do not really need, and then find they have to get rid of. The same can be said of the US. All this garbage is stuff that other people make in their work, and that we buy with the proceeds of our work. As Ivan Ilyich (in Tolstoy’s novel) finds out as he learns not to be so concerned about bent photograph frames or chipped new crockery, none of this matters very much. Illich (1980) suggests that a community held together by the voluntarily given work contributed by its participants might be more durable and healthier for its citizens than one characterized by accumulation of material things.
This view was reiterated by Putnam (2000) who pointed to one particular development which he thought was a source of the problem of decline in social capital (the value of other through our relationships with them) in the US as the fact that people invested so much of their energy in their work that they had no energy left to invest in their communities. He argued that work had become the community. However, because work itself was being redefined by a global economy in which job security was less guaranteed, the risk was that the work-based community was rootless and shifting. One day it was there and the next it was relocated to a place where labor and site costs were cheaper. Updike’s Rabbit (1991a; 1991b) is perhaps an exemplar of this shift in community values and subsequent meaninglessness. In four novels the life of this character spans the transition from the pre-television age to an era of the proliferation of consumer goods progressing from athletic basketball jock to an overweight and flabby car salesman with a heart condition. At the end of the tetralogy he returns briefly to his youthful pre-occupation with basketball, but after a life of modern consumerism, this is a mere fancy. In his way, despite the possibility that his life has progressed downhill ever since the beginning of the narrative, Rabbit manages a similar last minute redemption as Ivan Ilyich, suggesting that even in the modern consumer-oriented society, redemption of a sense of meaning in peoples’ lives is still possible.
Occupations, including those of leisure and work, offer powerful means through which individuals and societies can be used to mediate perceptions of meaninglessness and offer the redemption alluded to above. We can have confidence in the power of occupations in helping us achieve the above stated objective based on our observation that when people die, they are often remembered in terms of the things they did with other people, and mementoes related to such things as sports affiliations or social, usually family, roles. As we will see in chapter two, English worker-writers often defined themselves in terms of their work or other occupations, particularly occupations related to increasing a sense of personal efficacy and a feeling of connection to other people. It follows then that one way of addressing Frankl’s problem of meaninglessness in modern society would be by helping people find ways of orchestrating their occupations in such a way that what they do every day helps them experience positive emotions, create a positive identity for themselves, connect to something bigger than themselves, love someone or something other than themselves. In the process of engaging in such occupations, people may experience a sense of well-being due to a feeling that their lives are meaningful and purposeful. A member of a gardening project in Sheffield described to Nick how attending an allotment group twice a week and being given a plant to grow and care for through the winter gave him something to structure his week, and a chance to connect to other people, which made that period of time very meaningful for him. Specifically, he stated:
I don’t socialize with a lot of people outside the group and talk to anybody […] it [taking care of the plant] does get me out of the house early in a morning and it does get me in a weekly routine. And that helps me a great deal, cause you wake up in a morning and you think ‘Monday!, Ah I can go somewhere,’ you start feeling you belong somewhere, to me. And even later in the week, Thursday, I can go somewhere, even if I didn’t have somewhere to go that’s two days in the week I can have talks with people and possibly if I had a full weekly routine I wouldn’t get a situation like this where I can talk to people like this, so this would still be beneficial no matter what situation.
In their work, occupational therapists and occupational scientists can help people choose to engage in occupations that contribute not only to connection with other people, but also that facilitate connection to a cause that transcends personal “desires for pleasure or power” which would lead to “a meaning-saturated attitude” (Mascaro & Rosen, 2005, p. 987). By helping people create meaning in their lives through what they do as described above, occupational therapists and occupational scientists would be enabling them to develop personal and social strategies to resolve their perceptions of meaninglessness.
Furthermore, because occupational therapists and occupational scientists are educated to understand the form, function, and nature of occupations (Clark et al., 1991), it may seem that they are well placed to help people structure their occupational lives in such a way as to counter the experience of life as lacking meaning. Yet, there is little evidence that occupational therapists and scientists are proactively responding to this challenge to take their rightful place in serving humanity. That is perhaps why clients have repeatedly expressed disappointment with the services they receive from occupational therapists, while at the same time pointing out the potential of the profession to play a crucial role in helping people find meaning in their lives.
A good example of the above mentioned disappointment was by the world renowned astrophysicist Steven Hawking (1996), who wrote the following:
Now, however, people with disabilities and other previously disadvantaged groups, such as women and blacks, are demanding that they should be able to play a full part in society. As I see it, your job as occupational therapists is to make sure that they can. I cannot say that professional occupational therapists have been much help in my case, but may be I just did not encounter the right therapists. (p. 27, emphasis mine).
Hawking went on to suggest that:
With modern technology, it ought to be possible for many people with disabilities to lead a life in the community and to contribute to society. It is the task of occupational therapists to enable them to do this. The important jobs involve mental and organizational abilities rather than physical strength and dexterity. This is the direction in which people with disabilities should be encouraged rather than being put onto carpet making and basket weaving, which are inappropriate for those who are mentally alive. (p. 28, emphasis mine)
Occupational therapists need to respond to Hawking’s criticism by deemphasizing physical strengthening and focusing on helping people do things that make their lives meaningful. Although strengthening and re-education in motor functioning is indicated for some clients, these strategies should not be central to occupational therapy practice but only adjunctive to helping people engage in valued occupations. Criticisms similar to the one by Hawking have been leveled to occupational therapists by other famous clients, such as the eminent cultural and field anthropologist Robert Murphy (2001), who developed a spinal cord tumor in 1976 and described his experience in occupational therapy during his rehabilitation as a degrading, meaningless exercise.
If occupational therapists focus on helping their clients experience a meaningful existence by participating in society through engagement in valued occupations, they may answer Frankl’s challenge to help people deal with the problem of meaninglessness resulting from an existential vacuum. In recent years, with the emergence of the new professional paradigm focusing on occupation-based, client-centered, and collaborative practice, meaningful occupations are being rediscovered as the foundational media for authentic occupational therapy practice (American Occupational Therapy Association [AOTA], 2014; Kielhofner, 2009). Numerous theoretical conceptual practice models have been developed to guide therapeutic interventions with meaningful occupational performance and participation in life as the overarching goal of therapy. Examples of such theoretical frameworks include the Model of Human Occupation [MOHO] (Kilehofner, 2009), Canadian Model of Occupational Performance (Law, Polatajko, Baptiste et al., 2002), and the Occupational Adaptation frame of reference (Schultz & Schkade, 1992; Schkade & Schultz, 1992; Cole & Tufano, 2008).
The notion of occupational meaningfulness and in particular how occupations are used in meaning-making has been explored
