Spoon Theory… A Spoonful of Sugar Doesn’t Always Cut It with Chronic Illness!
When I was younger, I was obsessed with the comedian, Dane Cook. Don’t judge me, I was once young and fancy free. He had this skit about a kid who becomes obsessed with snorting Nestle Quik, the chocolate powder. Anyway, one of the jokes from this skit was the kid saying “I can’t kick the ball today, I just can’t!” He was saying it because he was hooked on the cocaine-like addictiveness of the chocolate Nestle Quik drink but it stuck with me. In case you think I’m insane – check out the skit here.
On days when I was not really ready to take on the day, I started to adopt the phrase “I can’t kick the ball today.” Did you ever wake up too tired, too overwhelmed, too sad, too anxious, too “something” to do an extra single thing in your day? How about to do the things you need like getting out of bed, brushing your teeth, washing your face, and getting dressed?
I’m sure everyone has had a day like that. Maybe you pulled an all nighter working on a project. Maybe a child kept you up all night. Maybe you were ill for a few days and this wiped you out. Just a day where you wake up and feel like you’re not “in it to win it.” That you have to fake it until you make it. Days when dinner will be something quick and easy. Days when the only thing getting you out of the bed in the morning is the prospect of a good nap/ returning to bed.
I would like to introduce you to a concept called the Spoon Theory. The Spoon Theory is “a metaphor used by people with chronic illnesses to explain how they manage their energy and cope with their condition. The theory was developed by Christine Miserandino, a blogger with lupus, in a 2003, to explain her chronic illness to friends.”
As a physical therapist, what I like about the Spoon Theory is that it helps to illustrate the energetic needs and expenditures of a person with chronic illness or disability. We can look at spoons as a unit of energy. Each chore and task requires a different amount of spoons. This process helps people coping with chronic illnesses visualize their total daily energy. Together, the calculations become a benchmark for pacing and prioritization strategies.
Not sure what I’m talking about? Imagine, energetically – whether that be emotionally, physically or spiritually – that you have a certain amount of spoons for a day. For fuzzy math purposes, let’s say you start with 75 spoons! We would then make a list of what you WANTED to complete in a day and how many spoons were needed for each task.
Example of my day:
- Wake up and get out of bed
- Take morning vitamins and medications
- Go to the bathroom
- Brush teeth
- Washy face
- Pick clothes
- Get dressed
- Make bed
- Wake child
- Assist child with her morning routine
- Feed pets
- Pack work bag
- Make breakfast (varying #1-3)
- Drop kid at bus
- Drive to work
- Enter work bringing supplies
- Treat patients
- Write notes
- Pack up work bag
- Pick up kid from bus stop
- Pick dinner
- Make dinner
- Feed pets
- Shower
- Assist child with bedtime routine
- Laundry
- Dishes
- Change into PJs
- Brush teeth/ wash face
- Go to bed
The other thing to consider is that a task may not always cost the same amount of spoons from day to day and a similar task may entail different variables. You start out with this bank of spoons and then have to spend them on the tasks you need to do throughout your day. Make sense? If you’d like, take a moment to write out what a day in your life looks like and consider your spoon expenditure.
Now think about what might happen if someone or something robs your spoon bank! You normally have 75 spoons and you’re gotten really good at budgeting them, saving them, and spreading their use throughout your life. And then, you sprain your ankle and this takes away 10 of your spoons. Now all you have is 65 to get through your day. Can you see how that day might be more challenging?
Imagine that your ankle sprain lasts for a whole week. Everyday, it takes 10 of your spoons right off the top. You try to keep up with your life and so maybe you go into spoon debt, using more spoons than you really have. How do you feel? What happens when you are bankrupt of spoons and your child asks for a cup of water after being tucked in or your partner indicates they’d like to spoon you? You may not feel so open to those things.
People dealing with chronic “stuff” whether from things like neuromuscular disease, autoimmune disease, mental health issues, neurodivergence, or cancer are likely to have a disruption to their spoon bank. As someone who has chronic fatigue issues from lifelong thyroid dysfunction, I am pretty familiar with the Spoon Theory. Sometimes you have to save the spoons you would spend on washing/drying your hair to make sure you have enough to entertain your kid until bed time. Sometimes you forfeit the spoons needed to make a healthy meal and opt in to a Wendy’s 4 for 4 so you have enough spoons to fit in a few more hours of work for the night.
I wanted to take time to write about this concept as I explain this to my patients who are undergoing and feeling some health issues. Here are some tips from our practice.
- Understand Your Spoons: Think about how many “spoons” (units of energy) you typically have each day. Keep in mind that not every day will have the same number of spoons and that some activities will require more spoons than others.
- Prioritize Tasks: Make a list of daily tasks and prioritize them based on importance and energy cost. If able, try to focus on completing high-priority tasks when you have the most energy, and skip any lower priority activities that you can!
- Plan and Pace Yourself: Break tasks into smaller, manageable chunks and schedule rest breaks between activities to avoid depleting all your spoons at once.
- Listen to Your Body: Pay attention to signs of fatigue and stop to rest when needed. Don’t push through exhaustion; it’s better to rest and conserve spoons for necessary tasks.
- Set Realistic Goals: Adjust your goals based on your energy levels. Celebrate small achievements and be kind to yourself if you need to adjust your plans.
- Communicate Your Needs: Explain the Spoon Theory to family, friends, and coworkers so they can better understand your limitations. Don’t hesitate to ask for help when you need it.
- Incorporate Energy-Saving Strategies: Use tools and techniques to make tasks easier, such as using assistive devices or simplifying routines. Prioritize self-care activities that replenish your spoons, like gentle exercise, meditation, or hobbies you enjoy.
- Monitor and Reflect: Keep a journal to track your daily activities and energy levels. Reflect on patterns that emerge and adjust your routines to better manage your spoons.
- Balance Activity and Rest: Strive for a balance between activity and rest to avoid overexertion. Incorporate regular, scheduled rest periods into your day.
- Practice Self-Compassion: Acknowledge that it’s okay to have limitations and that managing energy is a continuous process. Be forgiving of yourself on days when you run out of spoons faster than expected.
These tips can help people undergoing any type of struggle to manage their energy more effectively, leading to improved overall well-being and a better quality of life.
Leave us a comment to let us know if this was helpful to you!
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Practically Yours,
Dr. Mora and the Staff at PPPT
