Epictetus also said that we should actively accept sickness and painful feelings if they befall us (“Stoic acceptance”). He said that our feet, if they had minds of their own, would willingly be driven into the mud with each footstep we take, accepting it as a necessary part of their natural function.32 This recalls the early Stoic metaphor of the dog following the cart. A dog tethered to a moving cart can either pull on his leash and be roughly dragged along or accept his fate and run along smoothly beside the cart. Indeed, one of the earliest Stoic definitions of man’s natural goal is that it consists in a “smoothly flowing” life, free from unnecessary struggle. The concept of radically accepting unpleasant feelings has likewise become central to modern cognitive-behavioral therapy (CBT). Pain becomes more painful when we struggle against it, but the burden is often lightened, paradoxically, if we can accept the sensation and relax into it or even welcome it. Struggling to suppress, control, or eliminate unpleasant feelings adds another layer to our misery and frequently backfires by making the original problem worse.
Marcus actually imagines Nature herself as a physician, like Asclepius, the god of medicine, prescribing hardships to him as if they were painful remedies.33 To take Nature’s medicine properly, we must accept our fate and respond virtuously, with courage and self-discipline, thereby improving our character. So Marcus sees voluntarily accepting hardship as a psychotherapy of the passions. We must swallow the bitter pills of Fate and accept painful feelings and other unpleasant symptoms of illness when they befall us.
The Stoics were influenced in this regard by the older Cynic practice of voluntary hardship, as we’ve seen. They would deliberately expose themselves to discomfort, such as intense heat or cold, in order to develop psychological endurance. The paradox of accepting discomfort is that it often leads to less suffering. Diogenes the Cynic reputedly taught that we should treat painful sensations like wild dogs. They will bite and tear at our heels the more we try to flee in panic but will often back down if we have the courage to turn and face them calmly.
It is like the bite that one can get when one takes hold of a wild beast, says Bion [of Borysthenes]; if you grasp a snake by its middle, you will get bitten, but if you seize it by the head, nothing bad will happen to you. And likewise, he says, the pain that you may suffer as a result of things outside yourself depends on how you apprehend them, and if you apprehend them in the same way as Socrates, you will feel no pain, but if you take them in any other way, you will suffer, not on account of any of the things themselves, but of your own character and false opinions.34
However, most ordinary people unwittingly invite the assaults of Fortune by turning their backs in flight rather than confronting her face to face.
Dio Chrysostom, a Sophist who studied under the great Stoic teacher Musonius Rufus, compared the Cynic to a boxer who fares better if he prepares himself to be struck and to accept it with indifference. If, on the other hand, he shrinks anxiously away from his opponent, he will expose himself to a worse beating. Chrysostom also compared enduring pain to trampling out a fire—if we do it gingerly, we’re more likely to be burned than if we stamp on it confidently. Children even make a game of quenching flames on their tongues, he says, by doing it quickly and confidently. Today, we speak of “grasping the nettle” to make the point that facing something and accepting it often leads to less injury than approaching it hesitantly and defensively. (If you brush against a nettle, you’ll get stung; if you hold the nettle tight in the right way, pressing the sharp spines flat, you’ll prevent it from stinging you.) By calmly grasping the nettle of pain rather than struggling against it, resenting it, or complaining about it, we can learn to suffer less from it.
The Cynics and Stoics were thousands of years ahead of their time in proposing voluntary acceptance as a way of coping with pain and other unpleasant feelings. This acceptance has long been part of modern behavior therapy protocols for pain management, and in recent decades it’s become the central focus of many therapists dealing with these issues. Distraction can sometimes work for very brief (acute) pain, such as surgical procedures or dentistry, but avoidance strategies tend to backfire when used for coping with chronic pain. Like the Stoic dog following the cart, we have no real choice but to face our pain. Nevertheless, you can choose whether to do so roughly, struggling and fighting against it, or smoothly, through calm acceptance. Most people find that accepting pain greatly diminishes the emotional suffering it causes. Struggling with pain, trying to suppress or avoid it, consumes your time and energy, limits your behavior, and stops you from getting on with other things—so acceptance can also improve your quality of life in this respect. Moreover, in some cases, accepting our bodily sensations can allow natural habituation to take place, so that we begin to notice our pain less, and painful sensations may even begin to diminish as a result.
It’s therefore important to avoid struggling too much against painful or uncomfortable bodily sensations because there’s considerable evidence from modern psychology that doing so can be counterproductive. Researchers call this urge to control or avoid unpleasant feelings “experiential avoidance,” and it has proven quite toxic to mental health. People who strongly believe that unpleasant feelings are bad and try to suppress them from their minds often become more tense and preoccupied with the very feelings they’re trying to avoid, trapping themselves in a vicious cycle. For the Stoics, pain is “indifferent” and not bad. It’s therefore accepted as a natural process. In one graphic passage, Marcus tells himself that complaining about events is as futile and unhelpful as the kicks and squeals that piglets make as they struggle to free themselves during a ritual sacrifice.35 Struggling against things we can’t control does us more harm than good. CONTEMPLATING VIRTUE
Epictetus actually delivered a discourse titled “In What Manner We Ought to Bear Sickness.” In it he argues that pain and sickness are an inevitable part of life, and just as in any other part of life, there are relevant virtues, which are always within our power to exercise.
If you bear a fever well, you have all that belongs to a man in a fever. What is it to bear a fever well? Not to blame God or man; not to be afflicted at that which happens, to expect death well and nobly, to do what must be done: when the physician comes in, not to be frightened at what he says; nor if he says, “you are doing well,” to be overjoyed.36
Epictetus liked to tell his students that in the face of everything that befalls them, they should get into the habit of asking themselves what capacity, or virtue, they possess for making good use of the event. Similarly, cognitive therapists ask their clients, “What resources do you have that might help you to cope better with pain?” For example, if we’re faced with severe pain, then we will find that Nature has equipped us with the potential for endurance, and if we get into the habit of exercising that virtue, then the painful sensations will no longer have mastery over us.37
Another useful way to approach pain is to ask ourselves how someone experiencing the same kind of pain or illness we’re facing might cope with it more admirably (modeling virtue). What would we praise other people for doing in the same situation? Consider then to what extent we can do the same by emulating those strengths or virtues.
Like Epictetus, Marcus often stresses that many ordinary people show great courage and self-discipline in the service of worldly goals, such as greed or showing off to impress others.