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Occupation in Relation to the SelfMike Carlson PhD Research Professora, Daniel J. Park OTD, OTR/L Assistant Professorb, Ann Kuo BSc PhD studentc & Florence ClarkPhD, OTR/L, FAOTA Professor and Associate Deanc

a Occupational Therapy, University of Southern California, LosAngeles, California, United Statesb Clinical Occupational Therapy, University of Southern California,Los Angeles, California, United Statesc University of Southern California, Los Angeles, California, UnitedStatesPublished online: 05 Oct 2012.

To cite this article: Mike Carlson PhD Research Professor, Daniel J. Park OTD, OTR/L AssistantProfessor, Ann Kuo BSc PhD student & Florence Clark PhD, OTR/L, FAOTA Professor and AssociateDean (2014) Occupation in Relation to the Self, Journal of Occupational Science, 21:2, 117-129,DOI: 10.1080/14427591.2012.727356

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Occupation in Relation to the Self

Mike Carlson,Daniel J. Park,Ann Kuo &Florence Clark

Knowledge of the construct of occupation remains fragmented within

traditional social science disciplines. In this paper, we aim to provide a

theoretical synthesis by explicating the unique properties of occupation in

relation to the self within social science discourse. Occupations relate to

other social science constructs in three ways: (a) they recruit a set of

associated changes into a person’s life; (b) they serve a person’s ability to

achieve important goals; and (c) they act as a mirror by reflecting multiple

dimensions of the self. Key characteristics of occupation such as its

experiential salience and its repetitional flavor powerfully amplify its significant

role in affecting self-relevant outcomes. Occupation represents a crucial

playing field that profoundly affects the unfolding of human lives. Therefore,

the continued pursuit of occupational science is warranted and can uniquely

contribute to an improved understanding of the self.

Keywords: Occupational science, Social science, Self, Identity

Occupational science was formally

established nearly 25 years ago. In

this past quarter century, the disci-

pline’s scholarship has affirmed time

and again the crucial role that the

serial performance of occupations

plays in the everyday lives of people

(Dickie, 2003; Hocking, 2009; Riley,

2011). Not only do occupations

cumulatively define human exis-

tence, but they are also tightly linked

to individuals’ conscious experience,

physical health, and other life di-

mensions intimately related to the

sense of self. In this regard, scholars

in social sciences such as psychology,

sociology, anthropology, and social

gerontology have also explored the

importance of meaningful activity

in people’s lives (e.g., Diener &

Seligman, 2002; Dulin & Hill,

2003; Hultsch, Hertzog, Small, &

Dixon, 1999; Levasseur, Desrosiers,

& St-Cyr Tribble, 2008; Werngren-

Elgstrom, Brandt, & Iwarsson,

2006).

Occupational science, however, is

the only discipline with the primary

purpose of ‘‘generat[ing] knowledge

about the form, the function, and

the meaning of human occupation’’

(Zemke & Clark, 1996, p. vii). It is a

science devoted to filling an existing

gap in knowledge of occupation as a

fundamental dimension of human

life, through the study of occupa-

tion’s essential elements, occupa-

tional processes as they unfold

through time, and the relationship

of occupation to other phenomena

such as health (Clark et al., 1991;

Clark & Larson, 1993; Hocking,

2009; Wilcock, 1998a; Yerxa et al.,

1989; Zemke & Clark, 1996). This

explicit focus on occupation chan-

nels inquiry toward previously

understudied concerns such as oc-

cupational choice, occupational

j Mike Carlson, PhD,

Research Professor of

Occupational Therapy,

University of Southern

California, Los Angeles,

California, United States

j Daniel J. Park, OTD, OTR/L,

Assistant Professor of Clinical

Occupational Therapy,

University of Southern

California, Los Angeles,

California, United States

j Ann Kuo, BSc, PhD student,

University of Southern

California, Los Angeles,

California, United States

j Florence Clark, PhD,

OTR/L, FAOTA, Professor and

Associate Dean, University of

Southern California,

Los Angeles, California, United

States

j Correspondence to:

mcarlson@usc.edu

– 2012 The Journal of

Occupational Science

Incorporated

Journal of Occupational Science,

2014

Vol. 21, No. 2, 117�129,

http://dx.doi.org/10.1080/

14427591.2012.727356

JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014 117

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change, occupational adaptation, and the devel-

opment of recommendations for blending occu-

pations into coherent and healthful lifestyles

(Galvaan, 2012; Pierce et al., 2010; Wilcock,

1998b). Additionally, occupational science is

concerned with the synthesis of knowledge on

occupation, which had, prior to the establishment

of the discipline in 1989, previously existed only

in fragmented form within other social science

disciplines such as those identified above (Carl-

son & Dunlea, 1995; Clark, 2006; Jarman, 2004).

The overriding aim of this paper is to explicate

the status of occupation in relation to the self. In

pursuing this aim, we first attempt to locate

occupation’s positional relationship to the wider

gamut of constructs related to the self that have

been previously identified in the social sciences.

We then highlight several features of occupation

that underscore its importance in relation to the

self. Based on our analysis, we suggest that

occupation represents a playing field upon which

critical life experiences and outcomes are deter-

mined as the self interfaces with its world. Prior

to embarking on our main task, however, we will

provide a fuller elaboration of the occupation

construct.

Definitional Characteristics of Occupation

Even after more than 20 years of study, there

currently exists no universally accepted definition

of occupation. For example, although Wilcock

(1998a) defined occupation as ‘‘all ‘doing’ that has

intrinsic or extrinsic meaning’’ (p. 257), Clark et al.

(1991) more narrowly construed occupation as

chunks of culturally and personally meaningful

activity in which humans engage that are named in

the cultural lexicon. Recent debate within occupa-

tional science has sought to synthesize understand-

ings of the nature of occupation, thereby shedding

new light on the complexities of the construct.

