Rest is an essential part of ME-management. Everyone knows the feeling of crashing on the sofa and feeling the symptoms slowly abate. In my book “Classic Pacing for a Better Life with ME” I call this “repairing rest”, because this type of rest repairs overexertion. You can feel it working fairly quickly within minutes, hours or days. Repairing rest is an invaluable tool for getting over a symptom flare-up due to overexertion as fast as is possible. It usually works faster if you get total rest and deep relaxation, instead of just watching TV. In fact, if you’re quite severely ill watching TV and other light activities will drain you even further. Without repairing rest, there’s a real risk of a long-term relapse. However, repairing rest only gets us back to where we were before the overexertion. In order to get any further, we need healing rest.
The goal of pacing is to get the body into balance. Alternating activity and rest and alternating different types of activities are good ways of doing this. However, if your activity provokes a significant amount of symptoms, you need to rest the symptoms away. You are, in fact, going in and out of balance. The activity brings the body out of balance, and the rest will then bring it back into balance. It’s like using your checking line-of-credit and then paying it down. What we’re looking for is an upward spiral, where the body’s energy reserves gradually grow, rather like a savings account.
The quickest way to get a savings account to grow, apart from winning the lottery, is to plan a budget where you spend a bit less than you earn and then leave the surplus money on the account, so that you start getting interest. In terms of pacing, this would mean stopping each activity or group of activities before your symptom levels rise, and then having a rest, even if it feels like you don’t need it. In my book I call this type of rest “healing rest”. Although rest helps the body regenerate in any case, there’s a distinct difference between using rest to pay down debt and using rest to top up your savings account. Paying down debt, which equals repairing rest, brings your account in to balance but doesn’t get you any further. Saving up money increases your fortune, and in time you will get interest on your savings, and interest on the interest. This equals healing rest.
Does the theory of repairing rest and healing rest mean that pacing with enough healing rest will always be sufficient to kick-start gradual improvement? No, unfortunately not. There are many factors that affect the health of people with ME, including infections, food intolerances, stress and immune abnormalities. If there are enough negative factors pulling in the other direction, pacing will not itself be enough to start improvement. A good example is a friend of mine with severe ME who has a very aggressive human herpes virus 6 infection, which her immune system is incapable of keeping down. When her infection is not treated, my friend experiences progressive worsening of her health. Once she receives both antiviral and immune modulating drugs, her condition becomes stable, and then pacing has produced various positive effects. Pacing in itself is not enough to stabilize her condition. However, many people find that the opposite is also true - that treatments, on their own, do not work sufficiently without pacing. I am aware of many people with ME who have experienced temporary improvement from a treatment, but who increased their activity level too quickly and ended up crashing badly, often losing all the improvement they originally got. Those who combine pacing with other treatments appear to have a considerably greater chance of holding on to their improvement, since several approaches at once also appear to give greater effects than using only one. I would, however, strongly suggest that you learn one management technique at a time, and also try treatments one at a time. Trying to do everything at once can be overwhelming. Start with what seems most acutely needed and add new approaches when you feel ready.
Even when pacing gives improvement, it varies how quickly this happens. This is partly because it varies how much healing rest is possible for people to get in their particular life circumstances. Greater amounts of healing rest tend to produce quicker effects. However, there are also significant individual differences in the stubbornness of the illness. People with a very stubborn variety of ME find that it takes longer to get effects from pacing no matter how good they are at it. The good news is that the short-term effects of pacing, namely lower symptom level and fewer bad days, are usually so good that the method is worth using whether you experience long-term improvement or not.
Task
Organize your activities and rest breaks so that you get some healing rest every day. One method of doing this is to plan regular rest breaks and take them whether you feel you need them or not. If you’re not accustomed to resting, you can try resting for five minutes per hour and then increase gradually as needed. Listening to relaxation sessions can make resting easier and deeper and therefore more effective. Remember that healing rest is surplus rest. Whenever you end up being active to the point of symptom flare-ups, try to rest not only until the symptoms go down, but a bit longer.
Copyright Ingebjørg Midsem Dahl 2019.
ME groups are welcome to reprint this article in their newsletter or link to it provided that nothing is changed. If you choose to translate it, please email me: [email protected]
The goal of pacing is to get the body into balance. Alternating activity and rest and alternating different types of activities are good ways of doing this. However, if your activity provokes a significant amount of symptoms, you need to rest the symptoms away. You are, in fact, going in and out of balance. The activity brings the body out of balance, and the rest will then bring it back into balance. It’s like using your checking line-of-credit and then paying it down. What we’re looking for is an upward spiral, where the body’s energy reserves gradually grow, rather like a savings account.
The quickest way to get a savings account to grow, apart from winning the lottery, is to plan a budget where you spend a bit less than you earn and then leave the surplus money on the account, so that you start getting interest. In terms of pacing, this would mean stopping each activity or group of activities before your symptom levels rise, and then having a rest, even if it feels like you don’t need it. In my book I call this type of rest “healing rest”. Although rest helps the body regenerate in any case, there’s a distinct difference between using rest to pay down debt and using rest to top up your savings account. Paying down debt, which equals repairing rest, brings your account in to balance but doesn’t get you any further. Saving up money increases your fortune, and in time you will get interest on your savings, and interest on the interest. This equals healing rest.
Does the theory of repairing rest and healing rest mean that pacing with enough healing rest will always be sufficient to kick-start gradual improvement? No, unfortunately not. There are many factors that affect the health of people with ME, including infections, food intolerances, stress and immune abnormalities. If there are enough negative factors pulling in the other direction, pacing will not itself be enough to start improvement. A good example is a friend of mine with severe ME who has a very aggressive human herpes virus 6 infection, which her immune system is incapable of keeping down. When her infection is not treated, my friend experiences progressive worsening of her health. Once she receives both antiviral and immune modulating drugs, her condition becomes stable, and then pacing has produced various positive effects. Pacing in itself is not enough to stabilize her condition. However, many people find that the opposite is also true - that treatments, on their own, do not work sufficiently without pacing. I am aware of many people with ME who have experienced temporary improvement from a treatment, but who increased their activity level too quickly and ended up crashing badly, often losing all the improvement they originally got. Those who combine pacing with other treatments appear to have a considerably greater chance of holding on to their improvement, since several approaches at once also appear to give greater effects than using only one. I would, however, strongly suggest that you learn one management technique at a time, and also try treatments one at a time. Trying to do everything at once can be overwhelming. Start with what seems most acutely needed and add new approaches when you feel ready.
Even when pacing gives improvement, it varies how quickly this happens. This is partly because it varies how much healing rest is possible for people to get in their particular life circumstances. Greater amounts of healing rest tend to produce quicker effects. However, there are also significant individual differences in the stubbornness of the illness. People with a very stubborn variety of ME find that it takes longer to get effects from pacing no matter how good they are at it. The good news is that the short-term effects of pacing, namely lower symptom level and fewer bad days, are usually so good that the method is worth using whether you experience long-term improvement or not.
Task
Organize your activities and rest breaks so that you get some healing rest every day. One method of doing this is to plan regular rest breaks and take them whether you feel you need them or not. If you’re not accustomed to resting, you can try resting for five minutes per hour and then increase gradually as needed. Listening to relaxation sessions can make resting easier and deeper and therefore more effective. Remember that healing rest is surplus rest. Whenever you end up being active to the point of symptom flare-ups, try to rest not only until the symptoms go down, but a bit longer.
Copyright Ingebjørg Midsem Dahl 2019.
ME groups are welcome to reprint this article in their newsletter or link to it provided that nothing is changed. If you choose to translate it, please email me: [email protected]