Ancient spiritual exercises (Hadot) and care of the self

1. Introduction

Version followed: Pierre Hadot's account of ancient "spiritual exercises" as summarised from Exercices spirituels et philosophie antique (1981; English Philosophy as a Way of Life, 1995, trans. Michael Chase, introduction by Arnold Davidson) and his later works; the exercises themselves anchored in public-domain translations of Epictetus (T. W. Higginson) and Marcus Aurelius (George Long); Michel Foucault's "care of the self" (The Hermeneutics of the Subject, Collège de France lectures 1981–1982) as a related frame; and Donald Robertson's integration of Stoic techniques into CBT (2nd edn, Routledge, 2020) as the bridge into psychotherapy. [source: IEP, Pierre Hadot; Macmillan/Picador catalogue; Routledge catalogue]

This is not a psychotherapy. It is a historical and philosophical thesis, chiefly Hadot's, that ancient philosophy was practised as a way of life: a set of exercises, from forms of dialogue to meditative reflection and contemplation, repeated daily so as to change how a person lives and perceives, not only what they believe. Hadot called these exercises "spiritual" (sometimes "existential") to signal that they engage the whole person, and acknowledged that the word could suggest religious devotion. [source: IEP, Pierre Hadot] Ancient schools described their work as a therapy of the soul, each locating suffering differently: the Cynics in social constraint, the Epicureans in false pleasures, the Stoics in self-interest, the sceptics in false opinions. [source: IEP, Pierre Hadot] Foucault's late lectures examine how the self and the "care of the self" were conceived in antiquity from Socrates onward, as the background to modern ethics and subjectivity; Hadot's views on philosophy as a way of life influenced Foucault and also diverge from his (the details of that debate are not given here). [source: Macmillan/Picador catalogue; IEP, Pierre Hadot]

How change happens, as the tradition holds it: repeated, attentive practice of exercises (attention to the present, rehearsal of principles, examination of judgements, enlarging one's perspective) gradually re-habituates passions and desires and reshapes perception and conduct. [source: IEP, Pierre Hadot] In psychotherapy, Robertson presents Stoic exercises as the "philosophical origins" that CBT's founders named, usable alongside CBT, REBT and third-wave approaches. [source: Routledge catalogue] For the therapist this guide covers: using selected exercises inside an evidence-based treatment, supporting a client who practises them on their own or with a philosophical counsellor, and working with the meaning this way of life has for the client. Philosophical exercises are not presented here as a treatment for any mental disorder. [synthesis]

2. Framework

Hadot describes no clinical protocol, phases, session counts or durations; the ancient exercises were daily or continuous practices, not a course of sessions. [source: IEP, Pierre Hadot] Robertson's book includes an example "Stoic therapeutic regime" (Appendix I) whose content is not reproduced here [uncertain: not verified]. The following working framework for a psychotherapist is therefore [synthesis] throughout, built on the exercises the sources name.

Phase A: Assessment, fit and consent. Goal: establish the clinical formulation and the evidence-based treatment it calls for, then decide whether philosophical exercises add something (values, meaning, perspective, emotion regulation) and whether the client wants them. Move on when the client gives informed consent, risk is assessed (especially before death-related exercises), and the role of the exercises within the treatment plan is clear.
Phase B: Orientation. Goal: introduce the idea of philosophy as a way of life and the particular school the client is drawn to (most clinical material is Stoic), attributed and offered as a lens rather than a truth. Move on when the client can say in their own words what the exercise is for and how it relates to their goals.
Phase C: Core exercises in session. Goal: teach two or three exercises chosen for the formulation (for example dichotomy of control for worry, examining impressions for anger, view from above for rumination), practised live and debriefed. Move on when the client can run the exercise without prompting and reports what it changed.
Phase D: Daily practice between sessions. Goal: the morning preparation, attention during the day and evening review, supported by personal notes (hypomnemata). Review practice at the start of each session. Move on when practice is regular enough to evaluate and the client links it to observable change.
Phase E: Consolidation, review and ending. Goal: review progress against the client's own goals and the marks of progress the texts describe (for example less blaming of others), plan independent practice, and agree referral or ongoing study (reading group, philosophical counsellor, course) if wanted.

Format: individual therapy is the default; the exercises can also be adapted for groups by a clinician trained in group work. No source gives session numbers; set them by the treatment plan for the presenting problem. [synthesis]

