CBT, or Cognitive Behavioural Therapy, is now at the heart of the British government’s mental health policy. Successive British governments have committed a combined £580 million to a policy called Improved Access for Psychotherapies (IAPT), which hugely increases the availability of CBT through the NHS, and will train 6,000 new cognitive therapists by 2014. It is the boldest expansion of mental health services anywhere in the world.

While many mental health charities have welcomed this initiative, others in the mental health industry have fiercely criticized it. Therapists from other traditions say it has too much of a ‘one size fits all’ approach, and that 8 to 16 weeks of CBT only offers a short-term fix that ‘papers over the cracks’. Others have criticized CBT’s intense focus on an individual’s thoughts and beliefs rather than their socio-cultural and economic context.

Speaking personally, I found CBT very useful when I had depression and anxiety in my late teens. I went to a CBT support group: there wasn’t actually a therapist present, but we followed a CBT tape course, did the ‘homework’ and, after a few weeks, I stopped having panic attacks and got on the long road to recovery. That experience of CBT piqued my curiosity, because CBT reminded me very much of ancient Greek philosophy.

I started to research CBT, and interviewed the two founders of it – Albert Ellis and Aaron Beck – and discovered they had been directly inspired by ancient Greek philosophy, particularly by Stoicism, which insisted that ‘it’s not events, but our opinions about them, that cause us suffering’. CBT also takes from ancient philosophy the ‘Socratic method’ – Socrates’ idea that humans can be taught to examine their minds, bring unconscious beliefs into consciousness, and then rationally consider and challenge any beliefs that make them sick.

Ellis and Beck took ideas and techniques from ancient philosophy and brought them into the heart of western science, but in doing so, they removed any mention of ethics, values or the ‘higher meaning’ of life. They also removed the social, political and religious aspects of ancient philosophy, and turned it into a ‘tool-kit’ of non-moral, instrumental techniques for the individual. Beck then tested out the therapeutic effectiveness of these techniques with a barrage of empirical tests. This impressive body of evidence for CBT is what convinced our government to put half a million pounds into making it more available.

Yet something was lost along the way. Ancient philosophy wasn’t merely a set of instrumental techniques for the individual. Schools like Stoicism, Epicureanism and Scepticism also offered ethical theories about the good, which linked the personal to the social, cultural, political and cosmic. These schools didn’t agree on whether God existed or whether there was a higher meaning to human existence, but at least they recognized that was a conversation worth having. CBT narrowed the focus down to just the individual, and the result is a somewhat atomized and amoral version of self-help.

What we’re now seeing is the rise of the so-called ‘third wave’ of cognitive behavioural therapies, including mindfulness-CBT, Acceptance and Commitment Therapy (ACT), and Positive Psychology. These therapies often engage more directly with Eastern philosophies (particularly the mindfulness techniques of Buddhism), and in the case of ACT, they’re less afraid to include questions of values in therapy.

Positive Psychology has also included some mention of the ancient Greek philosophical schools that gave rise to CBT. Jonathan Haidt, for example, includes the Stoics and Aristotle in the course on ‘flourishing’ that he teaches at Virginia University. But on the whole, few cognitive therapists are aware of the links between CBT and ancient Greek and Roman philosophies, sadly. The emphasis is on training new practitioners and putting them to work, rather than teaching them where their techniques come from, or allowing them to question some of CBT’s ethical assumptions.

That’s beginning to change, however, thanks to a handful of therapists and counsellors here in the UK. Last year, a psychotherapist called Donald Robertson brought out an excellent book called The Philosophy of CBT, which expertly traced the many connections between ancient philosophy and CBT. He’s started to give workshops in ‘resilience’ that combine CBT, Positive Psychology and ancient philosophy.

Tim LeBon is another who has championed the integration of CBT with philosophy. His 2001 book Wise Therapy argued for the synthesis of philosophy and traditional therapies – including CBT. Tim was one of the first to set up a philosophical counseling practice in the UK, but found that the market for PC was small and that many clients benefitted more from a combination of philosophy and more traditional therapy rather than from philosophy alone. He undertook specialist CBT training and now combines a private practice with NHS work. Tim has successfully run workshops on ‘the good life’, which teach ideas from philosophy within the format of group discussions, and believes such a workshop could be adapted to work successfully within the framework of the NHS. You can read my interview with Tim about philosophical CBT here.

