Stoicism and modern therapy: how CBT grew from Stoic roots

Cognitive behavioural therapy, or CBT, is one of the most widely used and best-studied forms of psychotherapy. Its central idea is nearly two thousand years old. Epictetus stated it in his handbook:

The founders of CBT knew this, and said so.

This guide is about ideas, not treatment. If you are struggling with your mental health, please speak to a doctor or a qualified therapist.

What the founders said

Two people are usually credited with founding the cognitive therapies. Albert Ellis developed rational emotive behaviour therapy (REBT) in the 1950s. In his first major book he wrote that its central principle, that people are affected less by events than by their thinking about them, was originally discovered and stated by the ancient Stoic philosophers, and he illustrated it with the line from Epictetus above.¹

Aaron Beck, who developed cognitive therapy for depression, made the same acknowledgement. He and his colleagues wrote that the philosophical origins of cognitive therapy can be traced back to the Stoic philosophers, naming Zeno, Chrysippus, Cicero, Seneca, Epictetus and Marcus Aurelius.²

What Stoicism and CBT share

Thoughts shape feelings

Both hold that an emotion follows from an interpretation. Change the interpretation and the emotion changes. Marcus Aurelius:

Psychologists call this skill cognitive reappraisal. People who habitually reappraise upsetting events, rather than suppressing their feelings, tend to report better well-being.³

Stepping back from a thought

CBT teaches people to notice a thought as a thought, rather than as a fact. Epictetus taught the same move, and even gave the words to use:

Facing fears on purpose

Therapists often ask anxious clients to imagine the feared outcome in detail, and find it is more survivable than it seemed. Seneca recommends exactly this:

His advice to practise living on very little, and then to ask “Is this the condition that I feared?”, works the same way as a behavioural experiment: you test a fear against reality.

Daily self-monitoring

Keeping a record of situations, thoughts and reactions is a standard CBT exercise. The Stoic evening review is an older version of it. Seneca describes the practice and says he does it himself:

Seeing your situation from outside

The Stoic “view from above” asks you to look at your troubles as an observer would. Research on self-distancing finds that people reason more wisely about their own problems when they step back from them in this way.⁴

Where they differ

The similarities are real, but Stoicism is not simply old-fashioned CBT.

• Therapy or philosophy. CBT is a treatment for specific problems, usually over a limited period. Stoicism is a philosophy for a whole life.
• Values. CBT helps people think more accurately and act on their own goals. Stoicism has a view about what the goal should be: good character, which it calls the only true good. See the four virtues.
• How far the claim goes. A therapist might help someone see that losing a job is not the catastrophe it feels like. The Stoics go further and say that nothing outside your own character is truly bad at all. That is a philosophical position, not a clinical one.

What the research says

There is strong evidence that CBT works for a range of conditions: a review of more than a hundred meta-analyses found the strongest support for anxiety disorders, among others.⁵ Evidence for Stoic practice itself is much thinner, but it is starting to appear. In a 2025 randomised controlled trial run as part of a PhD at Royal Holloway, University of London, 119 people were assigned either to a two-week online programme of Stoic exercises or to a waiting list. Those who did the exercises reported lower depression symptoms afterwards, and lower anxiety at a one-month follow-up.⁶ It is one study and has not yet been published in a peer-reviewed journal, so it should be read as encouraging rather than conclusive.

Trying the Stoic techniques

The practices described here are set out step by step in our guide to Stoic exercises, and the Stoic account of feeling is explained in the emotions. For the fullest scholarly treatment of the connection, see Donald Robertson’s book.¹