3. Guiding principles

Philosophy as a way of life, not only as theory (Hadot). Practical meaning: judge an exercise by what changes in the client's daily conduct and perception, not by how well they can explain the doctrine. [source: IEP, Pierre Hadot]
Exercises engage the whole person and are repeated. Practical meaning: favour a few exercises practised daily over many tried once; use imagination and memorable phrasing as the ancients did. [source: IEP, Pierre Hadot]
Attention to the present is the key (Hadot calls constant attention to the present moment, in a sense, the key to spiritual exercises). Practical meaning: return each exercise to what the client can see, decide and do now. [source: IEP, Pierre Hadot]
Different schools, different diagnoses of suffering. Practical meaning: match the lens to the client (Stoic for judgement and control, Epicurean for fear and false needs, sceptical for dogmatic certainty) rather than treating "ancient philosophy" as one doctrine. [source: IEP, Pierre Hadot; application synthesis]
Concepts are attributed, not asserted. Stoic claims about providence, the cosmos as a whole, or the indifference of external goods are presented as what the Stoics held, neither stated as fact nor dismissed. Practical meaning: "the Stoics taught…", never "the truth is…". [synthesis]
Judgements, not events, are the working target (Epictetus, Enchiridion 5: men are disturbed "not by things, but by the views which they take of things"). Practical meaning: this converges with cognitive therapy's focus on appraisals; use it to explain why examining thoughts matters, without implying the client's distress is their fault. [source: Enchiridion, Higginson trans.; Routledge catalogue]
Sort what is up to us from what is not (Epictetus, Enchiridion 1). Practical meaning: direct effort toward one's own judgements, intentions and actions; respond to the rest with acceptance and problem-solving where possible. [source: Enchiridion, Higginson trans.]
The client is the author. Practical meaning: the client chooses which tradition, which exercises and which wording; the therapist does not convert the client to a philosophy or impose a value system. [synthesis]
Integration with evidence-based treatment. Practical meaning: exercises sit inside a formulation-driven plan (for example CBT); they do not replace first-line treatment for depression, anxiety disorders, trauma or other conditions. [source: Routledge catalogue for integration; synthesis for scope]
Safety before death-related practice. Practical meaning: assess suicidal ideation, recent bereavement and trauma before any meditation on death or premeditation of misfortune. [synthesis]
No ordeal or deprivation practices. Ancient Cynic and Stoic abstinence aimed to accustom followers to cold, heat and hunger. [source: IEP, Pierre Hadot] Practical meaning: the therapist does not prescribe fasting, cold exposure or physical hardship; such practices are discussed only as history, with screening for disordered eating and routing to medical and specialist guidance (cross-refer Domain X 196 on cold-water immersion). [synthesis]
Competence and roles. Practical meaning: teach only exercises you understand from the primary texts and can integrate with your licensed modality; if you are also a philosophical counsellor or teacher, keep the roles distinct. The APA Ethics Code, Standard 3.05, defines a multiple relationship and says a psychologist refrains from one that could reasonably impair objectivity, competence or effectiveness, or risks exploitation or harm. [source: APA Ethics Code; application synthesis]
Scope of philosophical counselling. Practical meaning: non-clinical philosophical counsellors are not licensed to diagnose or treat mental disorders; refer both ways according to need. [synthesis; see section 4, referral]

4. Intervention inventory

Hadot lists the ancient exercises as: practices of attention (prosoche), meditations (meletai), memorising dogmata (core principles), self-mastery (enkrateia), therapy of the passions, remembrance of good things, accomplishing duties, and cultivating indifference toward indifferent things; he also discusses premeditation of evils and death, concentration on the present, the view from above, "practical physics" (analysing an impression into its parts), writing personal notes (hypomnemata), and Socratic dialogue. [source: IEP, Pierre Hadot] Robertson's clinical "Stoic armamentarium" covers contemplation of the ideal sage, Stoic mindfulness of the here and now, self-analysis and disputation, autosuggestion, premeditation and retrospection, praemeditatio malorum and mental rehearsal, Stoic acceptance, and the view from above. [source: Routledge catalogue] Steps below are written for a psychotherapist; where they go beyond what the ancient texts or these sources describe, they are marked [synthesis]. Robertson's own scripts are not reproduced. Ancient quotations are from public-domain translations (Epictetus, Higginson; Marcus Aurelius, Long).

4.1 Assessment of fit, formulation and informed consent [synthesis]

Purpose / when: before any exercise; decides whether philosophical practice belongs in this treatment and how.
Steps: (1) Complete standard assessment and risk assessment; identify the evidence-based treatment indicated. (2) Ask what draws the client to ancient philosophy (reading, podcasts, a teacher, a crisis of meaning) and what they hope it will do. (3) Identify the target the exercises would serve (worry, anger, rumination, grief, loss of direction, values conflict). (4) Screen for factors that change the plan: active suicidal ideation, recent bereavement, psychosis or mania (cosmic or fatalistic ideas may feed it), obsessive scrupulosity (self-examination may become checking), disordered eating or interest in fasting and hardship practices. (5) Explain in plain terms what the exercises are, that they are drawn from philosophy rather than a tested treatment for their condition, how they fit the plan, and that they can stop at any time. (6) Record consent and the agreed role.
Example language (illustrative): "These exercises come from ancient philosophers, not from a clinical trial. We can use a few of them inside the treatment we've agreed, if they help, and drop them if they don't."
Watch for: a client hoping philosophy will let them avoid treatment they need; idealisation of "being a Stoic" as emotional suppression. Working: the client can state the exercise's purpose in relation to their own goal.

