The Spoon Theory written by Christine Miserandino


Please take the time to read Christine Miserandino’s personal story and analogy of what it is like to live with sickness or disability.

Click HERE to download “The Spoon Theory” in PDF format.

The Spoon Theory

by Christine Miserandino

My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.

Cartoon image of Christine Miserandino holding a spoon
As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?

I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn’t seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.

As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.

At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.

I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.

Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.

She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?

I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn’t even started yet. I’ve wanted more “spoons” for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.

I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too.” I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.

I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.

We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.

When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.

I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.”

Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day’s plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.

After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can’t go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”

Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my “spoons”.

© Christine Miserandino

*We have English, Spanish, French and Hebrew translations of “The Spoon Theory” available.

You may NOT publish or re-print this article without the written permission of Christine Miserandino and Thank you.

Now you can purchase small and large poster prints of “The Spoon Theory” from our Online Store! These posters will make a perfect “get well gift, or friendship/ I understand gift.” We also think it would make a perfect addition to any doctor’s office, or support group meeting room.

The Spoon Theory Large Poster – $22.99

The Spoon Theory Small Poster – $18.99

Most importantly, get one for yourself!

  • Melanie

    I’m so glad to see this written out in a way everyone can understand. Having Gastroparisis and constant pain, between the flare ups and stomach problems that differ from day to day and all the ups and downs, it was nice to see compassion in this story. I know all too well, the “but you don’t look sick” look.

  • Samanthe 1

    I have to start my comment in complete “wow”.. Ironically I decided to google my name out of boredom and curiosity-mainly because it’s very unique and I’m the only one I’ve ever met who spells it with an “e” at the end instead of a “a”, I named my oldest daughter after myself making sure her name had the “e” on the birth certificate and gave her the most beautiful middle name that flows perfectly behind it & knowing I Would always call her and introduce her by her middle name, I wanted her to have my first name. Here’s where the bafflement comes in when I stumbled upon this conversation; I, Samanthe, was recently diagnosed with fibromyalgia and have suffered from adhd, ocd, severe anxiety, and who doesn’t suffer from a bit of depression :/ .. The fibromyalgia has me in extremes of tension pain to the point of tears sometimes that I just have never been able to explain. Parts of my body “fall asleep” for no reason and it hits me all the sudden. So when I googled my name “Samanthe”, my eyebrows instantly scrunched in “wtf?! How odd is this!” When I opened this conversation dating back to over 4 years ago. I would like to find the beginning of it and see where it all started & who this other Samanthe is that obviously made ignorant remarks to the disease. I’m still trying to understand it myself but I can honestly say this shit is real & the pain gets worse every day, I exercise, im thin, pretty and only 5’2 32yrs old.. I’ve been trying the “mind over matter” philosophy my whole life & it helps to keep my head from falling off but the pain doesn’t go away. I don’t whine and nobody would even know how much pain I’m in from looking at me but to anyone out there who can relate I just want to say I empathize with all of you and I wish everyone well. Everyone in the world is suffering from something and people who run their mouth ignorantly, well I hope them assholes the best too..

  • Chloe Mediaraft

    Another heartfelt “Thank You” Christine. Like Lynn below I have fibro, cfs and arthritis as well as a REM sleep disorder, i’m only about 3 years into most of them (apart from arthritis). I found The Spoon Theory whilst researching my conditions and more importantly, showed it to my Sister In Law who was suffering very badly with a myriad of complex conditions and was in constant pain. We read it together that evening and she cried, saying for the first time it was like someone understood. Thank you for writing this, thank you for helping my wonderful SIL and one of my closest friends to find the words to explain her pain, which has all lead to her getting a diagnosis (ME, Endometriosis and Irritable Bladder Syndrome). Thank you because you’ve given us a way to explain to everyone we love, how this feels and thank you because without this as a constant reference point, I wouldn’t be able to run my business, my wonderful SIL wouldn’t have been able to control and manage her pain enough to go through pregnancy and ask for the support she needs whilst looking after her beautiful baby boy. Thank you for giving both of us the hope that one day, people can understand in some way. I hope your spoons for today are relatively plentiful and that you’re coping and managing your Lupus. Thank you. Gentle Hugs – Chloe. xxx

