The Christian Gospel offers healing and peace to the troubled. Jesus gives a gracious invitation in Matthew 11: 28–30, “Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light.” And Paul promises in Philippians 4: 6–7, “Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” Passages like these give the impression that accepting salvation and committing our concerns to God will bring healing and peace to our minds.
But many Christians do not experience this promised peace. Thousands of Christians suffer from anxiety, depression, and other mental illnesses. The healing we receive in our relationship to God does not always bring healing in all areas of our lives. Where, then, does the troubled Christian turn for help with mental illness? One of the most popular current approaches to finding healing for the psychologically distressed is cognitive therapy. Albert Ellis and Aaron Beck constructed the theoretical basis for this therapy, and David Burns popularized it in his 1980 bestseller Feeling Good. Cognitive therapy focuses on the role that our perceptions or cognitions play in mental illness. It asserts that a correction of faulty cognitions will lead to improved mental health. Cognitive therapists believe that with the right teaching and coaching our minds have the ability to achieve accurate perceptions and therefore find healing and happiness.
Cognitive therapy starts with the assertion that all of our moods are created by our cognitions or thoughts. The depressed person’s thoughts are dominated by a pervasive negativism. These negative thoughts always contain gross distortions. Consequently depression is caused by an inaccurate perception of reality (Burns 1980, 12–13). Depression is thus primarily a problem with our thoughts and not our feelings. Negative feelings are simply the result of negative thoughts. And where do negative thoughts come from? They are not caused by negative events, but rather by the way we interpret and respond to such events (Burns 1980, 28–30).
Cognitive therapists want to focus our attention on how we think about reality, how we experience life, and how we interpret what happens to us everyday. Burns compiles a list of ten common cognitive distortions. These ten cognitive distortions account for most if not all the faulty reasoning that causes depression. It would be too tedious to list and explain all of these cognitive distortions here, but two can illustrate how they work:
“All-or-Nothing Thinking” is the tendency to evaluate everything in extreme black-or-white categories. Burns gives an example of a politician who lost a race for governor and concluded that he was “a zero” and a straight A student who decided she was a total failure because she received a B on an exam (Burns 1980, 32–33). We all have heard people express sentiments like these and have probably sometimes thought them ourselves. All-or-Nothing thinking is as common as it is destructive.
“Jumping to Conclusions” involves arbitrarily jumping to conclusions not justified by the facts. Burns distinguishes two varieties of this error: the mind reader and the fortune teller. The mind reader reads thoughts into other people’s minds, but these thoughts are often contrary to what they are really thinking. A speaker who notices one listener in the front row dozing off during his lecture concludes that the whole audience thinks he is a bore, when, in fact, most of the audience is very interested and attentive. A woman whose friend ignores her when they meet on the sidewalk concludes her friend doesn’t like her anymore, when in fact she was just temporarily distracted at the moment they met. Reading our negative thoughts into other people’s minds is an inaccurate and self-defeating endeavor (Burns 1980, 36).
We commit the fortune teller’s error when we think that we can predict the future and expect only negative things to happen to us. A librarian who suffered from anxiety attacks thought she was going to pass out or go crazy the next time she had an attack, even though there was no evidence to support these fears. A depressed physician decided to give up his practice because he was convinced that he would always feel miserable regardless of any treatment he received (Burns 1980, 37).
Throughout his lengthy discussion of the ten cognitive disorders, Burns stresses that we must learn how to deal effectively with people and situations that tend to upset us. He asserts that critical comments from other persons can never upset us; only our own thoughts can put us down or get us frustrated. Another way of saying this is that other people can never make us angry; anger is created by our own cognitions. Our feelings result from the meaning we give to an event, not the event itself (Burns 1980, 132–133, 154). Therefore, if we learn to control our own responses to criticism and other negative events, we can prevent anger and frustration from taking control of our lives. Changing our cognitions about such difficult situations enables us to gain a new control over how we act and feel.
In the second half of his book, Burns prompts the reader to probe more deeply into his attitudes and perceptions to uncover the underlying assumptions that contribute to depression. He lists seven attitudes that can become dysfunctional and contribute to depression: approval, love, achievement, perfectionism, entitlement, omnipotence, and autonomy (Burns 1980, 285–289).
