Alien’s Occupational Journey

alien_frail_friendlyOccupational Alienation

Occupational alienation is a term that I closely relate to, in terms of my own mental health problems, health care treatment and recovery. So when I read that Dr. Wendy Bryant was hosting next week’s #OTalk Tweetchat on this very topic I decided I needed to avoid writing a blog about it and process my thoughts on here. I really recommend you read Wendy’s post about the Tweetchat.

Wilcock (1998) discusses occupational alienation as a negative consequence of engagement in occupations that do not align with a person’s needs and results in ‘estrangement from society or self’ (p. 257). I can think of many times that my engagement in occupation didn’t ‘fit’ with my needs, and most notably it would be the time I was engaging in a degree at a university that felt ‘too good’ for me. I perceived the subject matter and the level of study to be way beyond my abilities, and so I felt very estranged from the rest of my cohort. Perhaps unsurprisingly I became depressed, and my, already fragile, sense of self became more fragmented. The short version is that I didn’t overcome that occupational alienation and dropped out of university.

Self-Defeating Occupation as an Alienating Occupation

I’ve proposed before the concept that occupations that are ‘self-defeating’ in nature can serve purpose and meet internal needs. If you’d like to read the original post it can be found here: Self-defeating Occupation. For me, when I engaged in many self-defeating occupations their ‘fit’ with the person I experienced the world as was perfect. I was chaotic and distressed and those occupations were the only ones that provided any meaning or value at the time. So in that respect I wouldn’t support the idea that non health promoting occupations contribute to occupational alienation, however the alienation was experienced via the relationship between those occupations that were ‘right’ for me at the time and those which would be ‘socially acceptable’. My world felt very disparate to the one I was residing on, and perhaps explains why I valued online communities in which I could be honest about my occupational engagement. As part of this post on pro-eating disorder websites I discussed the unique support I found through such websites.

Symptomatic Causes of Occupational Alienation for people with Borderline Personality Disorder

I’m also conscious as I write this how much the nature of Borderline Personality Disorder (BPD) is quite a significant risk factor for occupational alienation. I’m sure there are more examples, but two of the common features of BPD seem to predispose a person to occupational alienation. As I alluded to in the opening paragraphs I experienced a very distorted sense of self. I found it incredibly challenging to know who I was, what I liked and what values I had. Consequently it was almost impossible for me to engage in occupations that weren’t going to feel alienating, because that understanding of myself was entirely absent. Linked to that is the experience of dissociation. One element of dissociation can be to experience the world as if you are watching yourself from the outside, you are removed and isolated from the world. If this occurs regularly it is unlikely that someone is going to have a sense of belonging or control in their engagement in occupation, thus exacerbating any occupational alienation experienced.
The potential for Occupational Alienation within Occupational Therapy

As I mentioned above I experienced my first university education to be a source of occupational alienation. When I dropped out I ended up needing a lot of hospital care over the next few years and this was my first experience of occupational therapy. I’ve written before about how unhelpful I found this due to receiving therapy that didn’t support my own needs and experience of the world. As someone who had become very alienated when studying at degree level being offered very low demand occupations, such as colouring in, reinforced this feeling that I was somehow destined to drift away from the world and get lost. My hope is that if the occupational therapy occurs in its ‘true sense’, that is, it really addresses the occupational needs of the person in a creative and individualised manner, it shouldn’t heighten occupational alienation but there is always the potential there. The virtue of the therapy occurring in clinical settings is often an immediate source of occupational alienation and I know I’ve had to work hard in clinical settings to minimise this risk.

Alienation versus Occupational Alienation

Wendy’s comments about the challenge of separating occupational alienation as an occupational and social construct are something I’ve wondered about. My experience of occupational alienation sometimes resulted from society having different views to myself. Those occupations were not alienating in how they aligned with my needs, but they were opposed to the values, and perhaps collective needs of society. At other times the alienation occurred because the occupation in question did not support my needs, but was entirely acceptable to society. So I suppose in my experience it can occur due to internal or external conflict between occupation and need.

Becoming an Occupational (non-Alien) Being


When I was a service-user in a therapeutic community I engaged in art therapy. Each week I drew a picture of Alien. Alien was lost and desperately unhappy at the start and I used his image to represent my struggles. By the end of my therapy he had managed to make a rather shaky journey to Earth, he landed and wasn’t quite sure what the next step would be but he was going to give it a try. As I reflect back on the time I can see parallels between someone who was ‘just’ feeling alienated from the world as a whole and the level of occupational alienation I was experiencing. As Alien floated around outer space I struggled to get through daily life in hospital. Alien would make tentative steps towards Earth as I attempted to find occupations  that supported my recovery and helped me begin find a space in the world. When Alien made it to Earth he was here, and pleased to be so, while also being incredibly different to the rest of the people he met, at this time I was attempting to meet people and find occupations that truly fit with who I was, rather than just being things I did to distract myself from distress or that created a contrived structure. Sadly I didn’t continue Alien’s journey! I suspect now he’d be someone who really enjoyed life on Earth and mostly forgot he had green skin and four antennae!

