The cognitive pyramid model

Why Thinking Costs Energy

What is the cognitive pyramid model

‍The cognitive pyramid model is a functional model that shows how our brain uses energy for different tasks. It was developed in neuropsychology and is widely used in the rehabilitation of people with brain injury, long COVID, and other conditions that affect brain functions.

The model explains why "just thinking for a moment" or "just concentrating" can be so exhausting with chronic conditions. It shows that complex tasks like planning or problem-solving only work when all underlying functions have sufficient energy.

The pyramid from bottom to top

The model must be read from bottom to top - each layer needs the underlying layers to function:

1. Energy (foundation)

The foundation of everything

Without your energy, nothing works

Just like your body, your brain needs fuel
Poor nutrition, little sleep, or illness directly affect this foundation
With chronic conditions, this foundation is often limited

2. Processing stimuli

Your senses and basic processing

What you see, hear, feel, smell, and taste
All these stimuli must be processed
This happens automatically, but does cost energy
Many stimuli at once = high energy consumption

3. Focus and concentration

The filter of your attention

Determines which stimuli are important
Filters out disturbing information
Keeps your attention on one thing
Gets quickly exhausted with too many stimuli

4. Memory

Storing and retrieving information

Short-term memory (remembering what you just read)
Long-term memory (retrieving stored knowledge)
Making connections between new and old information
Needs focus to work properly

5. Communication

Language and comprehension

Finding words that match your thoughts
Understanding what others say
Writing and reading
Needs memory and focus

6. Executive functions

‍The complex thinking tasks

Planning and organizing
Problem-solving
Making decisions
Performing tasks you've learned
Needs all underlying layers

‍Wat happens with limited energy?

‍For a healthy person

‍All layers of the pyramid are available. You can easily multitask, make plans while the radio is on, and solve complex problems even when you're a bit tired.

‍With chronic conditions

‍Due to limited energy, you only have access to the bottom layers of the pyramid. The higher functions become unreachable or cost disproportionately much energy.

‍The consequences of limited energy are quite significant. A few examples of limited energy:

Focus no longer works: You can't filter out disturbing sounds
Memory works poorly: You forget what you were doing
Planning doesn't work: Complex tasks become impossible
Communication becomes heavy: Finding words becomes difficult

‍Practical examples from daily life

‍A few examples from practice that are also recognizable if you're tired for longer, so not only with a chronic condition.

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‍Video calling is heavier than calling

‍With video calling, you not only have to listen, you also watch moving images. And if it's also with multiple people, you have to keep track of that too. All in all, you use quite a bit of energy. A phone call costs less energy, because you only have to listen, organize thoughts, and speak with one other person.

‍Watching fast TV

‍Watching a soccer match or a Formula 1 race seems okay, because it's relaxation. But you also have to process and analyze all those fast images. You unconsciously keep track of whether your club is playing well, how the opponent is doing. What the race pace is, etc. And then also process the images. That really costs much more energy than listening to music or reading a book.

With limited energy, you have to learn to choose, and the pyramid helps you with that. You have to make more choices, which are sometimes very unpleasant. Think for example of:

Either listening to music or reading (both require focus)

Either talking or walking (both cost energy from the same pyramid)

Either cooking or making plans in the meantime

Scientific background

The model is based on neuropsychological research into::

Brain functions: How different brain areas work together
Cognitive load: How much "processing power" tasks cost
Attention systems: How focus and concentration work
Executive functions: The role of the prefrontal cortex

For long covid and chronic fatigue

Research on Long COVID and Chronic fatigue has shown that:

The autonomic nervous system becomes disrupted
The available "processing capacity" decreases
Recovery from cognitive exertion takes longer
Multitasking costs disproportionately much energy

This means that if you have this condition, you really have much less energy. But other chronic conditions also require more energy that you can't use elsewhere. Think for example of Asthma, where energy goes to inflammatory reactions.

From model to practice: energy management and pacing

The pyramid model helps to understand why certain strategies work, such as:

Limiting stimuli (layer 2):

Wearing sunglasses in bright environments
Using earplugs (custom made) in noisy or busy areas
Phone on silent during important tasks

The effect:
These steps help to spend less energy on processing stimuli and thus more left for the higher functions

One thing at a time (layer 3 - 6)

Don't multitask
Break tasks in smaller pieces
Take breaks between different activities

The effect:
All available focus goes to one task

Use optimal timing

Heavy thinking tasks in the morning (when energy is highest)
Routine tasks in the evening (cost less from the pyramid)

The effect:
You distribute energy more over a day, so you don't have days left while you have no energy anymore

The activity log uses the pyramid model. By tracking how much energy different types of activities cost, you learn which layers of the pyramid are most stressed and can plan better.

Recognizable signals per layer

It's possible to recognize signals per layer for limited energy. Below are a few examples:

Energy (layer 1) shortage:

Everything feels heavy, even simple things
Physically exhausted
Motivation disappeared

Stimulus overload (layer 2):

Sounds seem louder
Light becomes bothersome
Quickly irritated by environment

Focus problems (layer 3):

Easily distracted
Difficulty following conversation
Forgetting what you were doing

Memory problems (layer 4):

Forgetting words
Losing names
Not knowing where you put something

Communication problems (layer 5):

Finding words doesn't work
Conversations become exhausting
Writing takes effort

Executive function problems (layer 6):

Can't plan or organize
Making decisions doesn't work
Complex tasks seem impossible

These complaints, for example, are a signal that you're reaching your limit. And a limit in energy has bigger consequences than at the top. Think of it as a diagonal line parallel to the left side that shifts to the right. Everything becomes significantly less. And the body regulates this itself. It shuts things down to protect.

For partners and family

The pyramid model helps to explain:

Why "just paying attention for a moment" doesn't work
That it's not about willpower, but about available energy
How you can help by reducing stimuli
Why a quiet environment is so important

Limitations of the model

It's important to know that it's a model, and therefore:

A simplification of complex brain processes
Individual differences are large
Daily condition influences which layers are available
It's a tool for understanding, not a medical diagnosis