For instance, Hocking (2009) exhorted fellow

occupational scientists to deepen their knowledge

of occupation itself, apart from people’s engage-

ment in it. In making her argument, Hocking drew

attention to a critical trend within occupational

science which distinguishes between the concrete

performance of occupation and the larger socio-

cultural idea of occupation which is ‘‘held in the

minds of persons and in their shared cultural

language’’ (Pierce, 2001, p. 139). Figure 1 portrays

this two-pronged nature of occupation. Nelson

(1988) first explored this distinction when he

argued that occupation incorporates both occupa-

tional performance and occupational form, in

which occupational performance is the actual

concrete ‘‘doing,’’ and occupational form is the

pre-existing physical and sociocultural structure

that shapes the doing. Nelson broadened his

analysis to note that while occupational form

(which encompasses the sociocultural expecta-

tions surrounding any given ‘‘doing’’) significantly

structures the occupational performance, this

relationship is by no means deterministic. In

fact, form and performance shape each other.

Pierce (2001) later drew a more definitive line

between the doing and the idea of doing by

defining ‘‘occupation’’ as the former, and

‘‘activity’’ as the latter. Occupation, according to

Pierce, is the thing that is done in a specific time,

place, and sociocultural context; is experienced

solely by the individual; and is therefore non-

repeatable. Drawing on both Nelson and Pierce’s

analyses, Hocking (2009) posited that occupation

does indeed exist apart from a person’s engage-

ment in it, and should be a subject of research and

study in its own right.

A second debate among occupational scientists

pertains to the location of occupation in relation to

the individual. As discussed above, Pierce (2001)

argued that occupation is solely the experience

of the person performing it. It is his or her

‘‘personally constructed, nonrepeatable experi-

ence’’ (p. 139), and cannot be fully understood by

others. However, recent thought within the disci-

pline has challenged this assumption. For example,

Dickie, Cutchin, and Humphry (2006) contended

that, as occupation is deeply social and contextual

Occupation as Object of Conscious Deliberation

Occupation as Concretely Performed Action

Figure 1: Interrelationship Between the Conceptualand Concrete Dimensions of Occupation

MIKE CARLSON, DANIEL J . PARK, ANN KUO & FLORENCE CLARK

118 JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014

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and exists in a transactional reality where a person

and his or her surrounding world are really part of

each other, occupation in fact resides not at the

individual level but at the level of the ‘‘situation of

which the individual is an integral part’’ (p. 91). In

this view, occupation does not emerge out of the

individual, but is a transaction that joins the

individual and the situation. Further, through

occupation, the individual and the situation (‘‘the

world’’) co-construct and co-define one another.

Other scholarship has defined occupation through

the lens of occupational justice (Townsend &

Wilcock, 2004), and through the synthesis of

occupation as being, doing, and becoming

(Wilcock, 1998b). It is clear, then, that the

construct of occupation is complex, and therefore

it is not surprising that no unifying definition

exists at this point. However, growing consensus

has coalesced around the following typical

characteristics of occupation, which this paper

will utilize as a starting point for our discussion

(e.g., Clark et al., 1991; Dickie, 2003; Gray, 1997;

Harvey & Pentland, 2004; Hinojosa, Kramer,

Royeen, & Luebben, 2003; Larson, Wood, &

Clark, 2003; Riley, 2011; Royeen, 2002; van Nes,

Runge, & Jonsson, 2009).

1. Occupation is ‘‘doing’’ that is purposeful andgoal directed.

2. Occupations tend to be performed con-

sciously and intentionally.

3. Occupations are temporally, historically, and

socio-culturally situated.

4. Occupations tend to be personally mean-

ingful within the context of situated lives.

Definitional Characteristics of the Self

Before discussing occupation’s relationship to the

wider set of social science constructs related to

the self, we will briefly consider the concept of

the ‘‘self.’’ Admittedly, and like occupation, the self

is immensely difficult to define. As Baumeister

(2011) noted, most people have a general intuitive

understanding that the self encompasses one’s

emotions, personality, thoughts, dreams, fears,

identities, and relationships. However, to clearly

define or place boundaries around the concept is a

tricky proposition.

The sociologist Owens (2003) defined the self as

‘‘an organized and interactive system of thoughts,

feelings, identities, and motives that (a) is born of

self-reflexivity and language; (b) people attribute

to themselves; and (c) characterize specific human

beings’’ (p. 206). Further, he acknowledged that

the self-concept (a critical element of self) is both

a social product (i.e., emerges from a person’s

socially contextualized interactions with other

people) and a social force (i.e., is able to exert

influence on both the individual and the outside

world). Baumeister (2011) recently identified three

conceptual roots through which to understand the

self: (a) the self as a knowledge structure in which

a person stores information about himself or

herself; (b) the self as an interpersonal being,

emerging out of social relationships; and (c) the

self as an agent with executive function. Taken

together, these concepts show that the self is born

out of social relationships and self-reflexivity;

encompasses and organizes one’s thoughts, emo-

tions, identities, values, and attributes; and is an

agentic force that is expressed while interfacing

with the outside world.

The related construct of identity, and its relation-

ship to occupation, has recently been a focal point

of study by occupational scientists. Christiansen

(1999) was among the first to explain that identity

is created and expressed through occupation.

Identity, a fundamental aspect of the self, consists

of the ‘‘definitions that are created for and super-

imposed on the self’’ (Christiansen, 1999, p. 548).

Through occupations, people provide themselves

‘‘with the contexts necessary for creating mean-

ingful lives’’ (p. 547), and it is through these

contexts that identity is shaped and expressed.

Since the publication of his seminal paper,

numerous studies have supported Christiansen’s

contention that people construct and re-construct

their identities through occupation (e.g., Asaba &

Jackson, 2011; Laliberte Rudman, 2002; Unruh,

2004; Vrkljan & Polgar, 2007). For example,

stories of recovery from illness or injury, in which

individuals are required to rebuild an identity,

MIKE CARLSON, DANIEL J . PARK, ANN KUO & FLORENCE CLARK

JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014 119

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are prominent in the occupational science litera-

ture (Charmaz, 2002; Hakansson, Dahlin-Ivanoff,

& Sonn, 2006; Klinger, 2005). Likewise, the

construct of ‘‘occupational identity,’’ defined by

Kielhofner (2008) as ‘‘a composite sense of who

one is and wishes to become as an occupational

being generated from one’s history of occupa-

tional participation’’ (p. 106), has arisen and been

considered in relation to arenas such as occupa-

tional adaptation and choice (Phelan & Kinsella,

2009; Unruh, 2004). Further, more recent scho-

larship has elaborated on the understanding that

self and identity are continuously constructed and

re-constructed by one’s social relationships, as

mediated through occupation (Charmaz, 2002;

Huot & Laliberte Rudman, 2010; Kuo, 2011;

Phelan & Kinsella, 2009).

