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Table 1 Description of core Stoic practices

From: Can stoic training develop medical student empathy and resilience? A mixed-methods study

Stoic practice


Negative visualisation

Negative visualisation is a psychological practice in which participants visualise the bad things that could happen to them for example: what would happen if you were to lose your job, or if someone you cared about were to die? Negative visualisation as a term was first introduced within Stoicism by William Irvine [29], with ancient philosophers referring to this practice instead as ‘premeditatio malorum’ [30]. This exercise may appear pessimistic, but it is a powerful tool for developing appreciation for the things within your own life, and developing tangible plans for what you could do, were things to go wrong [29].

Stoic mindfulness

Stoic mindfulness concerns reflection on one’s own emotions and thoughts. Once this reflection fosters insight into an individual’s emotions and thought processes, individuals must actively remind themselves that emotions are projections of their own judgments- people assign labels to what they feel and experience which classify things positively or negatively. There are some things in life outside of our control- Stoicism advocates focusing your attention on only what you can control- often this is our emotional response to what happens to us or around us. Reframing negative emotions and experiences by exercising control over how you respond to what is happening can reduce rumination, catastrophising, pity and anger [30]. Stoic mindfulness differs from Eastern mindfulness-based practice- though both advocate careful reflection on one’s own attention, Eastern mindfulness attempts to root attention in the present moment, whereas Stoic mindfulness advocates for a focusing of attention on judgments and actions that we can directly control.

Stoic reflection

Stoic reflection is a type of daily reflection, where individuals look both forwards and backwards upon their day, rationally reflecting upon what is practically achievable, how they may approach setbacks, and the highs and lows of the day [31].