Pacing wasn't something I was too aware of in the time of my life before my chronic illnesses kicked in to the degree they're at now. Before then I was overloading my plate and getting away with it, with only occasional breaks needed.
However as I have gotten older and with my chronic illnesses developing - or I guess actually being more in tune with my body to notice my needs more! - pacing is something that is very much needed.
Boom - Bust cycle
The boom bust cycle actually comes from economics (Karl Marx) however it has now been applied to psychology and how we can live as humans.
How I explain the boom-bust cycle is in terms of our energy levels and capacity, though this can then go deeper into pressures & expectations on ourselves.
As the graph shows, when we have capacity/energy - a "good day" - we might feel the need to get as much done as possible. But then we'll hit a peak as we've exceeded our max capacity - this might be a pain flare up, condition flare up, mental health dip, migraine, etc. - and we then end up on a drop into the bust part of the cycle where we have no energy/capacity to do anything. Then after resting & recovering, the cycle repeats as we feel the need to catch up on the 'bad days' we've just had.
The time that this cycle last might be different for everyone. It may be as volatile as every day, waking up with energy to do some tasks, overdoing it, and then needing to crash for the rest of the day. It may be that it's a monthly cycle. or a yearly cycle.... it will be individual to you. Have a think back to your last week/few months/year - does this sound familiar?
So, what is "pacing"?
Pacing is a process in understanding what your capacity is and working out a way to slow down so your capacity isn't overloaded. This can be done in many different ways and in a society where 'hustle culture', perfectionism, and comparing ourselves to others is rife, it can be hard to refocus purely on your own way of living and finding your own equilibrium within it all.
This can be done in different ways in a process:
Some people find spoon theory to be useful in understanding what their capacity is.
this will be a process of working out how many spoons you actually have (make your best guess) and then how much each task takes. You might start with 12 spoons and categorise tasks into whether they use 1 spoon, 2 spoons, 3 spoons etc.
Some people find timing events/tasks to see what you can manage before being at max capacity is useful.
Similarly to above, this is categorising tasks, however it will be into time taken categories rather than energy used. Generally it is a good idea to pick one task to start with e.g. going for a walk. From here you would do what felt manageable being really mindful of how you're feeling before, during, and after. You would time the walk and do this each time you went for a walk in the week. Then look at the average time from the week as this will be your 'pacing time' i.e. the time that is manageable for this task.
Some people might try a calendar approach by starting off with minimal tasks and building up to find their sustainable amount of events in a day/week before hitting capacity.
Others might go about it in a more trial and error way.
For me, personally, I looked at areas of my life and working them out in a layered way. E.g. my first priority has been work capacity. This involved working out how many clients felt manageable in a day, as well as spacing them out throughout the day for rest in between. I did this so I was under capacity, as then I've been able to layer on different areas of life like socialising, home life, looking after my dogs, housework etc. (I recognise here that I am really privileged to be able to do this with my work and have freedoms that others do not. If work isn't something that can be done in such a flexible way it's always worth looking into whether an occupational therapist visit is possible to help put reasonable adjustments in place at work.)
Depending on what's going on for you, the absoluteness of how far you go with the process will be up to you. For some learning their capacity for different tasks down to brushing teeth, getting out of bed, getting dressed, showers, etc. is needed as their max capacity might be a lot lower than expected and so even the 'smallest' of tasks will take energy to a greater extent. For others capacity might be at a higher capacity and so figuring out tasks won't need to be as absolute but might be more to an extent of physical tasks taking energy e.g. housework, travelling, exercise, or mental energy e.g. reading, learning, work, or emotional e.g. social events, messaging, phone calls, etc.
Or you might need to work out your capacity for a mixture of some/all of these things.
It might also be that your capacity changes over time with the amount of support you have around you, with life events out of your control, with treatment options you might have. With this in mind, pacing is a fluid process which needs to have check ins with yourself and where you're at to adapt to where you are in that moment.
Using a "Timetable"
I was first introduced to pacing when I had CBT for pain management. The process here was to identify different tasks I fill my days with/or want to fill my days with.
