There’s a version of this conversation that goes: “Stoicism is just repression with a philosophy degree.” Critics say it. Therapists sometimes say it. People who tried to “Stoic through” grief and ended up worse off definitely say it.

The critics aren’t entirely wrong about bad Stoicism, the kind where you white-knuckle through emotions rather than work with them. But they’re describing a corruption of the practice, not the thing itself. And now there’s enough clinical research that we can be more precise about what Stoicism actually does to emotional regulation, mechanistically, and why it’s not suppression.

The short version: it’s reappraisal. And reappraisal is one of the most well-studied emotion regulation strategies in psychology.

The Quick Version

A 2026 study from the University of Southampton found that participants practicing three Stoic exercises (negative visualization, cognitive distancing, and reflective journaling) showed measurable reductions in anxiety and depression compared to control groups over an 8-week intervention. Separately, researchers have established that Stoicism operates through the same psychological mechanisms as Cognitive Behavioral Therapy and Acceptance and Commitment Therapy: reappraisal, not suppression. This distinction matters enormously for how you practice.

What the Southampton Study Actually Found

The University of Southampton study is worth looking at carefully, because it’s more specific than most popular write-ups suggest.

The researchers ran an 8-week intervention with participants using three Stoic practices: negative visualization (imagining feared outcomes in advance), cognitive distancing (the Stoic exercise of stepping back from a first impression before assenting to it), and reflective journaling (the evening review Marcus Aurelius described in Meditations). A control group received no intervention.

At the end of eight weeks, the Stoic group showed statistically significant improvements on standardized measures of both anxiety and depression. And significantly better emotional regulation scores compared to controls. That second finding is the part that matters most.

Emotional regulation isn’t just “feeling better.” It’s a measurable capacity: the ability to notice an emotional response, evaluate it, and choose how to respond rather than react automatically. That capacity is what the study found improved. Not mood. Not happiness. Regulation.

This distinction is worth sitting with, because it maps directly to what Epictetus was actually teaching.

The Mechanism: Reappraisal vs. Suppression

Epictetus’s central claim was not that you shouldn’t feel things. He felt things. Marcus Aurelius felt things. Seneca (probably the most emotionally expressive of the three) felt quite a lot of things and said so at length.

The Stoic claim was about what happens after the initial emotional impression arrives. Epictetus called this the discipline of assent: the gap between an impression and your response to it, where you choose whether and how to accept the impression’s framing.

Modern psychology calls this gap cognitive reappraisal. And it’s the best-supported emotion regulation strategy in the literature.

Suppression is what critics think Stoicism does. You feel the emotion and push it down. You don’t change the emotional state; you just stop expressing it. Decades of research show suppression makes emotional distress worse over time, increases physiological stress responses, and exhausts cognitive resources. James Gross at Stanford has documented this extensively.

Reappraisal means you change how you interpret the situation before the full emotional response solidifies. You don’t block the emotion; you shape it at the source. The research on reappraisal shows the opposite pattern from suppression: reduced physiological stress, better long-term wellbeing, lower rates of depression and anxiety.

Stoicism, practiced correctly, is a reappraisal system. That’s why it shares mechanisms with CBT and ACT. Those approaches were partly designed by people who read the Stoics.

The CBT Connection Is Not Accidental

Albert Ellis, who developed Rational Emotive Behavior Therapy (the forerunner to CBT), was explicit that Epictetus was a direct influence. The foundational CBT model (that emotions arise from interpretations of events, not events themselves) is a modern restatement of what Epictetus wrote in the Enchiridion.

“Men are disturbed not by the things which happen, but by the opinions about the things,” Epictetus wrote in the first century. Ellis essentially built a therapeutic protocol around this.

ACT (Acceptance and Commitment Therapy), which is now one of the most evidence-based therapies for anxiety and depression, operates through cognitive defusion, which is exactly what Stoic cognitive distancing does. The ACT technique of saying “I notice I’m having the thought that…” is a direct formalization of the Stoic practice of treating impressions as impressions, not facts.

When the 2026 research shows that Stoic exercises improve emotional regulation, it’s not surprising. Stoic practices share underlying mechanisms with therapies that have been refined through decades of clinical trials.

What’s useful about the research isn’t the confirmation that Stoicism “works.” It’s that the research tells us which elements of Stoic practice are doing the work, and why.

What Each Practice Is Actually Doing

Negative visualization (premeditatio malorum) is often misunderstood as pessimism. The mechanism is actually pre-exposure: you imagine a feared outcome in advance, in a controlled setting where you can think through your response. This engages prefrontal planning systems while reducing the amygdala’s capacity to treat the imagined scenario as novel threat. Over time, it builds what researchers call “fear tolerance.” Not the absence of fear. The capacity to function inside it.

You can see how this connects to the neuroscience research on Stoic practices, which found that this exercise activates the same frontal systems involved in reappraisal.

Cognitive distancing is the practice of treating your initial impression of a situation as a hypothesis to examine, not a fact to accept. When you notice anger rising at a criticism, the Stoic exercise isn’t to not feel the anger. It’s to pause and ask: what is this actually saying? Is it true? What would a person I respect think if they saw me react to this? This pause is the mechanism. Emotion regulation research consistently shows that the ability to create this pause (even briefly) significantly predicts wellbeing outcomes.

