glee and the wheelchair assignment.

Before I started my Occupational Therapy program, I had heard that, for our Physical Disabilities class, we were going to have to do a “wheelchair assignment” similar to what was portrayed this week in the FOX show “Glee.”  For 24 hours, we would have to use a wheelchair as if it were how we lived our life every day and, hopefully, it would give us some insight and help us empathize with those who use a wheelchair rather than their legs to get around.

Once that class began, however, our instructor quickly explained to us why we would not be doing the wheelchair assignment.  Apparently, it turned out to have an unintended effect on the previous year’s class.  Rather than learning to empathize with wheelchair-users – as was the intended purpose of the assignment – these students became overly exuberant that they themselves were not “stuck” in a wheelchair on a day-to-day basis.  If they couldn’t find a ramp, they just picked up their wheelchair and took it up the stairs.  If they needed to go to the bathroom, they left their wheelchair at the door and waltzed right in.  And when the 24 hours was up?  They literally got up and walked right out of the wheelchair, thanking God that they would never have to do that again.  When they wrote their reflection papers about their experience, many vented about how they were so happy that they didn’t ever have to use the wheelchair again.  Not really what the professor was going for.

So what about for those who don’t have the option of getting out of their wheelchair and walking whenever there isn’t a ramp or curb cut-out in sight?

There are many suggestions about how we can become more aware and empathetic of the needs and experiences of wheelchair users, and the wheelchair experience is not one of them that is suggested in the current dialogue on this issue.  The reasons against it are pretty much in line with what last year’s class experienced.  You don’t know how to use it, you’re in pain because you have never used it before, and you just get plain frustrated because you can’t do what you’re used to.  It doesn’t give you an accurate experience because it’s just not enough time to acclimate to what it might actually be like over an extended period of time.

Instead, people are encouraged to engage in activities that will increase their awareness of accessibility and experience.  Some suggestions I have heard mentioned include walking a building’s premises to figure out where and how many wheelchair-accessible entrances there are; engaging in a daily routine with someone who uses a wheelchair; getting to know and asking questions of a person who uses a wheelchair; and reading an autobiography or watching a movie about a person who uses a wheelchair.  I’m sure there are many more that you can think of!

If you watch the FOX show “Glee”, then you know that this week’s episode revolved around the theme of difference.  In particular, it centered on the experience of Artie, the high schooler who uses a wheelchair, and the effect that his wheelchair usage had on his ability to participate fully in Glee Club (this episode did also address issues of difference related to cognitive limitations and sexuality).  It was a really interesting episode, and although it wasn’t completely perfect or sensitive in its use of the wheelchairs and the language associated with them, I thought that it highlighted some great scenarios (students in wheelchairs being too low to reach things they needed in the cafeteria, or realizing through their own experience that there is only one wheelchair accessible ramp at the school) and dialogue (When the girl with a studder admits to Artie she’s been faking it all these years in order to push people away and get out of public speaking, and Artie, heartbroken, replies, “I would never try to push people away, cuz being in a chair kinda does that for you…I’m sorry now you get to be “normal” and I’m gonna be stuck in this chair the rest of my life.  And that’s not something I can fake.”  Chills!).

Click here to watch the entire episode from www.tvshack.net.

And click here to read a group wheelchair reflection paper written by some students in Maine – replete with professor comments – who seemed to actually complete the assignment correctly and understood what it was trying to teach them.

For those of us who are going into OT, these issues of experience and difference are critical for us to try to empathize with and understand so that we can help our clients gain maximum function.

And for those of us who are simply living in the world every day?  We need to have respect for our fellow human beings.  Because whether we use legs or wheels to go from one place to another, we are all worthy of respect.

people are people.

When I was an undergraduate, I went through a period of being clinically depressed.  I met regularly with a Psychologist, and she helped me to understand what I was going through and how I could work on getting better.  Though it was a four-month period of my life that I hoped I would never have to re-live, it was also a time of great healing and self-discovery.  I almost cherish that time in my life because I was able to work through something that I thought would never end.  As a result, I have such empathy for people who experience depression or who are simply having a difficult time coping with the stressors of life.  It’s a difficult battle to fight.