The UK is uniquely well-placed to develop ‘philosophical CBT’. We have in this country a wealth of talented people who are interested in the therapeutic benefits of philosophy – people like Mark Vernon, Antonia Macaro, Julian Baggini, Clare Carlisle, Alain De Botton, Robert Rowland Smith and others. And we also have a government uniquely committed to mental health services, and to a therapy whose roots are in philosophy. It would be valuable to strengthen the links between these two movements, as people like Donald and Tim are beginning to do.

Philosophical CBT would bring together the empirical, practical focus of CBT, and the more values-conscious, open-ended and participatory approach of philosophy. It would bring together the sciences and the humanities, drawing on the best of both worlds.

It would teach practical and evidence-based techniques for self-management, but also explore the original philosophical contexts for these techniques, and create a space for philosophical discussion about wider questions – what am I seeking? what is the goal of life? what is the good society? – which could be discussed in a non-directive and open way, with a facilitator who drew links to different philosophical answers to these ‘big questions’.

As the psychotherapist and philosophical counselor Antonia Macaro puts it: “It’s useful to combine the reflective approach of philosophical counseling with a more practical, therapeutic one (for instance that of CBT) because then you’re better equipped to help people to clarify conceptual and value issues as well as make concrete changes if they want to. That combined approach doesn’t really exist so far – people like Tim and me have had to bring the two together piecemeal.”

How and where could we practice this ‘philosophical CBT’? First of all, we could provide workshops for cognitive behavioural therapists who are interested in exploring the historical and philosophical roots of CBT, and who want to discuss some of the wider assumptions of CBT – for example, what do we mean by ‘flourishing’ or ‘the good life’?

Secondly, clients and service users could be given access to philosophical CBT workshops on themes like resilience, flourishing and the good life. The NHS already provide ‘self-help workshops’ at their IAPT centres around the country, so there is a space and a precedent for this.

And thirdly, philosophical CBT could inform how we teach well-being in schools. The government has already looked at teaching Positive Psychology in schools: the problem with Positive Psychology is it presents itself entirely as a morally neutral science of the good life. That means it teaches a technocratic, instrumental model of the good life that leaves out goodness. It leaves out the important role of ethics, and of practical deliberation over values and ends. It tells people to seek a ‘higher purpose’, but leaves out any deliberation over whether the purpose you’re serving is good or bad. It tells people to seek ‘flow’ by engaging intensely in an activity, but leaves out the question of whether the activity you’re engaging with is genuinely worthwhile or not.

You can’t teach the good life without bringing in these subjective questions of values and ends. Positive Psychology tries to steer clear of ethical debate (that would be messy and unscientific), but the result is a process where people passively consume happiness techniques and ‘thinking styles’, and are deprived of the possibility of engaging in a conversation about the good life.

And the source material for ‘well-being classes’ is typically badly written, bureaucratic and (I’m sorry to say) soulless. Why not at least mention some of the original source material for these ideas? Philosophers like Seneca, Marcus Aurelius, Epictetus and Plato are some of the greatest writers our culture has ever produced – so why not introduce young people directly to them?

It’s exciting that our government is taking well-being and mental health seriously, both in schools and in the wider society. But the danger of the ‘politics of well-being’ is that it becomes technocratic, illiberal and elitist. The scientific experts get to decide what ‘well-being’ means, and the masses are simply conditioned in the correct techniques and lifestyles, rather than being empowered to engage in the ethical conversation as autonomous reasoning persons.

Philosophical CBT could be one way forward, combining the evidence-based approach of CBT with the more open-ended and values-conscious approach of philosophy. And it would introduce people to philosophies that connect the personal to the social and political, and that empower us not merely to overcome emotional disorders, but also to follow richer and more examined lives.

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On a visit to her parents in Israel in 2006, her father, a doctor, suggested she have a CT scan of her lungs. The evening after the scan, her father suggested they stop off at the radiology clinic so he could pick up the results. Havi tells me: “I sat in the car and waited for him to come back. And waited. After half an hour, I knew something was wrong, so I went into the centre. I walked into the lab, where my father and the radiologist were staring at a CT scan of my lungs. My father looked in shock. The radiologist looked surprised and embarrassed to see me there. He said to me: ‘Do you know what you’ve got?’ I said I didn’t. ‘Have a read.’ And he handed me this enormous diagnostic manual, opened at an illness called Lymphangioleiomyomatosis (LAM). It was full of dense terminology, but at the bottom it said ‘prognosis: 10 years’. I felt this deep, physical shock, and just kept thinking, I’m going to be dead by 45.”

