise courage and the endurance to rise above pain and that we admire these virtues in other people, which we discussed in relation to contemplating and modeling virtue.
We’ll look at each of these strategies in turn. COGNITIVE DISTANCING
The most important pain-management strategy mentioned by Epictetus and Marcus is the one we’ve called “cognitive distancing.” It’s summed up in a phrase that will already be familiar to you: “It’s not events that upset us but our judgments about events.”17 If we apply that to the concept of pain, it means that the pain isn’t what upsets us but rather our judgments about it. When we suspend the activity of assigning value judgments to the pain, our suffering is alleviated. It’s always within our power to do this in any situation—it’s up to us how much importance we choose to invest in bodily sensations.
Marcus describes the suspension of value judgments as the “withdrawal,” “separation,” or “purification” (katharsis) of the mind from, in this case, bodily sensations of pain and illness. He also likes to explain the suspension of judgment by saying that pain and pleasure should be left where they stand, in the parts of the body to which they belong. Even if the body, the closest companion of the mind, is “cut or burned, or festers or decays,” we can preserve our ruling faculty in a peaceful state as long as we don’t judge bodily sensations as being intrinsically good or bad.18
Marcus also calls this being “indifferent to indifferent things.”19 There’s a particularly important passage where he spells out the subtleties of Stoic psychology in this regard.20 We should keep our ruling faculty undisturbed by external things, including bodily sensations of pain and pleasure. He says this means not allowing it to unite with them but rather drawing a line around the mind, marking its boundaries, with bodily sensations on the other side, as if viewed from a distance—over there. On the other hand, when we allow ourselves to make strong value judgments about external sensations such as pain, we merge our minds with them and lose ourselves in the experience of suffering.
It’s important to note that Marcus isn’t asking us to deny that pain (or pleasure, for that matter) is part of life, even for the Stoic wise man. He notes that sensations of pain and pleasure will inevitably find their way into our consciousness because of the natural sympathy that exists between the mind and the body. He stresses that you should not try to suppress the sensations, because they are natural, and you should not assign judgments to them as good or bad, helpful or harmful. This delicate balance is central to modern mindfulness and acceptance-based cognitive therapy, which teaches clients neither to suppress unpleasant feelings nor to worry about them. Instead, you should learn to accept them while remaining detached from them.
For Marcus, what matters is that we stop looking at pain and illness through the lens of harm. Those judgments originate within us. They are projected outward onto bodily sensations and other external events. It’s important to remember that whether we view something as helpful or harmful depends entirely upon our goals. Most people take for granted assumptions they have about their goals in life, so much so that they are rarely aware of them. If my goal is to look handsome, then if I break my nose, I’m bound to view it as harmful rather than helpful. But if my most cherished goal is survival and I break my nose while narrowly escaping certain death, I’d probably view it with relative indifference. The Stoics want us to go through a radical upheaval in our underlying values so that our supreme goal is to live with wisdom and its accompanying virtues. They want us to treat physical pain and injuries with indifference. In fact, these misfortunes can even provide an opportunity for us to exercise greater wisdom and strength of character. Marcus tells himself:
Do away with the judgment, and the notion “I have been harmed” is done away with; do away with that notion, and the harm itself is gone.21
So do the Stoics not care at all about physical health? Yes, they do. They classify it as a preferred indifferent. It’s natural and reasonable for us to prefer health to sickness. Physical health provides us with more opportunity to exercise our will and influence external events in life. In itself, health is not really good or bad. It’s more like an opportunity. A foolish person may squander the advantages good health provides by indulging in his vices. A wise and good person, by contrast, may use both health and illness as opportunities to exercise virtue. Was Epictetus “harmed” when his leg was broken if we suppose that this was one of the events that set him on the path to becoming a great philosopher? He would say that what matters, ultimately, is the harm we do to our own character. By comparison, a mangled leg is trivial.
If we can learn to withhold our judgment that pain is terrible or harmful, then we can strip away its horrific mask, and it no longer appears so monstrous to us.22 We’re just left with the banal observation that our flesh is being stimulated “roughly,” as Epictetus liked to put it. It’s just a sensation. Through our judgment that it is intrinsically bad, unbearable, or catastrophic, though, we escalate the mere sensation of bodily pain into the inner turmoil of emotional suffering. For instance, Marcus elsewhere addresses (apostrophizes) his impressions and bodily sensations, saying,