Energy Pacing as Burnout Prevention Strategy
Post Written By: Lauren Wallace and Emily Myers - Student Interns at NDES in 2024-2025
What is pacing and why might it be helpful?
We have created this blog post to provide our neurodivergent identifying clients with pacing systems for avoiding overexertion and maintaining their well-being. Pacing consists of strategies that involve intentionally planning activities in order to prevent burnout.
Before learning all about pacing systems, it is important to understand the “Neurodivergent Boom-or-Bust Cycle” (Neff, n.d.). This cycle occurs when a neurodivergent individual intensely uses their internal resources (the boom part of the cycle) to the point of depletion (bust part of the cycle).
What does this cycle look like in neurodivergent folks?
Hyperfocus and hyperfixation → collapse
Hyperfocus can mean we forget to eat, sleep, use the bathroom, etc. because we are so afraid to lose that focus or not pick up on our bodies’ cues, but this could seriously impact our bodies for the rest of the week.
People pleasing
It can be hard to set boundaries and say no to others. This can lead to overexertion so as to not let someone else down.
Internalized ableism
Neurodivergent people often hold ourselves to neurotypical standards and end up in shame.
Interoception issue
Neurodivergent individuals may not receive the early signs of stress or fatigue, thus we may not realize we are fatigued or stressed until we are near a crash.
Why isn’t this cycle sustainable?
When we perpetually push ourselves beyond our bodies’ limits, it takes longer to recover each time and the burnout deepens.
This cycle sends our emotions on an unsustainable roller coaster.
Pacing systems are strategic plans for daily activities so that an individual can accomplish tasks while preserving their well-being
Why should we use pacing systems?
Helps us lead a more balanced life and prevent overexertion
Symptoms indicating over-exertion in activities can include physical symptoms such as pain, tension, and fatigue.
There can also be cognitive and psychological indicators such as having difficulty focusing and regulating emotions.
Managing energy is as crucial as time management for neurodivergent individuals.
Why does “pacing” work for neurodivergent folks?
Pacing systems turn something abstract (like energy) into something concrete and visual.
It provides language to talk with other people about our needs, which is a foundational step in self-advocacy.
It increases self-compassion through mindful check-ins.
Types of Pacing Systems: Energy Tracking, Traffic Lights, and Spoon Theory
Energy Tracking Pacing System
Throughout your day, reflect on and list activities/situations that drain yourself and/or give energy (Welshman, 2023).
Energy draining factors for neurodivergent individuals:
Activities of low-interest
Intense negative emotions
Physical state (poor sleep, chronic pain, hunger, overexertion in exercise)
Sensory overwhelm
Internal distractions (disorganized mental state where competing thoughts are holding attention)
Transitions to different tasks and environments
Over the course of a day, reflect on how your energy varies each hour and what task/situation is affecting your energy. Then create a plan that allows for a sustainable pace of energy depleting and restoring activities. Pairing energy restoring activities with energy depleting activities may balance energy exertion.
The Traffic Light System for Pacing
Activities have varying effects on our internal resources (e.g., our energy, motivation, overall well-being) (Royal Free London NHS Foundation Trust). Especially for neurodivergent and disabled folks who can easily overexert themselves, it is important to notice how activities rejuvenate and deplete our internal resources.
Within the traffic light system for pacing, activities can be categorized as red light, yellow light, or green light activities.
Red light activities - Activities that cause stress, pain, and/or fatigue
Examples:
For a person with chronic pain, using their computer may cause pain from repetitive clicking and typing so this would be a red light activity.
For an Autistic person, one red light activity might be going grocery shopping because of sensory sensitivities being overwhelmed.
Yellow light activities - Activities that do not cause any stress, pain, and/or fatigue
Examples:
This can vary for each person, but personally I think of listening to a podcast or collecting the mail.
Green light activities - Activities that decrease stress, decrease pain, and/or improve energy
Examples:
Eating your favorite foods, sleeping, taking a soothing bath, watching your favorite movie.
We can pace our activities by limiting red light activities and planning green light activities to enhance our well-being and ability to function in daily life.
Neurodivergent Adapted Spoon Theory
Originally created by Christine Miserandino to explain what it is like to live with a chronic health condition. Adapted by Cynthia Kim to be more tailored for neurodivergent individuals.
People start with a lower number of spoons (energy) if they live with a chronic health condition. People with CHC have to be more mindful of where they use their spoons as opposed to able-bodied individuals.
The adapted spoon theory proposes different types of spoons for various functions (i.e., executive functioning, physical activity, social, focus, sensory, and language) that can vary independently from one another.
The neurodivergent spoon drawer is often inconsistent, which can be a source of frustration and can lead to miscommunications with neurotypical folks.
Example: “If you have the energy to see your friends, you must have the energy to do your homework.”
Neurodivergent spoon theory can help us to better communicate about our experiences and needs–not all energy is created equal.
Try pairing an activity that requires a high level of spoons with something that recharges you.
Take a look at the neurodivergent spoon drawer graphic below. Parts of this graphic may or may not feel accurate for your neurodivergent identity and life circumstances.