Burns calls the person who has a problem in regard to love a “love junkie.” Such a person is overly dependent on the love he receives from other people. He thinks he cannot be happy or even survive without such love. Often this craving for love has the opposite of its intended effect and drives others away instead of attracting them. Most people are uncomfortable trying to supply this neurotic person with enough love to satisfy his unquenchable thirst for affection (Burns 1980, 285–289).
Burns responds to the love junkie by claiming that, although everyone wants to be loved, love is not an adult human need. People can and do live happy, successful lives without being loved. He also points out that love is not an effective anti-depressant, because most of the suicidal patients he treats are loved very dearly by their families and friends (Burns 1980, 322). His advice, therefore, is that we should learn to live without expecting to receive love from others and being dependent upon such love for our happiness. We should instead seek to build a happy, fulfilled life that is not dependent on how others treat us. If we receive love we can enjoy and celebrate it, but if we don’t we can live a full and rich life without it.
Another example is the individual who is very dependent on her achievement for her sense of well-being. Such a person is a workaholic whose sense of self-worth and capacity for joy are dependent on her productivity and success. This person can never be happy or content unless she is productive and successful (Burns 1980, 286). In a chapter called “Your Work Is Not Your Worth,” Burns refutes the notion that our value as human beings depends on how much we accomplish. He calls the assumption that our achievement is the measure of our worth “self-defeating, grossly inaccurate, and malignant” (Burns 1980, 327). He further points out that there is no causal relationship between success and happiness. There is no proof that a person’s happiness automatically rises with her level of success in life (Burns 1980, 330). We must never measure a person’s worth in terms of how much she has achieved.
Albert Ellis and Aaron Beck, the theoreticians behind cognitive therapy, both acknowledge that Stoic philosophers inspired their theories about the cognitive role in human emotion. Beck traces the philosophical origins of cognitive theory specifically to philosophers such as Zeno, Seneca, Epictetus, and Marcus Aurelius (Beck et al 1979, 8). Ellis, too, credits Stoics such as Epictetus and Marcus Aurelius with many of the principles of cognitive therapy, especially the basic assertion that people are not affected by outside events, but by their perceptions and attitudes about those events (Ellis 1962, 35, 53–54). In his 1962 book Reason and Emotion in Psychotherapy, Albert Ellis observed:
By direct statement and by implication, then, modern thinkers are tending to recognize the fact that logic and reason can, and in a sense must, play a most important role in overcoming human neurosis. Eventually, they may be able to catch up with Epictetus in this respect, who wrote—some nineteen centuries ago—that “the chief concern of a wise and good man is his own reason.” (Ellis 1962, 109)
Zeno started the Stoic school of philosophy in Athens around 300 bc. Chrysippus, who died about 205 bc, was the most important early Stoic philosopher, developing a comprehensive and systematic exposition of Stoic ideas. Since we possess only fragments of Zeno’s and Chrysippus’s writings, however, later Roman Stoics such as Epictetus and Seneca are essential sources for understanding Stoic ideas. Although early Stoics such as Chrysippus formulated an extensive philosophical system including logic, physics, and ethics, the Stoics were most famous for their ideas about how to live an effective life. The Stoics believed that the rational part of humanity was all that mattered and that achieving and maintaining the virtue of the rational soul was an individual’s chief purpose. They regarded emotions as the primary evil that disturbed reason and prevented the cultivation of virtue; therefore, their aim was to teach how to control emotion.
The Stoics believed that negative emotions are caused by unconscious judgments we make based on impressions from our experiences. They argued that it is a mistake to assign positive or negative value to these impressions because all events are actually indifferent (Sellars 2006, 67–68). The true Stoic was not affected by illness or death or imprisonment, because he believed such external events could not affect his soul or his virtue. All such external events are therefore immaterial to happiness. The philosopher was a physician of the soul, seeking to bring it to health by ridding it of negative emotions (Sellars 2006, 34). Thus we could plausibly claim—in today’s terms—that some of the Stoics were as much psychotherapists as they were philosophers. Their concerns were very concrete and practical.