Reflective journaling (the Stoic evening review of what you did, where you fell short, what you learned) builds what psychologists call metacognitive awareness: the ability to observe your own mental processes from the outside. This is the specific capacity the Southampton study found most improved. People who journal reflectively get better at noticing their emotional patterns before those patterns run automatically.

For a practical guide to building this into a daily habit, the journaling and daily philosophy practice post covers the actual mechanics.

A Quick Reference: What the Research Shows

Practice	Mechanism	Clinical Effect
Negative visualization	Pre-exposure, fear tolerance	Reduced anxiety over 8 weeks
Cognitive distancing	Reappraisal, defusion	Improved emotional regulation
Reflective journaling	Metacognitive awareness	Reduced depression scores
Full Stoic routine	Combined above	Comparable to short CBT interventions

The “comparable to short CBT interventions” finding in that last row is the most clinically significant. It doesn’t mean Stoicism replaces therapy. It means the magnitude of effect is in the same range, which is meaningful.

The Research Doesn’t Show Everything

Worth being clear about what the studies don’t show.

Eight-week interventions don’t tell you what happens at nine months or two years. Sustained practice almost certainly produces different (likely larger) effects, but the long-term data on Stoic-specific protocols is sparse. Most long-term data comes from CBT and mindfulness research, which overlaps but isn’t identical.

The Southampton study, like many psychology intervention studies, has limitations: sample size, self-selection bias (people who sign up for a Stoicism study may be predisposed to benefit), and the difficulty of isolating specific practices from the general attention effects of any structured intervention.

None of this makes the findings useless. It makes them properly provisional. The practices have strong theoretical grounding in mechanisms that are well-studied elsewhere. The 8-week data is consistent with what the mechanistic research would predict. But “promising evidence” is different from “proven.”

There’s also the question of who this helps most. Stoic emotional regulation practices appear most effective for cognitive anxiety: the spiral of interpretation and catastrophizing. They’re less straightforwardly applicable to trauma, where the issue isn’t bad interpretation of a neutral event but the aftermath of something genuinely terrible. The stoic grief guide addresses that distinction directly.

The Suppression Trap: Why Practice Matters

The gap between Stoicism-as-suppression and Stoicism-as-reappraisal isn’t just philosophical. It has real consequences for how you practice.

Suppression Stoicism looks like: something upsetting happens, you decide not to feel it, you push through, you treat the impulse to acknowledge difficulty as weakness. This is exactly what produces the phenomenon some researchers call emotional rebound, where suppressed emotions resurface stronger, often at worse moments.

It’s also what produces toxic Stoicism: the cultural version that uses Stoic language to justify emotional unavailability and call it virtue.

Reappraisal Stoicism looks different. Something upsetting happens. You notice the feeling. You name it. You ask: what is this feeling based on? Is the interpretation correct? What, if anything, can I do about the underlying situation? You let the reappraisal change the emotional state—or not, if the feeling turns out to be warranted.

This second version is harder to do, because it requires you to sit with the discomfort long enough to examine it rather than immediately pushing it away or immediately acting from it. That tolerance of uncertainty is itself a skill, and it’s one the research suggests Stoic practice builds.

Starting Where You Are

You don’t need to overhaul your life or become a philosophy scholar. The research points to three specific practices, each implementable tonight:

Cognitive distancing, once per day: When something stirs a strong reaction (an email, a conversation, a news story), write down the initial interpretation (“this is unfair,” “this means I’ve failed,” “this is going to go badly”). Then write what you actually know. Not what you fear. What you know. The gap between those two sentences is where reappraisal happens.

Negative visualization, five minutes: Pick one thing you’re anxious about. Walk through it as if it has already happened. Stay realistic, not catastrophic. Then write: if this happens, what’s still in my control? The third step is what distinguishes this from rumination. Don’t skip it.

Evening review, three questions: What did I handle well today? Where did I react rather than respond? What would I do differently? This isn’t self-criticism. It’s the metacognitive loop that builds the capacity to catch yourself faster next time.

The mental fitness post has more on building these into a sustainable routine without turning philosophy into another item on an already full to-do list.

A Note on Using This Alongside Therapy

The research on Stoicism and emotional regulation is good news, not a replacement for professional support.

CBT therapists often already incorporate Stoic-adjacent techniques. If you’re seeing a therapist, these practices can complement that work. Bring them up in session. If you’re dealing with anxiety or depression that’s significantly affecting your life, please don’t treat an 8-week study as evidence that philosophy is all you need.

What the research shows is that intentional Stoic practice can produce measurable improvements in how we regulate emotions. That’s genuinely valuable, and it means the ancient practices were pointing at something real. But Epictetus himself taught in a school, worked with students personally, and acknowledged that different people needed different approaches.

The practices work. They work better with support than without it.

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The University of Southampton research and related studies are published in Frontiers in Psychology. For a rigorous overview of cognitive reappraisal research, James Gross’s work at Stanford—available through Stanford Social Neuroscience Lab—is the foundational reference. For the CBT-Stoicism connection, Albert Ellis’s own writing on rational-emotive therapy makes the influence explicit.