Spoons, decision fatigue, and a glimpse into poverty
In recent years, people who have chronic illnesses have adopted lingo which may seem odd or fanciful to the uninitiated, dealing as it does with the presence or absence of spoons.
The choice of cutlery as a metaphor was random, but it appears to have filled an explanatory void for a whole lot of people. The original source was an essay written by a woman with lupus, but the idea has been picked up by people with everything from cancer to bipolar disorder.
In this metaphor, a â€˜spoonâ€™ is a unit of energy, either physical or mental. Most people have more energy than they need — they might be overworked and underslept (I suspect most Americans are), but at the level of ‘tired’, not ‘utterly depleted’.
So healthy people get a big pile of spoons, and never run out. Sick people get a much smaller pile of spoons, and run out very quickly if they try to live a â€˜normalâ€™ life:
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 wouldnâ€™t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely.
What does it mean to run out of spoons? Well, it varies according to the person and the condition, but generally: you collapse. The moment you use up your last spoon is the moment you fall apart and become completely and utterly non-functional. If your problem is physical, it might mean dropping in your tracks because you literally lack the energy to stand up. If mental, you might find that you can’t hold a single thought for even a few seconds. If emotional, it might mean becoming hysterical, or suicidal.
With those kinds of consequences, you can imagine that spoon management becomes absolutely critical. You have to think about the energy cost of everything, and subtract it from your expected energy. Even the smallest activity requires detailed advanced planning.
I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. â€¦ 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.
What do I know about spoons? Well, I suffered severe trauma at the hands of my abusive parents from birth through my late teens. As a result, Iâ€™ve struggled my entire life with post-traumatic stress disorder, chronic depression, and anxiety disorders. Like most PTSD sufferers, I have horrific nightmares alternating with bouts of insomnia, which contributes to frequent exhaustion.
The result is that even at the best of times, I live each day â€˜like I am strategizing a warâ€™. I am told that most people go to parties for fun; I on the other hand have to arrange supply lines, protect my flanks, and plan for multiple avenues of retreat.
When symptoms are especially bad, I am forced into an advanced state of triage. I have to decide which projects and responsibilities and relationships can survive being put on hold — and when whatâ€™s left is still too much, which ones to let die.
Northern winters always take a heavy toll on me, but some years are harder than others, and I donâ€™t know why. The last few months have been some of the worst of the last decade. I get exhausted easily — on a given day I can shop for groceries or I can cook dinner, but not both. Doing anything social generally costs me two full days: one to prepare and one to recover.
So I too have adopted spoons as a way to explain some of the realities of my life â€” like for example, why the frequency of Pocketmint posts took a nosedive in October. I lost a bunch of spoons.
Hereâ€™s the kicker: itâ€™s not just that those of us with few spoons can only accomplish a fraction of what healthy people do in a given span of time, but the constant spoon management itself actually uses up spoons.
The name for this phenomenon among social scientists is â€˜decision fatigueâ€™. The New York Times ran an excellent piece on decision fatigue by John Tierney last August:
No matter how rational and high-minded you try to be, you canâ€™t make decision after decision without paying a biological price. Itâ€™s different from ordinary physical fatigue â€” youâ€™re not consciously aware of being tired â€” but youâ€™re low on mental energy. … Once youâ€™re mentally depleted, you become reluctant to make trade-offs, which involve a particularly advanced and taxing form of decision making.
Personally, I would quibble with that: I am often very consciously aware of being mentally depleted. Sometimes Jak will ask me to make a decision or an assessment that I know ought to be easy, that would be easy at a better time, but is completely beyond me now â€” all I get is a jumble. Sometimes I try to write and I feel like Charlie in Flowers for Algernon, reaching for a word, an ability, that used to be there and now is not. (Writing is, after all, a complex cascade of choices.)
For people with chronic illnesses, everything is tiring.
The same thing is true when youâ€™re poor.
Iâ€™ve been thinking about poverty a lot in recent months, in part because we are a lot closer to it than weâ€™ve ever been.
Jak has been looking for a job for a solid year now, with no success. I havenâ€™t had full-time work since October of 2011; early last year I was having no better luck than Jak, and now with my current supply of spoons I could not keep a job even if I could find one. (In the past I covered for my low-spoon periods with credit cards, but Iâ€™ve resolved never to do that again.)
We made it through 2012 by virtue of unemployment benefits, a tiny amount of freelance income, free housing, and stark frugality. Now itâ€™s 2013, and our clock is ticking, as Jakâ€™s unemployment runs out before the end of the month.
This drop in income has added stress for both of us. Recently, Jak wrote the following:
That has to be the hardest part of being poor â€” and yes I consider myself poor now. Saying no to Claire and Michaela. In some ways I think that it’s good for them to learn that there are limits… and that they will appreciate the things they do get if they don’t get everything that they want… that perhaps they won’t feel entitled. But in other ways, I am embarrassed by being poor. Ashamed. I don’t think it’s right to feel that way, but sometimes I do because our society judges us by how much we make… and certainly Claire’s society judges her for not having money or stuff (ipod touch or whatever) … which I hate, but there it is.
Later, Jak and I had a conversation about what â€˜poorâ€™ really looks like, and he agreed with me that we are not literally poor. But I understand why he used the word. We are a long way down from the upper middle-class of our families, most of our friends, and even our former selves: weâ€™ve gone from the fifth, highest quintile of American earners to the second, yet we are bound (by child custody) to one of the more expensive cities in the country.