This is a really interesting topic and I hope to give more time to consider my thoughts and those of others more fully soon. The Tweetchat is being hosted by Dr. Wendy Bryant on Tuesday 18th November at 8pm GMT, more details here. I’m planning to be there – I hope you can join in!

Wilcock, A. (1998). An Occupational Perspective of Health. Thorofare: Slack,



VC Medal

*brushes dust off neglected blog*

That’s better. I’ve definitely not had much blogging-mojo in recent months. Perhaps this blog has served its purpose to some extent, although my hope is that I will still write the occasional post.  And here is one today! The title is, ‘Graduation’ although I suspect it may be a bit of a general reflective ramble.

When I started this blog it was the result of a conversation with my academic tutor about preparing myself for a career in research by having a space to regularly write and play about with ideas. It also was suggested that it could be a valuable place to explore the experience of being an occupational therapy student who had extensive experience of engagement with mental health services as a service-user. The idea was that the blog would be relatively anonymous and I could test the water of being a bit more open about my background, with the understanding that if it all went horribly wrong I would have a better understanding about the level of openness I could afford with colleagues. Fortunately it’s been a very positive experience and I’ve gained many connections, and even some wonderful friends, who knew me initially as ‘pd2ot’ before getting to know the ‘in real life’ me, with whom there has been an amazing level of acceptance. This has definitely translated into other situations as I tend to be much more open about my own history of mental health problems as I feel comfortable now about its value in my career as an occupational therapist/researcher, I also don’t worry about the anonymity any more (but I still like the ‘pd2ot’ name so hold onto it for that reason alone!).

This week I attended my graduation ceremony, following completion of my undergraduate degree in occupational therapy. The day was an amazing mix of nerves, excitement, happiness, sadness and pride. It prompted me to think about my starting point and the ‘journey’ I have been on (sorry, I hope this doesn’t come across as too ‘look at how far I have come, aren’t I amazing?’ as I hate that stuff, and equally I’m feeling reflective and want to validate the amount of effort I, and a huge number of supportive people, have put into me getting to this point). The other wonderful thing about the day was seeing so many of my cohort again, and beginning to understand just how much graduating meant to us all. It was a challenging three years and I don’t think anyone sailed through it untested, indeed many had massive hurdles to overcome along the way. I’d really love it if lots of people wrote down their ‘this is how I was at the start, and this is what I faced all the way through, and here I am now having learned x, y and z about myself’, but maybe I’m just nosey!

So yes, graduation! Well the picture above is the ‘Vice-Chancellor’s Medal for the Faculty of Health and Life Sciences’, which I won for my degree results. I was shocked when I found out, in fact I emailed a member of staff to check they’d got the right person… I guess I still lack a bit of self-belief! On a practical level I was a bit oblivious to the potential for there being prizes as the focus of my degree had never been about chasing marks. Due to previous experiences of university my only aim was to complete the degree in a good state of well-being. Of course, I always tried to produce work I was proud to hand in, but I actually has quite low expectations of the marks I needed to achieve. It was all about ‘just getting through’ and there were several points in the course where I questioned if it were possible. So yes, winning prizes wasn’t on the agenda! The other more tricky part to this is my past experience of being known for academic achievement. I have never had a good experience of getting good results in things. For this reason I decided that I would never discuss my marks with other people during this degree, and other than with very close, mostly non-uni, friends I kept that vow. So when I was told about the prizes I’d be receiving I realised that made it all a little more public! I can’t say being in the limelight for academic achievement felt at all comfortable, but it was manageable and nothing awful happened.

The part of the day that I’m probably most proud of though was being asked to give the ‘Student Vote of Thanks’. This involved reading a speech to a capacity-filled York Minster full of students, family, friends and academics. No pressure! I suspect anyone would have been a bit nervous, and I definitely was. However as I returned to my seat at the side of the stage after, I think, making a reasonable job of it I had one of those ‘Wow, I’m not sure anyone 5 years ago would have predicted that happening’. When I was part of a therapeutic community and beginning to engage in The Real World I had a real problem with being seen. When I left the therapeutic community I immediately commenced an Access to Higher Education Diploma and I remember that when faced with giving a presentation to one tutor with a video camera I really struggled. It took several weeks of my therapy time to discuss the issues around it and devise a plan of how to face it. I was incredibly uncertain of how I could continue into higher education and repeated experiences like that. So yes, four years later and there I was making a speech to, and definitely being seen by, over one thousand people. And in that moment, it felt OK to be me.

There are far too many changes to list here, but I think I feel content in the knowledge that completing my undergraduate occupational therapy degree has completely changed me. I feel so fortunate to have done it at a university that was the perfect mix of challenging and nurturing and I know that there were a lot of lecturers, tutors, friends, family and therapists who played their part in making sure I arrived at this point in one piece. (I have this image of lots of people around me ready with sticky tape to hold me together at the tough points and then some good quality furniture polish to give me a good clean up at the end… but hey, my brain is a little worn out at the minute!)

So to everyone who’s been there along the way (including all those on Twitter and here), thank you!