Participation in the development of a human-focused economic system
Expanding the profession’s scope of practice
Acknowledgements
We would first and foremost like to thank all the reviewers who closely examined our book proposal and provided very useful feedback. Their comments helped make this book a much better product than it would otherwise have been. Many thanks to David and the entire editorial team of Whiting & Birch Publishers, Ltd, for their assistance to us in this project.
Thanks also to our students, occupational therapy clients, and research participants in all our various scholarly ventures who continue to be our teachers and our motivators as we strive to be better clinicians, researchers, and teachers.
The first author would like to thank Marie Anne Ben for her love and support throughout this project, and Susanna Davila (his adopted mom) for her love, warmth, and support. As always, Susanna’s pride in his work gives him strength to continue during those moments when he feels like giving up. Her feedback to an earlier draft of the book manuscript was very valuable.
The first author would like to thank his department Chair, Barbara Brockevelt, the dean of the School of Health Sciences, Mike Lawler, and the faculty in the Occupational Therapy Department at the University of South Dakota for their continued support in all his work. This book would not have been possible without all their support and encouragement.
Finally, he would like to thank his two children, Ivan and Nora, his sisters and brothers-in-law, and his nieces and nephews for always providing that critical family support that gives him the confidence to keep going in the knowledge that they are always available to support him in all he does, not matter what life brings his way.
The second author would like to thank his colleagues at Sheffield Hallam University for their support, encouragement and interest in this project, and Linda, Sally, Molly, Joshua, and Daisy for their patience when he was ‘too busy working’ for meaningful engagements.
Dedication
To my late adopted US dad, Dick Curtis who was a valued friend, mentor, and a gentle critic of all my work, and my adopted mom, Susanna Davila who continues to be a valuable source of love and support in all my work.
Moses
To my wife Linda, who makes it all possible
Nick
Introduction
Frankl (1992) postulated that the will to meaning is the primary motivation for behavior in human existence. Frustration of the pursuit for meaning, especially in the 20th century (and probably in the 21st century in the modern and Western world as well), constituted what he referred to as “existential vacuum”. The cause of this vacuum is a decline of engagement in realistic transcendental activities such as philosophical discourses, religious practice, or activities providing a concrete sense of purpose such as planting and harvesting, combined with a corresponding increase in materialism, reductionism, and nihilism (Mascaro & Rosen, 2005). According to Frankl (1992), this existential vacuum led to a major disease of our times which he called “noogenic neurosis” (existential neurosis). Simply stated, noogenic neurosis may be conceptualized as a disease of meaninglessness. Symptoms of this ‘disease’, as Frankl termed it, include boredom, anxiety, alcohol and substance abuse, depression, and even suicide.
Although the medical implication of Frankl’s description of noogenic neurosis as a disease might be debatable, his postulations have been discussed in detail by a host of psychologists, philosophers, and sociologists. Numerous studies have been conducted, and the results have been found to support these postulations. Chief among these findings is that there is a clear relationship between a sense of meaning in life and one’s quality of life (Iwasaki, 2006), which strongly suggests a range of determining factors. Also, Frankl (1992) argued that while there was no universal definition of life meaning, some of its constituents included loving someone or something other than oneself, exercising choice of action (at least choice of attitude regarding how to respond to life events irrespective of circumstances), taking responsibility to solve problems presented by life and fulfilling requisite life tasks, and having a goal towards which to aspire (which may be perceived as a personal mission in life). In the rest of the book, we will refer to the problems identified by Frankl as “issues of meaning/meaningfulness/meaninglessness” rather than adopting Frankl’s construct of “noogenic neurosis”.
This departure from Frankl’s terminology is necessary due to recognition of the fact that these issues are more socially based and therefore they are not ‘diseases as such’. They are often consequences of social problems such as domination of minority by majority cultures with subsequent loss of indigenous cultural values, materialism that makes it very difficult for people to dwell on activities related to deeper reflection, self-understanding, meaningful connection with others, and meaningful connection to important institutions such as religious organizations or other bodies that provide guidance to individuals in formulation of values. Furthermore, people experiencing problems of meaninglessness are properly viewed as victims of these social dynamics. As such, we think it is wrong to refer to what they are experiencing as diseases because that would imply that they need to be cured, while what they really need is: 1) to learn how to cope with social problems; or 2) help removing social barriers to meaning in their lives.
Consistent with Frankl’s discussion of the indicators of life meaning, based on factorial analysis, Iwasaki (2006) deduced some of the constituents of a meaningful life as: goal-oriented life, positive emotions, self-esteem, and sense of identity. According to Iwasaki, these factors have been found to be related to lower incidences of depression, high levels of hopefulness, and a good quality of life. It has also been found that positive emotions, self –esteem, sense of identity, and goal oriented life are enhanced through what occupational therapists and scientists refer to as occupations [i.e., “chunks of culturally and personally meaningful activity(ies) in which humans engage that can be named in the lexicon of the culture” (Clark, Parham, Carlson, Frank et al., 1991, p. 301)]. For example, participation in leisure occupations has been found to contribute to an experience of positive emotions and sense of well-being, positive identity and self-esteem, social and cultural connection, learning and development, and demonstration of personal strength and resilience, and in the process, to a sense of meaning in life (Iwasaki, 2006).
For a long time, work has also been recognized as a central constituent of a meaningful life. In the literary world, one of the best illustrations of this centrality of work to meaning-making is the story of Ivan Ilych (Bayley, 1967) written by Tolstoy (1960). In this story, Tolstoy described the desolation that Ivan Ilych, reflecting on his past life, felt at his deathbed. Having lived largely for the social and material benefits his