The Relationship of Occupation to the

Wider Set of Social Science Constructs

If the theoretical construct of occupation is

capable of adding to the universe of knowledge

about the self, then it must do so over and above

the vast set of previously articulated constructs

and variables that has already been identified by

social scientists as being relevant. Numerous

constructs such as emotion, cognition, attention,

motivation, volition, subjective well-being, per-

ceptions of efficacy, locus of control, coping, and

personality are all intertwined with the self and

the rhythms of daily life in complex ways. Various

combinations of these factors can be drawn upon

to explain why people choose to perform various

occupations, how people experience occupation,

how different occupations affect a person, and so

forth. Consequently, it is a fair question to ask

whether the construct of occupation, as invoked

by occupational scientists, can offer a unique

contribution that goes beyond the understanding

that existing constructs cumulatively provide.

To address this concern about the uniqueness

of an explicit focus on occupation, it is first

necessary to explicate the position of occupation

alongside the above social science constructs. As

described below, we believe that occupation

relates to other constructs in three important

ways by acting as: (a) a recruiter that pulls a set of

attached consequences into play; (b) a servant

that fosters the achievement of important goals

and end states; and (c) a mirror that reflects

the self.

Occupation as a recruiterWhen a person engages in an occupation, he or

she inherits a large amount of attached baggage

intrinsically or coincidentally. In this sense,

occupations usher in an organized conglomera-

tion of self-related consequences such as bodily

alterations, novel cognitions, and affective ex-

periences. For example, a person’s choice of

reading a book versus playing basketball is likely

to dictate his or her ensuing breathing pattern,

arousal level, thought content, bodily position in

space, and emotional state. These alterations are

included as part of a package deal that is

connected to the occupation, and in some cases

may linger long after the completion of the

occupation’s enactment (e.g., due to an exercise-

based injury). In essence, then, an occupation

recruits onto one’s life a host of biological,

psychological, and social consequences that are

reflective of social science constructs such as

volition, attention, emotion, cognition, and so

forth. Further, when performing an occupation,

these ensuing accompaniments are not merely

present, but are organized into a coherent whole

in the support of the occupational performance

(Pierce, 1996). It is also important to stress that

recruited elements do not stem from occupation

considered in isolation, but rather from occupa-

tion as it emerges as the engaged self interacts

with and is constructed through its transaction

with the world (Kuo, 2011).

Primeau’s (1996) analysis of distance running

illustrates how continued participation in an

occupation has multiple ramifications. For exam-

ple, at a physical level, running enhances cardiac

stroke volume, increases pulmonary oxygen up-

take, and increases lean body mass. Additionally,

running is often associated with increased psy-

chological health, relief of tension, and heigh-

tened feelings of well-being. As a whole, Primeau’s

review clearly illustrates the recruitment function

of occupation. In relation to the previously noted

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ocean of social science variables and constructs

related to the self, occupation can function as a sea

current that pulls in and organizes a host of

elements within a person’s life.

Occupation as a servantOccupation can also be understood as a servant in

relation to social science constructs pertaining to

the self. Because occupations often represent

choices for filling one’s time through doing, they

frequently are performed as a means of achieving

overarching organismic aims such as survival or

broadly based personal goals such as being

physically fit or living a spiritual life. For

example, playing softball or attending a party

may contribute to an individual’s attempt to attain

a fuller social life. Further, a given occupation

may simultaneously contribute to more than one

broad-based outcome, such as when a person

sings in the church choir to fulfill both spiritual

and social ends. In its role as a servant, occupa-

tion enables an individual to reach upward to

satisfy goals that typically exist at a higher level

than the occupation itself.

The capacity of occupation to function as a

servant is not necessarily linked to any conscious

attempt by a person to satisfy a higher goal. For

example, a person who spends copious amounts

of time volunteering for charities in order to

experience feeling wanted, or a law enforcement

officer who exercises a need to control others

through a position of authority, may be largely

unaware of his or her inner motivations. As seen

in these hypothetical examples, the individua-

lized end states in question, as well as the types of

occupations capable of fulfilling them, vary

greatly on a person-to-person basis.

There is substantial support in the occupational

science literature for the premise that occupation

can function as a servant. Wilcock (1998a), for

instance, proposed that humans are prewired to

pursue occupation as a means of promoting

health and survival. Likewise, the performance

of personally valued occupations has been hy-

pothesized by occupational scientists to be a key

route to the achievement of a sense of meaning

(e.g., Clark, 1993). In demonstration of this, an

ethnographic study of exemplary older adults

revealed how their occupations are selected and

experienced in such a manner as to foster a sense

of meaning and fulfillment (Jackson, 1996).

Other research has shown that, through occupa-

tion, people maintain a sense of identity that is

acceptable to them and, following illness or

disability, strive to achieve a sense of continuity

with their previous lives (Laliberte Rudman,

2002; Unruh, 2004).

Occupation as a mirrorApart from pulling along various accompaniments

and enabling progress toward the fulfillment of

higher ends, occupations relate to social science

constructs in a third way by acting as a mirror that

reflects key aspects of an individual’s being,

including personality traits, attitudes and values,

motivational concerns, emotions, and more im-

mediate ongoing processes such as mood states.

Consciously or subconsciously, the selection and

style of performing occupations is often imprinted

with the unique stamp of a person’s self. For

example, vocational choices reflect the public

aspect of one’s identity, and occupations such as

leisure interests tend to reveal more of a person’s

private identity (Unruh, 2004).

