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The ancient roots of psychotherapy matter now
Cognitive behavioral therapy has the Stoics to thank for inspiring this field.
- Cognitive behavioral therapy, a 20th century invention, points to Greek Stoicism for inspiration.
- Stoicism and CBT share an emphasis on using logic and reasoning to overcome emotional difficulties.
- Knowing how to respond to challenges lies at the foundation of modern psychotherapeutic practices.
Where do thoughts come from? Though we've advanced our understanding of the physiological actions that lead to thinking, "where" they arise from remains uncertain. Freud believed thoughts operate at the level of the unconscious; modern psychology and neuroscience abandoned that idea decades ago. Experiences leave imprints—memories—that serve as blueprints for thought.
The developments of behavior therapy and cognitive therapy in the first half of the twentieth century laid the foundation for cognitive behavioral therapy (CBT), a form of mental health training that aims to disrupt cognitive distortions and behaviors and help regulate emotions. Initially applied to depression, this treatment now includes many other problems, including depression's sometime-kin, anxiety.
While CBT's roots can be traced to various therapists in the nineteen-twenties through the sixties, an emergence of "third wave" CBT kicked off in the eighties. This trend coincided with CBT being used as a catchall to describe a number of modalities, including dialectical behavior therapy, rational emotive therapy, and cognitive processing therapy. Today, CBT generally implies any treatment aimed at improving cognitive and emotional issues.
While a twentieth-century intervention, CBT was presaged in the philosophical school of Stoicism. CBT espouses a rational approach to psychosomatic and emotional malaise, making us recall the words of Socrates and Epicurus, both of whom believed philosophy is therapeutic. In fact, the latter, in Fragments, writes that "the philosopher's school is a doctor's clinic."
Stoicism was founded by Zeno of Citium in the third century BCE. The philosophical foundation sounds Buddhist: don't allow pleasure or pain to motivate your actions; accept each moment as it is; live a virtuous life by treating others fairly; live in accordance with nature. Also of note in this media-dominated age in which loud, unapologetic hypocrites hold office: judge a person by their actions, not their speech. Then you will know who they really are.
Zeno said that in order to flourish (eudaemonia), you must exhibit the will (prohairesis) to not be seduced by sparkly objects or the fear of death. This is accomplished through the acquisition of knowledge combined with an ability to implement the ethical framework that such knowledge demands. Stoicism flourished until Christianity dominated the region in the fourth century CE, though many have argued that CBT represents its modern incarnation.
Donald J Robertson and Trent Codd recently co-author a deep dive on the history of the relationship between Stoicism and CBT in the journal, The Behavior Therapist. The best modern example of Stoicism, they write, can be traced back to theologian Reinhold Niebuhr's 1934 prayer:
"God, give me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference."
The authors credit psychologist Albert Ellis, founder of Rational Emotive Behavior Therapy (REBT), for inspiring the modern renaissance in Stoicism as well as pointing out its applicability in psychotherapy. Ellis believed that emotional problems are not caused by external events, but rather "our irrational beliefs about such events." This idea was borrowed straight from the pen of Epictetus, the first century CE Stoic philosopher.
Ellis opened the floodgate of Stoicism in his field, though as Codd and Robertson write, psychotherapists tend to read Ellis instead of retrieving the source. Nonetheless, the lineage is clear. Aaron T. Beck, the founder of Cognitive Therapy (and also heavily influenced by Ellis), liked to quote Marcus Aurelius:
"If thou are pained by any external thing, it is not the thing that disturbs thee, but thine own judgment about it. And it is in thy power to wipe out this judgment now."
The School of Athens. (Fresco in Stanza della Segnatura), ca 1510-1511.
Photo by Fine Art Images/Heritage Images/Getty Images
Big picture outlook: We are in control of our emotions. Emotions, as psychology professor Lisa Feldman Barrett writes in How Emotions Are Made, are not reactions but creations inspired by past experiences. This falls in line with Aurelius, whose quote above is not about the suppression of automatic response but rather choosing logic over irrational thinking. Emotions do not arrive from a mystical abyss. We have control in how we act and feel.
This is where logic is applied to psychotherapy: don't simply fall back on old patterns of behavior because you're accustomed to them, especially when you cast yourself as a victim or powerless cog in an uncontrollable process. As Niebur implies, many things are beyond our control. What is not is how we act in the face of adversity.
