Rating Control in Cognitive Therapy
Employing Stoic Principles in CBT
Copyright © Donald Robertson, 2011. All rights reserved.
See www.philosophy-of-cbt.com for more information on Stoicism and psychotherapy. The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy (2010).
Some things are in our control and others not. Things in our control are opinion, intention, desire, aversion, and, in a word, whatever are our own actions. Things not in our control are our physical body, property, reputation, status, and, in one word, whatever are not our own actions. (The Enchiridion of Epictetus, §1)
The basic principle of Stoicism, the “Stoic hypothesis” if you like, is that suffering is caused primarily by placing too much value on things outside of our direct control and not enough value on things genuinely within our control. Taking too much responsibility for external events or other people, and not enough responsibility for our own thoughts and actions. How might this formulation be applied in modern cognitive therapy or self-help?
A simple method, based on the opening passage of the Stoic handbook above, consists in reviewing a problematic situation using a two-column form, with one column listing aspects of the problem which are under your control and the other listing aspects over which you have little or no direct control. Dividing a problem into different components and sorting them into those that can be changed and those that cannot is relatively quick and easy to do. It also resembles the “wisdom” referred to in the Stoic-inspired “Serenity Prayer” of Alcoholics Anonymous:
God, grant me the serenity to accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference.
Remember that although you may be able to influence many things, such as whether or not someone likes you, that’s not the same as having direct control over them, because other variables can always intervene that subvert your influence, the outcome is partly in the hands of fate. Do a rough draft now by picking a problematic situation and dividing the key aspects into “within control” and “not within control.”
Now consider this, the items under your control can probably be subsumed under one heading: your actions. (That might include your thinking and intentions as activities.) The things outside of your direct control should include other people’s thoughts, actions and feelings. You might influence these to some extent but you can’t guarantee how they will respond because they’re not under your direct control. The outcomes of your own actions, however, are probably not under your direct control either. You can do your best, but whether your actions succeed or fail is likely to be partly down to other factors in most situations, you can’t guarantee what the result of your own actions will be. Consider how you could take more responsibility for your own actions, the things under your direct control, by acting more in accord with your own values and priorities. Likewise, consider to what extent you might be willing to accept that other things are beyond your direct control, and to adopt a more “philosophical attitude” toward success or failure.
A more sophisticated method, which can be done alone, but also naturally follows on from the two-column technique above, consists in numerically rating your perceived control (0-100%) over each aspect of the problem identified. Similarly, a client may draw up a “problem list”, with the help of the therapist, and rate each item on the list in terms of their perceived control (0-100%). A very useful variant is to compare ratings of “how responsible (or to blame) you feel” (0-100%) for individual problems (or aspects of problems) with ratings of “how much actual control you have” (0-100%). For example, people frequently feel 100% responsible or “to blame” for accidents, over which they had little or no actual control. Highlighting this contradiction and modifying the underlying beliefs can alleviate excessive (irrational) guilt or anxiety.
Similarly, existing cognitive therapy “re-attribution” techniques involving the use of a pie-chart diagram can also be used in conjunction with Stoic concepts. Clients can be asked to identify what factors contribute to a problem and draw a pie-chart showing how much responsibility can be attributed to each one, including their own volition (or thoughts and actions). For example, someone experiencing relationship problems may either blame themselves or their partner excessively for their problems. However, in a normal relationship, responsibility is typically shared to some extent between the parties involved. Factors outside of either party’s control may also influence the outcome, e.g., financial problems or living conditions.
The Stoic prescription is to learn to better accept things outside of your control by focusing instead on the areas where you can actually make a change. Ultimately, this means your own will, and your judgements and intentions (or thoughts and actions). The questions below may also be used to help clarify your sphere of control and prepare to reformulate your problem in terms of the aspects you can actually change.
Sample Series of Questions
- What’s the problem?
- What’s your goal?
- How much control do you have over whether you achieve that goal (0-100%)?
- What prevents it from being 100%? What aspects are outside of your direct control?
- What prevents it from being 0%? What aspects do you have some control over?
- How could you redefine your goal so that it’s focused more on the aspects you actually control?
- Now rate how much control you have over whether you achieve that revised goal (0-100%)?
- Repeat if necessary.
See www.philosophy-of-cbt.com for more information on Stoicism and psychotherapy. The Philosophy of Cognitive-Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy (2010).