  • Lynn

    Thank so much for sharing your story. My sister told me about it. I have fibromyalgia, osteoporosis and osteoarthritis along with spinal stenosis. I have lived with pain most of my life, and as I have gotten older it has gotten worse. As I read your story I cried, because someone understands and you have shown me a way to explain how I feel all the time. Thank you!

  • Bouncin Barb

    Hi Christine…Thank you so much for writing this. I’ve heard to term “spoonie” and didn’t really know what it meant. I have fibromyalgia, cfs, osteoarthritis and possibly rheumatoid arthritis so I certainly understand what planning for everything and having that one spoon in reserve is for. It’s frustrating when people don’t understand or else they say they understand yet get upset when you can’t do something. I’m saving this to use for those that don’t get it. Be well.

  • Olga, eBankBooks

    Hi Emily, your condition is not only about triggers, it’s also about absorbing enough nutrients from your food. Please look into fruit-based raw food diet, it healed me and countless people I know, simply because it’s so light, it allowed the body to heal itself while providing it with all the building blocks it needs. There is so much suffering on this page! Best wishes.

  • BradandSarah Calhoun

    Yes, I read it. My daughter struggles daily with pain and fatigue, and finds the spoon theory concept a useful way to explain why she must limit her involvement in things. But she has not been labeled “disabled”; that’s an extremely subjective term. Any medical/legal designation of “disability” in order to qualify for benefits should not be the only criteria by which one is “allowed” to use this excellent illustration.

  • Unsellie

    Except that there is a marked difference between people who quickly run out of mental-physical energy, and people who don’t need to worry about running out in their daily life. Obviously humans have limitations, obviously people each have their own end-of-energy, however if there were no difference, no distinct separation, between ‘abled’ and ‘disabled’, then there would be no words for it, and there would be no disorders. So I’m sorry, but no, not EVERYONE can be covered with this analogy. It’s just not the same. Did you read the story?

  • Cypora Jonsson

    Tammy, I too am on pain medication and am thankful for them every day! They help me survive every day and I do not care what others may think about me. I am not a junkie! I do not get high or feel dependant (although I know I am), they just allow me to live and without them I would have no spoons at all!

  • Unsellie

    As one who struggles with chronic pain from fibromyalgia, along with depression and near constant tension headaches and migraines… I can certain understand my own version of the spoon theory. My mom, who has diabetes / lupus / fibromyalgia / heart arrhythmia / gastro problems and more… she could benefit from this analogy. Thank you for sharing this.

  • Cypora Jonsson

    Thank you for explaining to ME what I always felt guilty about! I have chronic pain, fibromyalgia and loose joints and always tried to act as if I had limitless spoons but I came to realise that trying to please others was over-extending me. This theory is a God-send to me! I should choose what I can or cannot do even if it hurts my family or relatives! I NEED to listen to my pain to survive….but I still feel guilty.

  • joe

    I really understand the spoon theory, I have had chronic pain for 34 years, my wife has had MS for 32, our spoons run out rather quickly.

  • Lulubelle

    But why not? Is it going to take anything away from you or from anyone else who ‘claims’ it? Why would you begrudge anyone else using it if it helps them?

  • BradandSarah Calhoun

    Careful; what constitutes “abled” and “disabled”? What you may consider “abled” in comparison to your disability may still be a struggle for someone else. I think most of us do have certain daily limits to our energy and capacity.

