INSTEAD OF STARTING YOUR DAY WITH A LIMITED NUMBER OF SPOONS, YOU HAVE THE ABILITY TO SELF-CHARGE THROUGHOUT THE DAY TO BOOST ENERGY AND IMPROVE MOOD.
Christine Miserandino's spoon theory has become popular with people with chronic pain. It assumes people with chronic pain have only so much emotional and physical energy each day to do the things they want to do.
You start each day with a finite number of spoons. Each spoon represents a unit of energy. As you use up your energy, you take away a spoon.
While it's a helpful concept to help explain to friends and family who don’t experience chronic pain what it’s like to live with pain, the spoon theory is commonly used by chronic pain patients to plan their days so they don't over-extend themselves.
The problem with the theory: there isn't a way to add more spoons (energy) or to make each spoon last longer than expected.
Therefore, it can be self-limiting - focusing on what we can’t do instead of the things we can and leading us to avoid activities that could make us feel worse but may very well help us in terms of giving us more energy and improving our mood. For instance, we may choose to save spoons by not joining our friends for lunch or going on a much-needed walk.
Recent research "demonstrated that on mornings when patients catastrophized more than usual about their pain in the day ahead, they spent more time in sedentary behavior and engaged in fewer minutes of moderate to vigorous physical activity that day. Cross-day lagged analyses further showed that the effect of morning pain catastrophizing on subsequent sedentary behavior extended to the next day. More time spent in sedentary behavior, in turn, contributed to greater pain catastrophizing the next morning" (Zhaoyang et al 2020).
Who wants to wake up each day thinking you're limited in what you can do? I tend to see things more positively.
We have more control over our pain, energy, and mood than we think.
Another idea: Think of your day like a battery system in a car.
If you don't use a car or if you leave on a car's lights or radio without the engine running, the car battery will eventually run out of energy. But if you drive the car, the alternator will recharge the battery as you drive.
Just like a car's battery system, we can add more energy to our days by doing things like:
Check out 50 ways to live well, despite chronic pain.
Note: This is just another tool to add to your chronic pain toolbox. If the spoon theory or another approach works for you, please continue using it.
People with chronic pain often do too much when they’re having good days and not enough when they’re having bad days.
Chronic pain can cause us to overprotect ourselves. Our natural reaction to pain is to avoid activities that worsen our discomfort or increase our perceived risk of further damage. When we become overly fearful and stop doing things in anticipation of pain, we can make things worse.
Inactivity reduces our functional ability and decreases our strength and stamina. It also prevents us from getting involved in the social, leisure, and work activities we enjoy.
Pacing/moderation has become a common tool for people living with chronic pain to help provide them with balance. It includes setting time limits, slowing down (start low, go slow), breaking up tasks, and taking frequent short breaks.
But be careful not to let pacing become an excuse for not being active or avoiding pain. Doing so can add more focus to the pain, worsen symptoms, and reduce physical stamina.
Pacing should instead be used to gradually increase what we can do, despite the pain. Stay consistent with your activity.
The difference is in the goal and execution. Keep moving forward.
Learn more and do more
Cooper, Booker and Spanswick, 2003
I just watched a great TEDx Talk from Dr. Trung Ngo about resilience that everyone who lives with chronic pain or treats chronic pain should watch.
He talks about how there are three types of people:
I can identify with all three types during my personal journey with pain. Early in my journey, I was the victim. It was the surgeon's fault for my pain. I was set on making that doctor pay for his mistake and make my pain go away.
As the pain continued, I became the catastrophizer. It quickly became gloom and doom. I become fearful of the pain. I worried about all the terrible things that might happen because of the pain. And I worried about my future and the future of my family.
Fortunately, my mindset changed to resiliency. Many thanks to the Mayo Clinic Pain Rehabilitation Center for helping me transition to that stage.
How to be resilient
According to Dr. Ngo, the keys to being resilient:
* Ojala, T., Häkkinen, A., Karppinen, J., Sipilä, K., Suutama, T., & Piirainen, A. (2014). Chronic pain affects the whole person – a phenomenological study. Disability and Rehabilitation, 37(4), 363–371. doi: 10.3109/09638288.2014.923522
Tom Bowen is a chronic pain patient who turned into an advocate, educator, and collaborator.
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