At first Havi thought it must be some mistake. Then she was furious. She was an atheist, but she still found herself railing against fate. “I didn’t smoke, I didn’t drink, I didn’t take drugs, I’d always been good, and now I get this incredibly rare illness? It seemed deeply unfair. Why me? Then I wondered if I was somehow being punished. I’d just finished my first book, about death. I wondered if writing about that subject had somehow caused the illness. It was really difficult to accept the randomness of it – the fact that it was simply a one in a million piece of very bad luck. Then I had to cope with the social reality of having a life-threatening illness: first of all, you’re often treated by medical staff just as a body with an illness, rather than a person experiencing an illness. And then many of your friends and acquaintances don’t know what to say. So they leave you alone, when in fact, I was terrified of being alone. The first few nights after the diagnosis, I slept in the same room as my sister, with the light on.”

She found Epicurus to be her most helpful mentor. She says: “I knew my future had been curtailed, but I could still find happiness even within illness, by using the Epicurean technique of focusing on the present. I tried to really enjoy whatever I was doing at that moment: yoga exercises, say, or going for a walk, or talking with my husband. Epicurus is right: we don’t need that much to be happy.” And yet, Havi is less sure about the Epicurean claim that ‘what is painful is easy to endure’. In fact, as her condition deteriorated, she found it harder and harder to endure. “You get used to a stage of the illness, and then suddenly it gets worse, and your world shrinks further. I really found that hard.”

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Greenblatt tells me: “ The book came to me at a moment when I was intensely receptive to it. It’s an experience that most of us have – a book seems to speak to you directly across a vast chasm of time and culture. It was as if Lucretius was speaking to me.”

The poem is Lucretius’ attempt to put the philosophy of Epicureanism into verse. It’s envisaged as a form of therapy – honey lining the rim of a cup of medicine, as Lucretius puts it – that would spread Epicurus’ therapeutic ideas to a wider audience, revealing to them the atomistic nature of the universe, and freeing them from their deluded fear of death and eternal punishment.

The young Greenblatt didn’t fear his own death, but he was instilled with a deep fear of his mother’s death, thanks to his mother, who possessed “an absolute certainty that she was destined for an early grave”. Greenblatt writes: “My life was full of extended, operatic scenes of farewell…even when I simply left the house for school, she clung to me tightly, speaking of her fragility and of the distinct possibility that I would never see her again.”

Mrs Greenblatt’s fears turned out to be unfounded – she lived until she was almost 90 – but Stephen was very struck by how the fear of death could make life unliveable. And this Lucretius knew and described well: “The poem crystallized things I’d been grappling with – the impatience that Lucretius gives voice to with excessive anxiety in the face of death. ‘Death is nothing to us’, he wrote. There’s a celebrated passage where he expresses quite powerfully how our endless complaints about death just get in the way of living:

Sometimes the phobia of death can grip a man so tight
He comes to loathe his very life and looking on the light,
And in his mournful heart resolves to die by his own hand,
Oblivious this fear’s the source of what he cannot stand.

In his new book, Swerve: How The World Became Modern, the Renaissance scholar examines the story of how Lucretius’ intensely modern poem was rediscovered in the 15th century by a Florentine book-hunter called Poggio Bracciolini, who brought it back to Florence and re-introduced its scandalous ideas into European culture, thereby helping (Greenblatt suggests) to create the modern world.

I spoke to Greenblatt to discuss Epicureanism, Lucretius’ vivid take on it, and its place in the modern world.

JE: Would you say you’re an Epicurean?

SG: Well, I’m not card-carrying. My card has expired. There are some aspects of it I don’t share. But if being an Epicurean or Lucretian means that I try to enhance pleasure and reduce pain, then yes. If it means that I don’t believe in a personal deity who intervenes in human affairs, or an afterlife where we’re rewarded or punished for our actions, then yes. I share Lucretius’ sense of hilarity at the belief that a deity cares about the outcome of the US election, or a sports match.

JE: What strikes me about the poem is how incredibly modern it is. In the last few years, we’ve had works by secular humanists like AC Grayling and Richard Dawkins that have tried to create a sort of secular poetry or myth to rival religious myths – but Lucretius has already done that, 2,000 years ago.

