I thought this cute little grasshopper (ok, yes, maybe I’m weird for thinking it’s cute) was a good metaphor for what I wanted to talk about today. Pacing. As my husband and I sat in the tall grass relaxing in the sun, a few of them landed on us and were perfectly still for a few moments, and then out of nowhere jumped what must be about 50 times the length of their own body! And I thought… “I wonder how much energy it needs to save up to jump that far?”
Now, for me, it’s not particularly surprising that this question popped into my head. Since becoming ill, I’ve learnt to think and talk in terms of measuring and scrutinising energy needed to carry out tasks. You develop some sort of secret and personal code that means that rules like “I can’t have a shower any longer than 20 minutes or I’ll pay for it later” seem completely normal. But this wasn’t always the case.
In my early chronic pain days, I used to get pulled into boom and bust, and my energy evaluations were all over the place (I talk more about that here), but I’ve since learnt the art of pacing. The ability to do just the right amount of activity so as not to deplete my energy stores and fall into cycles of boom and bust. Now it’s important to note that this is just my experience with pacing, and everyone’s different.
So, here are some of my tips for practising pacing… and that’s exactly what it takes. Practise!
Become aware of your activity
The first step in learning how to pace is becoming aware of your activity. Write down a basic diary every day for a couple of weeks. How long do you spend doing each activity? When do you do it? How do you feel while you’re doing it? How do you feel after? At this point it doesn’t need to be anything other than a curious experiment. Try not to change what you would normally do for the purposes of the exercise. If you normally stay in bed until 2pm, then do exactly that. If you normally overdo it with friends on a Saturday night, then do exactly that. This bit is just about becoming aware, and you may find you’re surprised by some things…
Notice patterns and ask questions
Once you have some decent data to use, start looking for patterns. Did you notice that a particular activity always triggers your pain more if you do it in the evening? Does 10 extra minutes doing x result in an increase in symptoms? Did eating a certain food send you into flare? How did the weather impact you? Did the company that you kept make any difference? What gave you the most energy? How effective was ‘rest’ time?
Through noticing patterns, you can have a better idea of what your triggers might be, what depletes your energy, but also, what has the power to replenish you.
Set your baselines
So, this bit is key! Take each key task that you do often (I’m talking showering, making dinner, doing chores, spending time with friends, watching TV, exercising etc) and look at the patterns you’ve noticed. Then find out (this may take some time and more data gathering) the sweet spot that you could manage to do even on your worst day. So for example, it might be that on a ‘good’ day you can manage to cook a healthy meal from scratch, chopping all the veggies yourself and spend about 90 minutes in the kitchen, but on a ‘bad’ day, you struggle to do more than throw together bits from the fridge and freezer into something resembling a meal and only spend about 20 minutes in the kitchen. So the baseline become just that - 20 minutes in the kitchen. The baseline is what you then do every day no matter how good you feel. You’ve already established that you can do it on your worst day, so the trick is to ‘limit’ yourself when you’re feeling better than your worst. A lot of this is very instinctive, but you find out what your baselines are pretty quickly. As weeks go by, the aim is to very gradually increase your baselines, by doing small amounts more each week. So if you start off saying you can walk for 10 minutes on your worst day, then do that for 2 weeks. Then when that’s comfortable and too easy, try walking for 12 minutes, and do that for a week. If you increase it too much, just go back to the last baseline.
“But how do I find the sweet spot?” I hear you say. “What if I get my baselines wrong?”. That’s fine. It’s all part of the process. There is definitely some trial and error involved here, but the aim is balance. Pacing hypothesises that if you do too little activity, you actually decrease your stamina, mood, and confidence, and increase your pain; do too much, and you also increase pain, symptoms, and force yourself into being able to do less. The important thing to remember is that you’re aiming for a nice even keel. Listen to what your body needs and aim for balance. I find personally that doing any activity (including resting) solidly for more than 1 hour tends to lead me into either over or under activity. A good way to tell if your baselines are about right, is that you should be able to do them almost every day, even when you’re in a flare.
Like most people with chronic pain, you might be ambitious, hardworking, and you have loads you want to get done, but you keep getting pushed into an unhelpful cycle. You have a few weeks at a time where everything is great and you’re a superhero, but then your symptoms start to flare and suddenly you’re stuck in bed for days on end. I get it, I’ve been there, but you must remember that cramming everything on your to-do list when you’re feeling good is going to lead to feeling bad. And it sucks. All I can say is try to prioritise. Look at the bigger picture. If certain things need to get done (like eating or working) then they take priority, but try and make sure the baselines for those activities are manageable. Also try to make sure you’re getting a rounded day. If you’ve prioritised all the stuff you know you should do like chores or DIY, but you haven’t made any room for fun or meaningful social interaction, then that’s going to negatively impact you too.
Be as consistent as possible
It’s ok to be flexible. Hell, I’m not sure it’s possible to live with chronic pain without being flexible, but you also need to form habits. Keep to your baselines as much as you can. Keep to helpful routines you initiate. These will help your body stay out of boom and bust as much as possible and get used to the level of activity you’re setting. This helps when you start to increase your baselines.
Keep track and record things
Our minds can be really deceiving. We can think, “oh, last week was a total write off”, or “I didn’t get anything done yesterday”, but when you go back and keep track of everything you’ve done, it soon mounts up! It also helps you reflect and notice patterns. As mentioned above, a lot of this is about raising your self-awareness and noticing what you notice. It’s far more difficult to do that when you haven’t got a record.
Pacing takes time, and it’s also not a quick fix. It doesn’t suddenly get rid of your pain, or ‘cure’ you (whatever that means). But it does help you increase your levels of activity bit by bit over time. It’s easy to feel frustrated or impatient on this journey, or like you’re limiting yourself when you’re perfectly capable of cleaning the house from top to bottom thank you very much, but those feelings are what fuel boom and bust. Trust the process, be patient, and think of the long-term.
Be kind to yourself
When you’re learning how to pace, it’s also easy to beat yourself up when you accidentally overdo it and end up in flare again, especially if it’s after a good patch. You were doing so well! But remember, having the ability to help yourself through practising pacing is not the same as being responsible for your pain. Sometimes things come up that mean it’s really difficult to pace, like moving house for example, but treating yourself with compassion will help you to get back to it and start fresh. If you slip up, all the pacing you did wasn’t wasted!
Reflect on your progress
I sometimes can’t believe how far I’ve come. A few years ago I never thought I’d be able to sustain the levels of activity I do now. Make sure you plan time to reflect on how far you’ve come, and celebrate the wins whenever you can! Try not to feel guilty about times in the past where you weren’t pacing. All you can do is focus on the present and what you can do now. Let yourself build your levels of energy with kindness and self-compassion.