4.2 Orientation: philosophy as a way of life

Purpose / when: at the start, to frame exercises as practice, not doctrine. Draws on Hadot's thesis that ancient philosophy was a lived practice of transformation. [source: IEP, Pierre Hadot]
Steps: (1) Describe, briefly and attributed, Hadot's idea that ancient schools trained people through daily exercises. (2) Name the school that interests the client and its view of where suffering comes from (as in section 1). (3) Ask the client which idea from that school already resonates and which they reject. (4) Agree that the client will test ideas against their own experience. [steps 3–4 synthesis]
Example language (illustrative): "Hadot argued that for the ancients philosophy was something you practised every day, a bit like training. We'll treat these ideas as experiments, not beliefs you have to adopt."
Watch for: intellectualising (long discussions of doctrine with no practice); a sense of being preached at. Working: the client moves from "what did they mean" to "what would I do differently today".

4.3 Attention to oneself (prosoche)

Purpose / when: the foundation exercise; constant vigilance over one's own judgements and impulses. Hadot treats attention as, in a sense, the key to the exercises. [source: IEP, Pierre Hadot] Robertson discusses it as Stoic mindfulness of the here and now. [source: Routledge catalogue] Use for impulsive reactions, automatic negative thinking, and as a base for the other exercises.
Steps: (1) Agree on two or three cue situations in the client's day. (2) At each cue the client pauses and notes: what am I telling myself, what do I feel, what am I about to do. (3) The client then asks whether this response fits the principle they are practising. (4) Brief note in the client's journal. (5) Review notes in session. [steps synthesis]
Example language (illustrative): "When the meeting starts, just catch the first thing your mind says. You don't need to change it yet, only notice it."
Watch for: hypervigilance or self-monitoring that becomes anxious checking; confusing attention with suppression. Working: earlier noticing of reactions and more moments where the client chooses a response.

4.4 Concentration on the present moment

Purpose / when: to cut worry about the future and regret about the past by returning to the present, where, on Hadot's account, decision and freedom lie. [source: IEP, Pierre Hadot] Marcus Aurelius writes that "every man lives only this present time" (Book 3, Long trans.). [source: Meditations, Long trans.] Use for worry, rumination, overwhelm by long-term tasks.
Steps: (1) Identify a moment of being overwhelmed by the whole of a task or of life. (2) The client names what is actually present now (this hour, this action). (3) The client names the one action available now. (4) After acting, note the effect. Pair with standard CBT worry and rumination work. [steps synthesis]
Example language (illustrative): "Marcus reminded himself that we only ever live in the present moment. What is the piece of this that is in front of you right now?"
Watch for: use as avoidance of necessary planning; dismissing legitimate grief about the past. Working: lower worry and more task initiation.

4.5 The dichotomy of control

Purpose / when: Epictetus opens the Enchiridion: "There are things which are within our power, and there are things which are beyond our power" (ch. 1, Higginson trans.); in the Stoic view, one's own opinions, aims, desires and aversions are ours, while body, property, reputation and office are not. [source: Enchiridion, Higginson trans.] Use for worry, helplessness, resentment, perfectionism about outcomes.
Steps: (1) Write the troubling situation at the top of a page. (2) Divide into two columns: what is up to me (my judgements, intentions, actions) and what is not (others' choices, outcomes, the past). (3) For the first column, plan one action. (4) For the second, practise a short acceptance statement in the client's words. (5) Notice that many items are partly in the client's influence; mark these and plan the part that is theirs. [steps synthesis; the partial-control step is a common modern refinement, not from Epictetus]
Example language (illustrative): "Let's sort this the way Epictetus did: what here is genuinely up to you, and what isn't? Then we'll put your energy into the first list."
Watch for: use to justify passivity in the face of injustice or abuse ("it's not in my control"), especially where the client could seek safety or help; self-blame for not controlling feelings. Working: less time spent on uncontrollable outcomes, more concrete action on the controllable part.

4.6 Examining impressions before assenting

Purpose / when: Epictetus advises meeting each harsh impression by saying it is "but a semblance and by no means the real thing" and examining it "by those rules which you have" (ch. 1, Higginson trans.). [source: Enchiridion, Higginson trans.] Robertson covers self-analysis and disputation. [source: Routledge catalogue] Use for anger, anxiety spikes, shame, and as a philosophical frame for cognitive restructuring.
Steps: (1) Catch a strong first impression ("this is a disaster", "he insulted me"). (2) Name it as an impression, not yet a fact. (3) Ask: is this about something within my power or not? (4) Ask what a person of the character I want would conclude. (5) Only then decide on a response. In CBT, follow with the standard thought record or disputation. [steps 3–5 synthesis]
Example language (illustrative): "Before you agree with that thought, try telling it, 'You're an impression; let me look at you first.'"
Watch for: invalidating real threats or real mistreatment; using the exercise to talk oneself out of all emotion. Working: a gap between impression and reaction, fewer escalations.

