What Do I Do?

“In therapy, we set the stage and begin the next chapter of the patients’ story, giving them the skills to write what comes next and propelling them forward to whom they will be. That ability to create those stories is the foundation upon which our profession is built.”    Janice Posatery Burke, 2010 Eleanor Clarke Slagle Lecture

Leanne’s Story:

A full year into the pandemic, with cake in hand, I went to my dad’s home to celebrate his 81st birthday.  It was only a small gathering of 4, but I was thankful that we were able to celebrate distanced and masked, as a year ago we had to cancel his surprise 80th birthday party altogether.

 While there, we recapped the year’s events and the angst associated with making changes to our daily routines, but also shared the many silver linings we discovered along the way.  We were knee deep in conversation, from out nowhere, my dad interrupted.  Shouting from across the room, “Leanne, I know you are an occupational therapist, BUT I am wondering, What DO you DO?”   

THE DREADED QUESTION!  I knew, in that moment, my mask would not save me from this now-airborne and suspended question.  Yes, even after 36 years of practice my heart still skips a few beats with this question.  In fact, my body froze with anxiety and my mind erupted with frustration. With a hint of sarcasm thankfully staying within my bubble above my head read; “Dad! Really? Why are you NOW asking me this question?  You had a couple of decades to ask!”

I took a deep breath, and paused so that the foggy interlude lifted enough for me to ask myself, “WHAT DO I DO?”  With a strong desire to make the definition relevant and memorable, I stood up, hands on my hips….and began….

“Occupational therapists are the Custodians of Meaning” Englehardt 1986

“Occupational Therapy strengthens the body, empowers the mind and transforms the soul” Redbubble.com

“Occupational therapy practitioners ask, “What matters to you?” not, “What’s the matter with you?” Virginia Stoffel, PHD, OT, BCMH, FAOTA

“Medicine adds days to life, occupational therapy adds life to days.” Unknown

“Occupational therapy practitioners help people of all ages develop the skills they need to succeed in everyday life, where they live, learn, work and play.” #OTmonth

At the end of MY litany of reciting these “wise nuggets” from the Eleanor Clark Slagle lectures and OT slogans, I looked into my dad’s deep brown eyes as they were glazing over, returning only a blank stare.  With limited attention, he mercifully ended my one-woman show saying “Oh, interesting.” There was no applause, or even a question to follow!  I knew at that moment I should not take a bow and actually found myself quite breathless and fatigued!

 “ARGH!” I thought to myself! An opportunity missed.  Apparently, the verbiage became a nonsensical sound to his ears. 

 After I paused and took a cleansing breath, I switched gears, and adopted an alternative approach.  I evoked Burke’s (2010) notion that occupational therapy is an interpersonal interaction.  In her own words, “Occupational therapists use physical space; therapeutic objects, their bodies, their voices, and their reasoning skills to create an interaction that produces a therapeutic outcome” (p. 618).  Acting on Burke’s (2010) words of wisdom, I used the interpersonal interaction to define occupational therapy for my dad.  The definition began with obtaining a narrative of his experiences that occurred this past year.  Within his story, I was able to notice my dad’s attributes, his distinctions, and how the disruption of the COVID pandemic influenced his ability to engage, adapt and perform his occupations.  What’s more, by using the interpersonal exchange I detected my dad’s emotional well-being, motivations, intentions and desires.   

You see, it is within each unique human story, a meaningful and memorable definition of occupational therapy is born!  Specifically, interpersonal interaction has the potential to elicit emotion, provide a relatable context and yield an experience that hard-wires the definition of occupation therapy into a person’s memory.  

Okay! Back to the story to illustrate my point:  

Instead of defining OT from my perspective- I reversed the script, and entered my dad’s mindset.  Also, I created a safe space, clear of judgement to actively listen, and observe nonverbal information.

