The Meaning of Occupation: Historical and Contemporary Connections between Health and Occupation
Reed, Kirk, Hocking, Clare, Smythe, Liz, New Zealand Journal of Occupational Therapy
This article builds on an earlier discussion of the development and use of the word occupation throughout Western history. In the earlier discussion (Reed, Smythe, & Hocking, 2012) an overview of the word occupation was presented from a hermeneutic and etymological perspective (etymology is the study of the history of words, their origin and how their form and meaning have changed over time). The aim was to show how different meanings of occupation have built up over the centuries. This article continues the analysis to show how in each new era, circumstances change and shape what counts as occupation. As the profession of occupational therapy developed, occupation became a notion that was named, framed and conceptualised as the domain of a professional group. Up until the establishment of occupational therapy, occupation had not been recognised as a notion that could form the basis of a profession. In this article the history of how occupation became more recognised and formalised will be outlined. The time frame spans the Age of Enlightenment to the current day. A broad outline is presented recognising there is obviously much more than can be recounted. The aim is to bring to the fore how, in the context of occupational therapy, understandings of the notion of occupation have changed and evolved.
As described in the previous article (Reed, Smythe, & Hocking, 2012) a hermeneutic approach based on the work of Gadamer (1960/2004) was employed to explore the history of ideas related to the notion of occupation. Hermeneutics creates the opportunity to explore texts, and to show how ideas have been passed down in language and words. In this review extensive reading through Western sociology, history, philosophy and leisure texts was undertaken along with a search of the professional literature using the CINHAL, Proquest 5000 and Medline databases. Literature published from 1997 to the present was the focus of the database search, literature which described occupation, the link between occupation and health, and contemporary understandings of occupation from an occupational therapy perspective were purposefully sought. A hermeneutic process of analysing the text was undertaken by noticing the words used, how they were brought into play, and the context in which they were used, to highlight what was and what was not spoken about. The questions that guided the analysis were as follows: 'how did occupation show itself in relation to other people?' and 'what influenced the understanding and use of occupation by occupational therapists?'
Analysis of the literature
Over the course of the profession's development occupational therapists have recognised that occupations either positively or negatively influence health. Prior to the existence of occupational therapy, scholars such as Galen (131-201 AD) identified occupations for the maintenance of health. Conversely during the Industrial Revolution those such as Fredrick Taylor and the Scientific Management Movement (Applebaum, 1992) manipulated occupation in such a way that the focus was on the production of items in large quantities, with little or no consideration for those people that were involved in the manufacturing process. This contributed to occupation having a negative impact on workers' health. To show how understandings of occupation have changed and evolved the analysis of the literature is separated into periods of development throughout Western history from the Age of Enlightenment to the current day.
The Moral Treatment Movement
The Moral Treatment Movement, which developed in Europe during the Age of Enlightenment, laid the foundation for the emergence of the profession by recognising the need to occupy people confined to asylums. Brockoven, a psychiatrist, insisted that "the history of moral treatment in America is not only synonymous with, but is the history of occupational therapy before it acquired its 20th century name occupational therapy" (1971, p. …