Editorial: British Journal of Occupational Therapy 2018, Vol. 81(3) 127–128. DOI: 10.1177/0308022617733245
Teena J Clouston
Occupational therapists believe that time to engage in personally meaningful occupations is integral to health and wellbeing. Meaningful occupations tend to be understood as those we enjoy, attribute value to, or that can create a sense of purpose, fulfilment or satisfaction in life (Wilcock, 1999). To achieve effective participation in these kinds of occupations requires an element of choice. Without this capacity for self-determination, the ability to achieve a personal sense of congruence between personal values, strengths and meaningful occupations (Pentland and McColl, 2008) can be compromised (Clouston, 2015). For occupational therapy, this notion of choice in the use of time is an interesting one. In contemporary life, particularly in Western economies, the time available to be ‘spent’ in personally chosen occupations is reportedly scarce. This appears to be related to how we think we should use our time and the value we attribute to certain occupations in the present socioeconomic-political climate.
Modelled on the principles of neoliberal capitalism, present drivers use a deregulated and global marketplace to create economic growth in the most competitive way. In this kind of economy, time is viewed as money and therefore the occupations we ‘do’ in time are measured in terms of their financial and productive worth. Consequently, occupations tend to have a ‘performance orientation’ (Clouston, 2015: 16) and this has notable impacts on the individual’s use of time and their choices in terms of participation. Paid work, for example, has become a highly valued occupation, as it is believed to promote market growth. On a practical level this does not initially seem to be problematic: paid work is important and it can be personally meaningful. However, to sustain its effectiveness in a market economy, paid work needs to be competitive, and this means that human as well as financial resources have to be used effectively. To achieve this, people are expected to do more in less time and to maintain this initiative, busyness is promoted as a ‘badge of honor’ (Gershuny, 2005: 287), making the drive for performance an accepted norm. The impact of this on individuals is two-fold. First, the time and energy available to participate in personally meaningful occupations is reduced and second, people feel pressured to compromise these to achieve socially accepted expectations (Clouston, 2015). In this kind of context, paid work is no more than a ‘focusing illusion’, used to ensure people strive to sustain market growth (Kahneman et al., 2006: 1908), albeit this directly challenges the notion of individual wellbeing found through participation in a variety of meaningful occupations. For occupational therapists and scientists this creates an intriguing dilemma: how can we find time for our service users to partake in meaningful occupations and apply this to our work in this kind of economic model? I would suggest that we, as a profession, can go some way to addressing this by adopting a more meaningful orientation to the use of personal time and energy, in line with our philosophical beliefs and values, and then promoting this as a solution to our performance driven lifestyles. This of course is not easy. The value of meaningful occupations in facilitating wellbeing would need to be understood and accepted at individual, organisational and societal levels in order for time and energy use to be adapted to incorporate these explicitly. This, in turn, would require the pace of life to slow down to accommodate the more reflective and/or relationship-focused being, becoming and belonging occupations, as well as creating time for engaging more meaningfully in ‘doing’ occupations. Finally, the individual’s personal experience of occupational meaning in time, as the occupation unfolds, would need to be facilitated and supported in order to promote individual wellbeing and a genuine sense of meaning in life. As occupational therapists we have the skills and knowledge to facilitate this reorientation, and hold the philosophical beliefs to advocate the value of living a more meaningful life in terms of wellbeing. However, in order to promote this we need to facilitate proactive change through education, evidence based practice and, essentially, through research. Only then will we be ready to drive change at socioeconomic-political levels in order to achieve a meaning orientation in everyday occupational life.
Corresponding author: Teena Clouston, Reader, Occupational Therapy, School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, UK.
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