The spoon theory is an introduction to understanding how chronic illness, chronic pain, and disability impact a person’s capacity to perform everyday tasks, engage in work and social life, and meet longer-term goals. Becky Bikat Tilahun, a clinical psychologist with the Cleveland Clinic, considers it a strategic planning tool.1
The theory suggests that people living with chronic illness, chronic pain, or disability have a limited amount of energy (represented by spoons) to spend on completing tasks on any given day. This means people living with chronic health conditions have to make many difficult, energy-consuming choices about how to spend their limited energy.
How many spoons it takes a person to complete a given task can vary considerably from day to day, too. This can make planning for future events more challenging when you're unsure of how many spoons you may have at a future date.
For example, John has osteoarthritis, which causes severe joint swelling and pain. He only has seven spoons for the day, and it takes him two spoons to get showered and dressed in the morning. Other activities, like going to the movies, will cost him further spoons.
The origin of the spoon theory is traced to blogger Christine Miserandino. Miserandino, who lives with lupus, created the spoon theory in 2003 over dinner while trying to explain to her companion in simplified terms how people with chronic conditions wake up each day with limited energy (spoons) to spend on tasks.2 Lupus is a chronic condition with symptoms affecting the skin and joints that causes pain and fatigue.
Why spoons? They were at the table when Miserandino was searching for a way to translate her experience to her friend. Since then, the spoon theory has been used to explain the complex choices in expending energy people living with chronic illness and disability make each day.
Spoon theory has significant benefits for people with chronic illnesses.
The spoon theory has become a way of unifying the chronic illness community through shared life experiences. People with any type of chronic illness or disability may choose to identify as a “spoonie.” In doing so, they can find and access in-person or online communities for spoonies and connect with others with similar experiences.
While the community of followers may know the meaning of "spoon theory" and "spoonie," the medical community may not be familiar with these slang terms. Communicating with your healthcare provider about this can help them develop a plan with you on how to better manage your energy.
Research published in the journal Pain Medicine in December 2021 demonstrates how peer support groups for people with chronic pain can be a cost-effective social intervention that provides emotional support, stronger social connections, and reduced use of health services.3
The spoon theory works to raise awareness about living with chronic illness, chronic pain, or disability. According to the University of Massachusetts, some 96% of chronic medical conditions can be considered "invisible illnesses," ie illnesses that aren't immediately apparent.4
Using a term like "spoonie" helps bring visibility to invisible conditions. It provides devotees with a universal language that views individuals' experiences through a shared lens.
Conditions commonly included in the spoonie community:
The spoon theory brings visibility to lived experiences, but visibility doesn't mean spoonies owe an explanation to anyone for how, where, when, and why they spend their limited energy resources. So while asking about another person’s “spoon count” is OK, judging how they use their “spoons” can be insensitive.
The spoon theory explains that people living with chronic illness, chronic pain, and disability have limited energy resources and also expend more energy on everyday tasks than people without illness and disability.
In spoon theory, spoons represent both the physical and mental load required to complete tasks. The theory was developed by a blogger with a chronic illness as a way to explain how living with a long-term disability impacts her daily life. It has created a community in which like-minded people can share their experiences.
If a person tells you they're a "spoonie," bear in mind that they have limitations in the amount of energy they can devote to any given task. Using the spoon theory is one way a person with a chronic illness can honor their needs and boundaries, while showing they trust you enough to share such personal details.
By Michelle Pugle
Michelle Pugle, BA, MA, is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. Her work focuses on lifestyle management, chronic illness, and mental health. Michelle is the author of Ana, Mia & Me: A Memoir From an Anorexic Teen Mind.