A multitude of personal considerations infuse this

mirroring aspect of occupation, including, for

example, physical ability, intelligence, locus of

control, religious beliefs, present state of alert-

ness, cultural background, attitudes and values,

extent of creativity, capacity for sustained atten-

tion, and current hunger level. This reflective

dimension of occupation can be easily observed

by noting how different people who are engaged

in the same occupation often display different

motivational orientations, tension levels, perfor-

mance tempos, facial expressions, and so forth.

As Laliberte Rudman (2002) denoted, occupation

is a means through which individuals reveal and

demonstrate their core characteristics, both to

themselves and to others.

The important role of personality in affecting

multiple aspects of participation in occupation

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JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014 121

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exemplifies how occupation can serve as a mirror

of the self. As a construct related to the self,

personality can be defined as ‘‘dimensions of

individual difference in tendencies to show con-

sistent patterns of thoughts, feelings and actions’’

(McCrae & Costa, 1990, p. 23). Differences in

personality are presumed to produce characteristic

adaptations that can affect the occupations in

which an individual participates, as well as the

style of performing them (Costa, Metter, &

McCrae, 1994; McHale, Kim, Dotterer, Crouter,

& Booth, 2009). For example, the trait of neuroti-

cism can steer a person away from choosing

healthful or adventurous activities, and can addi-

tionally saturate a person’s occupational experience

with fear, sadness, or other negative emotions.

The self-mirroring aspect of occupation is very

important because it indirectly leads to many of

occupations’ most powerful outcomes. Because

the characteristics of the in-context self affect both

(a) which occupations are selected and (b) the

manner or style of performing occupations, the

mirroring dimension has a strong indirect influ-

ence on both the recruitment and service aspects

of occupation. The implication of this is that

occupation represents an important vehicle

whereby the self becomes translated into many

of the key facets of a person’s existence. This is

consistent with Christiansen’s (1999) proposition

that occupation is the mechanism through which

people both construct and express their identities.

As a hypothetical example of the mirroring

dynamic, consider the case of a man whose

personality is marked by risk-taking tendencies.

In his younger days, this core aspect of his self

was reflected through occupations such as skate-

boarding and impulsive financial ventures. Later

in life, he takes up motorcycle riding and rides in

a reckless manner, which eventually results in a

serious crash. His occupational choice of motor-

cycle riding and the careless manner in which he

performed it have closely mirrored his person-

ality. Once enacted, the particular occupation,

in concert with the reckless manner in which

it was performed, both (a) served to fulfill his

deep-seeded need to experience intense emotion,

and (b) recruited changes into his life, including a

trip to the hospital ward and a lingering frustra-

tion with his new physical limitations. In a cyclic

manner, many of the changes brought on by the

occupation-linked mishap are likely to subse-

quently alter the man’s set of personal character-

istics and circumstances, an outcome potentially

capable of influencing future occupational en-

gagement. In accordance with this analysis, we

believe that numerous life outcomes are strongly

influenced by the ability of occupation to channel

self-relevant predispositions into concrete spatio-

temporal manifestations (i.e., through occupa-

tion), which in turn lead to avalanches of

congruent consequences in people’s lives.

The Unique Contribution of Occupation

As described in the previous section, in relation to

other constructs occupation plays an important

mediating role through which the self is con-

nected to both short-term and long-term life

choices and outcomes. On a simplistic level, it

might be argued that occupations are largely

peripheral to life outcomes, which are in actuality

inevitably linked to personal characteristics. For

example, a chronically psychosomatic individual

might experience a debilitating headache irre-

spective of whether she engages in gardening,

reading, or watching television.

In addressing this issue, we acknowledge that

occupation sometimes does play a minor role in

relation to other self-relevant forces. However,

there are reasons why the influence of occupa-

tions commonly looms much larger. First, in

accordance with their recruitment dimension,

occupations have their own important character-

istics that are substantially similar across different

individuals or different cultures. For nearly every-

one, running marathons will lead to soreness and

fatigue, and as mentioned above, reckless motor-

cycle riding entails the possibility of serious

injury. In light of the heterogeneity among people

who engage in these occupations, such common

outcomes cannot possibly be a mere reflection of

those who choose to perform them. Therefore, to

at least some degree, specific occupations induce

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122 JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014

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novel contributions into a person’s life that

extend beyond the self. Second, the bulk of key

self-relevant outcomes are not inflexibly linked to

a person’s character or to a constant environ-

mental situation, but rather stem from person-

environment-behavior interactions and are hence

influenced by the choice and style of performing

occupations. In sum, because (a) the same

occupation can influence different people in a

similar manner, and (b) different occupations

invoke different experiences for the same person,

any attempt to fully comprehend the engaged self

must include consideration of the unique con-

tributory role of occupation.

The Substantive Impact of Occupation on SelfDevelopmentIt is possible to identify several distinct patterns of

influence whereby occupations directly affect the

development of the self. In some instances, occupa-

tions can serve as enhancers, bringing out latent

abilities and offering chances for growth. Occupa-

tional therapy interventions that promote improved

occupational performance and quality of life in

older adults (e.g., Wilkins, Jung, Wishart, Edwards,

& Norton, 2003), for example, emphasize the role

of occupation as an enhancer. In a like vein,

Laliberte Rudman (2002) noted the example of a

widow who experienced an enhanced sense of

being independent as a result of engaging in a

support group. In an opposite way, occupations can

serve as mufflers within a person’s life, dampening

his or her potential. In such cases, as exemplified by

an individual who habitually watches an excessive

amount of television alone and as a result experi-

ences a sense of stagnation and isolation, the seeds

of personal growth have fallen on rocky, unfertilized

soil (e.g., Hamer, Stamatakis, & Mishra, 2010;

Hammermeister, Brock, Winterstein, & Page,

2005; Page, Hammermeister, Scanlan, & Allen,

1996; Williams, Sallis, Calfas, & Burke, 1999).