This week, as I have been doing my Inpatient Psychiatric fieldwork, I have had many opportunities to reflect on that difficult period of my life.

Throughout the day we have several interactions with many different patients.  Typically, we first interact in a group with patients who are dealing with issues such as major depression or bipolar disorder or schizophrenia (to name a few).  Then we document what they did and what we saw.  Some of the documentation is narrative.  But most of it involves simply checking off a bunch of boxes.  Type of participation.  Type of affect.  Type of psychotic symptoms.  Amount of assistance given. After a few times of filling out these forms, I began to wonder.

What if I had gotten so depressed that I couldn’t function, and I had to come to a facility like this?  What if someone had filled out forms like these about me when I was depressed? I would really be reduced to a bunch of check boxes?  I would hate that!

Now I know what you may be thinking. They have the check boxes in order to standardize the forms and make them quicker to fill out, since healthcare staff always have so many forms to complete.

I understand that.

But it doesn’t change the fact that, if I was depressed and was staying at an Inpatient Psychiatric unit, and I was able to see the boxes that were checked off as a reflection of my group participation that day, it would make me feel weird.  I would feel like an animal in the zoo.  Or an experiment.

Maybe nobody has thought about psychiatric documentation like this before.  Maybe they have.  But I just found it very interesting how my personal experiences from the past were able to profoundly impact my visceral reaction to how OT’s document the performance of patients in psychiatric settings.

I suppose these are feelings that will shape my perception of many other things besides psychiatric documentation in the future.  But I at least hope that they will serve as a personal reminder that people are people – not boxes to be checked – no matter what they are going through.

America’s Best Careers 2009

This afternoon as I was clicking around on the internet, I came across a list of “America’s Best Careers 2009.”  U.S. News & World Report looked at jobs with the “best outlook in this recessionary economy (and beyond), the highest rates of job satisfaction, the least difficult training necessary, the most prestige, and the highest pay. These careers have staying power: They’re smart moves now, and they’ll be smart moves for years to come.”

Can you guess, of the 31 careers that made the list, which one is on there that makes me smile?

Occupational Therapy.

If you’ve clicked around on my blog at all, then you’ve gotten somewhat of a feel for what OT’s do on a day to day basis.  You can read U.S. News & World Report’s description of Occupational Therapy by clicking here.

The following video was also included on their website as a supplement to the article about Occupational Therapy.

I’m so proud to be a part of the profession of Occupational Therapy!

Why I’m Proud to be an OT

With each day that I learn more about occupational therapy, the more proud I am to be on the road to becoming an OT.

This pride really became apparent to me last Friday.  Our class had just finished listening to a 90 minute medical lecture, given by the heads of Psychiatry and Occupational Therapy at our university’s hospital.  They flew through the neurological implications of conditions such as schizophrenia, major depression, and bipolar disorder.  It wasn’t the first time our class has learned the details of those disorders, so we have become fairly well acquainted with them by now.  Throughout the lecture, these men addressed ways in which OT’s could intervene with people experiencing mental health disorders such as these.  It was a fantastic lecture, but as soon as I walked out of the classroom, I had to shift my thoughts to my upcoming midterms I needed to study for and paper I needed to write, all for my physical disabilities class.

That’s when it hit me.

I just sat through a medical lecture about these intense mental health disorders.  Given by the doctor who is the head of the psychiatric unit at University Hospital.  And I totally kept up.  And now I’m gonna go study for Physical Disabilities. Those things are so different. OT’s can do anything!

And it’s true.  No two occupational therapists are really alike.  We are so diverse!

While one OT may be working with a premature infant in the NICU, training its reflexes so that it can learn how to use the suck-swallow-breathe pattern that it was supposed to have at birth so that it can begin feeding through its mouth, another OT may be working with an 85-year-old woman who has experienced a decline in her independence due to injury or aging, teaching her how to use some adaptive equipment or how to modify her home environment so that she can regain her independence.

While one OT may be teaching a teenage boy with a spinal cord injury how to navigate in his wheelchair, care for himself independently or participate in things that are important to him, another OT may be helping a homeless man learn what technical and social skills he needs in order to get back into stable housing and a job.

