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I’m doing what I can to help myself, so why do I still feel this way?

So, its been a while since my last blog. This is for a few reasons really: lock down lethargy, taking my own advice and trying to take opportunity for respite and using it, a general sense of uncertainty in what to offer.


Because of this, this blog comes with a bit of a caveat: I don’t know how helpful it will be. There are no forms to fill in, no suggestions of what might be helpful; just the hope that some of this experience may chime with yours and if it does, some of my reflections might be useful or interesting. Writing this has helped me to get my thoughts out of my head and down on paper so perhaps that’s the suggestion that comes out of this- get it out of your head (whatever your it is).


I am frustrated. I am lethargic. I am fed up.


Don’t get me wrong, I’m also at times perfectly content, fully engaged and happy in the moment. But these moments seem to be the minority not the majority.


I know that ‘before’ wasn’t perfect, it had its ups and downs, but the dissatisfaction was less present day to day and was certainly less oppressive when it did turn up.


So, what’s going on?

A friend of mine recently commented that she’s fed up because she “never wanted to be a fifties housewife” another talked about “missing the feeling of being productive”. These friends are in different situations with different demands on their time, but the underlying sense of dissatisfaction was shared. What struck me is that they’re talking about the same thing: loss. A loss of control, a loss of balance, a loss of identity.


I’ve talked about the difficulty of change, of managing mood and about the need for respite and rest. I feel like I have a bit of handle on some of this stuff (not always but sometimes!) So, what’s missing? Why can’t I put into words what I’m feeling? I’m doing what I can to help myself, so why do I still feel this way?


As usual, I’ve looked to my professional knowledge to try and put my experience into some sort of wider context. And here’s what I’ve come up with.


Occupational therapy literature often talks about the balance of occupation across

productivity, self-care, and leisure. The idea being that if we can get a ‘just right’ balance of these elements in our daily lives, we can be in ‘good health’: we feel satisfied and content.


Now, we can all see that the lock down has upset our usual balance of activity. But you could argue that some of the things we’ve found to do instead of our usual routines are replacements for the same type of activity. If that’s the case, logically our new routines should provide the same sense of balance.


If we’re not working, we might feel less productive and so spend time baking, making things, working on the house. These would all, objectively, fulfil the requirements of a productive activity.


We might have clawed back a bit of enjoyment- a few moments for respite and relaxation in our days or weeks and again, this would ostensibly satisfy the leisure element on our occupational balance picture.


Our habits and routines for looking after ourselves might have adjusted but for the majority they’re still happening, we still eat, shower, exercise etc. - self care continues.



I’ve done this:

  • I’m baking bread (productive)

  • I’ve made cards (leisure)

  • I shower, I eat (self care)


So… why am I still feeling so disgruntled, so ‘off’, so dissatisfied?


I think the answer is in meaning and purpose. In the world of occupational therapy activity without meaning or purpose is just that: activity. When activity is meaningful to an individual it becomes occupation and this is so much more interesting.


Firstly, we need to recognise that the same activity could have different meaning and purpose for different individuals. Or even different meanings for the same individual under different circumstances.


For example, sometimes I watch TV because I enjoy it, it’s engaging and interesting. Sometimes I watch it because it takes no effort, I want to switch off and not think or feel. Same activity- different purpose.


This means that even though all those replacement activities we’re finding to fill our time might objectively fulfil different elements of occupational balance- it doesn’t mean that they necessarily work that way for us as individuals. Or maybe they do but not all the time or not to the same extent or perhaps just aren’t satisfying in the same way. In some way, the difference means our experience is not as fulfilling.


The Model of Human Occupation (MOHO, Kielfhofner) talks about the optimum of occupational functioning as occupational adaptation. This is when our sense of occupational competence (how able we feel we can do things) matches our occupational identity (doing the things that are important and interesting to us, the things that make us who we are).


Basically, we feel able to do the things we need and want to do well enough that we feel satisfied with who we are. This inherently means that when we’re doing ok, the things we do are linked to who we are- they have individual meaning and purpose.


This happens in the context of our lives, both literally and metaphorically. We live in our specific circumstances at a specific time in our own, personal occupational narrative: the overarching story of what and how we do the things that make us who we are over the arc of our past, present, and future.



These stories are generated by our experiences, how we integrate and assimilate these experiences and how all of our personal skills, values, interests, environments, roles and responsibilities interact to produce our individual occupational worlds. Each of us is a unique individual governed by external and internal factors that combine to influence the choices we make in how we spend our time.


This link between past, present and future grounds us in our knowledge of who we are, shapes our goals and intentions and assists us to judge our successes and achievements in the wider context of who we were, who we are and who we want to be.


So, how does all this theory help right now? For me, it allows me to see beyond the immediate challenge; I can see the wider context.


We can clearly see that we are not likely to be experiencing occupational adaptation because our ability to do the things that are important to us, the things that makes us who we are, is compromised.


Whether this is by physical restrictions associated with Covid, changes to roles and responsibilities, or lack of access to the environments that support us to do the occupations we usually do. The outcome is the same; we aren’t doing the range of things that matter to our sense of identity and wellbeing. We are out of balance.


On top of that, our occupational narrative is disrupted. The present is not what we expected, our futures are uncertain, and we are in many ways unable to express the learning from our past.


We may well have competence in the things that we are doing to pass the time but these things have limited relevance to our occupational life stories. They lack the breadth and depth of variety and range of our usual occupations. Our current routines don’t enable us to express our multifaceted sense of occupational identity in the ways that we’re used.


I think this is the crucial part- although these occupations may appear to satisfy a level of occupational balance between productivity, self-care and leisure, they don't satisfy our occupational identities. There is a discrepancy between what these activities mean on paper and what they mean to us.


Usually, my life is organised so that it interweaves my values into my occupations. My routines support me to engage in the things I need, want and have to do. But right now, I have lost that choice. I have lost the ability to do all the things that really matter to me. The things that are about the me I am in different contexts, different roles. I am a more varied person with a wider skill set than the me I am at home with my family. I need more than home life because the occupational identity I’ve built over the years is more than my home life.


I don’t say this to denigrate being at home with the kids. I’ve done that and enjoyed it- the crucial part is that back then, it was my choice so at that time my occupational identity was fulfilled.


Right now, this is not choice; this is a necessity, out of my control and as such it feels frustrating and discordant.



That’s where my head’s at, it’s thinking about the gap. The gap between who I have to be in these restricted times and who I feel I am: identity built up over the years of making choices led by what I think is interesting, relevant and of value, decisions dictated by my assessment of my skills and abilities and governed by what opportunities have come my way.


I know that when the lock down is lifted there will be opportunity for me to do all the things that matter again. But, in the moment, in the repetitive, unsatisfying trudge of getting through lock down, the future feels far away and irrelevant. I am focussed on getting through the here and now.


Maybe that’s what needs to change.

Maybe that’s how I can express my occupational identity more effectively: stop thinking about how rubbish it is to be missing things (holidays, meals out, shopping trips with friends, even the school run) and think more about making my post-lockdown life as occupationally adaptive as I can.


I think I’ll start by working out what I want my future to feel like. What have I missed most at this time of restriction and how can I make sure I get as much of that as I need?


Who knows if it’ll work? Who knows if it’ll feel relevant when all this is over?

It doesn’t really matter, because I think that shifting my focus to the future might help me to manage the gap in the here and now.


Who knows, maybe it's something for you to consider too.



Thanks for reading,


Kate


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