Third, occupations can function as surprisers by

producing unexpected, but profound, conse-

quences relevant to the self. An active woman

who incurs a spinal cord injury resulting from a

rock climbing fall, as well as a gang member who

experiences increased self-esteem following the

discovery of previously unsuspected artistic talent,

are both recipients of unexpected occupation-based

consequences. Thus occupation, per se, has an

important, direct influence on the development of

the self. We further posit below that occupations

have at least three key characteristics that power-

fully magnify their role in human life and the self.

The ‘‘In-your-face’’ character of occupationIn performing many occupations, such as mow-

ing the lawn, engaging in sex, or playing

competitive sports, people enter into a profound

immediacy of direct experience which is orga-

nized around what they are doing. Not only are

various physical, emotional, and cognitive states

recruited into direct awareness, but on many

occasions these concomitant conditions possess

an exceptionally high degree of salience. Con-

sider the case of mowing the lawn. In performing

this occupation, the deafening sounds and the

vibrating sensations caused by the power mower,

the smell of freshly cut grass, and the pain of a

newly emergent blister can cumulatively mono-

polize one’s consciousness. Elliott’s (2011) vivid

description of her experience hiking in Nepal,

where she was acutely mindful of her body, her

breathing, and her sense of awe at the beauty

surrounding her is a wonderful example of the in-

your-face character of occupation. This experien-

tial salience differentiates occupation from many

other social science constructs, which tend to be

less tightly linked to immediate awareness.

Although such background constructs as locus

of control, intelligence, culture, level of physical

fitness, mood, and achievement motivation may

set the stage for transactions between the self and

the world, the particular occupation that people

are engaged in typically represents the main show

upon which their consciousness is situationally

focused. In this regard, the in-your-face character

of occupation acts to magnify the potency of

occupation’s role in human life.

Occupations as life menu optionsIn choosing to perform an occupation, oftentimes

an individual selects an option from a hypothe-

tical menu of possible ways to fill his or her time.

Analogous to a hiker who comes to a fork in the

trail, the choice of which occupation to perform

can significantly alter the subsequent course of a

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person’s life (e.g., through the recruitment dimen-

sion). Minimally for the initial time period during

which an occupation is performed, and some-

times to the point of becoming a dominant theme

that stretches over a person’s entire lifespan, by

initiating an occupation a person carves out an

individualized niche that may have powerful,

lasting self-definitional effects.

The occupational choice process can reflect

different degrees of generality. For example, a

person can select what to do at the immediate

moment, what to do in the weeks or months

ahead (as in choosing a new hobby), or what to

do for his or her career. At the time of menu

selection, occupation in its conceptual, culturally

labeled sense is the object of consideration. Once

the occupation is initiated, the individual enters a

new zone of being, and the occupation initiates a

set of complexly intertwined changes of personal

relevance. By virtue of selecting one occupation

as opposed to another, a host of alternate personal

histories have been nullified, and a new reality is

forged that can have significant consequences on

the self.

We also recognize that at times, people do not

have the ability to, or are prevented from,

choosing occupations. Townsend and Wilcock’s

(2004) scholarship in occupational injustice in

particular has increased understanding of the

ways that participation in occupation is ‘‘barred,

confined, restricted, segregated, prohibited, un-

developed, disrupted, alienated, marginalized,

exploited, excluded or otherwise restricted’’

(Townsend & Wilcock, 2004, p. 77) through

forces outside of people’s control. When this

occurs, the menu of occupations is likewise

restricted and the development of a person’s self

is impacted in negative ways (Laliberte Rudman,

2002; Whiteford, 2000).

Occupation’s repetitional flavorBeyond their general salience and their ability to

steer people’s lives in a given direction, occupa-

tions are important because they tend to be

repeated over time. The reasons for their repeti-

tion are varied and include such considerations as

the enactment of a personal routine, external

rewards, personality predilections, social role

requirements, and the ‘‘call’’ or commitment

individuals feel towards engaging in certain

occupations (Reed, Hocking, & Smythe, 2011).

As the objects of repetition, occupations are like

riverbeds on the landscape of human lives. As the

progressive channeling of water into a series of

riverbeds determines where water will be directed

in the future, continued engagement in a given

occupation serves to deeply define the substance

of the individual’s situated life and, hence, can

powerfully affect the development of the self

(Charmaz, 2002).

In considering the personal histories of accom-

plished individuals such as Albert Einstein, Serena

Williams, or Thomas Aquinas, it is obvious that

persistent engagement in a personally fulfilling

occupation can have profound effects. On the

other hand, continued repetition of occupations

experienced by an individual as unfulfilling, such

as when a person labors in a tedious repetitive job,

may lead to lives colored by a personal sense of

stagnation (Mitchell, 1988). Thus, the strong

potential for occupations to be repeated impor-

tantly magnifies their role in people’s lives.

Implications for Understanding the Self: Occupationas a Playing FieldFigure 2 overviews the dimensions of occupation

that we have outlined thus far and summarizes

their cumulative force by suggesting that occupa-

tion represents a playing field upon which the

self interactively transacts with the world. Based

on its status as a recruiter and servant, occupa-

tion has the capacity to instill significant changes

in people’s lives and contribute towards the

pursuit of higher goals and end states; in

addition, occupations manifest various amplify-

ing characteristics that can powerfully affect the

life course and the development of the self.

Therefore, in a broad sense occupation is a

critical playing arena in which a person’s hopes,

dreams, personal shortcomings, fears, talents and

abilities, and insecurities intermingle with, by

both changing and being changed by, the ex-

ternal world. The playing field of occupation is

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largely ‘‘where things happen’’ within the sphere

of everyday existence.

Whereas occupation in its general sense can be

likened to a playing field, the specific nature of

this arena corresponds to concrete occupational

performances. In this vein, occupational playing

fields differ significantly from culture to culture,

from person to person, and from occasion to

occasion. Because occupation is invested with a

high degree of personal meaning, and because it

is influenced by a host of nuances pertaining to

the self in relation to the environment, across

different contexts the nature of the playing field

varies according to the type of game, the

rules, the audience, the affective tone, or the

anticipated outcome. For example, for one per-

son the occupation of public speaking will be a

dark, nightmarish playing field, with mocking

demons filling the stadium seats and success

being defined as the ability to perform without

any humiliating disasters. To another person the

same externally defined speaking engagement

will be a sunny playing field surrounded by a

stadium filled with cheering fans, providing the

self not only an opportunity to succeed, but to

dazzle the audience.