While one OT may be helping a woman who had a stroke, teaching her how to care for herself and participate in activities she enjoys, another OT may be working with someone who is struggling with schizophrenia, offering them strategies for increasing their quality of life despite their difficulties.

While one OT may be playing with a boy with autism, teaching him to interact socially with other children or how to manage his behavior when he gets upset, another OT may be teaching a girl with cerebral palsy how to ride a horse, knowing that horseback riding can help improve her trunk alignment and strength, thus contributing to improvement in her hand skills so that she can do things like feed or dress herself.

And those are just a few examples.

I am so proud to be an OT.  We are creative.  We are smart.  We are powerful.  We care about improving people’s quality of life, which means more than just working to improve their physical condition.

What we do matters.  We are unique in what we offer and, yet, we are not pigeon-holed by it.

When we say that we help people “live life to the fullest”, we accept the fact that people’s “disabilities” affect more than just their body.  Physical and mental disabilities impact every aspect of a person’s life.  And we, as occupational therapists, get to look at the person as a whole and say, How we can improve this person’s quality of life? What’s going on in their body, brain, environment, and social life that will impact their everyday living?  What do they want to get back to doing that they can’t do now?  What’s important to them?  How will this disability affect the way they feel about themselves as a person…or how other people feel about them?

And after we ask those questions, we get to work.

I don’t know any other profession that operates like ours.

And that’s why I’m proud to be an occupational therapist.

Fieldwork

This week I finished my first round of Level I occupational therapy fieldwork in pediatrics.  In two weeks, I start my next round, this time, in a psychiatric inpatient setting.

Here’s a description.

The Psychiatric Inpatient Program provides intensive psychiatric care to voluntary adult patients with acute psychiatric disorders, such as major depression, bipolar illness or schizophrenia. Patients are immersed in intensive daily treatment, with the goal of returning them to the familiar surroundings of home as quickly as possible. Therapeutic activities focus on issues of self awareness, family matters, social skills and personal problem solving.

Quite a contrast from playing with kids on swings and tricycles.  Looking forward to it!

Occupation and Spina Bifida

I wanted to share this video with you about a man whose experience clearly demonstrates the power of occupation in coping with his disability and learning to thrive in every day life.

This is the story of Tyler Genest, a 20-year-old man who lives in Hawaii and was born with Spina Bifida.  He explains the basics of this congenital spine condition in a short documentary, and you can find more of his story and his e-mail address onYouTube.

A common theme that I have heard amongst guest speakers and videos like this one is, I can do pretty much everything that you can do, I just use wheels to get around instead of walking. Or another one I have picked up on is, I have been given more opportunities in my life sitting down than I ever did when I was walking.

To this end, I find that it is important for occupational therapists to make sure to focus on the strengths of a person with, say, Spina Bifida, rather than his or her limitations.  If there are safety issues, then sure, be aware of the limitations.  But in general, we can do more good by focusing on the skills that a person has rather than on the deficits.  Sure, maybe Tyler doesn’t have the use of his legs, and he has a really steep driveway that takes him several minutes to ascend, and he has to use a special wheelchair lift to get on and off the city bus.  But he is strong-willed and he has a passion for helping teenagers grow through difficult times.

This is where I see the power of occupation.  If an occupation is some activity that carries personal meaning for the person engaging in it, then for Tyler, youth ministry has become a life-changing occupation.  Not only is he good at it, but it is rewarding for him and it brings him great joy.  It tangibly shows him that his life, no matter how difficult it has been, is making a difference in the lives of young people.

One article I’ve read states what may seem obvious to most of us. “Living a meaningful existence or having a purpose in life is associated with well-being,” and, “Participation in valued roles is related to life satisfaction and measures of well-being.” *

Duh, you may think.

But what if Tyler had never realized that he was good at youth ministry?  What if he never had the chance to understand how meaningful his existence was?  What if he didn’t find an occupation in which he felt he was participating in a valued role?  Maybe he would have found something other than youth ministry.  Or maybe he would have attempted suicide again.