SG: What’s remarkable and moving is that this person who rigorously denies the efficacy of prayer begins his poem with the ‘Hymn to Venus’, which is one of the greatest prayers to a god ever written. Why? The answer has to be that he understood in a very deep way that humans have a natural longing for wonder and awe. And whatever the consequences of grasping an atomistic universe, it mustn’t be presented to the world as a deep disillusionment. A commitment to secular rationality doesn’t mean that the world is emptied out of wonder and ardour.

JE: The poem seems to me to put forward different views of nature. In the Hymn to Venus, nature is presented as a sort of festival of love, connecting and uniting all things. But in other parts of the poem, nature is scene as an atomistic clash or struggle between warring elements. And then the poem ends with this long and horrific description of a plague, which is like something by the Chapman brothers. Is there an ambivalence there?

SG: Yes, the poem expresses multiple views of nature. It’s one of the things that makes it an interesting work. It’s not a tract. The Hymn to Venus is extraordinary. It’s an erotic frenzy, an ecstatic and weird moment, when all of nature’s creatures feel an intense and ferocious urge to reproduce. They give up their food, they wade across rivers. It’s not a decorous or orderly moment:

Then beasts, the wild and tame alike, go romping over the lush
Pastureland and swim across the rivers’ headlong rush,
So eagerly does each pant after you, so do they heed,
Caught in the chains of love, and follow you wherever you lead.
All through the seas and mountains, torrents, leafy-roofed abodes
Of birds, and greening meadows, your delicious yearning goads
The breast of every creature, and you urge all things you find
Lustily to get new generations of their kind.

And then, at the end of the poem, there is this ghastly account of the plague. I think that Lucretius is looking at the worst that could happen, and attempting to think through it. He’s trying to show that the plague is not some divine punishment, but the outcome of ‘invisible agents’, as he refers to what we’d think of as pathogens.

JE: But it’s not very consolatory. You don’t find many long and graphic descriptions of a plague in self-help books.

SG: It’s not consolatory at all! That’s the hardest idea to grasp in some ways. There’s no reason in principle to think that existence is better in any sense than non-existence in Lucretius. In that sense, you could say his philosophy is Nietzschean. Now, I myself was brought up in a Jewish household that followed the Deuteronomic principle of ‘choose life’. So I’m not fully onboard with Lucretius’ vision of life. But I’d suggest it’s a consistent vision.

JE: Your book makes a juxtaposition, broadly, between the freewheeling and sexually liberal ethos of the ancient world, and the body-hating, ascetic and uptight Christian culture. But is it so black-and-white? Asceticism after all comes from a Greek word, askesis, which was central to Greek philosophy.

SG: Well, the juxtapositon is made grosso modo, so I’m not going to defend it belligerently. It could easily be disputed. But I would argue that, in the early Middle Ages, there was a quite sustained and very impressive collective attempt to reconceive the place of pain. It’s not that the ancients didn’t embrace pain – they had Stoicism in their culture, and the gladiator’s arena. But its quite significant that Christianity in the early Middle Ages erected a battered and bloody divinity at its centre.

JE: But, just to pursue the point, Lucretius himself was very suspicious of sexual love – didn’t he suggest that men should masturbate or go to prostitutes rather than fall in love?

SG: Lucretius is an interesting part of the conundrum. He was wary of sexual love because he understood deeply that certain ecstatic experiences of love are very close to pain [there’s a wonderful analysis of love-bites in Lucretius]. The flip-side of that, as we know of some ascetic practices in the Middle Ages, is that certain experiences of ecstatic pain are very close to pleasure.

[Greenblatt raises an interesting point here, which we didn’t have time to pursue. I wonder if Sado-Masochism, or the Marquis de Sade’s extreme philosophy of pain-pleasure, is a challenge for Epicureanism. Epicurus conceives pleasure as the absence of pain. But what if pleasure is actually mixed up with pain? Epicurus would obviously (and perhaps rightly) say that the Marquis de Sade is hardly a good model of ‘healthy pleasure’. And yet one doesn’t even have to get into S&M; to argue the point: perhaps the greatest pleasures of human existence necessarily involve some pain: the ache of love for one's children, or the music so beautiful it makes you cry. Perhaps Epicurus’ definition of pleasure as ‘the absence of pain’ is simply too dull to be either realistic or alluring.]

JE: Do you think Epicureanism is for the few or can it be for the many?

