Introducing “Energy Limiting Conditions”: The Emergence and Evolution of a New Impairment Concept, 2025, Hale

[Dolphin]

Introducing “Energy Limiting Conditions”: The Emergence and Evolution of a New Impairment Concept

<p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="first" dir="auto" id="d1540804e129">The terms “energy limiting condition” (ELC) and “energy impairment”locate the embodied experience of chronic illness into a category of impairment for the purposes of social...

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Introducing “Energy Limiting Conditions”: The Emergence and Evolution of a New Impairment Concept​

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Author(s): Catherine Hale <span title="Corresponding author"></span> , Dr Anna Ruddock <span title="Corresponding author"></span> , Ana Bê <span title="Corresponding author"></span>
Publication date (Electronic, pub): 12 November 2025
Journal: International Journal of Disability and Social Justice
Publisher: Pluto Journals
Keywords: emancipatory research, chronic illness, disability, energy limiting conditions, energy impairment, fatigue.

Abstract​

The terms “energy limiting condition” (ELC) and “energy impairment”locate the embodied experience of chronic illness into a category of impairment for the purposes of social policy and administration of disability.

This article discusses the origins of these concepts in the UK-based Chronic Illness Inclusion Project (CIIP).

Selected findings from the CIIP’s mixed-methods participatory research demonstrate how energy impairment, and related terms, arose as a practice of resistance against the invalidation of “fatigue” as impairment, giving rise to a transdiagnostic disability identity, and a strategy for self-advocacy.

Theoretical tensions between the rejection of impairment within disability studies and the emancipatory aims of the CIIP are discussed, as well as the political history of fatigue within the disability category.

Impairment labels, as a necessary evil, should reflect disabled people’s experience and identity, and further research should uncover their conditions of production.

 

[DMissa]

I feel like continued emphasis of the word "energy" is going to send more thinking off the rails and down the ATP = energy = fatigue trap. The problem with superficially related but nebulous words I guess.

 

[Sean]

Yep. The whole lack of energy concept, while superficially appealing, is seriously misleading. I really wish we could ditch it completely.

It is not a lack of energy (certainly in the technical sense), it is the inability to put it into effect without a very high cost, both at the time of action and the price paid for it later on.

Having to learn how to manage that and live exist with it is a core part of having ME//CFS.

 

[DMissa]

superficially appealing

I think I used this exact phrasing to one of my students in the last few weeks. Right there with you.

 

[Jonathan Edwards]

Selected findings from the CIIP’s mixed-methods participatory research demonstrate how energy impairment, and related terms, arose as a practice of resistance against the invalidation of “fatigue” as impairment, giving rise to a transdiagnostic disability identity, and a strategy for self-advocacy.

I am surprised that these people do not realise that this sort of thing plays straight in to the hands of the BPS people - turning everything into a psychosocial construct when what matters is feeling ill.

It seems to say that they chose a new name to call themselves because nobody was taking notice. I don't think that us going to help. It may turn doctors away from caring for people even more.

 

[bobbler]

I feel like continued emphasis of the word "energy" is going to send more thinking off the rails and down the ATP = energy = fatigue trap. The problem with superficially related but nebulous words I guess.

It’s tricky isn’t it . Agree if someone parses words and reads into the ‘but is it technically lack of energy does that mean fuel or pipeline etc’

But in the other hand there is a dimension that needs an over-arching word from a disability/non-dusability perspective here too

And I sort of get that people are trying to get people to imagine the concept of the envelope where you only have one good hour a week that you can either do your hygiene in or gets wasted by that person who made a phone call arduous unnecessarily so it was an hour instead of ten minutes.

Because when I was doing marketing degree the thing at that point in time was that people now weren’t just money-poor but could be time poor as a concept

In that context I can’t help but have seen the desperate need for an addition to this understanding which is something like energy poor

Particularly if we think how it seems to have accelerated for companies to use tactics that push work onto people like the auto-renewals then sit on phone for hours to get out of said renewal was used for ‘just’ time poor.