In connection with their relationship to person-

ally created themes, the playing fields of occupa-

tion reflect varying degrees of urgency. When the

outcome of the ensuing event is in doubt and

when the stakes are high, such as when a graduate

student must defend a marginal dissertation

before a stern doctoral committee, the occupa-

tional performance will be extremely intense and

personally meaningful. In contrast, if an occupa-

tion becomes routine or otherwise fails to con-

tribute significantly to variance in life outcomes,

its meaning can wane for a person and a

lackluster performance can result.

In highlighting the role of occupation as a playing

field, we are not claiming that all significant life

Occupation1. Purposeful and Goal Directed

Doing2. Conscious and Intentional3. Temporally, Historically, and

Socio-culturally Situated4. Personally Meaningful

Relation to Other Constructs

1. Recruiter2. Servant3. Mirror

Amplifying Characteristics

1. “In-Your-Face” Quality2. Life Menu Option3. Repetitional Flavor

Occupation as Playing Field: Self Interacts with the World in Space and

Time

Figure 2: Summary of Occupation’s Dimensions Relative to the Engagement of the Self in Everyday Life

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outcomes are determined by participation in

occupation. Non-occupational considerations

such as being victimized by child abuse, under-

going a religious conversion, or deciding to

move to a foreign country all have obviously

important ramifications within human lives and

self-development. Although we do not view occu-

pation as an exclusive playing field for the

determination of self-relevant outcomes, we none-

theless believe that its extent of cumulative

influence is profound. Within the realm of the

self as engaged in everyday life, occupations

provide crucial and primary contexts in which

personal concerns and outcomes play out.

Limitations and Future Area of Analysis

Recent critical thought in occupational science

has brought to light limitations in considering

occupation and the self from an individualistic

level of analysis, as neither occupation nor the

self arise solely from the individual, but rather

from a transactional world where the person

and his or her context are inseparable (Dickie

et al., 2006; Phelan & Kinsella, 2009). In this

paper, we have admittedly placed considerable

emphasis on the individual self and its interac-

tion with occupation, as the individual is an

integral piece of any understanding of person-

occupation-environment interaction. However,

we believe that further analysis of how occupa-

tion relates to the self, undertaken from a

‘‘situation level’’ of analysis (Dickie et al.,

2006), would be a valuable addition to occupa-

tional science.

Summary and Conclusions

In this paper we have attempted to more clearly

articulate the position of occupation in relation to

the self. Commonly, occupations connect to self-

relevant explanatory variables in at least three

ways: (a) they recruit a set of associated changes

into a person’s life; (b) they serve a person’s ability

to achieve important goals or end states; and (c)

they act as a mirror by reflecting multiple

dimensions of the self. Because occupations are

prominent in people’s consciousness, function as

crucial decision points, and are highly subject to

repetition, their effects can be profound. In a very

important sense, therefore, occupations serve as

the playing field on which, at an everyday level,

the self transacts in time and space with the

external world.

We believe that the analysis presented in this

paper contributes to occupational science by

further unpacking the intricate ways in which

occupation enacts a powerful influence on self-

development and meaningful life outcomes.

Potentially fertile areas for future study in-

clude the social-cultural aspects of the occupa-

tional playing field, the role of occupational

injustice in its various forms on the self, and,

as discussed above, the consideration of occu-

pation and the self from a transactional

perspective.

REFERENCES

Asaba, E., & Jackson, J. (2011). Social ideologies

embedded in everyday life: A narrative analysis

about disability, identities, and occupation.

Journal of Occupational Science, 18, 139�152.

doi:10.1080/14427591.2011.579234

Baumeister, R. F. (2011). Self and identity: A brief

overview of what they are, what they do, and

how they work. Annals of the New York Academy

of Sciences, 1234, 48�55. doi:10.1111/j.1749-

6632.2011.06224.x

Carlson, M., & Dunlea, A. (1995). Further

thoughts on the pitfalls of partition: A response

to Mosey. American Journal of Occupational

Therapy, 49, 73�81. doi:10.5014/ajot.49.1.73

Charmaz, K. (2002). The self as habit: The

reconstruction of self in chronic illness.

OTJR: Occupation, Participation and Health,

22(Suppl. 1), S31�S41.

Christiansen, C. H. (1999). Defining lives: Occu-

pation as identity: An essay on competence,

MIKE CARLSON, DANIEL J . PARK, ANN KUO & FLORENCE CLARK

126 JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014

Dow

nloa

ded

by [

Uni

vers

ity o

f N

orth

Dak

ota]

at 2

1:58

19

Dec

embe

r 20

14

coherence and the creation of meaning, 1999

Eleanor Clarke Slagle Lecture. American Journal

of Occupational Therapy, 53, 547�558.

doi:10.5014/ajot.53.6.547

Clark, F. (1993). Occupation embedded in a real

life: Interweaving occupational science and

occupational therapy, 1993 Eleanor Clarke

Slagle Lecture. American Journal of Occupational

Therapy, 47, 1067�1078. doi:10.5014/

ajot.47.12.1067

Clark, F. (2006). One person’s thoughts on the

future of occupational science. Journal of Occu-

pational Science, 13, 167�179. doi:10.1080/

14427591.2006.9726513

Clark, F., & Larson, E. A. (1993). Developing an

academic discipline: The science of occupation.

In H. L. Hopkins & H. D. Smith (Eds.), Willard

and Spackman’s occupational therapy (8th ed., pp.

44�57). Philadelphia, PA: Lippincott.

Clark, F. A., Parham, D., Carlson, M. E., Frank,

G., Jackson, J., Pierce, D., . . . Zemke, R. (1991).

Occupational science: Academic innovation in

the service of occupational therapy’s future.