Epictetus, one of the most well-known of the Roman Stoics, claimed: “Men are disturbed not by things, but by the views which they take of things” (Epictetus 1944, 333). Both Aaron Beck and Albert Ellis quote this very passage (Beck et al 1979, 8 and Ellis 1962, 54). Epictetus’s point is also almost identical to Burns’s claim that negative events cannot anger or depress us, but that only our reactions to those events disturb us. At another point Epictetus commented: “What is it to be reviled, for instance? Stand by a stone and revile it, and what will you get by it? If you, therefore, would listen only as a stone, what would your reviler gain? But if the reviler has the weakness of the reviled for a vantage point, then he carries his point” (Epictetus 1944, 66). This reminds us of David Burns’s claim that the critical comments of another person can never upset us. It is only our thoughts in response to the criticism that make us angry and upset.
Seneca is another source of Stoic teachings. He remarked: “None can be despised by another unless he is first despised by himself” (Seneca 1958, 126). This is another precursor to David Burns’s assertions that we should not be overly dependent on our need for love and approval from other people. We should have enough self-esteem that other’s comments and actions will not disturb us. Seneca again: “The sage is neither elated by prosperity nor depressed by adversity. His endeavor always is to rely mainly on himself and to seek his whole satisfaction from within himself” (Seneca 1958: 111). Here again we are reminded of cognitive therapy’s insistence that we not rely on achievement or success for our feelings of self-worth. Instead, we should have a secure internal sense of our own value that is not disturbed by outward events.
Finally, Emperor Marcus Aurelius wrote: “It is in our power to refrain from any opinion about things and not to be disturbed in our souls; for things in themselves have no natural power to force our judgments” (Aurelius 1945, 66). Here is another clear parallel to Burns’s argument that we must be free to evaluate our experiences and form our own cognitions about that experience. Both the Stoic philosopher and the cognitive therapist agree that the healthy person has the ability to rise above his experiences, evaluate them in his own terms, and not allow them to determine his attitudes and feelings.
When we move from cognitive therapy and Stoic philosophy to the Christian tradition, we enter a very different world. Scripture describes the human as a weak and sinful creature in desperate need of the mercy and love of God. Humanity’s basic problem is not simply a distortion of thought, but a condition of alienation and slavery that can be remedied only by the salvific initiative of a gracious God. Instead of an individual able to achieve healing through reformed thinking, we see a creature mired in sin and subject to forces that no human can control. The path to healing and salvation for such a creature is very different from the path advocated by the Stoic philosopher and the cognitive therapist.
The Stoic ideal was complete self-control or self-mastery (egkrateia). Such self-control enabled the sage to prevent his mind from being constantly agitated and disturbed by upsetting emotions. Some of the Stoics, in fact, argued for complete freedom from all emotion (apatheia). And, since the body is an inferior part of the human being, physical pain and illness should not be a concern. Physical ailments cannot affect our rational soul. This ideal is not as pronounced in cognitive therapy as in the Stoics, but there is once again an emphasis on self-control and the power of the mind to prevent outward and physical events from disturbing the inner peace that the mature individual has achieved.
By contrast, the healthy person in biblical religion is one who has found his peace and security in a new relationship with God, and the mature believer is one who participates fully in the physical and emotional life of the created order. The idea of emotional self-control is not central in Christian faith. Rather, persons in the Bible fully experience a wide range of feelings from grief and guilt to joy and gratitude. There is no disparagement of feeling in the Bible. Just a cursory reading of the Psalms is enough to prove this. The Psalms express fear, anger, doubt, depression, peace, joy, contentment, and almost any emotion we can imagine. The Stoic would have rejected with disgust the kind of emotion shown in the Psalms. Just try to imagine a Stoic reading a Psalm of lament!
All of this challenges a part of both Stoic and cognitive therapeutic theory. Is it true, as Burns claims, that love is not an adult human need? Can a mature person be so self-reliant that he does not depend on the care that other people take for him? Can the Stoic who claims to feel no pain at his own child’s death find any real joy in his child’s life? Can I be so strong and self-satisfied that my success or failure does not really matter to me anymore? Some weakness, some need, some vulnerability are inherent in the human condition. Someone who does not grieve deeply at a loved one’s death or feel serious pain at one’s own failure seems somehow less human and mature than someone who does. God did not intend us to be automatons moving through life without any feelings, but rather sensitive and vulnerable beings who find deep joy in meaningful relationships and profound satisfaction in significant personal achievement.