The Stoics knew that life was not about pleasure. Seeking only good feelings does not lead to freedom from the unpleasant realities of existence. These ancient philosophers preached the development of arete, excellence of character. They utilized the four foundations of Platonic virtue—wisdom, justice, temperance, and fortitude—as the philosophical bedrock in which to build that character. Such development requires self-control. Our brains seek quick dopamine hits that come with instant gratification. The tempered spirit sees the long game and adjusts accordingly.
Modern cognitive therapy techniques align with Stoicism in the understanding that emotions and beliefs are not derived from separate processes. Neuroscience backs this up: emotions are feelings, but what we feel must be translated into concepts. An upset stomach could be due to a break-up, yearning, or spoiled food. How we experience that feeling is not separate from the context that causes it. In each case, we have some amount of control over how we treat the symptom.
This leads us to another ancient practice that has recently experienced a renaissance: mindfulness. Paying continual attention (prosoche) to thoughts and feelings is the foundation of Stoic therapy. By recognizing destructive patterns of thinking the patient has an opportunity to reshape their experience of life.
The quest for this levelheadedness persists today and will likely persist as long as we're alive. We should derive some comfort from the fact that humans have been chasing it for millennia. Maintaining poise and control during challenging times has always been difficult. Knowing that how we act during times of challenge begins in our heads is the key to empowerment.
- Should cognitive behavioral therapy be taught in school? - Big Think ›
- 10 quotes from Meditations to unlock your inner Stoic - Big Think ›
Andy Samberg and Cristin Milioti get stuck in an infinite wedding time loop.
- Two wedding guests discover they're trapped in an infinite time loop, waking up in Palm Springs over and over and over.
- As the reality of their situation sets in, Nyles and Sarah decide to enjoy the repetitive awakenings.
- The film is perfectly timed for a world sheltering at home during a pandemic.
In more than a dozen countries as far apart as Portugal and Russia, 'Smith' is the most popular occupational surname
- 'Smith' is not just the most common surname in many English-speaking countries
- In local translations, it's also the most common occupational surname in a large part of Europe
- Ironically, Smiths are so ubiquitous today because smiths were so special a few centuries ago
Meet the Smiths, Millers, Priests and Imams - the most popular occupational surnames across Europe.
Image: Marcin Ciura<p>Although very few people are smiths by profession these days, there are millions of Smiths by surname the world over. It's the most popular surname in Britain, Australia, New Zealand and the United States, as well as the second most popular surname in Canada and the fifth most popular one in Ireland. And they're a thriving bunch, at least in the U.S.: the 2010 Census (1) counted 2,442,977 Americans called Smith, 2.8% more than in 2000.</p><p>Curiously, 'Smith' also is one of the most popular surnames across most of Europe –translated in the various local vernaculars, of course. This map shows the most common occupational surnames in each country. By colour-coding the professions, this map shows a remarkable pro-smith consistency across Europe – as well as some curious regional exceptions.</p>
‘Smith’ popular throughout Europe<p>'Smith', in all its variations, is the most popular occupational surname throughout Europe. Not just in the UK, but also in:</p> <ul><li>Belgium (<em>Desmet</em>) and Luxembourg, (<em>Schmitt</em>);</li> <li>France (<em>Lefebvre</em>), Italy (<em>Ferrari</em>) and Portugal (<em>Ferreira</em>);</li> <li>Slovenia (<em>Kovačič</em>), Croatia (<em>Kovačevič</em>), Hungary (<em>Kovács</em>), Slovakia (<em>Kováč</em>), Poland (<em>Kowalski</em>), Lithuania (<em>Kavaliauskas</em>), Latvia (<em>Kalējs</em>) and Belarus (<em>Kavalyov</em>);</li> <li>Estonia (<em>Sepp</em>); and</li> <li>Russia (<em>Kuznetsov</em>).</li></ul>
‘Miller’ on top in many Germanic-language countries<p>'Miller' is the most popular occupational surname in many Germanic-language countries, but also in Spain and Ukraine (perhaps because the grain in both countries is mainly in the plain):</p> <ul><li>There's <em>Müller</em> (in Germany and Switzerland), <em>M</em><em>ø</em><em>ller</em> (in Denmark and Norway) and <em>Möller</em> (Sweden);</li> <li><em>Molina</em> (in Spain – the map also shows the most popular surname in Catalonia/Catalan: <em>Ferrer</em>, i.e. 'Smith'); and</li> <li><em>Melnik</em> (in Ukraine).</li></ul>
