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About
About
'Spoon Theory' - the namesake for my game - is a widely adopted metaphor for explaining energy limiting conditions.
It was supposedly created when someone tried to explain their condition and spoons were the nearest prop. The concept is that spoons are a resource (a spoonful of energy) and the average able-bodied individual gets a certain number a day which they can spend as they need on tasks like working, shopping, showering, etc.
A chronically ill person will start their day with less spoons, and tasks like showering might cost significantly more because of co-morbidities like dysautonomia which make the tasks physically more taxing; or perhaps they require focus which takes more effort with a foggy brain. Rest might not necessarily recover spoons, or be less effective in doing so. Over-spending spoons can cause crashes that can impact function significantly for days, weeks, or even years.
My game uses spoons very literally as a resource to represent energy, as the player engages with the main character, Sage 春柳 (Chun Liu) who has mild ME/CFS. It augments the visual novel style by limiting how much Sage can push themselves through the narrative events. Her needs are represented by five scores - achievement, environment, physical, social, and wellbeing - which interact dynamically with the music and affect story outcomes.
Sage 春柳 (Chun Liu)
Character Portrait
Although managing resources is a key part of the game, I want it to tell a meaningful and engaging story too. Sage is a uni student, navigating new relationships, independence, changing family dynamics, and forging her path in life. They have a passion for botany and horticulture, love reading and creating art, and have a nerdy side that loves games - tabletop, digital, or online.
Decisions made in Spoon Theory, should not only be governed by social and narrative implications, but also from a needs and energy management perspective. It complicates decisions, which in my experience, is the nature of living with chronic health conditions. There is no perfect balance, but with careful management, there is room for happiness.
Myalgic Encephalomyelitis (ME)
Myalgic Encephalomyelitis (ME)
Quick Note: ME vs CFS (Chronic Fatigue Syndrome)
ME is the largely preferred term amongst people with the illness as it more accurately explains the condition in medical terms...
Myalgic: muscle pain
Encephalo: the brain, Mye: spinal cord, –itis: inflammation
or Inflammation of the Brain and Spinal Cord.
What is it?
A chronic inflammatory and energy limiting condition characterised by disproportionate exertion from activities
Affects every part of the body, including the brain
Common symptoms include: Brain Fog, Sleep Disruptions, Sensory Hypersensitivity, Muscle Weakness & More (Seltzer, MEAction)
Characterised primarily by PEM (Post Exertional Malaise), not Fatigue
What is PEM?
Delayed worsening of symptoms caused by exertion - often presenting with flu-like symptoms
Triggers can be: Physical, Orthostatic, Cognitive, Sensory, Emotional, or Environmental
Described as an 'impaired ability to recover' - over-exertion can cause permanent worsening of the condition
What causes it?
Onset typically occurs when contracting a viral infection, suggesting an immunological component
A recent study by DecodeME (Aug 2025) suggests a genetic pre-disposition
How severe does it get?
Mild ME/CFS is defined by a 50% reduction in energy and is still a significantly life-altering illness
Moderate ME/CFS patients are largely house-bound and can typically handle only a small number of tasks a day
Severe ME/CFS patients are mostly bed-bound, often requiring significant care and accommodations
Very Severe ME/CFS has been described as 'living death', where function can decline significantly from simple motions like reaching for something
It is critical not to conflate mild ME/CFS with mild illness. As per the CDC's (2024) clinical overview...
"Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, life-altering disease affecting many organ systems. It goes well beyond "being tired" and profoundly impacts patients' quality of life and abilities."
DecodeMe collaboration 2025 ‘Initial findings from the DecodeME genome-wide association study of myalgic encephalomyelitis/chronic fatigue syndrome’ Edinburgh Research Explorer, early version/pre-print, https://institute-genetics-cancer.ed.ac.uk/decodeme Seltzer, J Pacing and Management Guide for ME/CFS, MeAction, https://www.meaction.net/wp-content/uploads/2021/02/Pacing-and-Management-Guide-for-ME_CFS-9.pdf CDC 2024, ME/CFS Clinical Overview, U.S. Centers for Disease Control and Prevention, https://www.cdc.gov/me-cfs/hcp/clinical-overview/index.html
Project Objectives
Project Objectives
Personal
Personal
Create a work that is a culmination of my skills as a story-teller, a musician, and someone who just generally likes making things, about a subject that I feel personally connected to.
Learn more about game development and game audio so I can work more readily in the game music field.
Community
Community
Objective 1:
Create an immersive and enjoyable experience that educates people without energy limiting conditions about how impactful they are on daily life.
