The Spoon Theory
If you live with chronic pain, you probably know what it feels like to wake up already exhausted — before the day has even begun.
Christine Miserandino’s Spoon Theory offers a simple but powerful metaphor to explain this experience. She described each spoon as a unit of energy you have to spend in a day. People living without pain or illness might start the day with a full handful of spoons — and rarely think about how they’ll use them. But for someone living with chronic pain, each activity costs more: getting dressed might use one spoon, making breakfast another, a phone call or a doctor’s visit two more. Some days you start with fewer spoons, and when they’re gone, they’re gone.
For many of the people I work with, this theory captures something profoundly validating: the constant calculation that happens in the background of every decision. “Do I have enough spoons for this?” “If I do this today, what will it cost me tomorrow?”
In Dialectical Behaviour Therapy (DBT), we talk a lot about balance — between acceptance and change, between doing and resting, between caring for others and caring for ourselves. Spoon Theory fits perfectly within this approach. It gives us a way to notice our limits without judgement, to plan ahead, and to communicate our needs clearly.
Here’s how DBT can help us use our spoons wisely:
Wise Mind: Before acting, pause to ask yourself how many spoons you have and where you want to spend them.
Radical Acceptance: On the days when you wake up with fewer spoons than you’d hoped, remind yourself — this is not failure, it’s reality. Fighting it only drains more energy.
Coping Ahead: Anticipate challenging days or events that will require extra spoons and plan recovery time.
Interpersonal Effectiveness: Let others know when you’re running low: “I’d love to help, but I’m out of spoons today.” That’s not selfish — it’s honest and protective.
This way of thinking changes everything. Instead of feeling guilty for needing rest, we begin to honour rest as a legitimate part of recovery. Instead of comparing ourselves to others, we learn to measure success by how skilfully we use the spoons we do have.
If you’re on this journey of living with chronic pain, know this: you are not weak or lazy. You are working with a limited energy supply and still showing up each day with courage and intention. That’s resilience.
And for those supporting someone in pain — ask them about their spoons. Listen. Believe them. Sometimes the most validating thing we can say is: “I understand you’re out of spoons today. Take care of yourself.”
By Dr Michelle Beukes-King
If you’re living with chronic pain and wanting practical tools to cope, connect, and rebuild your life, my online ACT for Chronic Pain group may be a good fit for you.
You’ll learn evidence-based skills in a supportive community — all from the comfort of home.