Having noted these significant differences, we also need to acknowledge some common ground between the Stoics and the cognitive therapists on the one hand and Christianity on the other. In searching for such common ground we are doing nothing new, for many of the Church Fathers drew on ideas from the Stoics in their own ethical discussions. Richard Sorabji has studied the relationship between Stoic philosophy and early Christianity. He points out that the Church Fathers converted the Stoic theory about how to avoid negative emotions into a theory about how to avoid temptation (Sorabji 2000, 8). Just as the Stoics taught that emotion is a result of a mental judgment or conscious determination, some of the Church Fathers explained that a temptation does not become a sin until one has given it conscious approval. Sorabji cites Origen, Jerome, and Evagrius as Christian thinkers who extensively used Stoic concepts in their discussions of temptation (Sorabji 2000, 350–367).
When we search the Old Testament to see what it has to say about the human mind we may at first be surprised and disappointed to find out that there is not even a Hebrew word for brain or mind. The heart is instead the center of our being, and the biblical picture of the heart is not good: “The heart is deceitful above all things and beyond cure. Who can understand it” (Jeremiah 17:9)? But the focus on the heart does not eliminate concern for our rational capabilities. The Old Testament Hebrew words for heart include everything we ascribe to the head and brain: perception, understanding, reason, insight, reflection, judgment and discernment. In fact, reasoning and discernment play an important role in the wisdom literature that makes up a significant part of the Hebrew Bible. If God is acknowledged as the source of wisdom, the person who stands in a reconciled relationship to that God is capable of observing and understanding many important things about human life. Some of the statements of biblical wisdom even align with Stoic and cognitive therapeutic thought: “A fool shows his annoyance at once, but a prudent man overlooks an insult” (Proverbs 12:16). There is at least one mention, too, of the value of self-control: “Like a city whose walls are broken down is a man who lacks self-control”(Proverbs 25:28).
The New Testament, too, contains positive statements about the human mind. Paul called for our transformation by the renewal of our minds in Romans 12:2. Further, the central concept of repentance (metanoia) means essentially a changing of one’s mind. There is therefore a clear implication that the redeemed mind can and should play an important part in Christian living. But we look in vain for a clear and detailed explanation of how that takes place. And maybe that should not trouble us. The Bible, after all, is not a book of philosophy, nor a manual for therapeutic psychology. If Christians can use medical doctors to find physical healing they should be able to use psychologists to find mental healing.
Even some Christian therapists and thinkers argue that cognitive therapy is an appropriate tool for the Christian to use. Dr. William Backus, a licensed psychologist and ordained Lutheran pastor, warns that Albert Ellis’s use of reason can lead to error and that his ideas about right and wrong contradict Christian teaching, but then goes on to advocate an approach that combines talk therapy and cognitive therapy (Backus 1995, 21–22). Siang-Yang Tan, a professor in the School of Psychology of Fuller Theological Seminary, also attempts to include the best insights of cognitive therapy in a Christian approach to dealing with mental illness. Tan and John Ortberg argue that irrational thoughts are one important cause of depression but not the only one. Christians must also learn to see themselves as God sees them (Tan and Ortberg 1995, 71–73). There is some agreement, then, among Christians that it may be appropriate and effective for troubled Christians to use the contributions of cognitive therapy as they seek healing for their troubled minds.
Christians cannot accept the Stoic’s denigration of the body and failure to recognize the need for forgiveness and grace from God. Some of the more extreme statements of cognitive therapy also contradict Christian beliefs. The cognitive therapist has no room in his system for genuine guilt or the vulnerability without which we cannot be wholly human. But, recognizing these limits, there is much in cognitive therapy that can and should be useful for the troubled Christian as he or she seeks growth and healing. Wisdom about how to live joyful and productive lives can come from many sources, since God is the final source of all truth.
Daniel Boerman is a graduate of Calvin Theological Seminary. He works at home as a freelance writer.
Aurelius, Marcus. Marcus Aurelius and His Times. George Long, tr. Irwin Edman, ed. Roslyn, New York: Walter J. Black, 1945.
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Epictetus. Epictetus: Discourses and Enchiridion. Thomas Wentworth Higginson, tr. Irwin Edman, ed. Roslyn, New York: Walter J. Black, 1944.
Sellars, John. Stoicism. Los Angeles: University of California, 2006.
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Sorabji, Richard. Emotion and Peace of Mind: From Stoic Agitation to Christian Temptation. New York: Oxford University, 2000.
Tan, Siang-Yang and John Ortberg. Coping with Depression: The “Common Cold” of the Emotional Life. Grand Rapids: Baker, 1995.