So, skepticism is an ability to discover opposed arguments of equal persuasive force, the practice of which leads first to suspension of judgment and afterwards, fortuitously, to tranquility. This makes Sextus’ version of Pyrrhonian skepticism dramatically different from other Western philosophical positions, for it is a practice or activity rather than a set of doctrines. Indeed, insofar as the skeptic is supposed to live without belief (adoxastôs), he could not consistently endorse any philosophical doctrine. But how is it possible to live without beliefs?
The short answer is that one may simply follow appearances and withhold judgment as to whether the world really is as it appears. This seems plausible with respect to physical perceptions, but appearances for Sextus include evaluations, and this creates a complication. For how can the skeptic say “this appears good (or bad) to me, but I don’t believe that it is really good or bad”? It seems that there is no difference between evaluative appearances and evaluative beliefs.
One possible response to this problem is to say that Sextus only targets sophisticated, philosophical theories about value, or about physics or logic, but allows everyday attitudes and beliefs to stand. On this view, skepticism is a therapy designed to cure the disease of academics and theoreticians. But it seems that Sextus intends his philosophical therapy to be quite widely applicable. The skeptical life, as he presents it, is an achievement and not merely the recovering of a native innocence lost to philosophical speculation. (See Burnyeat and Frede , Brennan  for the debate regarding what the skeptic is supposed to suspend judgment about.)
Any answer to the question about how the skeptic may live without beliefs will depend on what sort of beliefs we think the skeptic avoids. Nevertheless, an elaboration on living in accordance with appearances comes in the form of the fourfold observances. Rather than investigate the best way to live or even what to do in some particular circumstance, Sextus remarks that the skeptic will guide his actions by (1) nature, (2) necessitation by feelings, (3) laws and customs, and (4) kinds of expertise (PH 1.23-24). Nature provides us with the capacity for perception and thought, and we may use these capacities insofar as they don’t lead us to dogmatic belief. Similarly, hunger and thirst will drive us towards food and drink without our having to form any explicit beliefs regarding those physical sensations. One need not accept any nutritional theories to adequately and appropriately respond to hunger and thirst. Laws and customs will inform us of the appropriate evaluations of things. We need not actually believe that the gods exist and that they are benevolent to take part in religious ceremonies or even to act in a manner that is (or at least appears) pious. But note that the skeptic will neither believe that the gods exist nor that they do not exist-he is neither a theist nor an atheist, but agnostic in a very robust sense. And finally, the skeptic may practice some trade or profession without accepting any theories regarding his practice. For example, a carpenter need not have any theoretical or geometrical views about doors in order to be skillful at hanging them. Similarly, a doctor need not accept any physiological theories to successfully heal his patients. The further question, recalling the dispute explored in Burnyeat and Frede , is whether the skeptic merely avoids sophisticated, theoretical beliefs in employing these observances, or whether he avoids all beliefs whatsoever.