Tuesday, November 17, 2015

Spoon Theory and Health

Spoon Theory is an analogy developed to explain the difficult choices that have to be made, day by day, by those with chronic diseases, serious depression, fibromyalgia and other debilitating conditions. Here's a link to the original story, created in a restaurant, to help a healthy, able-bodied person understand just a little better about how difficult it can be when one doesn't look ill, but has drastically limited energy for even the most basic of tasks.

The idea is now widely known, and used in many contexts. But the disabled community - in the broadest sense, including the chronically sick and exhausted - insist that it's only relevant for those with health conditions of some kind. It does not, some of them say, apply to the able-bodied. The difference is apparently about the need for choices; healthy people (one blogger wrote) have an endless supply of 'spoons', and thus don't need to make constant decisions about which of two options they must do.

I think it's unfortunate that it's seen as so black and white. For one thing, 'health' is a vast spectrum of conditions. Even amongst the chronically sick, one person might have twelve 'spoons' worth of energy for the day, another might have only six. Someone else might wake up with just one, if their condition worsens, or if they've made choices the day before that deplete their entire energy for the rest of the day.

Amongst the generally healthy, too, there are ups and downs. After a bout of influenza, even the fittest of people can feel entirely lacking in energy. Just getting out of bed to go to the bathroom can drain them for hours. Yes, it's temporary. Yes, they will almost certainly get better. It's not to be compared to the chronically sick, who have to suffer in this way day after day. But the reason that the analogy is so powerful is that the rest of us DO understand, not just in theory, but from having been in that situation ourselves, albeit temporarily.

More significantly, though, different people have different amounts of energy. And different activities replenish or diminish it, through the day. I don't think anyone starts the day with an infinite number of spoons; even the most energetic bouncy person will eventually flop.  A child usually has more energy than a young adult. A young adult has more energy than a busy mother. A busy mother has more energy than an elderly person. There are a limited and varying number of spoons for each of us.

I'm fortunate enough to sleep well, usually. So perhaps I wake up with a hundred spoons, rather than just ten or twelve. My situation is undoubtedly much easier than that of someone with chronic illness. I feel rich in spoons; I get out of bed and pull on clothes with barely a thought; yes, the actions take up a couple of spoons, but that's okay; there are lots left.

But there aren't always sufficient spoons to last the day. I have to pace myself too. Not in the ordinary chores which pose so much difficulty to the chronically sick; I certainly understand that there's a wide gulf between someone who has to sit down for half an hour after walking downstairs, and someone who can hurry straight back up the stairs because they've forgotten something. I am very thankful for the spoons I receive every morning, and that, most of the time, they are sufficient.

But I'm an Introvert; that means that simply being with other people is an energy drain.  A pleasant evening with two or three friends is very enjoyable, but it depletes my spoons rapidly. That's okay if I'm going straight to go to bed when they've left; I recharge well when I'm asleep. But if I still need to clear the kitchen, and put the rubbish out, and think about what I'm doing the next day, my mind will go blank; it will be difficult to drag myself to bed. Sometimes I barely have the energy left to brush my teeth.

I'm also growing older. I like pottering in the kitchen; I make almost everything from scratch. It's a choice I make, and I'm thankful that I can. But if on one morning I make soup, and ketchup, and granola, and a cake, none of which is particularly difficult by itself, my spoon supply depletes rapidly. Sometimes there's nothing left by the time everything is finished.

I'm immensely thankful that I'm not chronically ill. I'm thankful that I am able to make choices - genuine choices, to make this, or go there, or do that. But those choices do have an impact on the rest of my day, particularly if I'm with other people. There have been times when I've said 'no' to a suggestion of activity that would probably have been enjoyable, because I know that if I do it, I won't have the energy I need for the following day.

Energy levels can be reduced by pain of any kind, by standing for too long, by stress or arguments. I rate almost 100% on the 'highly sensitive person' scale; in recent years I've adjusted my life so that few of these things impinge too much. I avoid bright lights and loud music; I don't watch television; I make sure I have plenty of time to do things, and try not to run into stressful deadlines. But all those things can deplete my energy - or reduce my spoons, depending on how you prefer to look at it - in ways that are hard to understand by those for whom they are energising.

We each have our own likes and dislikes, our own stresses and concerns. We each have our own energy levels which vary from day to day; we each have different things or people who drain us. There's no easy formula to maximise energy, and sometimes it's inevitable that we run out. Those who are chronically ill have it far worse than those who are able-bodied and healthy, but that doesn't mean we don't or can't 'get it'.

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