Objective 2:
Deconstructing the misconception that ME/CFS is "just being tired."
Objective 3:
Cultivating room for hope within the chronically ill community that with proper management and accommodation, one can still have a good quality of life.
ME/CFS Awareness (The WHY)
ME/CFS Awareness (The WHY)
These questions were pitched to a class of around 30 people when I first conceptualised this game to get a feel for the existing awareness of ME/CFS in a demographic of arts/media students, largely in their early-mid 20s.
You have heard of ‘chronic fatigue’ in general
You assumed ‘chronic fatigue’ just meant being tired a lot
You have heard of ME/CFS before
You have heard of 'Spoon Theory' before
You or someone you know is chronically ill
You or someone you know has ME/CFS
Most of the class raised their hand for question 2, and less than five raised their hand for question 3.
Two people knew what Spoon Theory was - both were chronically ill themselves.
Do you feel like the idea of ‘rationing your energy’ (pacing) is an applicable skill for managing energy in general?
e.g. even in a ‘healthy body’ you will still be affected by ‘overspending your spoons’ (staying up late, exercising too much, long days at work, etc.)
If your answer is yes then you might understand how this game could be applicable to your own life experience, even without an energy-limiting condition.
Remember: Most people with ME/CFS were not born with it; it is often triggered post-virally from infections like Glandular Fever. Open Medicine Foundation Australia estimates that as many as 1 in 30 people in Australia have ME/CFS, with an increase of more than 3.5x initial patients following the outbreak of COVID-19.
There is no cure, awareness is everything.
The Art of Spoon Theory
The Art of Spoon Theory
Bird of Paradise
Bird of Paradise
The five wellbeing scores (achievement, environment, physical, social, wellbeing) are represented by different plants. The health of the bird of paradise reflects the physical health of Sage, and whether they've been eating right, sleeping enough, etc.
Sage's Room
Sage's Room
The background art for Sage's bedroom, as inspired by my own bedroom with elements from my friends' rooms too.
Concept Sketch
Concept Sketch
The first sketch for Sage's design, she is curious and naturally 'bouncy' despite her fatigue.
Gameplay
Gameplay
Spoon Theory's timeline should span approximately a fortnight, with each day structured in two sections:
The Resource Management section, and the Narrative section.
Resource Management
Resource Management
The technical / daily upkeep side of the game. At the start of each day, the player interacts with the pinboard in Sage's room. Here they can see a number of tasks, categorised approximately by which self-care need they affect.
It's a quick way of earning some points in certain areas, but also a quick way to loose all of your spoons before you get to the narrative events.
Some tasks can be made cheaper from the acquisition of items or hiring services (available in the shop) but to afford them, Sage has to work which takes most of their energy.
Some tasks are mandatory to complete every few days, like showering, or checking emails, others while not mandatory, come with pretty hefty deductions to the self-care scores if not kept up with.
Screenshot in Godot Engine of pinboard with tasks listed on sticky notes
Task popup screenshot for exam revision
Spoon Mechanics
Some number of spoons recover every morning after sleeping. The player can also make decisions in the narrative that result in recovering a small number of spoons during the day by resting.
There will always be the option to over-spend spoons, just as chronically ill people have the autonomy to decide that it's worth pushing their limits for their goals. It does however, come at a significant cost. Spoons will become much harder to recover, having a low-base reserve at the beginning of the day will cause tasks to cost more spoons. It also causes a significant detriment to Sage's physical score, which can lock Sage out of narrative options because they are just too exhausted to participate.
The Music
The Music
Reflecting the scores...
Reflecting the scores...
A huge motivator for this project is the music. With the tools and sound libraries available now, the options for the score to dynamically adjust in reaction to the players input are many, and quite accessible. With this project, I do not want the player to ever find out exactly where their five self-care scores sit - it's unrealistic. People with chronic illness learn their bodies, but there's still a lot of guesswork involved hence, there needs to be other ways of measuring the health of these scores, of which one method is... the score!
Using FMod studio, control parameters for the music can be mapped directly to the self-care scores. My concept is to have each score represented by an instrument / instrument group, and adjust it's presence dynamically (volume), rhythmically, and melodically/harmonically in the mix the player hears. See the below table for an outline of how each track represents the scores in its instrumentation.
Music Demo
Music Demo
While Spoon Theory is still in alpha development, the completed tracks will be available to listen to using the Music Demo (on GitHub). This is an executable (.exe) which allows the values of the scores to be adjusted, such that the dynamically changing elements of the score can be demonstrated.
Most recent release: N/A
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