So those of us in the field may take the power of occupation for granted.  But when I hear a story like this, and then relate it back to what I’m learning in OT school, I can’t help but stand back and smile at just how meaningful what we do really is.

*These two quotes were taken from Matuska and Christiansen’s article entitled, A Proposed Model of Lifestyle Balance. It can be found in the April 2008 edition of the Journal of Occupational Science, Vol 15(1).

Assistance in Learning: Scaffolding and Modeling

“Well-meant protectiveness gradually undermines any autonomy.” *

In occupational therapy, it is our job to help people reach their goals of becoming more independent in every day life.  I think the above quote is important because it reminds us that if we help people for too long, without allowing them a chance to try for themselves because we want to protect them from failure, we may actually end up doing them more harm than good.

While I’m sure there are many techniques out there that instructors can use to assist learners without undermining their autonomy, I have two favorites: scaffolding and modeling.

(1) Scaffolding is a technique that gets a lot of attention in the realms of education and child development.  Essentially, it acts as a bridge between what learners can already do and what they can’t yet do on their own. The instructor is encouraged to offer assistance to a learner only in the area that is not yet mastered.  Mistakes are expected, and the instructor can respond to them with positive feedback about how to improve.  Once the skill is nearly mastered, then the instructor can begin to fade out the assistance being given so that the learner can proceed to perform the newly learned skill on his or her own.  There are many strategies for effectively facilitating a scaffolded approach, and both the learner and instructor need to make sure that the target skill is neither too easy nor too hard, so that they will be presented with the “just right” challenge.  The concept of scaffolding relates to Vygotsky’s “Zone of Proximal Development” (ZPD).  The ZPD is the distance between what a learner can actually do by him/herself, and what the learner can do with the help of a more knowledgeable adult or peer.  As people learn, their ZPD is constantly shifting to adjust to their newly learned skills.

It seems obvious how scaffolding relates to occupational therapy, but I think it is something that is easy to lose sight of as life moves forward at a rapid pace.  Whether it is an OT who is teaching a child how to properly hold a pencil and write his name, or who is helping a stroke survivor learn how to independently feed herself, scaffolding is one of those concepts that I believe will never get old.  It is meant to enable people’s abilities, and if our job as occupational therapists is to give power to those who are working to gain it, then I believe scaffolding can be one of our most potent tools.

(2) Modeling is a concept taken from Albert Bandura’s Social Learning Theory in the 1970’s.  Without going into too much detail, Social Learning Theory has been one of the most influential theories about learning, and it states that learning through observation is one of the most powerful ways in which we learn, and that it can account for many types of behavior.  This theory informs many fields, including sport psychology (to which I devoted much of my undergraduate experience), where some observational learning techniques may include watching a coach or another athlete perform a skill well (either in person or on video), watching a video of oneself performing a skill well, or visualizing oneself doing a skill perfectly.  These are all techniques that lend themselves to learning through observation (real or imagined).   Additionally, my pediatric development class in OT school has taught me that, in the second year of life, children learn mostly through observation and imitation (as opposed to exploration, as they do in their first year of life).  I’m sure you could think of several other instances – as could I – in which observational learning is a viable mode of attaining or improving a new skill.

In the world of occupational therapy, I think that modeling can be used as part of a scaffolding approach to teaching new skills.  Perhaps, if you as an occupational therapist are trying to teach someone how to use a walker, and he or she is having a difficult time following verbal instructions, modeling can be used to show the proper technique.  Or if you want to teach someone a safer position in which to sleep due to recent hip surgery, and it’s too complicated to describe with words, simply modeling the appropriate position can be a powerful teaching tool.  Simply stated, modeling can succeed where words fail.  That’s not to say that verbal instructions are useless.  But modeling proper behavior is a powerful technique that can be used as the foundation for many important teaching moments.

As an OT student, in my eagerness to learn how to help people become more independent in their everyday lives, I know it will be important to remember that well-meant protectiveness can gradually undermine autonomy.  This doesn’t mean that I have to resist temptation to help people when it seems that they’re struggling.  It simply means that I need to be mindful of the process through which they are moving as well as the strategies that I am implementing in order to help them attain their goal.

