Originally written for RCOT blog on their website I am reposting here also.

Throughout this blog I’ve used occupational therapy terminology and language that was not used by the creator in an effort to show how it aligns with occupational therapy theory. I want to be clear this is not an attempt to change the theory or claim it as occupational therapy. I very much recommend you read the original blog post and reflect on how and why this theory has become popular. 

Disability History Month is all about reflecting on movements within the disability community that shape better understanding and help to move toward equality for those living with long-term health conditions and/or disability. It is important that occupational therapists keep up to date with movements within the communities they work with. One very popular and in my opinion very appropriate theory for occupational therapy practice is the Spoon Theory. 

Christine Miserandino, who has lupus, created the spoon theory metaphor to help people understand what it’s like to experience fatigue and to manage their daily occupations. In her blog post from 2003 she tells the story behind her theory. She explains whilst eating lunch with her friend she was asked how it felt to live with her condition. In response, Christine grabbed every spoon she could find and began to explain how her illness impacted her using the spoons to represent units of energy. 

People who aren’t living with health conditions or disabilities often wake up with an unlimited amount of energy. They can get out of bed and manage their activities of daily living without a great deal of thought or planning. However, people living with physical health conditions, disabilities or mental illnesses may only start out each day with a certain amount of energy – or spoons. It varies from person to person, day to day and only you know, how many spoons you have. 

Christine illustrated her theory by giving an example: a person with a health condition like lupus, may wake up and feel they only have a certain amount of energy (say 12 spoons) explaining on an average day, the activities of daily living a person might want, need or are required to engage in would include:

1. Wake up
2. Brush your teeth
3. Wash your face
4. Get dressed
5. Eat breakfast
6. Go to the doctors
7. Come home
8. Make and eat dinner
9. Change into your pyjamas

These are nine individual, tasks, activities or occupations, however the complexity of each requires different amounts of energy or spoons.  

‘Brushing your teeth is a routine and familiar occupation that may only use up one spoon. Whilst going to the doctor is more complex and uses all five occupational performance components (biomechanical, sensory motor, cognitive, intrapersonal, interpersonal), needing much more energy or spoons.

In Christine’s example, she states that going to the doctor might take six spoons, reflecting that this only leaves you with five spoons for everything else, stating there is no way you can make five spoons stretch far enough to manage all the other occupations you may want to engage in. Christine goes on to say:

‘You can opt to “borrow” spoons from the next day’s allowance. However, this means you start the next day in deficit. Imagine trying to get all those tasks done with an even smaller number of spoons! It’s easy to get trapped in a cycle of overdoing it and exhausting yourself, due to not managing your spoons well enough’.

For me, this is a great theory that perfectly explains the idea of energy conservation within occupational therapy. The #Spoonies hashtag is being used within the disability community across social media to unite and identify people who struggle with energy management. 

Why not take some time to read up and search the hashtag, you might find some useful resources.

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