American Journal of Occupational Therapy, 45,

300�310. doi:10.5014/ajot.45.4.300

Costa, P. T., Metter, E. J., & McCrae, R. R. (1994).

Personality stability and its contribution to

successful aging. Journal of Psychiatry, 27, 41�59.

Dickie, V. A. (2003). The role of learning in quilt

making. Journal of Occupational Science, 10,

120�129. doi:10.1080/14427591.2003.9686519

Dickie, V., Cutchin, M. P., & Humphry, R. (2006).

Occupation as transactional experience: A cri-

tique of individualism in occupational science.

Journal of Occupational Science, 13, 83�93.

doi:10.1080/14427591.2006.9686573

Diener, E., & Seligman, M. E. P. (2002). Very

happy people. Psychological Science, 13, 81�84.

doi:10.1111/1467-9280.00415

Dulin, P. L., & Hill, R. D. (2003). Relationships

between altruistic activity and positive and

negative affect among low-income older adult

service providers. Aging and Mental Health, 7,

294�299. doi:10.1080/1360786031000120697

Elliott, M. L. (2011). Being mindful about mind-

fulness: An invitation to extend occupational

engagement into growing mindfulness dis-

course. Journal of Occupational Science, 18,

366�376. doi:10.1080/14427591.2011.610777

Galvaan, R. (2012) Occupational choice: The

significance of socio-economic and political

factors. In G. E. Whiteford & C. Hocking

(Eds.), Occupational science: Society, inclusion,

participation (pp. 152�162). Oxford, UK: Wiley-

Blackwell. doi:10.1002/9781118281581.ch11

Gray, J. M. (1997). Application of the phenom-

enological method to the concept of occupa-

tion. Journal of Occupational Science, 4, 5�17.

doi:10.1080/14427591.1997.9686416

Hakansson, C., Dahlin-Ivanoff, S., & Sonn, U.

(2006). Achieving balance in everyday life.

Journal of Occupational Science, 13, 74�82.

doi:10.1080/14427591.2006.9686572

Hamer, M., Stamatakis, E., & Mishra, G. D.

(2010). Television-and screen-based activity

and mental well-being in adults. American

Journal of Preventive Medicine, 38(4), 375�380.

doi:10.1016/j.amepre.2009.12.030

Hammermeister, J., Brock, B., Winterstein, D., &

Page, R. (2005). Life without TV? Cultivation

theory and psychosocial health characteristics of

television-free individuals and their television-

viewing counterparts. Health Communication,

17(3), 253�264. doi:10.1207/s15327027hc17

03_3

Harvey, A. S., & Pentland, W. (2004). What do

people do? In C. Christiansen & E. Townsend

(Eds.), Introduction to occupation: The art and

science of living (pp. 63�90). Upper Saddle

River, NJ: Prentice Hall.

Hinojosa, J., Kramer, P., Royeen, C. B., & Luebben,

A. J. (2003). Core concept of occupation. In

P. Kramer, J. Hinojosa, & C. Royeen (Eds.),

Perspectives in human occupation (pp. 1�17).

Philadelphia, PA: Lippincott Williams & Wilkins.

Hocking, C. (2009). The challenge of occupation:

Describing the things people do. Journal of

Occupational Science, 26, 140�150.

doi:10.1080/14427591.2009.9686655

Hultsch, D. F., Hertzog, C., Small, B. J., & Dixon,

R. A. (1999). Use it or lose it: Engaged lifestyles

as a buffer of cognitive decline in aging.

Psychology and Aging, 14, 245�263.

doi:10.1037/0882-7974.14.2.245

MIKE CARLSON, DANIEL J . PARK, ANN KUO & FLORENCE CLARK

JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014 127

Dow

nloa

ded

by [

Uni

vers

ity o

f N

orth

Dak

ota]

at 2

1:58

19

Dec

embe

r 20

14

Huot, S., & Laliberte Rudman, D. (2010). The

performances and places of identity: Concep-

tualizing intersections of occupation, identity

and place in the process of migration. Journal of

Occupational Science, 17, 68�77. doi:10.1080/

14427591.2010.9686677

Jackson, J. (1996). Living a meaningful existence

in old age. In R. Zemke & F. Clark (Eds.),

Occupational science: The evolving discipline

(pp. 339�361). Philadelphia, PA: F.A. Davis.

Jarman, J. (2004). What is occupation? Interdis-

ciplinary perspectives on defining and classify-

ing human activity. In C. H. Christiansen &

E. A. Townsend (Eds.), Introduction to occupa-

tion: The art and science of living (pp. 47�61).

Upper Saddle River, NJ: Prentice Hall.

Kielhofner, G. (2008). Model of human occupation:

Theory and application (4th ed.). Baltimore, MD:

Lippincott Williams & Wilkins.

Klinger, L. (2005). Occupational adaptation:

Perspectives of people with traumatic brain

injury. Journal of Occupational Science, 12, 9�16. doi:10.1080/14427591.2005.9686543

Kuo, A. (2011). A transactional view: Occupation

as a means to create experiences that matter.

Journal of Occupational Science, 18, 131�138.

doi:10.1080/14427591.2011.575759

Laliberte Rudman, D. (2002). Linking occupation

and identity: Lessons learned through qualita-

tive exploration. Journal of Occupational Science,

9, 12�19. doi:10.1080/14427591.2002.9686489

Larson, E. A., Wood, W., & Clark, F. (2003).

Occupational science: Building the science and

practice of occupation through an academic

discipline. In E. Crepeau, E. Cohn & B. Schell

(Eds.), Willard and Spackman’s occupational

therapy (10th ed., pp. 15�26). Philadelphia,

PA: Lippincott Williams & Wilkins.

Levasseur, M., Desrosiers, J., & St-Cyr Tribble, D.

(2008). Do quality of life, participation and

environment of older adults differ according to

level of activity? Health and Quality of Life

Outcomes, 6(1), 30, 1�11.

McCrae, R. R., & Costa, P. T. (1990). Personality

in adulthood. New York: Guilford.