4.7 Judgements, not things (cognitive reattribution)

Purpose / when: Epictetus writes that men are disturbed "not by things, but by the views which they take of things" (ch. 5, Higginson trans.), and that a philosopher "looks to himself for all help or harm" (ch. 48). [source: Enchiridion, Higginson trans.] Robertson traces this idea to the "philosophical origins" CBT's founders cited and to REBT. [source: Routledge catalogue] Use as a rationale for cognitive work and to reduce blaming.
Steps: (1) Take a recent upset and separate event from interpretation. (2) Name the judgement that made it painful. (3) Generate alternative judgements. (4) Rate the emotion again. (5) Discuss the limits: some events are terrible on any reasonable view, and the aim is a proportionate response, not indifference to harm. [steps synthesis]
Example language (illustrative): "Epictetus thought what hurts most is often the view we take of an event. Let's look at the view you took and see whether there are others that are just as true."
Watch for: victim-blaming of oneself ("it's my fault I'm upset about the assault"); do not use with fresh trauma or abuse. Working: the client spontaneously separates events from judgements.

4.8 Practical physics: objective description of an impression

Purpose / when: Hadot describes Stoic analysis of an impression into its matter, form and parts. [source: IEP, Pierre Hadot] Marcus Aurelius advises: "Make for thyself a definition or description of the thing which is presented to thee" (Book 3), and describes a purple robe as "some sheep's wool dyed with the blood of a shell-fish" (Book 6). [source: Meditations, Long trans.] Use for cravings for status objects, inflated fears, overvalued symbols.
Steps: (1) Choose an object, event or role the client overvalues or fears. (2) Describe it plainly, as a neutral observer would: what it is made of, what it consists of, how long it lasts. (3) Notice what the plain description changes in the feeling. (4) Discuss what value remains and why. [steps synthesis]
Example language (illustrative): "Marcus described a royal robe as wool dyed with shellfish. Can we describe this promotion just as plainly, and see what's left?"
Watch for: cynicism or devaluation of relationships and the body; do not apply to the client's body or appearance where body-image or eating concerns exist. Working: reduced intensity of craving or dread with values intact.

4.9 Premeditation of evils (praemeditatio malorum)

Purpose / when: imagining future misfortunes in advance to limit fear, anger or sadness when they come; Hadot cites Galen and Marcus. [source: IEP, Pierre Hadot] Robertson treats it with mental rehearsal. [source: Routledge catalogue] Use for anticipatory anxiety about a specific, likely event (a difficult meeting, a medical procedure) and to rehearse coping.
Steps: (1) Screen first: not for clients with generalised worry who already over-rehearse catastrophes, active suicidality, PTSD with intrusive imagery, or OCD, unless integrated into a formulated exposure plan by a trained clinician. (2) Choose a realistic, specific setback. (3) Imagine it briefly and concretely. (4) Shift to rehearsing one's best response: what is still in my power, what would I do, whom would I call. (5) End by returning to the present and something good in it. (6) Debrief anxiety before and after. [steps synthesis]
Example language (illustrative): "The Stoics rehearsed setbacks so they wouldn't be ambushed. Let's picture this one going badly for a moment, then spend most of our time on how you'd handle it."
Watch for: the exercise becoming worry itself (rising anxiety, repetition, reassurance-seeking); consent and a right to stop; distinguish clearly from formal exposure therapy, which has its own protocol and safety steps. Working: calmer anticipation and a concrete coping plan.

4.10 Meditation on death ("learning to die")

Purpose / when: Hadot reads Plato's Phaedo, where philosophy is learning how to die, as emblematic of the exercises. [source: IEP, Pierre Hadot] Epictetus: "Let death and exile, and all other things which appear terrible, be daily before your eyes, but death chiefly" (ch. 21, Higginson trans.). [source: Enchiridion, Higginson trans.] Marcus: "Do not act as if thou wert going to live ten thousand years" (Book 4), and regulate every act "as if it were the last" (Book 2). [source: Meditations, Long trans.] In therapy, the aim is clarity about priorities and reduced procrastination, not dwelling on death. Use for drift, postponement of what matters, existential concerns, with care.
Steps: (1) Mandatory screen: current or recent suicidal ideation, recent bereavement, terminal illness in the client or family, health anxiety. If present, do not use, or use only within specialist grief, palliative or existential work. (2) Frame the purpose: values and priorities. (3) Invite a brief reflection: if this were among my last days, what would I want to do, say, repair? (4) Translate into one action this week. (5) Close by grounding in the present. [steps synthesis]
Example language (illustrative): "Marcus kept in mind that life is short so he wouldn't waste it. Without dwelling on death, what would you stop postponing if you took that seriously?"
Watch for: any emergence of hopelessness, wishes to die or preoccupation with death: stop, assess risk using standard practice and safety planning, and give crisis resources (988 Suicide & Crisis Lifeline in the US; Samaritans 116 123 in the UK and Ireland). Working: concrete value-based actions, not increased distress.

