The Meaning Crisis and Occupational Therapy

What does the discipline of occupational therapy have to offer our current existential moment?

Roughly one year ago, I made the decision to accept an offer to study a Master of Occupational Therapy (OT) at the University of Sydney. Now, as I write these words, I’ve just completed my first year. The majority of my 20s involved a significant amount of exploration, successes, and supposed failures (learnings) as I sought to find meaning in a vocational path. And now, after completing a fantastic albeit brief placement in a rural hospital earlier this month, I can honestly say that I’ve found a profession which aligns well with me, my values, and the way I seek to serve humanity.

It is somewhat ironic, then, that OT so highly values meaning. At the heart of the discipline lies the notion that engagement in meaningful activity is vital for human wellbeing as both a means and an end. Such activity is, moreover, therapeutic within-and-of itself. Thus, OTs are health professionals who help enable/empower people to engage in meaningful activities despite illness, impairment, injury, and/or other life barriers. One could say that OTs ‘specialise’ in meaning; we work to increase meaning in peoples’ lives in practical and evidence-based ways.

It is striking, then, that some have made the claim that we are amidst a meaning crisis. John Vervaeke, a cognitive psychologist and professor at the University of Toronto, is one such figure. According to Vervaeke, our modern life is characterised by a profound lack of meaning. A pervasive sense of alienation overwhelms us. We feel increasingly disconnected: from ourselves, one another, and the world. Suicidality, rates of mental illness, and loneliness continue to rise in affluent societies. Social media merely adds fuel to the fire.

What is the antidote to this crisis? In seeking to answer this question, Vervaeke turns to the cognitive sciences, philosophy, and various wisdom traditions. His YouTube lecture series Awakening from the Meaning Crisis provides a comprehensive and integrated account of how we can respond. Here, Vervaeke argues that two key things can help ameliorate this perennial crisis: transformative (spiritual) practices and genuine community. Amongst other things, both work to increase our sense of connectedness which forms the foundation of wisdom. And, it is ultimately a recovery of wisdom which will provide the cure to our crisis of meaninglessness.

The notion that we’re currently in such a crisis is gaining traction amongst many. The clinical psychologist turned public intellectual Jordan Peterson recently released a podcast titled The 4 Horsemen of Meaning, a not-so-subtle riff off the (once) Four Horsemen of the New Atheism. Vervaeke features in this conversation alongside Peterson, Bishop Robert Barron, and Jonathan Pageau. Now, in all honesty, I tend to find Peterson quite frustrating and — at times — deeply misguided (e.g. he does not have a sound grasp of political philosophy). But, given his growing popularity, it’s worth paying attention to the content he releases. And, the crisis of meaning is a topic that features frequently (under various guises).

So, what does this mean for OT? What can it offer this crisis? And, what can it learn from the likes of Vervaeke?

As I’ve undertaken my studies this year, I’ve been energised and appreciative of the way OT places meaning — and by consequence people — at the centre of its practice. That is, the therapeutic process is guided by each individual and their own hopes, dreams, and goals. The lived experience of the person is front-and-centre: they define what is meaningful and what it means to live fully. Backed by rigorous science, OTs ‘prescribe’ interventions that are both evidence-based and holistic. Indeed, holism is a core philosophical principle of OT. All aspects of the human person (and human experience) are taken into account without giving in to any form of reductionism. Each person is viewed as a human being within a wider web of relations as opposed to merely being viewed as a list of pathological symptoms.

Yet, whilst OT is holistic in its theoretical underpinnings, it is still very much developing and evolving as a profession. Ask the average Joe what occupational therapy is and you’ll be lucky to get an accurate response. And, for those that do have some idea, OT is often associated with physical therapy alone. However, what is less well-known is that you’ll find OTs working in all kinds of settings: from public mental health teams to disability care, to acute hospital wards and insurance companies. Even in its origins, modern OT began within a psychiatric setting (caring for returned, traumatised war veterans).

Below, the Occupational Performance Model (Australia) — developed by Dr. Judy Ranka and Dr. Christine Chapparo — comprehensively sets out the scope of human occupation and performance.

Occupational Performance Model (Australia)

Whilst what many consider as OT would exist predominantly within the bio-mechanical, sensory-motor, and cognitive realms (think structured upper limb therapy for stroke patients), the meaning crisis features heavily in the intra-personal, inter-personal, and what we would tend to (broadly) define as the ‘spiritual’ domains of human experience. Here, OT has an opportunity to play to its strengths as a discipline which values the role of meaning. As a profession which is also deeply pragmatic, OT has the potential to offer evidence-based, practical solutions to the ways in which this crisis manifests in peoples’ everyday lives, particularly if it is leading to illness or injury (which Vervaeke and others would insist it is). For instance, what could OT provide to someone battling with chronic, debilitating major depression? Could certain spiritual practices — backed by empirical research — be ‘prescribed’? Could greater links be made to communities centered around a particular wisdom tradition? What about the current ‘psychedelic renaissance’? Could OT-specific research be conducted into the functional outcomes of psychedelic-assisted therapies? And, in the academic space, what insights could be gained through productive dialogue between the disciplines of theology, philosophy, and occupational therapy?

These are just some of the questions that have been sparked for me as I’ve journeyed through the first half of the master’s program. And, the more I learn and reflect, the more I’m convinced that OT has something important to offer society in this critical moment.

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Shane Fenwick

An Oz-based bi[bli]ophile writing about all things mind, spirituality, philosophy, health, and flourishing. Endlessly fascinated by this wondrous universe.