Can busy, paediatric and adult OT’s, ASI® practitioners with big caseloads, and overworked practice owners “re-imagine doing”, or “not doing”?

The pandemic has left us in a strange kind of in-between.  Lockdown started on 27 March 2020 in the most extreme form.  Some of our privileges and routines had already been stopped in the week prior to the president’s big announcement, but then. life. stopped. We all took a big pause, challenged by the time to do less, have access to less, socialise less.  As weeks became months, we became used to uncertainty, waiting week on week for new and updated rules.  Gradually, some restrictions were lifted.  But here we sit now, in Level 1.  In between. Lockdown is not over.  There was no lockdown “off” switch.

Many of us as OT’s spend our days helping clients and patients get back to being busy, after life or disability or illness has interrupted their daily normal.  Many of us had our “usefulness” challenged when our outpatient clients disappeared overnight.  Some needed to take a break and rest.  Others found themselves faced with a whole range of new challenges – to keep earning an income, to save a clinic, to maintain contact, to address urgent client needs.  Where did you find yourself?  Did you have a chance to think, or did you settle into a new kind of hustle?

This week The Daily Maverick (24 October 2020) had an article by Yvonne Jooste, challenging the notion that the “hustle culture” we subscribe to might not be best for our health.  Jooste weighs up the benefits of switching one form of hustle pre-lockdown, for another at home.  This article really struck a chord and seemed to be published somewhat coincidentally in line with World OT Day on 27 October. While some people needed to be busy to stay sane, others felt the pressured through online social channels that they weren’t doing enough.

“Although routine, productivity and work may help some people alleviate their anxiety during the coronavirus crisis, feeling guilty because you are not designing an app, doing a course in digital marketing, starting a business or writing some of the best plays ever written, will only be detrimental to your health and wellbeing.  Many of us will oscillate between fear and anxiousness, optimism, sadness and searching for comfort.  We will need to address our needs whatever they may be and take care of ourselves, nothing more.”

As I read through her article it challenged me as an OT to make sure that my goals and objectives for my clients are always according to their priorities.  Not mine.  Not society’s.  Not our perhaps unhealthy culture’s.

Hustle culture refers constant working. It means devoting as much of your day as possible to working, or hustling. Hustle culture implies that the more you work, the more celebrated you are. It interferes with basic sensible health needs such as meals, sleep, exercise and family time. Hustle culture breeds a toxic sense of competition.

Many occupational therapists are caught up in this irony.  While wanting the best for clients, supposedly subscribing to a mindset of life balance, they get caught up in one of two frantic races – the entrepreneurial one, or the service model.  Occupational therapy personalities come in all shapes and sizes, but many a final year student, lecturer, therapist or board member has worked, chased or served to the point of burnout.

“Several authors have suggested strategies to resist hustle culture and its effects, such as burnout and depression.  Suggestions range from doing nothing, to finding more meaningful pursuits, to focusing on relationships, family and passions.” (Jooste)

Jooste goes on to say “Hustle culture, apart from ignoring vast systemic inequalities in part created by modern ideas of progress and individualism (some people have no option but to hustle and is it possible to hustle when your basic human needs are not being met?), it also reduces life to getting and spending.  There is no time left for sadness, reflection, slowness, and activities imbued with love – values much needed in a time of crisis.”

The pause of life as we know it in 2020, forced us to rethink our careers, our values and our goals.  While some OT’s were able to lean into that pause and learn from it, others felt threatened by the loss of momentum.  Addicted to busyness? Which side were you on?  Admitting that you’re addicted to the transactional nature of a getting-and-spending culture seems so counter-intuitive to the generally accepted stereotype that OT’s are caring individuals who want to “help other people”.

And here is the crux, for us OT’s who have been challenged to “re-imagine doing”:

“We must challenge the notion of development at all stages of life, and imagine the course of life differently than through speed or milestones.” – Vincenzo di Nicola (psychiatrist) in writing a manifesto for Slow Thought.  “This requires practices that have no object, no measurable result “that allow us to live more fully in an a-temporal present, freed from the burden of an imperfect past or the futile promise of a redemptive future”.  In other words, do whatever sings to you, Jooste says.  I love that.

For a profession built on activities, participation, just-right challenges and growth, these edgy words push our clinical reasoning to new heights.  We have to really re-imagine. Reframe our thoughts and beliefs. That means taking the creative process and walking the path of our thoughts not once, but twice, with enough courage to believe that we might come to a different conclusion the second time around.

What is optimal for the child’s development in the midst of a pandemic?

How do I view technology and screen time in a socially-distanced world?

How does school-readiness look in 2020?

How has Covid-19 affected mental health – of those with known issues and those who are being confronted with anxiety and depression for the first time?

Which part of my practice offering adds value to my clients when they might’ve lost their income?

How do re-invent myself to build new momentum when this has passed?

What is urgent while “normal life” is paused?

What is most important for me now?

How will things look for my family in an uncertain 2021?

And, who needs OT now?

There is no finite answer.  Each OT and each client will have walked their own path through 2020.  It is vital however, that we each acknowledge that we will emerge changed.  And that we need to re-imagine whatever it is that we’re going to be doing.


Happy World OT day on 27 October 2020 to all the phenomenal occupational therapists who are part of our community!  We value your contributions to your families, your workplace and your society.