There are now new levels of game playing someone being allowed to write something inaccurate then you correct it and they deliberately play games and avoid fulfilling what they supposed to properly but you then have to find a way to contact and write exactly how it was done but in a way that was unacceptable etc.

And these are all over the place and can happen with parcel delivery, phone calls, your job, medical care , any service. Each adding huge burdens of work into people . And these more unwell you are the more you often have to engage with these because it’s harder to do you over in a shop than a delivery and not ill people don’t need healthcare or equipment or aren’t having to use their insurance as much etc.

There is of course the other level of what happens with those who get dementia or other age related illness that means all those things that auto renew end up being set to rip them off for years after they got too ill to be on top of it for the first time.

People really do get taken advantage of here if they suddenly get ill just due to the way all those things work and make it hard.

 

[Yann04]

I do feel like energy in the purely experiental and “feeling” sense can be a much better way to get the lived experience across than fatigue.

But yes just as fatigue is a slippery slope into psychoBS it seems energy is into bioBS.

I wish there was a proper way to bring up the experiental concept of energy limits without the physical-chemical-biological concept of energy.

IMO “disability” doesn’t really cut it. Lack of stamina? Sounds too mild…

 

[bobbler]

I do feel like energy in the purely experiental and “feeling” sense can be a much better way to get the lived experience across than fatigue.

But yes just as fatigue is a slippery slope into psychoBS it seems energy is into bioBS.

I wish there was a proper way to bring up the experiental concept of energy limits without the physical-chemical-biological concept of energy.

IMO “disability” doesn’t really cut it. Lack of stamina? Sounds too mild…

Indeed. Because, and I really notice it on the fatiguability front. It is very much a topic that needs to be brought up because it is being deliberately used out there in the world to prevent accessibility and get away with saying 'people could complain or get a refund or x' when it is made so hard that it is not true for those who do not have the ability to run that ever-increasing (to the point of absurdity often) gauntlet to the end.

I use this term fatiguability first because for me it is like an egg-timer that means:

- if the phone queue (or in the old days when I was more well then real queue) doesn't end soon then I'm going to have to hang up. ANd the callback option is useless because I both have no control over when that is (and need a nap, along with it taking me a considerably longer time than most to get the bits of info they might need together - and had that order number to hand already on the phone) and have now used my good slot of energy listening to their music instead of tackling the task

- if the person plays dumb and parses my words as a game (which I feel I shouldn't write because it gives out a roadmap, but that type do it anyway) it drains a normal, well person but really has significant impact on both my strength to fight and ability to get to the end without being coerced into agreeing to something not in my interests just to get off said train.

It is basically filibustering often me out of the 'good time' that I have in order to then catch me when I'm instead incredibly ill and vulnerable and crumbling physically. Or requiring such a complex amount of tasks eg using technology that I'm shocked if a huge % of the population can't complete it for other reasons.

I really do sense that these days we seem to be in a weird place where what is clearly taking advantage and immoral behaviour has become increasingly not called out to the point it isn't just socially acceptable but the norm.

Anyone who is ill or old or in a bad place for another reason just getting predated on by them not having the capacity these things demand in order for someone to get access to what is right/not end up with something wrong not being corrected.

And for well people I'm astounded it is allowed to snowball to where it is because the amount of productivity stolen by people who have to donate 2hrs of their intense thinking time to not get caught out on something that 5yrs ago the rights would have been simple to enact, stretches to so many products and services that most people must be spending huge amount of their brains each week just doing useless stuff to not get conned. Not to mention an entire industry of people whose jobs are just messing others around.

 

[bobbler]

I do feel like energy in the purely experiental and “feeling” sense can be a much better way to get the lived experience across than fatigue.

But yes just as fatigue is a slippery slope into psychoBS it seems energy is into bioBS.

I wish there was a proper way to bring up the experiental concept of energy limits without the physical-chemical-biological concept of energy.