Clergy surnames rule in the Balkans<p>Catholic clergy must remain celibate, so 'Priest' as a surname is rare to non-existent throughout Europe. Except in the Balkans, where Catholicism is largely absent. Here, the Orthodox and Islamic clergies have passed on the title from father to son, eventually as a surname, to popular effect. Orthodox clergy are addressed as <em>papa</em> or <em>pope</em> (which means 'father' – so the surname rather redundantly translates to 'father's son'). Islamic teachers or imams are known by the Turkish/Persian term <em>hodzha</em>. An overview:</p> <ul><li><em>Popov</em> (in Bulgaria), <em>Popovic</em> (in both Serbia and Montenegro), <em>Popovski</em> (in Macedonia);</li> <li><em>Popa</em> (in Romania); </li> <li><em>Papadopoulos</em> (in Greece); and</li> <li><em>Hodžić</em> (in Bosnia-Herzegovina), <em>Hoxha</em> (in both Kosovo and Albania).</li></ul>
Landowners and other professions<p>Austria and the Czech Republic have different national languages but are neighbours and share a lot of history. Could that explain why they have a similar most popular occupational surname, for 'landowner'?</p> <ul><li><em>Huber</em> (in Austria) and</li> <li><em>Dvořák</em> (in the Czech Republic).</li></ul> <p>Just four professions, that wraps up all but five countries on this map. Those five each have their very own most popular occupational surname:</p> <ul><li><em>Bakker</em> (in the Netherlands): 'Baker'</li> <li><em>Kinnunen</em> (in Finland): 'Skinner'</li> <li><em>Ceban</em> (in Moldova): 'Shepherd'</li> <li><em>Avci</em> (in Turkey): 'Hunter'</li> <li><em>Murphy</em> (in Ireland): 'Sea Warrior' </li></ul>
Even more Smiths<p>Judging from the popularity of these surnames, your generic European village of a few centuries ago really couldn't do without a smithy. It was a much more essential craft even than that of the miller (or the baker, who put the miller's flour to good use) – except in the Balkans, where spiritual sustenance apparently sated a greater need. On the outskirts of <em>Anytown, Europe</em> live the shepherd and the hunter, the skinner and the pirate.<br></p><p>A bit too simplistic? Perhaps not simplistic enough. This map could have been dominated by even more Smiths. As the original poster explains, he always picked the most frequent version of an occupational surname, even if multiple variants point to a more popular alternative. </p><p>In the Netherlands, for instance, people with the surnames <em>Smit, Smits, Smid, de Smit, Smet </em>and <em>Smith</em> collectively outnumber those with the surnames <em>Bakker, Bekker, de Bakker</em> and <em>Backer</em>. So, the Netherlands could be considered another win for 'Smith' – except that the variant <em>Bakker</em> is more frequent than any other single variant.</p><p>Same story in Germany: added up, there are more people named <em>Schmidt, Schmitt, Schmitz </em>and <em>Schmid</em> than <em>Müller</em>. Ditto for Spain: <em>Herrero, Herrera </em>and <em>Ferrer</em> together outnumber <em>Molina</em>. Also in Finland, where <em>Seppä</em>, <em>Seppälä</em> and <em>Seppänen</em> together have a higher count than <em>Kinnunen</em>. </p>
Smiths in other cultures<p>'Smith' was a crucial occupation in other cultures too, judging from the familiar ring it has in these languages:<br></p><ul><li><em></em><em>Demirci</em> (Turkish)</li><li><em>Hadad</em> (Syriac, Aramaic, Arabic)</li><li><em>Nalbani</em> (Albanian)</li><li><em>McGowan</em> (Gaelic)</li><li><em>Faber</em> (Latin)<span></span></li></ul>
Other most popular surnames<p>Take note, though: 'Smith' may be the most popular surname in in the Anglosphere, this map does not mean to show that its variants in French, Russian and other languages also are the most popular surnames in the countries marked grey. They are merely the most popular <em>occupational</em> surnames.<br></p><p>As this sample of most common ones for each country shows, surnames can refer to a host of other things. Personal qualities or physical attributes, for example:</p> <ul><li>Russia: <em>Smirnov</em> ('the quiet one')</li> <li>Turkey: <em>Yilmaz</em> ('unflinching')</li> <li>Hungary: <em>Nagy</em> ('big')</li> <li>Italy: <em>Rossi/Russo</em> ('red', in northern and southern Italy, respectively)</li></ul> <p>Another option: the origin of the name-bearer (be it a place or a person):</p> <ul><li>Sweden: <em>Andersson</em> ('son of Anders')</li> <li>Slovakia: <em>Horvath</em> ('Croat')</li> <li>Kosovo: <em>Krasniqi</em> (refers to the Krasniq tribe and their mountainous home region)</li> <li>Portugal: <em>Silva</em> ('woodland')</li> <li>Latvia: <em>Bērziņš</em> ('little birch tree')</li> <li>Estonia: <em>Tamm</em> ('oak')</li></ul> <p>But sometimes, even for the most popular ones, the exact origin of the surname is lost in time:</p> <ul><li>Spain: <em>Garcia</em> (originally Basque, possibly meaning 'young', 'bear' or 'young bear')</li> <li>Finland: <em>Korhonen</em> ('hard of hearing' or 'dim-witted'; 'village elder'; 'proud'; 'upright'). </li></ul>