In Detail Guide to Successful Pacing
Effective pacing considers:
Individual energy levels will vary at different times of day (ME/CFS & Fibromyalgia Self-Help, n.d.).
Are you a morning person, afternoon person, or a night person? It may be more productive to do energy/resource depleting tasks during those high energy periods.
Limiting energy/resource depleting activities per day
Experiment with what amount of high energy/resource activities feels right to you
Asking for help from others with tasks (that do not have to be completed by you) that would otherwise cause overexertion
If there is a task that a family member or friend can help you do that would otherwise cause you to meet your daily threshold, it may be worthwhile to delegate that task to another person.
Switching between energy/resource depleting activities to energy giving activities
This allows for a balanced schedule so that you are not doing too many depleting activities one after the other.
(See CFIDS and Fibromyalgia Self-Help Website for more details)
Implementation steps:
Select a pacing system that works for you: Choose one that resonates with personal preferences.
Energy inventory: Monitor energy input and output over a period.
Set goals: Define intentions for using a pacing system. What does energy management look like to you?
Create a schedule: Balance activities based on energy demands. Try to see if you can swap a more energy consuming task (e.g., reading a book) for a less energy consuming task (e.g., listening to an audiobook).
Prioritize self-care: Incorporate practices that recharge energy.
Mindful check-ins: Regularly assess energy levels.
Adjust as needed: Be flexible with the pacing system based on experiences. This is not one-size-fits-all. Do what works best for you.
Track progress: Keep a journal to reflect on energy management. You can use a physical journal, notes app, or draw out your energy levels each day.
Seek Support: If needed, seek guidance from professionals, support groups, or mentors who have experience using pacing systems.
Personal statement:
This article was written by two graduate student interns who are neurodivergent and/or have a physical disability.
References
Neff, M. A. (n.d.). How to use pacing systems to help with neurodivergent burnout. How to use pacing systems. Insights of a Neurodivergent Clinician. Retrieved October 30, 2024, from https://neurodivergentinsights.com/blog/how-to-use-pacing-systems
Neff, M.A. (n.d.). Spoon Theory For Autism and ADHD: The Neurodivergent Spoon Drawer. Neurodivergent Insights. Retrieved October 30, 2024, from https://neurodivergentinsights.com/blog/the-neurodivergent-spoon-drawer-spoon-theory-for-adhders-and-autists
10: Pacing | me/cfs & fibromyalgia self-help. (n.d.). Retrieved October 30, 2024, from https://cfsselfhelp.org/library/10-pacing
Royal Free London NHS Foundation Trust (n.d.). Royal free chronic fatigue service | the traffic light system. Retrieved October 30, 2024, from https://rfcfs.co.uk/Home/Energy-Management/The-Traffic-Light-System#Opt-In
Welshman, L. (2023, July 19). Adhd and energy management. Liz Welshman | ADHD Coach. https://lizwelshman.com/adhd-energy-management/
Getting Started in Therapy
Intro and Author’s Statement 🌱
I, Eyram Bossiade, interviewed six clinicians at Neurodiversity Empowerment Services (NDES) and asked their thoughts for helpful advice and experiences with getting started in therapy. As an intern who has gotten to know the practice over the past nine months, I felt clinician and NDES founder Sherry Mergner summed up its getting started experience well with the phrase, “All are welcome here.” I hope this post provides a brief snapshot of the getting started process at NDES and showcases its clinicians’ genuine care, acceptance, and thoughtfulness. Thank you, and enjoy!
Step One: Building Trust 🌱
You may have heard that trust and a strong relationship with your clinician are the keys to success in therapy. A critical first step in the getting started process at NDES is naming and normalizing that it can feel like there is a lot of pressure to meet this goal of building trust. Therapy intern Amelia Currie shared that especially when you’re just discovering your neurodivergence or recently out of a crisis, the process of starting therapy can feel “stressful” and “disorienting.” It can be “hard to know what’s up and down,” and you may start questioning yourself, your diagnosis, or feeling that you have to hide parts of yourself to navigate inaccessible or disabling systems to survive. Discovering neurodivergence can feel “freeing” but also “frustrating,” Amelia continued. This is why it is so helpful to find a “neurodivergence-affirming therapist” whom you can trust to validate complex types of struggles and share, as well as model, essential therapy skills. Build trust with your clinician by asking questions. When asked what was helpful for clients to know for building bonds of trust with their therapist, clinician Bailey Woodruff replied being aware that, “Therapists and providers are people with huge life experiences.” “Ask your therapist at least two questions.” Your therapist is someone you are going to be “building community with,” and to do that, you are going to need a connection firmly rooted in “authenticity.” To brainstorm questions, you may ask yourself, “What do I need to know about this person,” or, “What experiences could I ask about or think about with this provider that would help me see how they show up for me?” Your therapist is also going to need to be a “strong container,” Bailey emphasized. “What matters is that you trust this person and feel like you can talk to them about things that really matter.” So that you feel there is “so much space in the therapeutic container” and you “also don’t feel alone.”