IMO “disability” doesn’t really cut it. Lack of stamina? Sounds too mild…

Only because it came up in a crossword I did recently and I remarked on realising the following exact wording of the definition

'overburden with demands' = 'harrassed'


And I thought well yes, technically when someone is doing that deliberately to someone else then both senses of that term 'harrassing' are and should be acknowledged as true and correct.

Of course bps (as it is as an ideology, as is psychsomatic, really also I think something that has come from those who do things that are inconsiderate and have consequences for others that they will do anything do disacknowledge and try not to be accountable for) would love to try and reframe this to 'feel harrassed'.

But of course both are true, someone harrassed by someone else, which they shouldn't do, might feel harrassed but that doesn't mean that the harrassment shouldn't be stopped as it is unnecessary and the cause. But the framing is all about trying to suggest illogically that the solution is for people who are being harrassed by someone else to magically try not to feel it, as if that somehow changes anything.


SO I think this is actually far more important than we realise. This is about not just us, but it is very important in holding accountable behaviour that absolutely is unnecessary and done in order to take advantage and call it out. And it is about - it shouldn't need terms put to it, but legally it seems that is now necessary - labelling something that we all know happens, particularly those who do it know they are doing it most of the time.

ANd acknowledging our existence and what 'added disability' we deliberately suffer, just in the same way someone is out of order building steps to a voting booth making wheelchair access impossible, or for healthy persons they'd be pretty peeved if their office suddenly changed all the chairs to a height or width that they could not fit into, or found they could only vote online or get a refund from all sorts of places if they had or bought a particular brand of phone or laptop (at which point it makes it clear that it is about preventing/impeding access, not just disability).

Maybe something to do with convenience and frustrating that, something to do with 'reasonableness of demand'? Given convenience is a term known in business terms as being important.

 

[Kitty]

I wish there was a proper way to bring up the experiental concept of energy limits without the physical-chemical-biological concept of energy.

IMO “disability” doesn’t really cut it. Lack of stamina? Sounds too mild…

Yup, the best I've come up with to replace 'energy' is 'capacity'.

But it's still employing a negative term, an absence of something, to describe what is very much a gain of something: PEM, aka feeling like death dug up.

Without that part of the meaning, terms like 'energy shortage' and 'limited capacity' just sound as if we need to sit down for a minute. There's no sense that events we have no control over, such as building work near our homes or being forced to stay out too long because of gridlocked traffic, can trigger really horrible illness that lasts for days or weeks.

 

[MinIreland]

I do feel like energy in the purely experiental and “feeling” sense can be a much better way to get the lived experience across than fatigue.

But yes just as fatigue is a slippery slope into psychoBS it seems energy is into bioBS.

I wish there was a proper way to bring up the experiental concept of energy limits without the physical-chemical-biological concept of energy.

IMO “disability” doesn’t really cut it. Lack of stamina? Sounds too mild…

Debilitation?

 

[Yann04]

Debilitation?

It sounds constant. Like “I can never do X”

What I like about energy is it conveys more the “I can sometimes do X but it depends what else I’ve done that day and…”

 

[Hoopoe]

Rather than trying to find the best name for a subjective symptom, wouldn't it be best to focus on describing the impact of the illness?

The goal is to be understood, right?

An article with patients describing their day and why they do things in a certain way, don't do things, and explaining what would happen if they acted normally would be effective at improving understanding of the illness.

The behaviour can seem irrational and self-defeating if you don't know that it is the result of experience and a way of living with the illness.

 

[DMissa]

For me this is less an issue of capturing patient experience and more an issue of bearing specificity with regard to knowledge of mechanism. It is a publication and the general public or feckless professionals will see words in titles and automatically think it gospel. The concept of "energy" may describe what people seem to experience but using it to formally describe the illness implies knowledge of mechanism that isn't there (the same trouble with "ME" on its own). Especially when coupled with "limiting". If a biologist external to the field were to scan the title and assume rigour in good faith they will come away from this thinking that we know the illness to be driven by insufficiency of cellular energy production.