Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK.
Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, UK.
Neurol Sci. 2023 Jun;44(6):1861-1869. doi: 10.1007/s10072-023-06651-w. Epub 2023 Feb 2.
Stoic philosophy has multiple parallels with cognitive behavioural therapy interventions. In their ancient texts, the Roman Stoics present a set of theoretical principles and behavioural strategies that are directly relevant to the clinical care of patients with a wide range of neuropsychiatric conditions. Mindfulness is a key component of the 'third wave' of modern psychotherapy that closely resembles the ancient Stoic practice of attention or 'concentration on the present moment'. Stoic mindfulness draws attention to one of the main principles driving both Stoicism and modern psychotherapy: the assumption that cognitive activity (reasoning) mediates emotions and behaviours. This principle can be traced back to Epictetus' Enchiridion, where he recognises that 'men are disturbed not by things, but by the views which they take of things'. It has been shown that cognitive behavioural therapies and mindfulness-based interventions directed at patients with neuropsychiatric disorders were originally developed as Stoic-inspired treatment interventions. Both Albert Ellis and Aaron Beck (the founders of rational emotive behaviour therapy and cognitive behavioural therapy, respectively) explicitly acknowledged the role of Stoicism as the philosophical precursor of their treatment approaches. The effective implementation of evidence-based guidelines would benefit from an increased awareness of the influence of the Stoic tradition of philosophical therapy on the treatment approaches currently in use in neuropsychiatry.
斯多葛哲学与认知行为疗法干预有多个相似之处。罗马斯多葛派在他们的古代文本中提出了一系列理论原则和行为策略,这些原则和策略与广泛的神经精神疾病患者的临床护理直接相关。正念是现代心理治疗“第三波”的一个关键组成部分,它与古代斯多葛派的注意力或“专注于当下”的实践非常相似。斯多葛派的正念引起了人们对推动斯多葛哲学和现代心理治疗的主要原则之一的关注:即认知活动(推理)调解情绪和行为的假设。这一原则可以追溯到爱比克泰德的《手册》,他认识到“人不是被事物打扰,而是被他们对事物的看法打扰”。事实证明,针对神经精神疾病患者的认知行为疗法和正念干预最初是作为斯多葛式治疗干预而开发的。理性情绪行为疗法和认知行为疗法的创始人阿尔伯特·埃利斯和亚伦·贝克都明确承认斯多葛哲学作为他们治疗方法的哲学先驱的作用。如果增加对斯多葛哲学治疗传统对神经精神病学中当前使用的治疗方法的影响的认识,那么循证指南的有效实施将受益于此。