Many people with CFS and FM find themselves caught in repeating cycles of push and crash, swinging between overactivity and forced rest. When their symptoms are low, they push to get as much done as they can. But doing too much intensifies their symptoms and they crash.
Pacing offers an alternative, a way to live a more stable and predictable life by knowing and staying within limits. With pacing, you can live your life according to a plan, rather than in response to symptoms, so you have a sense of managing your illness, rather than illness controlling you.
The benefits of pacing include:
- Lower symptoms
- Less suffering
- More stable and preditable life
- Sense of control
- More accomplished
- Chance for improvement
Pacing can help you reduce the suffering that results from overdoing. One hallmark of CFS/FM is post-exertional malaise (PEM), the intensification of symptoms that results from overdoing. The amount of rest needed to recover from PEM is out of proportion to the overactivity, a punitive price even for small mistakes.
Dr. Lapp talks about a person having a certain number of "energy dollars" to spend each day. A healthy person might get $100, but the average person with CFS or FM is likely to have something like $25. If they spend $30, they are in the hole by $5, but in addition get assessed a $20 PEM penalty fee for overdrawing their account. They have to deposit $25 to get back to zero.
This section walks you through the nuts and bolts of pacing, beginning with how to define your limits and continuing on through how to minimize relapses. Each of the six parts in this section includes a worksheet plus our suggested first steps.