Adapting to Deficiency: Addiction and the Therapeutic Power of Occupation

Occupational therapy (OT) has been greatly influenced by the medical model, despite its origins as an alternative to medicine. OT practice that finds its theoretical basis in a medical model is criticized as limited in therapeutic value, and as lacking boundaries distinguishing OT from other disciplines. By advancing a philosophical anthropology (Gehlen) with biological evidence from detachment theory (Moss), this project identifies and illuminates the power and unique value of occupational therapy. Occupational participation, made possible by OT, is described as a tool for structuring human lives into manageable temporal components with varying degrees of motivation and social interconnection. The value of providing opportunities for occupational participation is described as analogous to the value of instincts in animals’ lives; occupations are seen as the core elements that drive and shape human experiences. The inadequacies of current definitions of and research on addiction are reviewed and, as an alternative to current approaches, an occupational model for understanding addiction is outlined. Addiction is described as an attempt to create a manageable life—that is, as an occupation, and the concept of focused flexibility is introduced to normatively distinguish ‘addiction-occupations’ from other, potentially more ‘healthy’ occupations. Health is discussed in relation to the proposed philosophical anthropological, social, and biological situation of human beings. Finally, a qualitative study is undertaken to examine whether an occupational model of addiction accurately describes the experiences of addicts, thereby warranting further research. Findings from this preliminary study suggest addiction is experienced as an occupation, and that the concept of addiction as an occupation should be further explored