McHale, S. M., Kim, J. Y., Dotterer, A. M.,

Crouter, A. C., & Booth, A. (2009). The

development of gendered interests and person-

ality qualities from middle childhood through

adolescence: A biosocial analysis. Child

Development, 80, 482�495. doi:10.1111/j.1467-

8624.2009.01273.x

Mitchell, R. G. (1988). Sociological implications

of the flow experience. In M. Csikszentmihalyi

& I. Csikszentmihalyi (Eds.), Optimal experi-

ence: Psychological studies of flow in consciousness

(pp. 36�59). New York: Cambridge University

Press.

Nelson, D. L. (1988). Occupation: Form and

performance. American Journal of Occupational

Therapy, 42, 633�641. doi:10.5014/ajot.42.10.

633

Owens, T. J. (2003). Self and identity. In

J. Delamater (Ed.), Handbook of social

psychology (pp. 205�232). New York: Kluwer.

doi:10.1007/0-387-36921-X_9

Page, R. M., Hammermeister, J. J., Scanlan, A., &

Allen, O. (1996). Psychosocial and health

related characteristics of adolescent television

viewers. Child Study Journal, 26, 319�331.

Phelan, S., & Kinsella, E. A. (2009). Occupational

identity: Engaging socio-cultural perspectives.

Journal of Occupational Science, 16, 85�91.

doi:10.1080/14427591.2009.9686647

Pierce, D. (1996). The work of scholars. In

R. Zemke & F. Clark (Eds.), Occupational

science: The evolving discipline (pp. 125�141).

Philadelphia, PA: F.A. Davis.

Pierce, D. (2001). Untangling occupation and

activity. American Journal of Occupational

Therapy, 55, 138�146. doi: 10.5014/

ajot.55.2.138

Pierce, D., Atler, K., Baltisberger, J., Fehringer, E.,

Hunter, E., Malkawi, S., & Parr, T. (2010).

Occupational science: A data-based American

perspective. Journal of Occupational Science, 17,

204�215. doi:10.1080/14427591.2010.9686697

Primeau, L. (1996). Running as an occupation:

Multiple meanings and purposes. In R. Zemke

& F. Clark (Eds.), Occupational science: The

evolving discipline (pp. 275�286). Philadelphia,

PA: F.A. Davis.

Reed, K., Hocking, C., & Smythe, L. (2010). The

interconnected meanings of occupation: The

call, being-with, possibilities. Journal of Occupa-

MIKE CARLSON, DANIEL J . PARK, ANN KUO & FLORENCE CLARK

128 JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014

Dow

nloa

ded

by [

Uni

vers

ity o

f N

orth

Dak

ota]

at 2

1:58

19

Dec

embe

r 20

14

tional Science, 17, 140�149. doi:10.1080/

14427591.2010.9686688

Riley, J. (2011). Shaping textile-making: Its

occupational forms and domain. Journal of

Occupational Science, 18, 322�338.

doi:10.1080/14427591.2011.584518

Royeen, C. B. (2002), Occupation reconsidered.

Occupational Therapy International, 9, 111�120.

doi:10.1002/oti.159

Townsend, E., & Wilcock, A. (2004). Occupa-

tional justice and client-centred practice: A

dialogue in progress. Canadian Journal of Occu-

pational Therapy, 71, 75�87.

Unruh, A. M. (2004). Reflections on: ‘‘So . . . what

do you do?’’ Occupation and the construction of

identity. Canadian Journal of Occupational

Therapy, 71, 290�295.

van Nes, F., Runge, U., & Jonsson, H. (2009). One

body, three hands and two minds: A case study

of the intertwined occupations of an older

couple after a stroke. Journal of Occupational

Science, 16, 194�202. doi:10.1080/14427591.

2009.9686662

Vrkljan, B. H., & Polgar, J. M. (2007). Linking

occupational participation and occupational

identity: An exploratory study of the transition

from driving to driving cessation in older

adulthood. Journal of Occupational Science, 14,

30�39. doi:10.1080/14427591.2007.9686581

Werngren-Elgstrom, M., Brandt, A., & Iwarsson, S.

(2006). Everyday activities and social contacts

among older deaf sign language users: Relation-

ships to health and well-being. Occupational

Therapy International, 13, 207�223. doi:10.

1002/oti.218

Whiteford, G. (2000). Occupational deprivation:

Global challenge in the new millennium. British

Journal of Occupational Therapy, 63, 200�204.

Wilcock, A. A. (1998a). An occupational perspec-

tive of health. Thorofare, NJ: Slack.

Wilcock, A. A. (1998b). Reflections on doing,

being and becoming. Canadian Journal of Occu-

pational Therapy, 65, 248�257.

Wilkins, S., Jung, B., Wishart, L., Edwards, M., &

Norton, S. G. (2003). The effectiveness of

community-based occupational therapy educa-

tion and functional training programs for older

adults: A critical literature review. Canadian

Journal of Occupational Therapy, 70, 214�225.

Williams, C. D., Sallis, J. F., Calfas, K. J., &

Burke, R. (1999). Psychosocial and demographic

correlates of television watching. American

Journal of Health Promotion, 13, 207�221.

doi:10.4278/0890-1171-13.4.207

Yerxa, E. J., Clark, F., Frank, G., Jackson, J.,

Parham, D., Pierce, D., . . . Zemke, R. (1989). An

introduction to occupational science: A founda-

tion for occupational therapy in the 21st cen-

tury. Occupational Therapy in Health Care, 6(4),

1�17. doi:10.1080/J003v06n04_04

Zemke, R., & Clark, F. (Eds.). (1996).

Occupational science: The evolving discipline.

Philadelphia, PA: F.A. Davis.

MIKE CARLSON, DANIEL J . PARK, ANN KUO & FLORENCE CLARK

JOURNAL OF OCCUPATIONAL SCIENCE, Vol . 21 , No. 2 , 2014 129

Dow

nloa

ded

by [

Uni

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ity o

f N

orth

Dak

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at 2

1:58

19

Dec

embe

r 20

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