Climbing the Ladder of Recovery 4 -When you Pace How Do you Pace? Is it useful?

Updated: Apr 2

In 2006 I recovered from 14 years of disabling post viral fatigue. Before I recovered I paced. I worked with a brilliant physio who helped me to pace. I found a pattern of life which worked for me and enabled me to (mostly) stabilise my symptoms. It is an approach being recommended for people with long covid, and it is useful (1) until a time when physiology is switched to one of health(2). But consider when you pace, how do you pace?

My routine required to stay well was a strict one. I needed to do 15 minutes activity to 45 minutes rest for most of the day. The activity was tiny amounts of activity like walking into the next room, sitting down and making a cup of tea. If I did that I could leave the house twice a week, and watch some TV in the evenings. Most of the time there was little nourishment in this process. At the end of my 15 minutes I would often feel tired and frustrated and angry.

From a nervous system perspective the help of the physio was invaluable. The stability was very useful. However, the way I paced myself wasn’t that helpful. When I paced my nervous system wasn’t usually creating a space for healing. What I did which was accidental and unintentional is described below.

On my last blogs I considered neuroception and the hierarchy of the autonomic nervous system. It was a consideration of how bodies assess for safety, danger and threat and 3 different states of the autonomic nervous system. The clue to my accidentally unhelpful pacing is there.

I realise I was often pacing from a place of fear and anger. The fight and flight system of the body was running alot. I paced because if I didn’t do that something bad was going to happen. I followed a routine, and if I moved out of it I was fearful. My language was “should”, “got to”, and oh no (if I stepped out of my routine). If I was ill because I had "overdone it" or life had somehow got in the way of my safe routine I was cross. Sometimes I'd just feel like giving up.

Take a look at the polyvagal ladder. Consider, what is the state of the nervous system when you pace? When you pace, when you plan and prioritise for healing are you doing that or are you accidentally doing something else? When would it be useful to move up the ladder?

When I have a client who is recovering and needs to pace I do things quite differently than how I paced myself. I work with client to encourage them to be their greatest version of themselves. We work to encourage a regulated nervous system which encourages healing. Clients to pace from a place of care and nurture.

Consider what you could do more of and less of when you pace. Consider how you might apply the more of and less of activity here - it's a modified version of a tool for working with chronic pain, but it works well here to.

Might you include the Lightning Process to build an internal coach and includes a state change tool to create that change easily? (3) Might you use EFT can help help to clear negative past experiences influencing the now? (4)

(1) Managing Your Daily Activities

(2) Phil Parker, DO et al Understanding the Lightning Process Approach to CFS/ME; a Review of the Disease Process and the Approach July 2018



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