*The opening quote was taken from page 87 of Ellen J. Langer’s 1989 book, Mindfulness.  A Harvard psychologist, she explores the definitions and implications of living both mindlessly and mindfully.  Because of its detrimental effects, well-meant protectiveness which gradually undermines autonomy, then, is seen to be an indication of mindlessness.  More to come on this topic.

Self-awareness.

It seems to be a common assumption that, at some point in our lives, we will seek to find ourselves.  To discover who we are and what we stand for.  Who we want to be.

Five weeks in OT school has taught me that, at this point in my career, this idea is more true now than ever.

I am learning that OT school is about more than simply accumulating knowledge.  Knowledge is important, and theory and technical skills are necessary for good practice.  But before any of that knowledge turns into practice, it is vital that we discover who we are as therapists and what we have to offer.  Self-awareness is critical.  Who we are and what we believe affects how we interact with people, how we relate to them.  And as OTs, it is our job to use everything we have to offer in order to connect with people and help them get back on their feet.  If we don’t really understand what our own strengths, values, shortcomings, and tendencies of thought and behavior are, we run the risk of selling our clients short by not giving them our best.

This point in our career is perhaps one of the most important we will encounter.  It is a formative period.  It is when we are encouraged to become the most aware of our personality traits and difficulties, so that we can start improving on them now.   It is when we are graded on our ability to look at ourselves objectively and identify areas in which we want to grow.  It is when we are asked to set definitive goals for how we are going to improve ourselves so that we can help improve others.   This is when we decide what kind of therapist we want to be.

Self-awareness can be hard, because it forces us to confront the things that we don’t like about ourselves.  But becoming aware of our shortcomings in a supportive and constructive environment such as the one we are currently in is a unique opportunity that I think many people may never have.  Our professors are here to build us up, not tear us down.  They want to see us succeed.

And so I am learning that honest self-awareness is perhaps the step at the bottom of the bridge that allows us to begin to move from a head full of knowledge to a career full of opportunities where we will have the chance to be with people and help them out in an important way during some of their most difficult times in life.  And if that is the case, then self-awareness is not simply for the sake of our own personal transformation, but also for the sake of those with whom we will work to transform.

Honest self-awareness may not be easy or comfortable.  But it gives us the insight into how we can improve, and the power to do so.

And I think that’s awesome.

Dignity and Freedom.

Today I had an interesting experience.  Surreal, almost.

As with most Fridays, I planned to take the campus bus from school to the train station, and then take the metro (a subway-like entity) from the train station to home.  While standing at the bus stop, exhausted from both the long week and from the heat of the late summer, I learned that I had about 45 minutes until the next campus bus was coming.  I decided to walk to the library to go pass the time sitting in the air conditioning and clicking around on some mindless websites on one of the campus computers.  As I began meandering down the hill, I noticed a man in a wheelchair who was being pushed up the hill by two healthcare professionals (medical assistants or maybe nurses, I guessed).  I’ll call him ‘Juan.’  Once the two women got Juan ‘parked’ near the bus stop, they quickly turned around and hurried back in the direction from which they had come.  I passed Juan, making sure to smile and say hello, but not to linger and stare (I am an Occupational Therapy student, after all, and isn’t that what we’re supposed to be good at?  Not assigning labels or judgment upon people?  Knowing how to act around people with different abilities and conditions?  I say this sarcastically because, yes, we should but, no, we don’t always know.  At least I don’t yet.).

I continued walking, all the while guessing that he was about my age – mid- to late-20’s – and wondering what led him to be sitting in that wheelchair on this particular day.  An accident?  Was it recent, or did he experience a traumatic childhood injury?  He seemed to have good use of both of his arms, but that darn hill was just too much for him to handle on his own.  Was it an illness? Did he just have surgery?  I remember being in a wheelchair after I had broken my leg and had surgery.  But I didn’t have a catheter, though, and he had a catheter bag hanging under his chair, so maybe he injured more than just his leg.  His head looked like it had been shaved several weeks ago, and he did have a fairly sizable incision or scar on the back of his head.  Maybe he did have an accident.  But the university hospital is right next to the bus stop, so maybe he  just finished a check-up of some sort and he’s fine, and now he’s heading home for the day. Such were the thoughts swirling around in my head.