Smith popularity theory<p>So why exactly is Smith – and not Miller, for example – the most popular surname in many English-speaking countries? The theory propounded by historian C.M. Matthews in <em>History Today</em> (July 1967) probably also holds for the other-language variants so popular throughout Europe:<br></p><blockquote>"The reason for (the) multiplicity (of the surname 'Smith') is not so much that metal-workers were numerous as that they were important and widespread. On the skill of the smith, both rich and poor depended for the most essential things of life, the tools of husbandry and the weapons of hunting and war. Every community in the land must have one, every castle, every manor; and so distinctive was his trade that he would seldom need another name".<em></em></blockquote><p>That does not mean all people with the surname have a forefather who forged iron into weapons and farm tools. Especially in North America, 'Smith' was adopted by many people precisely because it was already common – as a secret identity or to blend in, for example by natives, slaves and immigrants.</p>
A recent analysis of a 76-million-year-old Centrosaurus apertus fibula confirmed that dinosaurs suffered from cancer, too.
- The fibula was originally discovered in 1989, though at the time scientists believed the damaged bone had been fractured.
- After reanalyzing the bone, and comparing it with fibulas from a human and another dinosaur, a team of scientists confirmed that the dinosaur suffered from the bone cancer osteosarcoma.
- The study shows how modern techniques can help scientists learn about the ancient origins of diseases.
Centrosaurus apertus fibula
Royal Ontario Museum<p>In the recent study, the team used a combination of techniques to analyze the fibula, including taking CT scans, casting the bone and studying thin slices of it under a microscope. The analysis suggested that the dinosaur likely suffered from osteosarcoma, a type of bone cancer that affects modern humans, typically young adults.</p><p>For further evidence, the team compared the damaged fibula to a healthy fibula from a dinosaur of the same species, and also to a fibula that belonged to a 19-year-old human who suffered from osteosarcoma. Both comparisons supported the osteosarcoma diagnosis.</p>
Evans et al.<p style="margin-left: 20px;">"The shin bone shows aggressive cancer at an advanced stage," Evans said in a <a href="https://www.rom.on.ca/en/about-us/newsroom/press-releases/rare-malignant-cancer-diagnosed-in-a-dinosaur" target="_blank">press release</a>. "The cancer would have had crippling effects on the individual and made it very vulnerable to the formidable tyrannosaur predators of the time."</p><p style="margin-left: 20px;">"The fact that this plant-eating dinosaur lived in a large, protective herd may have allowed it to survive longer than it normally would have with such a devastating disease."</p><p>The fossilized fibula was originally unearthed in a bonebed alongside the remains of dozens of other <em>Centrosaurus </em><em>apertus</em>, suggesting the dinosaur didn't die from cancer, but from a flood that swept it away with its herd.</p>
Dinosaur fibula; the tumor mass is depicted in yellow.
Royal Ontario Museum/McMaster University<p>The new study highlights how modern techniques can help scientists learn more about the evolutionary origins of modern diseases, like cancer. It also shows that dinosaurs suffered through some of the same terrestrial afflictions humans face today.</p><p style="margin-left: 20px;">"Dinosaurs can seem like mythical creatures, but they were living, breathing animals that suffered through horrible injuries and diseases," Evans said, "and this discovery certainly makes them more real and helps bring them to life in that respect."</p>
Join the lauded author of Range in conversation with best-selling author and poker pro Maria Konnikova!
UPDATE: Unfortunately, Malcolm Gladwell was not able to make the live stream due to scheduling issues. Fortunately, David Epstein was able to jump in at a moment's notice. We hope you enjoy this great yet unexpected episode of Big Think Live. Our thanks to David and Maria for helping us deliver a show, it is much appreciated.