This is a professional who understands ME and failed metabolic recovery, aka post exertional malaise or PEM*.
ME is physiological illness that has historically been incorrectly framed in psychological terms, at incalculable cost in terms of suffering and loss of life and living.
There is a critical psychological element, but itâs not the one that has been misused and abused.
The psychological element is that, as some stages of illness, especially but not only when mild, people with ME will repeatedly do too much, thinking that energy that feels available can safely be used in a way that would be normal for someone without ME.
This causes post exertional malaise, which is a painful and dangerous reminder of the illness. In time, the baseline level of function (hopefully) returns, and the cycle repeats.
đ I feel like I have some energy
đ I can use the energy to get things done
đ Iâve done a normal amount of things but now I have crashed (failed metabolic recovery)
đ I need to lie down and rest, urgently
đ I feel like a failure because itâs happened again
đ I feel frustrated and guilty for resting
đ I feel like I have some energy
Itâs a cycle without learning until the consequences of overexertion are bad enough and repeat often enough.
Eventually, hopefully, you learn to pace. This is a science and an art requiring enormous mental strength and discipline, especially in an always-on society that prizes the opposite. You have to unlearn your old ways - âcharging aboutâ, people pleasing, over committing - and get good at pacing. Ironically, you need to do this quickly, before your illness progresses and PEM damage sets in. Pacing is the only thing you can really rely on.
* sometimes post exertional symptom exacerbation (PESE), or post exertional neuroimmune exhaustion (PENE) are used by different groups.
I have NEVER â EVER â had to encourage someone with ME to do more.
I always â ALWAYS â have to persuade them to do LESS.
To stop a favourite activity.
To adjust a task to lessen the effort.