What is spoon theory for chronic pain?
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What is spoon theory? Christine Miserandinoβs spoon theory is a metaphor for describing the experience of chronic illness and its limitations on disabled people and people with chronic illness.

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Β©Esther Pueyo / Adobe Stock
What is spoon theory for chronic pain?
Mum: βYou arenβt always sensible you know.β
Me: βName six occasions.β
Mum: βThe time you climbed all five storeys of Loche chateau keep.β
Me: βThat was 26 years ago.β
Mum: βIt wasnβt a good idea.β
Me: βYouβre going to bring up the time I climbed Richmond castle when I couldnβt walk unaided arenβt you?β
Mum: βWell that wasnβt sensible either.β
Why do we need to budget physical and emotional energy
Chronic illness and disability often come with the need to budget physical and emotional energy. As neatly outlined in Christine Miserandinoβs Spoon Theory for chronic pain, people with conditions such asΒ myalgic encephalomyelitis,Β multiple sclerosis,Β Ehlers-Danlos syndrome, and a whole host of others, have a limited amount of energy to spend on day to day life.
Activities many able-bodied people take for granted β showering or getting dressed β eat into that budget, so every single thing we do gets weighed up for cost/benefit and paced. Itβs the only viable, and sensible, way to live.
Christine Miserandinoβs spoon theory and many of the articles around it cover the problems that arise when people around us donβt understand how our energy budgets work β the good old question of βhow come you canβt do this if you were able to do that?β
Why are you doing that? Donβt you have a chronic illness AND a disability?
What I want to talk about is something less explored β the awkward conversations we have, not when we canβt do something, but when we decide we can. Especially if it is something other people donβt think is a good use of energy.
Iβve been ill since 1990. There have been good years and bad years. The glorious sunlit seas of 2010 when I could sail quite regularly, to the tooth-grinding annoyance of early 2018 when a giant invisible vampire sucked my energy dry. One thing is consistent though β every single day, whether well enough to work full time, or landing in bed because I had a shower, a bespoke budget is calculated.
Much of the calculation is straightforward. Does the benefit gained from this activity outweigh the cost? If so, it gets ranked by priority, crucial stuff pushing out the nice but non-essential. When I needed to support myself, work topped the list. When there was oomph to spare it went into friends and hobbies because no one lies on their deathbed regretting the housework they didnβt do. The sneered at the phenomenon of ready-meals tipped the budget in favor of independent living.
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Read more:Β Tilly Lockey, bionic girl: βMy difference is my superpowerβ
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Just as overspending on a credit card weekly is not a great long-term plan for financial health, so regularly overspending on physical energy will leave you broke and broken. Nonetheless, there are times when I do the cost/benefit calculation on an activity, note the probable physical cost heading my way like a freight train without brakesβ¦ and do it anyway. Understanding this is key to understanding Christine Miserandinoβs spoon theory for chronic pain.
I donβt understand your chronic illness and disability β you should be in bed!
Thatβs where the awkward conversations occur. Frequently people who love and care for us, and who understandably donβt want to see the collapsed heap on the sofa the next day, canβt understand why anyone would stand in the path of that freight train to achieve something seemingly trivial. Itβs just not sensible.
Itβs the medical equivalent of spending your savings on a giant fiberglass dinosaur for the garden. Itβs not actively irresponsible β youβve got the money right now β but do it, and youβll be eating bread and butter for the next month. Thatβs ok, you know ten different recipes to make bread and butter palatable. Β And you really, in the truest depths of your heart, need to own that replica diplodocus. But as far as your parents are concerned, youβve just blown the price of a car to put a diplodocus among the delphiniums andβ¦ wouldnβt it be better to be sensible?
To listen to the videoΒ What is spoon theory for chronic illness and disability, watch the video above (if the CC icon is not on your screen, tap the screen to make it appear)
Well, no. Sometimes it damn well wouldnβt. Sometimes, we all need our diplodocus. Thatβs doubly true for people who spend 95% of their lives being sensible because they have no choice. If you can climb a castle tower, or head to the cinema anytime you fancy it, taking a raincheck on one event isnβt a big deal.
When every single day, for decades, absolutely everything, right down to your hairstyle and how often you have a shower, is a calculation, then it is. When, on the vast majority of days you are sensible, even if it means foregoing hobbies or friends or dating, because you physically canβt survive any other way, then the times you look at that calculation and say, ok, possibly bad idea, but Iβm having that damn dinosaur, those times matter. They are precious. And this is what spoon theory is really about.
I havenβt climbed a good big tower since 2012 when I defied maternal opinion to tackle Sacre Coeur in Paris. My condition has progressed and most times now I look at high towers, deep caves, long flights, loud movies and decide they are just not worth the pain. Itβs not that Iβve grown up or evolved more common sense. Itβs just that after nearly 30 years, the pain and exhaustion are starting to win. It makes me sad. It makes me less me. Nonetheless, when I spot a new diplodocus on the horizon, I have no intention whatsoever of being sensible.
And this is what Christine Miserandinoβs spoon theory is all about.

Aphra Pell
Aphra Pell was born slightly too long ago in the UK, to a family with a dilapidated cottage, dogs and cats, and a lot of books.
Caption:
Chronic illness and disability often come with the need to budget physical and emotional energy. Some people use spoons.