Occupation in stressful times.

May/June 2002, Volume 56, Number 3 The events of September 11, 2001, have changed the world forever (Schuster et al., 2001). As occupational therapists and occupational therapy assistants, we struggle to respond to both the tangible and intangible consequences of these events for ourselves, our clients, our families, our profession, and our society. I am sure that many of you have been confronted, as I have, with the question of whether as an occupational therapy professional, you can make a contribution to the restoration of health and well-being in the wake of these events (Hasselkus, 2001). As I write this article, it is 3 months since the American tragedy. The Taliban government in Afghanistan has been defeated; Osama bin Laden and many of his co-conspirators elude capture; bodies continue to be recovered from the wreckage of the World Trade Center; and many people still experience the economic consequences of the crisis. Commentators and experts tell us that the fallout from major tragic events continues for years after the event itself but that a critical period of distress follows between 3 and 9 months later (Lee & Young, 2001; Ursano, 2002). In the past 3 months, the American Occupational Therapy Foundation convened a group of interested individuals to attempt to formulate a response from the profession. This group discussed initiatives that might reach out to people in distress because of the events and help occupational therapists and occupational therapy assistants to come to grips with their role vis a vis their clients and their communities. One of the initiatives of this group is this article—an attempt to understand how occupation might be a source of healing and relief in stressful times. As long as human history has been recorded, we have known that it is important for human beings to be occupied in meaningful ways (Kielhofner, 1982; Licht, 1948; Reed, 1986). Without being involved in activities (e.g., looking after one’s self; contributing productively to one’s home, family, or community; engaging in leisure in one’s free time), both physical and mental health are seriously compromised. As early as 172 CE, the Greek physician Galen is quoted as saying that occupation “is Nature’s best physician and is essential to human happiness.” St. Thomas Aquinas spoke eloquently about the value of occupation for a full life: “To live well is to work well.” Victorian proverbs, such as “idle hands are the devil’s playground,” show us the extent to which this idea pervaded our culture. Long before the profession of occupational therapy was conceived, the word occupation was used colloquially in much the same way that occupational therapists and occupational therapy assistants now use it—to refer to a meaningful way to use time. However, not until the 20th century did we begin to understand the full impact of occupation on human health (Law, Steinwender, & LeClair, 1998; Wilcock, 1998b; Yerxa, 1998). The development of occupational therapy and occupational science advanced the study of occupation in order to afford a more comprehensive perspective on the many benefits associated with being meaningfully occupied (Clark et al., 1991; Yerxa, 1993; Yerxa et al., 1989). We know how useful having something to do can be in the midst of stressful times (Blair, 2000; Clark, 1999; Fine, 1991). In fact, evidence from studies in primatology shows that the need to be occupied is “hard-wired” in the human species (Wood, 1993). Reilly (1962) perhaps expressed it best in her seminal article: “[Humans], through the use of [their] hands, as they are energized by mind and will, can influence the state of [their] own health” (p. 2). (I hope I will be forgiven for updating the language. My experience as an educator is that young people—those who do not remember that 1962 was a different time—are distracted from the power of the idea by the gender-specific language.) This article explores how occupation exerts its powerful effect on health and wellbeing. We will consider seven ways that occupation provides a bridge to health in difficult times.