The pacing component of the trial is much more encouraging. All being well this will come out the most successful and massively infuriate the proponents of the psychological model. Probably why they are taking so long to publish it. Adaptive Pacing Therapy - Aim To stabilise the symptoms and activity with the anticipated benefit of: (a) maximizing what can be achieved within a limited amount of energy; (b) preventing exacerbation of symptoms and disability; (c) enabling participants to plan activities; (d) providing the best environment for the body to naturally recover; (e) allowing gradual increases in activity as the participant feels able. Theoretical Model The assumptions of simple pacing are that it is beneficial to stabilise activity and to balance rest with activity. An analogy of balancing the energy account to avoid overdrawing it is often used. Symptoms are regarded as warning signs to be listened to. It is assumed that the symptoms reflect a pathological disturbance, which is not reversed by undertaking increases in activity. Rather the assumption is that ignoring fatigue and other symptoms risks activity induced exacerbations of the illness and consequently impeding natural recovery, whereas good pacing will maximize the chance of natural recovery and hence improve function in the long term. Activity is therefore planned so as to balance activity and rest. The aim is to maximise what can be done on the one hand but to limit activity related exacerbations of symptoms on the other. Procedure The manual includes the following components: (a) the participant is helped to monitor their activity and their energy using simple self-ratings. (b) By learning about the relationship between what they do and how they feel, the participant is more able to plan their pattern of rest and activity; (c) The process is an iterative one whereby level of energy and other symptoms and activity are monitored; activity is planned and then modified in the light of its effect on symptoms. (d) The participant is encouraged to do as much as they are able within the limits imposed by their knowledge of what risks exacerbating symptoms.