 As part of the interpersonal interaction, Burke (2010) suggests using physical space and objects.  Therefore, I looked around my dad’s home, scanning displayed artifacts and objects of importance that give meaning to him.  I noticed throughout his house are many pictures of his children, grandchildren and great grandchildren, and one in particular, set off to the side, giving it a feeling of importance, was a picture of his beautiful wife who is deceased.  On the shelves there were many books of interest such as mystery novels, and periodicals about social justice, in particular, animal rights.  There was US Marine corps memorabilia, and many souvenirs from places traveled. These keepsakes serve as a reminder of past and current events, and assisted me with understanding his identity.  Furthermore, I used the objects as a way to generate questions, as Burke (2010) asserts, use your voice to support both the inquiry and elicit dialogue.  Hence, I commented “Wow, Dad I notice you have a lot of pictures of family out on display!” This led him to share that during the COVID-19 Pandemic stay-at-home shutdown, he became nostalgic and reminiscent of his life, and he decided to “dig through ” and organize several boxes of old pictures.  In fact, this activity propelled him to document his family lineage and write his memoirs.  With a questioning tone, I commented, “You wrote your memoirs?”  He chuckled with a smile, and then he said, “I started out with an autobiography that chronicled my life from birth to present.  BUT I have started to impart my experiences, world views and life lessons into the stories.”  He told me that his inspiration to write his memoirs stemmed from his strong desire to leave a collection of reminiscences, a legacy for his family.  

From here, I paraphrased by restating his statements in my own words to gain understanding.  I used my own words to tell what I think my dad meant, not what he said.  This verbal feedback provided him an opportunity to validate if I am understanding his frame of mind correctly.  I said, “Oh, I see family is important to you.” Interestingly, this one comment gave way to a list of the things he missed and what has changed for him over the course of a year.  I was quiet while he shared his experiences and what crafts his own sense of identity, and how the pandemic changed the way he participated in his daily routines and activities.

My Dad’s lists:

What I Miss……

•   I miss “being needed.”
•   I miss our traditional Sunday football games centered around family and food.
•   I miss my family and the spontaneous homecomings of my children, and grandchildren, with their children.
•   I miss going to the YMCA every day to exercise followed by coffee with “Y” friends. 
•   I missed you and Jessica (granddaughter) coming over to decorate my Christmas tree.  (I did not like you making me do it!)

o   Please NOTE THIS comment: My dad was disgruntled by my proposal to put up his Christmas tree!!!!!

 What has Changed…

•   I have a new companion, Kerry
•   I watch daytime television such as the “The Talk”
•   I go on Daily walks with Kerry and our dogs.
•   I fix things at Kerry’s house.
•   I listen to the hum of Kerry’s sewing machine make gifts. 
•   I sneak out to Costco for chocolate chip cookies.
•   I am writing and rewriting my memoirs
•   I organized for my children a family photo album and lineage
•   I put up the Christmas tree and lights
•   I listen to church services-sermon via podcast
•   I cook dinner for me and Kerry

o   FYI: He never cooked  

I am curious, as you read my dad’s contemplations and his two lists, are there any words that stick out to you?  For me, the words “miss” and “changed” emerged.   

Hmm! Burke (2010) does encourage the facilitator of the interpersonal interaction to use their reasoning skills.  Therefore, I inferred with the word “miss” there is an emotional experience of longing, feeling loss, and possibly grief.  With the word “change” I could infer potential feelings of anxiety and excitement.  Although these feelings are part of the human experience of living, I needed to listen closely to assess how these emotions affected my dad’s ability to perform his occupations.   

You see, throughout my years as an OT I have learned the experience of loss can depress movement, the experience of change can cause instability in movement and the experience of novelty can invigorate the movements that are infused in human occupation.  In short, certain feelings can either facilitate physical and mental movement or stifle it.  

Okay! Back to the story for the definition of occupational therapy!

“Well Dad, let’s go back to the question, What does an occupational therapist do?”