First off, we separated the tasks into enjoyable tasks (tasks we choose to do for pleasure), routine tasks (tasks we do daily/weekly) and necessary tasks (tasks that have to be done otherwise there is a negative consequence).
Once you have these lists sorted, you would then colour code these tasks into Easy (green - tasks that don't take up much energy), Medium (yellow - tasks that are doable but take some energy), Hard (red - tasks that take a lot of energy).
Then you look at sprinkling these tasks across your weekly timetable, with a mixture of enjoyable, routine, and necessary, as well as easy, medium, hard being mixed up.
You would then review how you feel each day and for the week overall to look at any amendments that might need to be made.
Picture below as a brief example:
The cognitive change to pacing
It is one thing planning and prepping how you are going to pace yourself to try and even out the boom bust cycle, but putting it into practice when you've been used to going 'full speed ahead' is difficult - it's something I still have to work on and monitor daily!
We might have narratives we have grown up with - "get on with it", "keep going", "man up", "stop being so flaky"... this list goes on. Putting a schedule in place doesn't remove those narratives and so some internal work is also needed, to be able to sit with those thoughts, acknowledge the feelings that might come up alongside them, and find a way to work through them to acceptance.
My BIGGEST mindset challenge has been with exercise. I have always been someone who does so many different types of exercising, I get such enjoyment, empowerment, and release from exercise, but unfortunately all the types of exercising I used to love aren't accessible to me anymore. This was a huge hit for me, it took a lot to accept this, and some days I still mourn the fact that I might never be able to do them again. So, to face a day of resting because I am depleted of energy/spoons is hard when my mind is bringing thoughts like "lets do something!!!" which I would love to do.
Therapy is helping, and has helped, me get through this. It is true that we grieve our old selves, our 'healthy' selves, to then look forward at what we can do now with what's accessible for us. This is a big process in itself, so please don't be hard on yourself if you still have moments of slipping back into the boom-bust cycle, it happens, but take each day as it comes and offer yourself compassion.
Whilst you're building your pacing timetable or getting an idea of how much energy different tasks use, be mindful on what's coming up for you and any thoughts that follow too. Maybe you get caught up in the moment because it feels good to be doing something you enjoy, or you just want to feel 'normal' again, or you don't want to 'fail yourself' by doing less than you would have done before. Those thoughts are important to recognise so you can explore them and work through them.
Is pacing giving up on myself?
I had this fear. That slowing down so much would mean I was giving up on myself, when in reality you are being compassionate and offering yourself support where you're struggling. A boom-bust cycle is only sustainable for so long before burn out or your body catches up to you.
Pacing is a proactive way to look after yourself in the long run.
It might feel like giving up because of the ableism in our society, but accepting you need to take more time for yourself isn't a failure, it's a success in looking after yourself.
Of course, there will be extremes on the opposite end of getting into thoughts where everything feels too hard to do, in these instances it is about using pacing to increase your activity levels in a controlled way. This might be starting with 1 minute of stretches a day for a week, then going up to 2 minutes for a week until you get to 15 minutes.
Recommendations:
Get some support in place for yourself through this process as it can be mentally and emotionally draining
Take your time. My need to have things done and in place tried to take over with pacing; ironically, pacing the process when looking at pacing your life is needed.
Therapy helped me with having someone guide me through it, challenge my thought patterns, explore the feelings, and look forward at what I had already done for myself (you'd be surprised how much this last bit gets overlooked).
Explain what you are doing to those around you - obviously where you feel comfortable to - but it can be helpful so others are on the same page with you.
You can still have fun, this process isn't meant to strip the joy from life, rather it's meant to help you find a way to live life to YOUR fullest, meeting you where you're at with your needs and health. i.e. I've learnt that if I want to go to a gig, or have a social day, I probably need to take some time to myself to allow rest and regrouping afterwards.
The takeaways:
Understand what pacing means for you - spoon theory? timings? energy ratings? capacity? etc.
Figure out how pacing can work for you in your timetable
Be mindful of your thought processes and narratives that come up for you in the process
Try to offer yourself compassion in the process - it's not easy!
Pacing is proactive and can be used to increase activity in a controlled way over time.
You're allowed to take time for yourself. Resting and restoring your energy and wellbeing is important, as are you!