4.11 Remembering that what we love is mortal

Purpose / when: Epictetus advises reminding oneself of the nature of what one loves, so that "if you embrace your child or your wife, that you embrace a mortal" (ch. 3, Higginson trans.); the Stoic aim was that loss would not overthrow the person. [source: Enchiridion, Higginson trans.; Stoic aim as stated there] In therapy, the usable kernel is appreciation and presence with loved ones. [synthesis]
Steps: (1) Do not use with recently bereaved clients, those with anticipatory grief, or with intrusive harm thoughts about loved ones (OCD). (2) Reframe toward appreciation: notice the person now, as someone not guaranteed forever. (3) Choose one act of presence or care. [steps synthesis]
Example language (illustrative): "The Stoics reminded themselves that the people they loved wouldn't be here forever. For you, could that be a reason to be more present with your daughter this evening?"
Watch for: the exercise being misread as an instruction not to grieve or not to love fully; Stoic detachment presented as a goal for grief. Grief work follows grief-specific guidance. Working: more appreciation, not emotional distance.

4.12 The view from above

Purpose / when: reconsidering one's life from a cosmic perspective, as in Cicero, Seneca, Boethius and Marcus. [source: IEP, Pierre Hadot] Marcus: "the whole earth is a point" (Book 4) and "Look down from above on the countless herds of men" (Book 9). [source: Meditations, Long trans.] Robertson gives a full chapter and a script (Appendix II, not reproduced here). [source: Routledge catalogue] Use for rumination about status, interpersonal slights, catastrophic over-importance of an event.
Steps: (1) Brief settling (comfortable posture, eyes open or closed by choice). (2) Guided imagery: the client imagines seeing themselves from just above, then the building, the city, the country, the earth, as perspective widens; pause at each level. (3) From the widest view, the client notices the problem's size relative to the whole and to the many lives being lived. (4) Return slowly to the room. (5) Debrief: what feels different about the problem; what remains important. [steps synthesis, in the outline Hadot and Marcus describe]
Example language (illustrative): "Let your view rise a little above where you're sitting... now take in the whole street... the city... From up here, how big is this morning's argument?"
Watch for: depersonalisation or dissociation (stop and ground); nihilism ("nothing matters") in depressed clients; never use to minimise abuse. Working: reduced intensity of rumination with the client still caring about what matters.

4.13 Retreat into oneself

Purpose / when: Marcus notes that people seek retreats in the country, by the sea and in mountains, while one can at any moment "retire into thyself" (Book 4). [source: Meditations, Long trans.] Use as a brief recovery practice in a stressful day.
Steps: (1) The client chooses two or three short principles that steady them (see 4.17). (2) In a stressful moment, they pause and silently recall these. (3) They return to the task. [steps synthesis]
Example language (illustrative): "Marcus thought you could take a retreat without going anywhere, just by turning to a few principles you trust. Which two would you take with you?"
Watch for: withdrawal from people as avoidance. Working: shorter recovery after stressors.

4.14 Morning preparation

Purpose / when: Marcus begins Book 2: "Begin the morning by saying to thyself, I shall meet with the busy-body" and other difficult people, then reminds himself of his shared nature with them. [source: Meditations, Long trans.] Robertson covers autosuggestion and premeditation. [source: Routledge catalogue] Use for interpersonal irritability and a reactive day.
Steps: (1) Each morning the client briefly anticipates likely difficulties of the day. (2) Recalls the principle or virtue they want to act from. (3) Sets one intention. (4) Notes it in the journal. [steps synthesis]
Example language (illustrative): "Marcus started his day expecting difficult people so they wouldn't catch him off guard. What's one thing you can expect today, and how do you want to meet it?"
Watch for: turning into anxious forecasting or contempt for others. Working: fewer reactive episodes; client reports meeting difficulties "as expected".

4.15 Evening review (retrospection)

Purpose / when: a nightly review of the day's conduct, associated with Seneca's account of the practice of the philosopher Sextius in On Anger [uncertain: not verified]; Robertson covers retrospection alongside premeditation. [source: Routledge catalogue] Use for building self-awareness and learning without self-punishment.
Steps: (1) At day's end, the client reviews briefly: what went well, what did not, what to do differently. (2) The tone is that of a fair teacher, not a judge. (3) One lesson is written down for the morning. (4) Close the review and stop. [steps synthesis]
Example language (illustrative): "Look back at today the way a kind coach would: what did you do well, and what would you try differently tomorrow?"
Watch for: self-criticism, rumination before sleep, scrupulosity; if sleep is affected, move the review earlier, and treat insomnia with CBT-I (cross-refer II 069 and II 068). Working: shorter, kinder reviews that change next-day behaviour.

4.16 Writing personal notes (hypomnemata)

Purpose / when: Hadot reads the Meditations as notes Marcus wrote to himself to keep Stoic principles at hand. [source: IEP, Pierre Hadot] Use to support all other exercises.
Steps: (1) The client keeps a notebook for exercises, short principles in their own words and reflections. (2) Entries are for themselves, not for display. (3) Agree in advance what, if anything, they will share in session. [steps synthesis]
Example language (illustrative): "Marcus's book was really his private notebook. Yours can be the same: a few lines in your own words that you want to remember."
Watch for: perfectionism about writing; privacy risks if others may read it. Working: the client returns to entries spontaneously.