Additionally, “Trust your own first impressions.” So often, when we come into therapy and aren’t feeling safe due to our circumstances, it can feel like we need to please people or change ourselves, but doing that can lead to our challenges getting harder as we mask our discomfort and struggles. Asking trust-building questions during an initial consult call or meeting with a therapist is a “huge opportunity to deflate the pressure” in the getting started process, and through practice, it will become easier to use your values and intuition to identify how a clinician can show up for you.
Step Two: Self-Care and Compassion 🌱
As NDES clinicians guide you through the intake paperwork and trust-building steps in starting therapy, focusing on self-care and compassion is the next essential part of beginning the hard and rewarding work of checking in with yourself and navigating your challenges. During our interview, Sherry explained, "Therapy is just as important as self-care.” Both therapists and clients must pay attention to their “mental, emotional, and physical health” during and after therapy sessions. Sherry shared that after years of engaging in therapy and self-care, she continues to find that "I have to keep working on compassion to myself” in order to be a compassionate human being and provider. We receive many messages from society that can cause us to feel resistance towards self-care and compassion. It is really common for our culture to tell people that “taking care of themselves is selfish,” going to therapy is “shameful,” and if they “can’t pull ourselves up by our bootstraps,” then they are worth less. Both clinicians and clients may bring effects of these messages to therapy. Similar to the process of finding a clinician you feel you can build trust with, it is important to work with clinicians who help you heal from the harmful effects of shaming messages. Clinicians who engage in regular self-reflection can use their experiences to display “a deep presence,” Sherry continued. They can role model what it looks like to “affirm vulnerability” and use their “authentic selves” to benefit their clients and promote safety. We all carry different experiences and have different relationships with healing. Amelia shared that it can be helpful to "see clinicians modeling the tools that they are suggesting for clients.” She emphasized that through engaging in intentional self-disclosure (therapists sharing their own relevant experiences), skills modeling, and validation they can help therapy feel more “collaborative.” While promoting and modeling effective self-care in therapy, NDES clinicians share "unconditional acceptance” and "positive regard” through their therapeutic relationship with clients. Amelia and I discussed how, for clients, this deliberate sharing by clinicians can spark “genuine” and “authentic” communication and connection that promotes self-care and community-based healing vital to releasing trauma, internalized ableism (disabling beliefs), and legacies of invalidation.
Step Three: Embracing Difference and Curiosity 🌱
The final part of getting started in therapy at NDES is embracing difference and curiosity. Clinician Lydia Stellwag shared that differences in “labeling and naming conventions” and treatment “frameworks and modalities” can be a lot for clinicians to decide how to navigate with clients. Clinician Yaa Yamoah shared that because providers differ in so many ways, finding a provider “who is the right fit,” “has experience with people with your diagnosis and identity,” and has “warmth and compassion” can at times feel like “dating different therapists.” and take a great deal of “patience.” Clinicians may also differ in their willingness to discuss fit or their openness to sharing that they “may not feel confident with your diagnosis or identity.” Yaa has found it helpful to know that you may tell if you will have a healthy relationship with your provider during your initial intake conversation—or it may take as many as “five sessions” before you know for sure. Clinician Molly Marus-Quinley shared that explaining her specialties and capabilities “in really practical terms with simple language and providing more information to make it [her role] seem less abstract” helps her clients feel less hesitant to share what they want to pursue in therapy. From “verbal processing,” “guidance,” “role-play,” “skills practice,” and “homework” to “a mix of asking questions and practicing skills,” the clinicians at NDES extend curiosity toward their clients’ needs and embrace the inherent value and potential in each difference present in the getting started process. For example, to acknowledge differences in language and disparities in relationships to the DSM-V, Lydia often helps her clients identify and use vocabulary and modalities that feel “most helpful” to them. Through centering and highlighting her clients’ unique experiences, she has found that “Cognitive Behavioral Therapy can feel very dis-affirming” to her clientele. Instead, conversational and check-in-based “relational therapy” and body-based “somatic therapy” with a neurodivergence-affirming clinician helps her clients “shift their perspectives,” reconnect with themselves and their “resilience,” and have the space, flexibility, and time to work on liberation from feelings, thoughts, and memories tied to complicated cycles of shame or other emotions. To acknowledge influences such as race and sexuality, Yaa regularly checks in with her clients to help them explore if looking for clinicians who have experience with their identity and how their “diagnosis fits within their identity” is important to the work they are looking to do in therapy. Illustratively, she shared that when she was upfront about lacking experience with a client’s diagnosis of dissociative identity disorder (DID) during their getting started process, they decided to work on other skills for “one and a half years, and the client asked for a referral to a provider with DID experience when they were ready.”
In short… 🌱
When starting therapy, NDES clinicians shared that it is beneficial to focus on building trust with your provider, normalizing real conversations about self-care and compassion, embracing differences, and being curious about our different needs, identities, and experiences. Again, as Sherry beautifully stated, “All are welcome here.”