How to Pace

I thought I’d use some space to write down my interpretation of ‘Pacing’. This technique is usually provided to manage fatigue but I think it is something a person with any illness can use, to help monitor symptoms and space out their day.

Here I use imaginary money to value how much energy I’m spending. Some people prefer to use Spoons (see end note). I’ve tried to stick to easy examples as it can get complicated.

Step 1) Go about your day timing your usual daily activities and work out how long you can do something before you feel a symptom starting. For example, making a meal. Can you do this for 5 minutes? do you feel tired or start to ache? Continue to make your meal and note down when symptoms start.

You should now have a list of activities and their timings.

Step 2) Work out which activities cost more. If an activity takes less time compared to another activity e.g. you can watch a TV soap longer than doing the hoovering, then hoovering uses more energy and therefore costs more money. This is my own monetary value…

An activity using:

High energy costs £10

Medium energy costs £5

Low energy £2

Relaxation techniques are FREE

Step 3) Now you can design your daily timetable. I give myself £100 to spend in a day. So that’s £80 to put in my timetable and £20 change, as I don’t want to crash out by the end of the day.

For example, I allow myself up to 3 high energy activities (£30), up to 6 medium energy activities (£30), up to 10 low energy activities (£20) and as many as I want no energy (resting/relaxation) activities per day. Of course this all depends how you are feeling each day. There are no rules as to when you do your activities but I find keeping the high and medium energy activities to before 4pm means I can start to wind down for the afternoon.

I realise life is not easy and some of you will have children etc which can’t be ignored. This advice is intended as a guide to help understand the technique of Pacing. If you find it difficult to make up a full timetable or just find the whole thing unrealistic, then perhaps just try adding in a time to rest and relax each day or even each week to start with. Making one small change could make big difference and once you get used to that, then maybe add in something else.

Here are some examples of activities and their possible costs:

High energy (£10) – 10 minute daily walk, 20 minutes computer work, 15 minute shower, 5 minutes dusting the house, 20 minutes listening to an audio book, 20 minutes making a meal.

Medium Energy (£5) – 1 hour scrolling social media, 10 minutes washing dishes, 30 minutes watching a comedy, 10 minutes making a meal, walking upstairs.

Low energy (£2) – Walking to another room in the house, washing face, getting dressed.

No energy (free) – Daydreaming, meditation, petting the dog.

The different types of energy we use can effect us too. Watch out for an emotional suspense film, it can cost more than a romantic chick flick. Check out the Psychology menu to see the different types of energy we use. Of course you will get to know your limits with the different activities, as you work through your list. There are no wrong answers, its all about how you feel.

End note: Everyone’s Pacing levels will have their own amount of money to spend and activities will cost more or less depending on how badly fatigue is. Someone who is only mildly affected could have £200 to spend. You may even hear the term Spoonie, as in we are all Spoonies. This is because many medics use ‘The Spoon Theory’ and the use of spoons instead of money as a hypothetical value for our energy spends. For example, you have 8 spoons per day to use, equivalent of £80 per day. Both theories are essentially the same thing. It’s up to you what you use.

Example
Pacing Timetable – Lancashire Care NHS Foundation Trust (2019)