4.17 Memorising core principles (dogmata) and keeping them "at hand"

Purpose / when: Hadot lists memorising dogmata among the exercises. [source: IEP, Pierre Hadot] Use when the client needs portable reminders under stress.
Steps: (1) The client picks a few principles that genuinely move them (for example the dichotomy of control). (2) Puts each in a short sentence in their own words. (3) Places them where they will be seen (notes, phone). (4) Practises recalling them in calm moments first. [steps synthesis]
Example language (illustrative): "Let's boil it down to one line you'd actually remember in the middle of an argument."
Watch for: slogans used to override emotions. Working: the client recalls the line at the relevant moment.

4.18 Contemplation of the ideal sage (role model)

Purpose / when: Robertson describes contemplation of the ideal sage as a Stoic technique. [source: Routledge catalogue] The Stoics' sage is an ideal of wisdom (attributed, not asserted). Use for value-guided decisions.
Steps: (1) The client describes the qualities of a wise person, or a real exemplar they admire. (2) In a dilemma, they ask how that person would respond. (3) Choose an action and review it later. [steps synthesis]
Example language (illustrative): "Think of someone whose judgement you trust. What would they do here?"
Watch for: unfavourable comparison and shame; perfectionism. Working: a usable inner reference point.

4.19 Marcus's three-part present check

Purpose / when: Marcus describes as sufficient "thy present opinion founded on understanding, and thy present conduct directed to social good" and a present disposition of contentment with what happens (Book 9). [source: Meditations, Long trans.] Hadot's reading of the Meditations in The Inner Citadel (1992; English 1998) organises the work around related disciplines [uncertain: not verified]. Use as a brief daily check.
Steps: (1) Ask three questions in the moment: Is my judgement here accurate? Is what I am doing helpful to others? Can I accept what is not in my power? (2) Adjust one. [steps synthesis]
Example language (illustrative): "Three quick questions: Am I seeing this clearly? Is what I'm doing helping? Can I make peace with the part I can't change?"
Watch for: "contentment" heard as tolerating harm. Working: quicker re-orientation in difficult moments.

4.20 Remembrance of good things

Purpose / when: listed by Hadot among the exercises. [source: IEP, Pierre Hadot] Use to balance a negative bias and in low mood.
Steps: (1) The client recalls specific good experiences, people or benefits received. (2) Dwells briefly on details. (3) Notes one. [steps synthesis]
Example language (illustrative): "Before we look at the hard week, can you bring back one good moment from it in detail?"
Watch for: forced positivity, guilt about not feeling grateful; depressed clients may need behavioural activation first (cross-refer II 040). Working: some lift in mood and more balanced recall.

4.21 Cultivating indifference toward indifferent things (values sorting)

Purpose / when: Hadot lists cultivating indifference toward "indifferent" things among the exercises. [source: IEP, Pierre Hadot] For the Stoics, externals such as wealth and reputation were not goods in themselves (attributed). In therapy the usable kernel is distinguishing what the client values most from what they chase by habit or social pressure. [synthesis] Use for status anxiety, burnout from chasing external markers, values conflicts.
Steps: (1) List what the client spends time, money and worry on. (2) For each: is this valued for itself, or as a means, or out of fear of others' judgement? (3) Identify one thing to hold more lightly and one value to act on more. [steps synthesis]
Example language (illustrative): "The Stoics called things like money and reputation 'indifferent': not bad, just not what makes a life good. Which of these are you treating as if your worth depended on them?"
Watch for: devaluing genuine needs (income, housing, health) in clients under hardship; social position matters to wellbeing. Working: decisions guided by stated values.

4.22 Self-mastery (enkrateia) without hardship practices

Purpose / when: Hadot lists self-mastery; he notes that Cynic and Stoic abstinence aimed to accustom followers to cold, heat and hunger. [source: IEP, Pierre Hadot] In psychotherapy, the therapist does not prescribe fasting, cold exposure, sleep deprivation or physical hardship. [synthesis] The usable kernel is delaying or declining one impulse in line with a value, as in urge-management work. [synthesis]
Steps: (1) Screen for disordered eating, compulsive exercise and self-harm; if present, refer to a registered dietitian or eating-disorder service (support: National Alliance for Eating Disorders), and do not frame restraint as virtue. (2) Choose a small, safe, values-linked impulse to notice and delay (for example checking the phone in a conversation). (3) Observe the urge without acting; note what happens. (4) Review. [steps synthesis] If a client wants to practise cold water or fasting as "Stoic training", discuss risks qualitatively and route to medical advice and recognised safety bodies (for cold water: RNLI, Outdoor Swimming Society, Swim England; cross-refer X 196). No schedules or targets are given.
Example language (illustrative): "Self-mastery here doesn't mean hardship. It means noticing an urge and choosing whether it fits what you value."
Watch for: asceticism used as self-punishment; restriction; pride in deprivation. Working: more freedom with urges, no harm to health.

