10 Life Lessons I Learned as an Occupational Therapist: Part 1
“Treat failure as a lesson on how not to approach achieving a goal, and then use that learning to improve your chances of success when you try again. Failure is only the end if you decide to stop.”
—Richard Branson
As an occupational therapist (OT), I meet new and unique people every day who are in some of the toughest moments of their lives. Physically and mentally their backs are against the wall but they work with me as a way to gain a little independence, address some weaknesses, and to simply become better.
Every interaction with them is an opportunity to learn something new. Every moment is as impactful as I let it be. One occurrence is an interesting point or an “a-ha” moment but with time these moments become trends and these trends become lessons I can transfer to the rest of my life. Here is part 1 of the lessons I’ve learned as an occupational therapist.
Occupational Therapy Life Lessons
1. The importance of self-awareness
One of the most significant determinants of recovery after a neurological injury is the amount of insight the patient has. Someone can have 99 of the 100 attributes for an optimal recovery like good muscle movement, coordination, and memory but lacking that metacognition puts them at such a safety risk that it can negate it all. Not realizing that one side of the body is weaker than the other can lead to a tumble down the steps. Not being aware of the visual field cut can lead to a car accident or missed zeroes on the check they’re writing. The more you can identify your weaknesses the better you can become.
2. ….but more insight doesn’t mean happiness
There is a trend in society now to address trauma, embrace the mind-body connection, and improve the awareness within ourselves. This is generally important but there is also a reason we lose all memory of the traumatic event we experienced--our brain is trying to protect us.
The man who is bedbound and can't tell you who he is and where he lives may be happier than he could ever be knowing those answers. The homeless woman with schizophrenia who’s laughing on the corner may have the key to happiness after all. Insight is a double edge sword. It can be extremely important but recognize the situations where ignorance is bliss.
3. Disassociate the issue
A new medical issue is often accompanied by strong emotions. These could come in the form of guilt, dread, anger, anxiety, grief, or all of the above. When you tell the person that “their” issue is having an impact on their life and it needs to be addressed then those negative layers rise to the top and a wall of self-defense stands between you and that patient.
When you disassociate the issue and label it with the third person, the walls crumble and you immediately become teammates against that issue. One lesson I’ve learned as an occupational therapist (OT) is to blame it on the brain, the hand, the pain, the neurotransmitters, or any adjacent issue that can be recognized as separate from the person. This compartmentalization makes it less personal, dampens the negative emotions, and channels the focus on addressing the new target.
This is the best approach I’ve found to fostering buy-in and unity in addressing issues. It’s also extremely effective with any difficult or abstract conversations you have in a week. Implement this strategy in arguments, in moments of tantrums or teaching lessons with kids, and even with addressing your own personal woes.
4. The power of the posterior chain
The muscle group that goes along the back of the body from the upper shoulders to the calves is the powerhouse of the body. This posterior chain is critical to knee and spine stability but also has importance with any standing, bending, and reaching. Ever see someone pull their low back or hamstrings? They’re totally incapacitated.
The modern world is anterior chain dominant meaning there’s a muscle imbalance between the front and the back of the body in the average person. After an injury, this compounds because the back of the body atrophies very quickly. This can lead to pain, stiffness, a high risk of pulled muscles, and permanent contractures. Maintain a strong and flexible posterior chain.
5. Your tribe matters
The difference between a discharge plan to a loving and supportive system of friends and family versus a discharge plan home alone or to a nursing facility is the difference between independence and dependence.
Rehab establishes the foundation for the skills lost from a severe injury such as a spinal cord injury or a stroke but the upward trend of progress is extremely variable as soon as that person leaves the clinic or hospital. This trend is dependent on the advocates who keep you motivated when you want to stay in bed and give you the physical support to move when you’re unable to do it on your own.
Most importantly a strong support system provides a level of comradery, compassion, and love that loneliness and strangers can’t hold a candle to. Humans are meant to be social and supportive of their kin. Anything short of that leads to dehumanization.
6. The conversation is often more important than the treatment
One of the most fundamental components of humanity is socialization. So much so that isolation is used as a torture technique. Having a long face-to-face conversation is increasingly rare with the all too common glow of a screen on people’s faces. This is evident with the rate of loneliness skyrocketing in recent years. The benefit of physical rehab to heal the body after a car crash or a gunshot wound is important but sometimes the conversation within the occupational therapy session provides more benefit than the physical treatment itself. Make time for conversation.
7. The hedonic treadmill never shuts off
Our brains have an ancient hardwiring that keeps us steady. When we get too high–say we win the lottery or we eat a great dinner–our happiness setpoint jumps up but due to the hedonic treadmill it eventually comes back to baseline. The same thing happens with negative situations.
Whether you were in an argument with your partner or sustained a permanent injury, the brain resets to baseline. Adjustment to a new way of doing things is never easy but time is a great healer. Know that things will eventually clear up as you swim through the mud.
8. We don’t know what we have until we lose it
When I was in school for OT it was tough to wrap my head around the idea of having to help grown adults do their ADL all day. Then my career began and I discovered a whole population of people who are constantly searching for therapists to give them the slightest edge in regaining the slightest independence with things like feeding themselves, wiping their butt, or being able to get in the shower again. We take for granted more than we’ll ever know.
9. Meet them where they’re at
Everyone is in a different place. Some are at the beginning of their recovery and others are at the end of their life. Some are grieving the loss of their former selves while others are taking advantage of the situation as "an opportunity" to show others and themselves what they can do. I wouldn't tell a newly injured patient about how their depression will resolve just as I wouldn't talk to a 2-year-old about mortgage interest rates. Assess the context and respond accordingly.
10. Movement is directly linked to happiness
I found that the people that move the most generally smile the most. Whether they’re cruising along in a wheelchair or shuffling with a cane as fast as a turtle, the ones that take advantage of the movement they have are the ones who have the best outlook on life. Create joy through movement.
What life lessons have you learned in your career?
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