The Pebble-in-Shoe Model of Autistic Overwhelm

AJ Tanksley
6 min readSep 21, 2023
Photo by Na visky on Unsplash

When I was in college and became more seriously involved in autism activism (if “ranting about neurotypical ignorance on Facebook” counts as activism), I learned about spoon theory as a model to describe chronic illness. I highly recommend learning more about spoon theory and spoonies (individuals who utilize spoon theory to describe their chronic illnesses) in general, as there’s a lot of fantastic information and community to be gleaned from chronic illness activism.

There are many intersections between the neurodivergent community and the chronic illness community as a whole. Many individuals with autism and ADHD also struggle with chronic illnesses, such as fibromyalgia, rheumatoid arthritis, PCOS, migraines, and other conditions.

Although I do not have any formally-diagnosed chronic illnesses, I have struggled with some physical difficulties similar to chronic conditions myself. I experience severe menstrual cramps, gastrointestinal distress, nausea, vomiting, and sometimes even fainting during my period, and I’ve often had to take half or whole days off from work due to the intensity of my menstrual symptoms. I had frequent headaches that sometimes culminated into migraine attacks during my pre-teen years, which in retrospect was a very obvious indicator of an anxiety disorder.

Another way I relate to spoonies is in my lived experiences with not being believed. Many sufferers of chronic illnesses I’ve met are often dismissed as hypochondriacs or attention-seekers, their health concerns ignored by medical professionals. I’ve had my own manifestations of autism dismissed in this capacity by both well-meaning and not-so-well-meaning people.

Because I am highly-verbal, graduated from college, and excelled academically, I’ve had many people in my life unintentionally downplay the severity of my overwhelm and mental health struggles. I am often told that my problems are “all in my head,” or that I can overcome my struggles through exceptionally-good habits or behaviors. It’s one of the greatest joys of being an American: being told that you’re a lazy piece of shit for suffering.

The pebble-in-shoe model of autistic overwhelm describes internal and external triggers of overwhelm/shutdown as pebbles that become stuck in your shoe throughout the day.

Many chronically ill people are often told the same. This is especially true if they are overweight due to a thyroid or other hormonal condition (“You just need to lose some weight!”) or if they’ve had the misfortune to come across the worst sort of person: a “have-you-tried”-er. I should make a bingo sheet for the “helpful” comments that chronically-ill and neurodivergent folks are subjected to when disclosing their conditions. Or maybe I’ll make a drinking game instead. Sound off your preferences in the comments below!

With this in mind, I’ve created a model inspired by spoon theory to explain my own experiences with autistic overwhelm: the pebble-in-shoe model. The pebble-in-shoe model of autistic overwhelm describes internal and external triggers of overwhelm/shutdown as pebbles that become stuck in your shoe throughout the day. Some pebbles may be tiny (ie a slightly-itchy shirt, a loud noise), while other pebbles may be huge and impossible to ignore (ie sleep deprivation).

Quick disclaimer: as far as I know I’m the only person who’s posted anything about this model, but I can’t be the only one whose connected the dots in this way. If anyone else online has devised a similar model describing autistic overwhelm, please send that article/blog post my way so I can shout ’em out!

An autistic person may start the day with one or more pebbles in their shoe (they didn’t sleep well, their stomach hurts, etc), and more pebbles may accumulate throughout the day. Because these pebbles can’t be seen by other people, a neurotypical may be confused and/or angry as to why an autistic person is struggling so much; meanwhile, all the autistic person can feel are the little pebbles pressing against their foot and causing them pain.

Imagine someone shoving sharp, pointy rocks in your shoes, yelling at you to keep walking, and then screaming and spitting in your face, “What the hell is wrong with you??” while stabbing your eardrums with sharp pencils and shining a flashlight on you at the same time. That’s what sensory overwhelm feels like.

Eventually, so many pebble accumulate that the autistic person may either shut down or melt down, unable to concentrate on anything else because of the sheer intensity of the discomfort they are experiencing. A neurotypical person trying to be helpful might beg them to “push through” without stopping to help them take the pebbles out of their shoe, making the overwhelm so much worse.

Not all autistic people are able to communicate if there are pebbles in their shoes, just like not all can communicate that they’re in a state of overwhelm. Sensory overwhelm freezes up the brain, and “calm, rational thinking” demanded by neurotypicals may not be possible. Many autistic people go nonverbal when overwhelmed, or may not be able to articulate their thoughts.

Basically, imagine someone shoving sharp, pointy rocks in your shoes, yelling at you to keep walking, and then screaming and spitting in your face, “What the hell is wrong with you??” while stabbing your eardrums with sharp pencils and shining a flashlight on you at the same time. That’s what sensory overwhelm feels like. Would you be able to communicate clearly in those conditions?

Some pebbles may be so deeply-lodged in your shoe that you can’t properly get them out, while others may need another person’s help to remove.

Giving lots of advice when someone is in a state of overwhelm is generally the worse thing to do. Advice, even when well-intentioned, can often be another pebble in our shoes, as it can feel like yet another demand that we are expected to meet.

Pebbles can include internal triggers, such as:

  • Sleep deprivation
  • Stress carried over from the day before
  • Chronic pain
  • Gastrointestinal distress
  • Depression

Or external triggers, such as:

  • Loud, noisy environments
  • Angry/shouting people
  • Bright, artificial lighting
  • Overwhelming workloads
  • Living in Las Vegas, where everyone drives like a stunt driver on the set of Mad Max and the summers are triple-digits for four months straight

If you’re a neurotypical person whose autistic loved one has one too many pebbles in their shoe, the best actions to take are 1) removing the overwhelmed person from the situation causing overwhelm, 2) helping remove what pebbles you can (ie turning off bright lights, lowering your voice), 3) accepting that there are some pebbles that can’t be removed (aka don’t try and “fix” them), and 4) shutting the f*ck up.

Talking profusely and giving lots of advice when someone is in a state of overwhelm is generally the worse thing to do. Some autistic people live in a mild to moderate state of overwhelm 24/7 (like me, who has specific sensory difficulties that I cannot block out), and may not be receptive to advice at all unless explicitly asked for. Advice, even when well-intentioned, can often be another pebble in our shoes, as it can feel like yet another demand that we are expected to meet.

What are your thoughts on describing autistic overwhelm as pebbles in your shoe? Would you use this model in your day-to-day life? Are there other models/analogies that explain your experience better? Let me know in the comments below.

Memento mori, and, to all the neurodiverse folks out there, illegimiti non carborundum.

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AJ Tanksley

A lifelong learner and poet, AJ (they/she/he) writes about the intersection of neurodiversity, mental health, spirituality, and identity.