4.23 Socratic dialogue as an exercise

Purpose / when: Hadot describes Socratic dialogue as a spiritual exercise that implicates the interlocutor in examining their own life. [source: IEP, Pierre Hadot] Robertson places Socratic method in the lineage of CBT. [source: Routledge catalogue] Use to examine a value or concept central to the client's difficulty (what is courage, fairness, a good parent).
Steps: (1) Agree the question with the client. (2) Ask for a definition. (3) Explore an example together. (4) Look for a case that fits the definition poorly. (5) Revise the definition together; repeat. (6) Ask what the revised understanding means for the client's situation. [steps synthesis; for the structured Socratic dialogue of Nelson and Heckmann see the separate Socratic dialogue guide in this family]
Example language (illustrative): "You said a good son never says no to his father. Can we look at that together? What do you mean by a good son?"
Watch for: the client feeling cross-examined or trapped; therapist steering to a predetermined answer. Working: the client reaches a more nuanced view in their own words.

4.24 Care of the self as reflective inquiry

Purpose / when: Foucault's lectures take the ancient "care of the self" as the ethical formation of the self, from Socrates onward. [source: Macmillan/Picador catalogue] His third volume of The History of Sexuality, The Care of the Self (1984), also addresses these practices [uncertain: not verified]. Use with clients concerned with who they are becoming, how they shape their life, and how social norms shape them. Procedures are [synthesis].
Steps: (1) Invite the client to describe the practices through which they already shape themselves (routines, reading, relationships, rules they live by). (2) Ask which of these they chose and which were imposed. (3) Identify one practice of self-formation they want to adopt or drop. (4) Review how it changes their relation to themselves. [steps synthesis]
Example language (illustrative): "Ancient philosophers talked about 'caring for the self' as an ongoing practice. What practices are already shaping who you're becoming, and which would you choose?"
Watch for: overly abstract discussion; self-care reduced to consumer advice. Working: the client articulates and enacts a chosen practice.

4.25 Debriefing a client's independent practice [synthesis]

Purpose / when: many clients practise Stoic or other ancient exercises through books, courses, online communities or a philosophical counsellor before or during therapy.
Steps: (1) Ask which source and teacher they follow and what they practise. (2) Ask what effect it has: helpful, neutral, harmful. (3) Look for misreadings that increase distress (emotional suppression, harsh self-judgement, contempt for others, hardship practices). (4) Integrate what helps into the treatment plan; discuss what harms.
Example language (illustrative): "Tell me how you've been practising Stoicism. What has it changed for you, for better and for worse?"
Watch for: online communities promoting suppression, misogyny or risky hardship framed as Stoicism. Working: practice is aligned with the client's goals and wellbeing.

4.26 Referral and collaboration both ways [synthesis]

Purpose / when: non-clinical philosophical counsellors work with questions of meaning and values; they are not licensed to diagnose or treat mental disorders. The American Philosophical Practitioners Association offers certification in client counselling for people with advanced degrees in philosophy [uncertain: secondary, unverified]. APPA's founder is Lou Marinoff, and City College of New York ordered a halt to Marinoff's on-campus counselling (his own account dates the order to November 2000; a 2004 New York Times Magazine article reported it) [uncertain].
Steps: (1) Refer from therapy to philosophical counselling or study when the client wants extended philosophical inquiry beyond the treatment's scope and no clinical need is being displaced. (2) Check the practitioner's training, what they say they do not treat, and how they refer on. (3) With the client's written consent, agree roles. (4) Accept referrals from philosophical counsellors when a client shows signs of a mental disorder, risk or crisis, and assess fully.
Example language (illustrative): "A philosophical counsellor could be a good partner for these big questions; I'll keep working with you on the depression."
Watch for: blurred roles if you also practise as a philosophical counsellor (APA Ethics Code 3.05 on multiple relationships; keep separate agreements, records and fees); a practitioner who presents philosophical counselling as treatment for mental illness. Working: the client is clear who does what.

4.27 Reviewing progress against the client's goals

Purpose / when: Epictetus describes signs of progress: the proficient person "censures no one, praises no one, blames no one, accuses no one" (ch. 48, Higginson trans.). [source: Enchiridion, Higginson trans.] In therapy, progress is measured against the client's own goals and standard outcome measures. [synthesis]
Steps: (1) Review standard measures for the presenting problem. (2) Ask what has changed in daily conduct (less blame, quicker recovery, more value-led action). (3) Decide which exercises to keep, adapt or drop. (4) Plan independent practice and relapse prevention. [steps synthesis]
Example language (illustrative): "Epictetus thought progress shows in how little we blame. Have you noticed changes like that, as well as in your mood scores?"
Watch for: using ancient ideals as a standard the client fails. Working: change on clinical measures and in daily conduct.

5. Handling problems

The sources describe the exercises, not clinical difficulties with them; the guidance below is [synthesis] unless a source is given.

