It’s More Than the Pants!

“For even in such a seemingly physically oriented activity as teaching a patient to dress himself, our ultimate goal is a psycho-social one.  That is, by increasing the client’s capacity to be independent we help him perceive himself as possessing worth.  He is not a “thing” to be manipulated helplessly by others but is a human being who can exercise some control over his environment, even in being able to put on whatever shirt he wants to put on when he wants to do it.” 

Elizabeth June Yerxa, OTR  1966 Eleanor Clarke Slagle Lecture 

Our Story

In May, during our scheduled Zoom meeting with Leesa (Leanne’s sister) set with the intent for her to show us how to interface our Homestyle website page and social media accounts, we quickly learned she was not our “go to person” for “trouble-shooting” any technology issues.  So, WE quickly abandoned the subject altogether and savored the opportunity for some “table talk”.  Why not spend our scheduled time doing what we love? Then while sipping coffee, nibbling a cookie, taking time to defuse and eventually reviewing our latest blog draft “What Do I Do?”Leesa graciously offered us her own unique and simplified understanding of occupation and occupational therapy.  As a pastor who has beautiful insight, understanding of the spiritual, and a good sense of humor … we had to share.  Collectively we had lots of laughs, and our “It’s More Than the Pants!” blog was born!

Leesa’s Story

“Well you guys… it’s like this.  I  was waking up in the morning and my hip hurt, and putting on my pants began to be a challenge.  So, after asking Leanne to assess the possible culprit for my hip pain and stiffness she suggested that I see a physical therapist to help with my balance, hip pain and range of motion.  Then, in the meanwhile, Leanne, as an OT, also understood that I needed to put my pants on so I am able to engage in occupations that provide me with purpose and meaning like walking my dog.  Walking Nutmeg is absolutely necessary to maintain my health and hers, and so that I can continue to nourish my adventurous spirit, hiking canyons and making it to mountain tops! Leanne understood that I am a passionate hiker.  Therefore, she also looked at the ergonomics of my hiking gear- boots, backpack, poles, sleeping gear, etc., and then inquired about how I put my pants on.  After our conversation and her visual assessment of my hiking gear and dressing technique, Leanne’s recommendations were easy modifications:  

• Purchase inserts for my hiking boots
• Buy a new supportive sleep mattress 
• Change my dressing technique 

She then looked around my house and spotted a solid-stable wooden kitchen chair.  She advised, until my hip heals, I need to sit on the kitchen chair to put my pants on.  Amazingly, given PT and the above modifications my hip pain is almost gone, and in a month, I will be backpacking in Yosemite and the Redwood Forest!

In the midst of her intervention,  Leanne asked me “Why hiking?”.  I then teared up, “Well, since Al (my husband) died, when I’m  hiking I am able to release my grief and  connect to all that is around me in nature, human and nonhuman.  Walking is meditative, and nature is medicine for my soul.  I breathe out there and it soothes and renews me…so I am able to return here to be the best possible mother for Ellie, and pastor for my congregation!” 

“You see, Jennica and Leanne, I know now… It’s not really all about  the pants!  Dressing is the functional skill that supports my ability to engage and perform my occupations that maintain and further develop who I need to be”.

At that moment, WE were speechless!  Her beautiful synopsis revealed the many moving components that work together making it possible for her to perform the activity of daily living, dressing.  And yet, she reminded us as we intervene, it is vital to be conscious that we are silently tabulating and not so silently asking questions that address the psychosocial and spiritual pieces, the essences that turn the function of dressing into occupation. 

In this example, on top of  task analysis, environmental observations,  and recommended modifications, Leanne  ventured to ask “Why hiking?”. In eliciting Leesa’s response, Leanne has addressed dressing as part of  an occupation, attached to personal meaning, not simply a task to be completed. Fully embracing “It’s More Than the Pants”, for Leesa.

So Now What?

In her lecture(1966), Yerxa encourages us to practice “Authentic Occupational Therapy.”  Reminding us that  our goal as therapists is so much more than addressing  the task at hand – like in Leesa’s case – not just putting on her pants but helping her to continue on a journey that allows her to grieve and renew her spirit.  Yerxa encourages us to realize that our ultimate goal in addressing occupation is one of “function with self-actualization”(p.114).   

There is so much in this lecture to Authentic Occupational Therapy (Yerxa, 1966) but we feel the strong need  to emphasize this one thought!! We, as occupational therapists  need to embrace that we can be true catalysts in propelling our clients toward their self-actualization! Yerxa, of course goes on to explain that although this goal is not unique to our profession, that we are truly unique in the way in which we use “choice; self -initiated, purposeful activity; reality-orienting; and perception”(p.107) in practice to help our client’s on their way to self-actualization.  We will save these concepts for our future blog!

What is Self-Actualization again? As many may remember, the term “self-actualization” was coined by humanistic psychologist Abraham Maslow. He defined the term as “the desire to become more and more of what one is, to become everything that one is capable of becoming.” A 2020 Healthline article further explains that, “Self-actualization doesn’t involve perfection or things always going smoothly. You can become self-actualized and still face difficulties. In fact, a huge part of self-actualization is recognizing your limits in addition to focusing on strengths.” (Raypole, p. 4) This is one of the 4 ways in which occupational therapists are truly unique in this process, as we are often first meeting our clients at challenging times of loss and change. Yerxa (1966) labeled it “Reality Orientation”.  In our efforts to help with self-actualization,  therapists must journey with their client to help them “discover both his limitations and his possibilities” (Yerxa, p. 107).

Self-Actualization through occupational therapy is a HUGE concept.  One that we feel deserves it’s own blog, and it’s own moment to deeply think about.  We encourage you to  STOP right there and acknowledge this awesomeness, along with some true responsibility.  This blog’s recipe is one of reflection. Asking ourselves questions.  We are huge believers in the importance of reflection in practice and in life (which is how this blog came to be). It is often through reflection on what we’ve done in our practice that we have become better at embracing occupation, and becoming what Yerxa, (1966) calls more “Authentic” occupational therapists.  

So now go grab that cup of joe, chocolate bar,  glass of wine, or whatever inspires deep thought for this recipe.  Then be sure to meet us in our next blogs-in-the-making  “Cool Shoes” and “Beautiful Bows”, where we  will take a deeper dive into Yerxa’s (1966) lecture, propelling us all on our way to becoming more “Authentic” in practice. 

Warm Regards,

Jennica & Leanne

Sharing our stories…

 

  References

Raypole,C. (2020, February 26). A (Realistic) Guide to Becoming Self-Actualized. Healthline.com. https://www.healthline.com/health/self-actualization

Yerxa, E. J. (1966).  1966 Eleanor Clarke Slagle Lecture Authentic Occupational Therapy In Padilla, R., & Griffiths, Y. (2017).  A Professional Legacy, The Eleanor Clarke Slagle Lectures in Occupational Therapy 1955-2016 (Centennial ed, pp. 105-115). Bethesda: American Occupational Therapy Association, Inc.

Acknowledgements

A special thanks to Leesa for coming to the table and sharing your beautiful perspective of occupational therapy and to Jennica’s mom, Joan, for your editorial skills, preparing our message to share with readers!