Upon reaching the library, my mind quickly shifted to how pleasurable the temperature of the air conditioner was and where in the world I could find an unoccupied computer.

A little over a half hour later, I left the library and headed back up the hill to the bus stop.  Juan was still there, sitting out in the open sun. How miserable, I thought to myself, it’s so hot out here.  I can’t believe he’s just been sitting out here in the sun the whole time.  Maybe he wanted to.  Maybe he didn’t, but the two women who brought him here didn’t really care because they had other things to get to.  Bummer.

Upon the bus’ arrival, everybody at the bus stop boarded, including Juan.  I took a seat toward the back of the bus, behind the area where Juan and his chair had been secured in the ‘wheelchair accessible’ portion of the bus.

As the bus lurched forward and then made it’s way around the first corner, I noticed that Juan and his wheelchair weren’t really that secure.  Maybe his brakes didn’t work, or maybe the bus driver hadn’t properly secured his chair into the harness system.  But whatever the case may be, Juan and his chair were in for a hectic ride.  He grasped for stability, one hand on the overhead rail, the other on the seat next to him.

In that moment, I had no idea what to do.  Do I offer to help him?  I’m a pretty small person, though, and I might do more harm than good.  I may just end up getting run over by the wheels and actually getting in the way, and embarrassing him.  Maybe I’d embarrass him anyway simply by offering to help.  I don’t want to embarrass him.  Do I stay in my seat and keep an eye out, and then jump in to help if it seems like things are getting out of control?  Do I just stay where I am and allow another passenger to help him if it looks like he needs it?  There IS a grown man sitting nearby who helped the bus driver operate the wheelchair lift and get Juan into the bus successfully.  Maybe he’ll be inclined to help, and he’d probably do a better job than I would anyway.

Do you see the conflict brewing in my head?

In my mind, it had to do with the dignity and freedom, concepts that – I have learned – are official core values of Occupational Therapy.  Dignity has to do, in part, with maintaining an attitude of respect toward others and nurturing their sense of competence and self-worth.  Freedom, in this sense, relates to people’s ability to freely choose their level of independence as they find a balance between autonomy and interdependence in pursuing activities that are meaningful to them.*

My education in action.  Or maybe, more appropriately, inaction.

So as I sat there, fighting this battle in my head about whether I should help or not, I was frozen with indecision.  As iterated above, I didn’t want to jump in and offer to help if it would only solidify the notion that, yes, he was in a wheelchair and, yes, he was unable to help himself.  Sometimes even the offer of help can be belittling to people.  Maybe it was important and meaningful to him that he could take public transportation independently, without relying on nurses or family or friends.  The fact that he was a strong, young man made me suspect that he would probably want to get through this episode on his own.  From my experience, men like to get through difficult situations on their own, to take care of themselves without help from anybody else.  Maybe that was how Juan felt.  I wanted to respect his dignity and his freedom.  I wanted him to be able to get through this bus ride the way he wanted, in a way that would honor his independence.  But I wanted to help.  Oh, how I wanted to help.

In the end, I decided to to stay in my seat and keep an eye on things.  Juan seemed to manage himself okay, and so I didn’t want to jump in and offer to help, for fear that it would serve as a blow to his ego and frustrate him for the rest of the day.

As our bus pulled into the train station, I noticed that Juan began scanning the area in which our bus would soon be stopping.  Looking for an elevator, I thought to myself.  I personally had never seen an elevator that could take passengers down to the underground station, only a great multitude of stairs.  I couldn’t imagine how difficult it must be to try and find an elevator in such a bustling and expansive environment.

But here’s the part that gets me.

Just as I was considering about how difficult it might be for Juan to find an elevator and get to his train, another bus pulled in front of ours.  On the back of the bus was written this:

Elevators are for wimps.

Seriously?!  Does it really say that?!