Stuck in theory (intellectualising). The client enjoys discussing Stoic doctrine but does not practise. Response: return to Hadot's point that the exercises are a way of life [source: IEP, Pierre Hadot]; agree one small exercise for the coming week and begin each session by reviewing it.
"Stoic" as suppression. The client uses Stoicism to deny or hide emotion (common in popular versions). Response: name the difference between examining judgements and suppressing feelings; validate emotion; use emotion-focused or acceptance-based work where indicated (Robertson discusses links with third-wave CBT [source: Routledge catalogue]).
Self-blame from "it's your judgement that disturbs you". Response: clarify that the idea concerns where one can work, not fault; in trauma, abuse, discrimination or poverty, validate the reality of the harm first; do not use 4.6 or 4.7 with fresh trauma.
Passivity and acceptance of the unacceptable. The dichotomy of control is used to tolerate abuse or injustice. Response: map the controllable part (seeking safety, support, advocacy, legal help); where safety is at risk, follow safeguarding and domestic-abuse procedures.
Overwhelm or distress in death-related or adversity exercises. Response: stop, ground in the present, assess risk with standard practice, safety plan, and give crisis resources (988 in the US; Samaritans 116 123 in the UK and Ireland). Do not resume these exercises until risk is reassessed. In bereavement, use grief-specific assessment and treatment, including assessment for prolonged grief disorder as DSM-5-TR and ICD-11 describe it [uncertain: criteria not verified here].
Dissociation during the view from above. Response: stop; orient to the room (feet on the floor, describe surroundings); use eyes-open, shorter versions or drop the exercise.
Worry or scrupulosity amplified. Premeditation turns into catastrophising; evening review into compulsive checking or confession. Response: drop or restructure; for OCD or GAD, use the evidence-based protocol for that condition.
Non-adherence. Response: shrink the exercise; attach it to an existing routine (morning coffee, commute); explore whether the chosen tradition fits the client; try another school's lens (section 3).
Hardship or deprivation practices. The client wants fasting, cold exposure or sleep deprivation as "training". Response: no schedules or targets; discuss risks qualitatively; screen for disordered eating and refer to a registered dietitian or eating-disorder service (support: National Alliance for Eating Disorders); route cold-water interest to medical screening and the RNLI, Outdoor Swimming Society or Swim England (cross-refer X 196). Never advise starting, stopping or changing a medicine.
Online or ideological misuse. The client follows communities that use "Stoicism" for contempt, misogyny or domination. Response: explore what the client gains; contrast with the ancient emphasis on duty and conduct directed to social good (Marcus, Book 9 [source: Meditations, Long trans.]); work with values and relationships.
Religious, spiritual or worldview conflict. Stoic ideas about providence or the cosmos may clash with, or substitute for, the client's faith; a turn to philosophy may follow a loss of faith. Response: use the DSM-5-TR Cultural Formulation Interview and its supplementary module on spirituality, religion and moral traditions; practise cultural humility; where the difficulty centres on faith, the DSM-5-TR "Religious or Spiritual Problem" may be considered, coded Z65.8 [source: ICD-10-CM Z65.8 (Unbound Medicine); DSM-5-TR wording uncertain]; collaborate with the client's religious leader only if the client wishes.
Ruptures. The client feels lectured or judged by ancient ideals. Response: acknowledge, return authorship to the client, use their words rather than the texts', and repair openly.
Psychosis, mania or grandiosity. Cosmic perspective or fatalism may feed delusional or grandiose ideas. Response: do not use view-from-above or fate-related exercises; prioritise psychiatric assessment and treatment.
Dual roles. The therapist is also a philosophy teacher or philosophical counsellor to the client or their circle. Response: apply APA Ethics Code 3.05 [source: APA Ethics Code]; keep one role per client where possible; separate contracts, records and fees; check professional insurance covers what is offered.
Scope drift by a collaborating philosophical counsellor. Response: with consent, clarify roles; if the counsellor is treating a mental disorder, discuss with the client and document; ensure clinical care remains in place.

Sources

Web sources:

Books cited:

Hadot, P. (1981). Exercices spirituels et philosophie antique. English: Philosophy as a Way of Life (1995), trans. M. Chase, introduction by A. I. Davidson.
Hadot, P. (1992). La citadelle intérieure. English: The Inner Citadel (1998).
Foucault, M. The Hermeneutics of the Subject: Lectures at the Collège de France 1981–1982, ed. F. Gros, trans. G. Burchell. Picador [year of edition uncertain].
Foucault, M. (1984). The Care of the Self (The History of Sexuality, vol. 3) [uncertain: not verified].
Robertson, D. (2020). The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy (2nd edn). Routledge.
Epictetus. The Enchiridion, trans. T. W. Higginson (public domain).
Marcus Aurelius. Meditations, trans. George Long (public domain).
Seneca. Of Anger, trans. Aubrey Stewart (1900, public domain).
Duane, D. (2004, 21 March). "The Socratic Shrink." The New York Times Magazine [uncertain: secondary, unverified].

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