The “Spoon Theory” of Mental Health

spoonsBy now, most people with chronic illness have heard of “spoon theory“.  The idea of having enough “spoons” has worked its way into the vocabulary of loved ones and even people who do not suffer from chronic illness, but who understand that we all have a limited amount of “spoons”.

The original article was written Christine Miserandino, several years ago.  The idea is that spoons represent our daily allotment of energy.  We wake up with a handful of spoons each morning, and each activity represents and expenditure of spoons.  Once we run out of spoons, we are done for the day. Some of us are fortunate to have an abundance of spoons.  Others may only have a few, and must budget their spoons carefully.

The spoon theory has become more broad, over the years, becoming part of the discussion around mental health as well.  Despite this, it hasn’t really made it into clinical circles, and I think it’s valid to discuss it from a clinical perspective.  This may be especially useful for loved ones, who are supporting someone’s recovery.

When people are recovering from depression, anxiety or trauma, there can be a lot of effort applied to re-gaining a sense of control.  In the initial phases of therapy, there can be a lot of psychoeducation involved.  What I usually do is brainstorm with the client to come up with a list of coping skills.  I usually start by asking when the client felt most relaxed or most like themselves throughout the course of the week.

Some people say they feel most relaxed when they took a walk, spend time with a pet or read a fantasy novel.  This usually leads to people coming up with a list of relaxing activities that they can do in times of stress.  I prefer to work with things that the client is already doing for themselves, so their coping skill “toolbox” is uniquely theirs. Sometimes, however, people just need suggestions to get started…so I offer a few they can try, to see what works best for them.

As a general rule, people tend to start feeling better after a few weeks of consciously taking care of themselves.  That said, it is important to remember that applying coping skills takes effort, at least at first.   It takes courage and determination to tell ourselves, over and over, that we deserve self care.  As cliche as it is, we often have to fake it ’till we make it.  When we are not used to valuing ourselves, coping skills are not our habitual inclination.  Changing deeply-ingrained habits takes energy, until they become habitual.

In time, the “list” of coping skills stops being a list and starts to be a habit that we do not have to consciously think about…but it takes time, and sometimes we just have to forgive ourselves for setbacks.

I’ll offer an example.  Please understand that it is just an example, not meant to apply to everyone:  Someone who experiences panic attacks may need to learn to ground, grab some soothing tea or take a momentary break from a social situation.  For someone who has never had a panic attack, they may not understand that their friend needs these things.  Applying those coping skills may involve an expenditure of a spoon (though less expenditure than continuing to have a panic attack).  This means that the friend may need more “down time” to rest and recuperate.

This is not something to take personally.  It just means that your friend has a lower allotment of spoons.  One can use money as an analogy.  A friend whose job does not pay as well as yours may not be able to afford an expensive vacation.  It is important to understand that if they decline an invitation to travel, this is not personal.  It may be supportive to help your friend get a better paying job (assuming they dislike the job they have), but pressuring them to take the vacation without understanding their situation would not be helpful.  Only they know how much money is in their bank account.

If we go back to the hypothetical friend with the panic attacks, only they know how many spoons are in the spoon account.  The best thing you can do is encourage them to be mindful of that, and take care of themselves when the spoons are running low.

Spending time with a caring, non-judgmental person may be a source of spoon-regeneration for your friend.  You may wish to see how many spoon-boosting activities you can work into your time together.  You might find yourself with an increased level of spoons, just from allowing yourself to slow down and practice and act of kindness.

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