The feeling of inadequacy and failure can be overwhelming. I try not to dwell on what we used to have, or compare myself to people who have more than we do, because that only makes it worse. Instead Iâ€™ve been thinking about the ones â€” still about 30% of Americans â€” who have less.
Social scientists have been acknowledging for a while now that decision fatigue is one of the things that keeps people in poverty. â€œBecause their financial situation forces them to make so many trade-offs, they have less willpower to devote to school, work and other activities that might get them into the middle class,â€ writes Tierney. â€œLapses in self-control have led to the notion of the â€˜undeserving poorâ€™ â€” epitomized by the image of the welfare mom using food stamps to buy junk food â€” but Spears [an economist studying decision fatigue] urges sympathy for someone who makes decisions all day on a tight budget.â€
Tierney offers â€˜wedding planningâ€™ as a source of decision fatigue to which the middle class can relate. I donâ€™t doubt that weddings are exhausting, but itâ€™s a very privileged example. The one-time flurry of dresses and caterers and gift registries has got to be easier than constant, unrelenting choices between buying medicine or food, between paying rent or the electricity bill, between one bad outcome and a different one.
Despite what many well-off people seem to believe, frivolous spending is not the heart of the poverty problem. The poorest 20% of the American population had an average after-tax income of about $10K in 2011. Yet they had average expenses of $22K. Housing and utilities alone ate up an average of $11K, putting them in the red before we even consider food, clothing, transportation, or health care, let alone such luxuries as education.
For a taste of what the decision fatigue of poverty is like, try the online simulation Spent, where you play a single adult with a child, a pet, and a minimum wage job. Can you make it through a whole month without running out of money?
The game presents you with a series of choices and tradeoffs. No matter what you do, there are more bills coming due than you can possibly pay. Do you skip the gas bill and go without heat or any way to cook food? Or do you skip a car payment and risk repossession?
When I played Spent, I soon found myself in the middle of the month with $398, having to choose between putting my pet to sleep ($50) or letting her suffer ($0), because I didnâ€™t have the $400 that treatment would have cost. I felt like Iâ€™d been punched in the stomach. Suddenly I regretted my earlier decision to return a $10 bill to the person who dropped it; I could see how the finer points of morality could become an unaffordable luxury. Worse, I later realized that even if Iâ€™d had the $400 and gone to the vet, I would have failed anyway, because I wouldnâ€™t have been able to make rent two weeks later.
(The hard-hearted may argue that a poor person doesnâ€™t have any business supporting a pet anyway, but you know what? Sometimes life is so crappy that a warm purry snuggle or a tail-wagging face-lick is the only thing standing between you and total despair. Pets are important emotional support for people who havenâ€™t a prayer of affording therapy.)
We are not poor because we still have a savings cushion. This means that when the cat had a medical emergency last September I could take her to the vet â€” I didnâ€™t have to just listen to her suffer and hope she wouldnâ€™t die. When Jak had a car accident that shattered the windshield, we only lost the use of the car for a few days, because we could tap our savings to repair it.
But we are having just the smallest taste of what poverty is like. We are making just a few of the kinds of tradeoffs that middle-class people never have to think about, but poor people live with all the time. We are postponing dental cleanings and doing without heat in most of the house â€” not because we flatly canâ€™t pay the bill, but because the $60 per month difference between 60°F and 70°F is too significant to ignore. I need therapy to help with my current PTSD symptoms, but I worry that it will deplete our savings too much â€” savings that might be our sole support soon.
I wage a daily battle to hold our spending level steady â€” and I am losing, as increasing amounts of privation fail to make up for the increase in health insurance premiums and child support payments, the costs of accidents and illnesses and other circumstances beyond our control.
Itâ€™s stressful â€” and stress exacerbates my anxiety and depression, as well as taking its toll on my body. And the vicious cycle rolls on.
The point Iâ€™d like to make is that we all need to be less judgmental of other peopleâ€™s choices. I read news stories about people in poverty or in debt, and they are always followed by a string of comments about how the person deserved what they got because they made a poor choice, and what did they expect.
Well, itâ€™s very easy to sit in comfort and say, â€˜I would never do thatâ€™. But the truth is that if you had to live in those circumstances, you probably would do that, or something equally ill-advised. First, because often all of the options are bad. And second, because the ability to make good decisions is not a natural virtue â€” itâ€™s an ability that fluctuates according to oneâ€™s situation. We are all Charlie, to some extent.
We also need to stop thinking of poverty as a condition that anyone could just work their way out of if they were really trying. Social mobility hasnâ€™t been a statistical reality in America for forty years â€” and thatâ€™s not because people suddenly got lazier. Itâ€™s because the environment changed.
We arenâ€™t all working with a full set of spoons, silver or otherwise. Some of us have physical challenges, some mental, some financial. You wouldnâ€™t tell someone with cancer that they could get better if they were really trying, right?
Then donâ€™t imagine that anyone could just shake off a mental illness, or pull themselves out of poverty, if they wanted to badly enough. We want to. Almost to a person, I promise, we all want to live better lives.
This essay took me two weeks to write. As I was finishing, Jak got a three-month part-time contract job: 10-15 hours per week. Itâ€™s not enough to cover our current expenses, but it will at least slow the depletion of our emergency fund.