  • Theresa Reckamp

    I just got back from a meeting with my speech therapist. I suffered from a traumatic brain injury, broken neck and broken back when I got rear ended on a highway. Even though I’m out of the neck brace and able to move around better, I still have debilitating headaches every day and problems with my short term memory. When I move too much or try to have conversations with too many people during a day, the headaches get worse. My therapist starting talking to me about the spoon theory, and it led me to this page. This is so inspiring and genuine, and it has finally given me the words to explain to the people in my life that I’m still recovering even though I look better. Thank you so much for this.

  • louise

    This is exactly how I feel. It is difficult to explain to people what it is to live with chronic pain. I have not been specifically diagnosed so I am far from even giving my pain a name.

  • joe markovitch

    Thank you for sharing this story.


  • TichWilson

    Thank you so much for this. My partner lives with chronic pain, and even as his caregiver I often feel like I will never understand, but the spoon theory is definitely a part of both of our lives. I can’t wait to share this with friends and family, to help bring them closer to a place of empathy for the choices and daily battles he lives with. Thank you.

  • kim

    This is so accurate! I have Fibromyalgia, Rheumatoid Arthritis, and recovering from a stroke. Some days I feel like every task costs me 2 spoons. But no point in dwelling on it. This the hand I was dealt. I’m just trying to play the best game possible. So I try to stay positive, alway trying to find the bright side and laugh when I want to cry. Because if I give in and cry, there goes another spoon.
    Thank you for putting my feelings into words.

  • Eme

    I have been here many many times. “Pacing” was the hardest lesson to learn, and one that I constantly relearn as my illnesses progresses. Learn to be compassionate and kind with yourself. You are doing battle on a level that most people will never know.

  • Eme

    I like that! The “Eat Dessert First” Theory. :)

  • Cheryl Harding Swift

    You really are a bold soul. To actually say something is so difficult for any of us, for fear of what people will think or say, or even how we will relate to it ourselves. God bless you and your courage.

  • Joseph Procopio

    Any relationship to my law school buddy Richard?

  • Jeanette_Mangaard

    Thank you so much for this post, I have read it many times before. And it really helps when you have to explain too people that you have chronic diseases. I deal with Idiopathic intracranial hypertension, migraine, fibromyalgia and IBS so it`s a struggle.

  • bpdying

    no. no it cannot. able bodied and able minded people do not have to count their spoons. spoon theory applies to disabled people and we would really appreciate it if abled people didn’t claim this term as well.

  • Kiboko

    A friend with lupus just signposted me to this. I don’t have lupus, but I do have a disability and heart problems. I don’t really know what to say because I’m choked up. This describes my life so perfectly. There’s someone out there who knows exactly the day to day reality of my life.

    I’m sad because I used too many spoons on Sunday for something that really wasn’t worth it. I was due to go to the theatre this evening with some friends and I was really looking forward to it. But when the time came, I had no spoons. I feel I let everyone down because I wanted to go so badly, I left it until the last possible minute to make the call. I don’t want to be the unreliable friend who doesn’t show up. I really wanted to share a spoon with them, and I feel upset now that it simply wasn’t there. :)

  • LeeAnne Hanks

    Thank you! I’ve been dealing with Ankylosing Spondylitis for a year now. My kids have had a difficult time adjusting. I used the spoon theory (with fruit loops) to explain how I have to make choices through the day. The sweetest part was when I was down to 2 loops and had 10 things to do still, but had to choose, and my son tried to give me some of his with so much compassion on his face. I said I wish you could give me more but it means so much that you want to! They really get it now. Thank you again!

  • charlesburchfield

    Life changing diagnosis of age related diabeties on top of depression/anxiety AND alcoholism (there i’ve said it!) *{|°-

  • Julie Kauffman Barton

    Diabetes is another spoon disease… how to get home after a low,,, etc.

  • A Rose

    Your “Spoon Theory” is an eloquent way to describe the daily ordeals of lupus or any disease. My boyfriend doesn’t really understand what I go through, very much like your roommate. I was diagnosed about a year ago with lupus and my life has been a rollercoaster. I am definitely going to have him read this article. I’m glad I found this.

