Posted in Life & Happiness

Spoon Theory

In 2003, a woman by the name of Christine Miserandino coined the Spoon Theory to explain what it is like living with a chronic medical condition to her friend. When asked by her friend what it is like to live with lupus (an autoimmune condition resulting in various symptoms such as joint pains, fatigue and rashes), she gathered twelve spoons and handed it to her friend.

Miserandino explained to her friend that the spoons represented units of energy. Doing tasks – whether they be simple or complex, fun or a chore – used up spoons.

Getting dressed in the morning? That’s a spoon. Catching up with a friend in the afternoon? That’s another spoon. Cooking a proper meal for dinner? That might even take up two spoons. Even the simplest task such as doing dishes or taking a shower uses up energy.

When all of the spoons are used up, you don’t know what will happen, but you do know that you won’t be able to do anything else. To make it safely to the end of the day, you must carefully ration your spoons so that you have at least one spoon left by the time you get to sleep in your bed.

Most healthy people have a much larger pool of spoons to start the day with: large enough that they can reliably do pretty much all of the things they want to do throughout the day, then replenish the spent spoons through sleep and rest. But for people with chronic conditions such as lupus or depression, they live with a constant awareness of the limited supply of spoons that they have, along with the crushing fatigue and lack of motivation that awaits when the spoons run out.

You never know when you’ll have a sudden need for more spoons: you might get acutely sick, a friend may need emotional support, your relationship may become strained. Ergo, not only do you have to ration the spoons for a typical day, but you need a rainy day reserve of spoons.

Of course, the Spoon Theory is not only helpful for understanding what it is like to live with a chronic condition (or being a “spoonie” as some people would say), but it also helps us understand what our own reserves are when we are reasonably well.

No matter how healthy and well-adjusted we may be, life will indubitably challenge us with various demands. We will have to expend physical and emotional energy to keep up, whether it be going to work to pay bills, supporting our loved ones through tough times, or even doing enjoyable things such as indulging our passions.

There will no doubt be a day when we run out of spoons and we find ourselves unable to do anything, even if it’s as easy as getting out of bed in the morning.

By knowing about the Spoon Theory, we can always be mindful of how many spoons we have left and have the wisdom to keep a spare spoon in our pockets for that particularly tough day.

Posted in Philosophy

Skeleton

Is it better to have a skeleton inside the body, or on the surface?

In the case of insects, the skeleton is on the surface and takes the form of a shell that protects them from external damage. The flesh is protected by this shell and becomes soft until it becomes fluid-form. Therefore, when something sharp penetrates the armour, it causes critical, irreversible damage.

If the skeleton is inside the body, it takes the form of thin, hard bones. The soft flesh on the outside is exposed to harm. This leads to endless number of wounds. However, the weakness of being exposed leads to the muscles becoming harder with more resistant muscle fibres. The flesh evolves.

I have met many people who wear an intellectual shell made from remarkable knowledge and intellect, protecting themselves from attacks made by people with different ideas. They appeared much more robust than normal people. They would laugh at everything else, saying “I don’t care”. But when a different opinion would penetrate the hard exterior of their mind, the blow to their ego was indescribable.

I have also met people who would be hurt by even the smallest, insignificant confrontations or dissonance. However, they were sensitive because their minds were open and they learnt something from whatever attack they received.

(from The Encyclopaedia of Relative and Absolute Knowledge by Bernard Werber)

Werber spoke of the “skeleton” of the body and mind, but human beings have one other thing that needs a sturdy skeleton – the heart. Many people protect their heart from being broken with hard armour. They do not open up themselves easily and always give an image of strength and stability. But there is no such thing as a life without pain. People who put a skeleton on the outside of their heart tend to be those who have been hurt badly before and trying to protect themselves from being hurt again. This may be effective to some degree, but if you close off your heart, you cannot heal your wounds and you also shut off the happiness of connection. If they suffer pain greater than their armour can withstand, their heart is shattered and they fall into a pit of despair, unable to recover.

On the contrary, some people open up easily to others, exposing themselves to frequent pains from social interactions. These people are sensitive to pain and heartbreak. Hence, the world considers them frail and weak. But as these people have a strong skeleton inside their hearts, they can recover from any wound and they become stronger like well-developed muscle. They grow through pain and their heart – like a warrior who has fought countless battles – becomes strong and resilient against the pains of the world.

We mustn’t avoid suffering and pain and instead try to overcome it. Through this we learn how to bounce back and through experience, we develop ourselves. Suffering is hard, but it is a catalyst that helps us grow into a strong, resilient person.

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Posted in Psychology & Medicine

Pain

Perspective is everything. By changing your perspective, you may discover an innovative solution to a problem, or understand the actions of someone else. But more importantly, your perspectives have direct implications in your life and health.

For example, let us consider pain. Pain is a sensation – an electrical signal in response to a noxious stimuli that is causing damage to your body. It is a warning system that screams to the brain that something is wrong. To boil down the complex physiology of neurotransmission, essentially imagine the system as an electrical circuit. If something damages tissue, like a knife slicing through flesh or a clot blocking off oxygen supply to the heart, the pain “switch” is activated, a signal is sent to the brain, and it is interpreted and “felt” by the brain as pain. Because your brain needs to interpret the signal, pain is essentially subjective. If you are distracted or in a good mood, you will feel less pain compared to when you are distressed and focussing on it. The same stimuli can be handled completely different by every person, making pain extremely complicated and difficult to assess in a medical setting. Pain scales may be used to try objectify the level of pain, but this is still very crude.

UCEM Pain Scale

One way or another, pain is technically all in your head. That is not to say that pain is not real – that would be an insult to sufferers of chronic pain. But your perspective, way of thinking and frame of mind can make a significant difference to the amount of suffering the pain causes. This is not just an overly-optimistic view of the world that everything can be fixed with optimism. There are real physiological systems in place to alleviate pain when you are happy. These chemicals are called endorphins – so named because they are so potent that they match the effect of morphine (endo(inside) + morphine). This natural painkiller is released in response to pain, but can also be stimulated by having fun and being happy. Laughter is literally medicine.

Not only that, but by being in a good mood, you become more resilient and “distracted from the pain”, allowing you to bear the pain more easily. A woman going through childbirth suffers quite possibly the most extreme level of pain a human being can experience, but the prospect of seeing their newborn child (and probably finally ending their pregnancy) and the loving support of their spouse, family and friends keep them pushing onwards. Even though the noxious stimuli of stretching is real, the brain can choose to downplay how much pain it thinks it should feel with these positive factors.

Although it may not be able to make your pain magically disappear, never underestimate the power of positivity, laughter and happiness. Perhaps that is why the emotion of happiness was evolved – to alleviate the misery and pains of living in this world. To survive.

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