I quickly scanned the back of the bus to see if I could tell what type of product or program it was advertising.  I couldn’t tell.  But at that point, I didn’t care.  The timing was just too surreal.  What if he saw that quote? I thought to myself.  What kind of message is that sending to him?  Not only has he had to endure this hectic bus ride and maybe feel embarrassed by the fact that he and his chair are being jolted around, but now the words on the bus in front of us are telling him that elevators are for wimps.  What is he supposed to do with that?  Just brush it off and go on as if nothing happened?  Ahhhhh!

And then I got off the bus.  As I crossed the street, noticed that there was an elevator nearby, and I hoped that Juan would see it too.  I descended the stairs, found my platform, got on the metro, and went home.

I don’t know what happened to Juan.  I don’t know where he was headed, or how he felt about his bus experience.  Maybe he was proud that he had made it through the turbulence on his own.  Maybe he was annoyed that no one had offered to help him.  Maybe he was fine, and I was overthinking it all.  But regardless of how he felt, I realized that striving to help someone maintain dignity and freedom in the face of physical disability just might be harder than it seems.  And maybe it is something that you can do the most effectively only by getting to know that person, and the things that are important and meaningful to him or her.  These are things I’m sure I will be considering as I continue in my Occupational Therapy journey.

So what about you?  What do you think about all this?  And how do you strive to help promote dignity and freedom in people’s lives?  I know there are more ways than one.

*My descriptions of dignity and freedom are loosely based on the article written by Elizabeth Kanny and Ruth A. Hansen, “Core Values and Attitudes of Occupational Therapy Practice.”  It can be found in a 1993 issue of the American Journal of Occupational Therapy.

Health and Occupation.

“Man, through the use of his hands as energized by mind and will, can influence the state of his own health”(Reilly, 1962).

How does this quote strike you?

Read it again.  Go ahead.  I’ll wait.

For me, it strikes me as empowering.  Optimistic.  Energizing.

I am learning much about the influence that our participation in occupation can have on our lives, particularly as it relates to our mental and physical health.  In an article entitled, “Health and the Human Spirit for Occupation,”* the concept of occupation is defined as “self-initiated, self-directed activity that is productive for the person (even if the product is fun) and contributes to others.”

Think scrapbooking. Or gardening.

The author then goes on to define health in a unique way.  ”Health,” she writes, “is an encompassing, positive, dynamic state of ‘well-beingness,’ reflecting adaptability, a good quality of life, and satisfaction in one’s own activities.”  Her definition is unique because it doesn’t define health strictly as the absence of illness or injury.  Using her definition, health does not exclude people with disabilities.  It focuses more on overall satisfaction, regardless of ability level.

So why does this all matter?  How are occupation and health related?  Who cares?

Well, when considering people who are recovering from spinal cord injury, strong support has been found for a relationship between activity level and survival.  Those who are more active in participating in daily occupations – both in actually doing the occupations and in socializing during their completion – are more likely to survive.  In the group of people referenced in this article, activity level was actually even more important than medical history or emotional state for these people who were recovering from spinal cord injury.  Bottom line: the more engaged they were in daily occupations, the more likely they were to survive their spinal cord injury, regardless of severity.

Pretty amazing, right?

This relationship between health and occupation is continually being discovered and re-discovered, and so here is my question to you.

What occupations do you engage in that are meaningful and satisfying to you?  Have you ever thought about how your involvement in these occupations can actually serve to enhance your overall health and well-being?

Of course, I am not suggesting that people live a destructive or overly sedentary lifestyle (e.g., sit around and eat candy bars all day), and then assume that if they engage in meaningful occupations that it will cover over their plethora of health-related “sins.”  Yes, occupational engagement is important for promoting overall health.  But it is not an excuse to ignore common sense healthy lifestyle practices.

However, if we can remember and trust that there is a powerful relationship between health and occupation, then maybe those of us who are over-worked, over-scheduled, and under-rested will think twice before we dismiss the importance of our involvement in personally meaningful activities.  For the use of our hands, as energized by mind and will, can influence the state of our own health.

*The article referenced, “Health and the Human Spirit for Occupation,”  was written by Elizabeth J. Yerxa and was published in the June 1998 edition of the American Journal of Occupational Therapy.