 “I listen to people, to find out WHO they are – their roles and personal values.”  On the premise of our interpersonal exchange, I was able to tell my dad that I gleaned his sense of self is woven into his roles of being a widower, father, grandfather, friend, a companion of Kerry’s, an advocate for animals and a voice for the marginalized.  The other distinguishing characteristics that I mentioned were “You are a caretaker, story-teller, U.S. Marine (man of service), problem solver, carpenter, and a Christian.”  From personal knowledge, I added that “You are also young at heart and at times a rascal!”. He chuckled, in agreement, like a teenager!  

“Dad, once I figure out WHO a person is, I also look for obstacles that interrupt their ability to engage in the meaningful activities that aid in developing their human potential.”  Given his above two lists of “I miss” and “What has changed” I explained to him that I became aware of how the COVID pandemic changed the way in which he was able to do the relevant activities that define WHO he is.  I then said, “You showed resilience, displaying ways to recover from the disruption of the COVID pandemic in your life.”  I went on to inform him that if he had been unable to adapt and re-invent his routines (e.g., listening to podcasts and cooking) and maintain his identity or lost his sense of purpose, an Occupational Therapist would enter into his story, listen, and together, they would problem solve solutions and co-create a recipe for living.

 Well…Little did he know over this past year, he had a built-in occupational therapist, as I never can turn off that switch.  As an OT, I monitored and anticipated where he may be feeling loss, and watched how he adapted and changed the occupations that afforded him mental, physical and spiritual well-being.  To preserve his health, I prodded him to “Put up his own Christmas tree!” This was meant to get him moving and doing and keeping a sense of normalcy.  Therefore, I encouraged my dad to assemble (movement), decorate (create), and reminisce about each ornament held in his hand!  This is an occupation!  What is more, I knew providing purpose assists in moving, doing, reclaiming and reinventing oneself in the midst of a bewildering time, like a pandemic. 

Okay, I have to confess that Jennica and I planned to give you a very specific and direct script to use when you are asked, “What is occupational therapy?” Instead, we want to encourage you to use the interpersonal exchange because human occupation lies in the details of each person’s story.  We believe that the best definition of occupational therapy is fastened within each person who inquires, and is as unique and as numerous as there are people on the planet! 

 Did you notice, I never mention fine motor or gross motor skills in the definition of occupational therapy I gave to my dad?  Please, reserve some of these thoughts for our future blog entitled “It’s More Than Pants!” Yes, a prelude into our next blog where we dive a bit more into this idea of occupational therapy- so much more than the Activities of Daily Living (ADL’s), handwriting, and fine motor skills, language so often used to define or rather “pigeon hole” the scope of what  we do.    

Warm Regards,  

Jennica & Leanne

Sharing our stories….  

 

To print the recipe card, download the image by right clicking > save image to downloads. Then print the recipe card from your downloads!

 

 

References

Burke, J.P. (2010). 2010 Eleanor Clarke Slagle Lecture What’s Going On Here? Deconstructing the Interactive Encounter. In Padilla, R., & Griffiths, Y. (Eds.). A Professional Legacy, The Eleanor Clarke Slagle Lectures in Occupational Therapy 1955-2016 Centennial Edition (pp.615- 631). Bethesda: American Occupational Therapy Association, Inc.

Englehardt, T. (1986). Occupational therapists as technologists and custodians of meaning. In G. Kielhofner (Ed.) Health through occupation (p. 139-144). 

Rebubble.com https://www.redbubble.com/i/t-shirt/Occupational-Therapy-Strengthen-The-Body-Empower-the-Mind-Transform-The-Soul-by-Whynot123/34558777.FB110

Stromsdorfer, S. (2021, May 9). The 11 best occupational therapy quotes. My OT Spot. https://www.myotspot.com/occupational-therapy-quotes/

Williamson, M. (1997). A year of daily wisdom perpetual flip calendar. Carlsbad: Hay House, Inc.