  • Maman Seo

    tnx intothegloss,Thank you for your good site. I wish you success . good luck , هک کلش اف کلنز

  • Nikhil Autar

    This is sooo bloody great…

  • Arlene

    Very emotional reading this, and especially to find a comment from someone that lives with the pain of Hemicrania Continua, as I do. Thanks for this post

  • PJ

    Ended up here tonight because I needed to reread the story. I had to make the decision not to go meet my new niece tonight, because I had borrowed against today’s spoons, then used more than I anticipated, and had to reserve some to eat. It’s been a difficult day.

  • PJ

    definitely. I have debilitating depression, and use it often to explain to people.

  • Fran Sword

    Thank You so very much for this therapy!! I have had Fibromyalgia since 1994 and have not ever been able to explain, “You don’t look like you feel bad”…. until now!! Thank you again so very much. I did ‘share’ this on Facebook from my sisters page, for others to understand more about those of us that are sick or don’t feel good most of the time and have more ‘not so good days’ than most with just a virus!

  • Theresa Grothe

    I am so glad that you have explained the Spoon Theory in depth and how it works to explain any type of illness. It will be something I can use to help others to understand what it’s truly like to live in my shoes. Thank you

  • Sanskruti Sonak

    A spoon theory.. realy v innovativly explained. Usualy makin some1 understnd ths wud b so difficult but thnku for doin ths. Helped me a lot in seeing things from a different angle. God bless u

  • playgirlc

    i think it can apply to anyone, really

  • Kat

    Is it acceptable to apply this theory to those with chronic mental illnesses as well?

  • Emily Selway

    Yes. I avoid artificial sweetness and colors, but no other foods have proved to be migraine triggers. As for my colitis, it is so low in my colon that it doesn’t respond to dietary changes.

  • Julie

    So helpful, you have no idea. Thank you!

  • Jaquy Yngvason

    Have you tried changing your diet? I worked with someone who had colitis and after one year she no longer has symptoms. I highly recommend looking into more plant based foods. Also I used to have chronic migraines growing up and through food I no longer suffer it has been a blessing.

  • BillipPhailey

    Yep. Life-changing injury on top of dep/anx.

  • Lisa

    Please get tested for Thyroid as well as Hashimoto’s

  • Star

    I’m so sorry you’ve had trouble with doctors. So very many people run into the same problem, especially with invisible diseases and it shouldn’t be like that. It’s especially hard when they attribute problems to your age- I was told I was depressed because “that’s just how teenagers are” when my symptoms were actually caused by a tumor.

    I hope you’ve been able to find some decent doctors <3

  • Star

    The spoon theory has helped me so much in explaining things to people that don’t understand. Yesterday I ended up borrowing most of today’s spoons. What spoons I had left got used up by the fire alarm going off in ny building, so I had to get my cats in their cages and carry them down. Not fun.

    I had no idea this site existed, even though I’ve known about the spoon theory for a while. Happy to know it does.

  • Pamela Steinkamp

    I was just diagnosed with Ehlers-Danlos syndrome and I am 56 years old! I have been looking for answers to my pain since I was a teenager. I have had 22 surgeries, multiple spine fusions, an ankle fusion and a ruptured ACL to name a few. I have been told things like “You have arthritis, and degenerative disc disease.” But despite all the meds I am on I still feel pain 24 hours every day. I sleep only a couple of hours at a time when my meds are working and I am exhausted. I used to have a spotless house with 4 kids and be involved in every club and activity my kids were in. Now, I absolutely think about every move I make and have to decide if it is worth the effort it is going to take to do or worth the increased pain and suffering I know it is going to cause after I have done it.
    Thank you for your story! I am going to use it to explain to my friends who do not understand chronic pain and illness. Health and physical ability is taken for granted by so many. Life is too short. After almost dying from a botched spine surgery and surviving a septic infection and meningitis due to the complications, my families new motto is “Eat dessert first!!”

  • Debbie Jones Smith

    Excellent analogy, thank you so much.