SG: That’s an interesting question. It’s not just flag-waving on my part that I end the book with Jefferson. Before him, Thomas More imagined a society founded on Epicurean principles in Utopia, but he clearly thought that the only way you can have an Epicurean society is if you insert the idea of punishment in the afterlife, because otherwise the people will behave too badly. It’s not until the Scottish Enlightenment, and Jeffersonian democracy, that the idea of a truly Epicurean society is put forward. The key moment is the Declaration of Independence, when Jefferson inserts that phrase about the ‘pursuit of happiness’.

JE: Do you think we live in an Epicurean society today?

SG: Of course not! But we could live in a more Epicurean society. That’s the hope.

JE: But how would you bring Epicureanism to a wider audience? Would that mean an expansion of the role of philosophy and the humanities?

SG: Well, I hadn’t thought of it in such self-serving terms! I’m not going to climb onboard that particular train. I think if anything we need more sciences as well as the humanities. We need people, including politicians, to come to terms with the implications of the world we live in. Have you read the Book of Mormon? Well…we better not go there.

Philosophy for Life - official website of author Jules Evans -

Then death to us, and death’s anxiety,

Is less than nothing, if a less could be.

For then our atoms, which in order lay,

Are scattered from their heap and puffed away,

And never can return into their place,

When once the pause of life has left an empty space.

And last, suppose great Nature’s voice should call

to thee or me or any of us all:

“What dost thou mean, ungrateful wretch, thou vain

Thou mortal thing, thus idly to complain,

And sigh and sob that thou shalt be no more?

For if thy life were pleasant heretofore,

If all the bounteous blessings I could give,

Thou nast enjoyed, if thou hast known to live,

And pleasure not leek’d through you like a sieve;

Why dost thou not give thanks as at a plenteous feast,

Cramm’d to the throat with life, and rise, and take thy rest?”

Greenblatt, whose work of Renaissance criticism ‘Renaissance Self-Fashionings’ was one of my favourite books at university, jokes: “I’m on the 12 step Epicurean programme for recovery”.

You can read his New Yorker article about Epicurus here (it’s behind a pay-wall), and the podcast is here.

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“Things got much better when I had my own little project and outlet for creativity”, he says. Quite quickly, the magazine did well. His friend and co-founder, Gavin Pretor-Pinney, was a design graduate and the magazine looked much better than the average alternative zine. Tom’s writing articulately laid out his Idler philosophy. And, from the start, he showed a genius for getting interviews and guest articles, from the likes of Damien Hirst, Will Self, Louis Theroux, Alain De Botton, Alex James of Blur, Bill Drummond of the KLF, and others. “We were interested in interviewing anyone who had managed to get through life without a proper job.” The Idler diversified into books, producing works glorifying the Idler lifestyle such as How To Be Free, How To Be Idle, and The Book of Idle Pleasures, and other books attacking the rat-race, such as Crap Jobs. For one who openly extolled the pleasures of the slacker life, Tom was surprisingly busy, and successful.

In his early 30s, however, Tom and his wife, Victoria, decided to leave the wild London nights behind them and move to Devon, where they rented a ramshackle old house without central heating, and devoted themselves to the bucolic dream of growing your own vegetables, raising livestock (including some ferrets), making your own beer (“that particular experiment was a disaster”, Tom confesses), and having long, leisurely lunches. “I can make a living working three to four hours a day on writing and journalism, and the rest I can hanging out with my kids, reading, going for walks, doing whatever I want really.” It has been quite a creative time: Tom’s written three books since he moved to Devon in the early Noughties. His wife and he also organized occasional weekend workshops on rural self-sufficiency, in partnership with Alain De Botton’s School of Life.

The School of Life, like the Idler Academy, has a bookstore and a classroom where workshops and talks take place. It also holds ‘secular sermons’ every Sunday, the first of which was given by Tom back in 2008. The shop has tree trunks in it “in honour of Epicurus”, and a bust of the master. De Botton says that the School, like the Garden, “gathers a regular contingent of people, and together we eat, hear lectures, go on journeys and, most importantly, attempt to live philosophically.”

Tom decided to set up his own Academy in 2010, after organizing Idler events at Port Eliot literary festival and other festivals during that year, where talks and classes were held alongside lessons in music and merriment. Classes at the Academy also take place beneath a bust of Epicurus, and cost around the same as the School of Life (£20-35 a class, including wine and nibbles). However, unlike Alain De Botton, Tom is a very visible presence at his Academy – manning the till, answering the phone, making the tea, introducing the classes in the evening, although he doesn’t actually teach them himself. The philosophy classes are mainly taught by Mark Vernon, who also teaches at The School of Life (both schools ask him what the other school is up to).

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