Occupation as an agent of social transformation and intercultural dialogue: the historical concept of occupation, Gramsci, oral culture and lore.
Nick Pollard
[email protected]
Aim: • To explore whether the current social transformational discourse in occupational therapy can benefit from the cultural theory of Antonio Gramsci
If one of the elements of our human nature is our occupational engagement with the world around us then all people have the potential to play a transformational role in the society around them.
“The human being is a naturally political animal”
The 'new intellectual, a term which potentially includes occupational therapists as professionals, has to become
“an active [participator] in practical life, as constructor, organiser, 'permanent persuader‘ and not just a simple orator" Aristotle
Gramsci
Gramsci said… A ‘new intellectual’ as a member of ‘the political society’ or the ‘civil society’ depending on which sector (state or private) the occupational therapist is employed in, has certain functions to carry out as the mediator of state care, or entitlements to forms of treatment or state benefits, occupies a position that sets him or her apart from the clients or service users.
…so an occupational therapist is part of the framework, the status quo, which supports disabling conditions... the challenge for an occupational therapist is to recognise how their situation enables them to work with their clients but also contains aspects that work against their clients
Gramsci also said…
“transformational processes are difficult, full of contradictions, and set backs which test the loyalty of the masses” (for example service users with different cultural perspectives).
…and might have said the most a transformation through occupation would produce is a passive revolution, in which reform occurs but the underlying class relationships which determine occupational deprivations and occupational injustice remain?
Who was Gramsci? He doesn’t feature much in occupational therapy literature, but was an Italian communist party leader who was imprisoned by Mussolini’s fascist government in1926, and released just before his death in 1937. The majority of his philosophical writing was produced in prison, and published posthumously. Gramsci has been a significant influence in the critique of culture, history, politics and sociology whose value has been to recognise the value of accommodating debate, difference, and adaptability to different contexts.
Does his thought offer a process of critical consciousness and intercultural dialogue that speaks to occupational therapy's emerging role and the new partnerships it will develop?
We are working in new and changing contexts
Boundaries in health and social care are being redrawn; new types of workers take on the roles connected with occupation that had previously been developed by therapists; occupational therapy has to work out where it sits. Occupational therapists have been: •reappraising their roles and reinventing themselves, •responding to the occupational needs of a culturally diverse society, •reasserting social and transformational values in the profession •and recognising the complexities underpinning occupational science.
But upholding the value of occupation and setting occupational goals has become a struggle which some practitioners are taking outside the framework of care and into the community at large. If the roots of occupational therapy are in transformational practices and social action then they are also embedded in an intercultural dialogue or process.
Vernacular and narrative A key factor in the spread and the developing awareness of the profession is its strong narrative element. Often people become occupational therapists not because they have read about the profession somewhere but because they meet one.
Professions such as nursing and medicine out-number allied health professions, command greater resources for education and research and the public imagination through their greater contact with the public. The vernacular understanding
of the hospital experience, the narratives that people tell and expect of each other with their stories of ‘my operation’, does not often include occupational therapists.
Many of the exchanges we have are actually extraprofessional. We are reaching outside our professional base to the world of the client, carer or service user and the communities that they live in. This is an intercultural
exchange, even though we may also belong to the same community when we are out of uniform. The language of these communities is not the technical vocabulary of the interdisciplinary process. Wilcock’s doing, being, becoming and belonging (D+3B) is expressed in the language of daily life – the intercultural exchanges, and
the basis for rapport we have with the other people that we work with are therefore vernacular.
Supposing we could have an intercultural dialogue with Gramsci...
Hmmm…from my interest in linguistics and in folk lore, I’d say the vernacular is important Na then, Tony, mi owd mate, vernacular knowledge from everyday interactions
between professionals, between professionals and clients and perhaps between clients too, telling each other what has happened in the progress of their treatment shares a great deal with the concept of lore, a folk consciousness, and form of tacit knowledge.
The political perception of occupation emerges from the daily experiences of the wider community with whom we work. These experiences are the basis of our questioning of the status quo, of the direction of occupational therapy’s goals of social transformation, or our agency for social change.
…. But these experiences are often ephemeral, for example the oral narrative we use in our everyday lives, but it is from a different culture: we have learned
not to respect or value oral testimony as much as written and researched evidence with its veneer of objectivity. “the value of autobiography is in the depiction of life in action, and the differences it reveals from the norms or laws of history and culture” In the UK, there have been many working class autobiographies, which write down this everyday oral narrative
The Good Soldier Svejk (Hasek) My story is all about getting around the norms of history, just an ordinary bloke caught up in a Great War and trying to survive
... these working class autobiographies are about what people really did while the official history was going on. Many were written because ordinary people are left out of history: they wanted to write their own For example La Perruque (the wig) – in English “the wangle”. Like Svejk, here fighting a war, but really drinking a beer. In beer there is truth. ... Right, Michel, this is my truth. Vernacular strategies are an inevitable
De Certeau
result of occupational adaptation to being managed and controlled – we all seek to cut a corner here and there to get a job done a bit quicker, so we can have a life.
Professional culture…
…is distinct from a working class culture.
Autobiographical material by working people, the kind of story that people will tell you as they recount their occupational history, is part of the real history of human occupation, but
is not part of the popular cultural discourse. Yet, paradoxically it underpins so much of the culture we live on and what our culture depends on.
It’s a real history that we already know, if only we could listen to ourselves talking.
So this working class narrative is in written autobiographies that were produced after my time, Paolo Well, it's been going on a while, but after my pedagogy of the oppressed community literacy movements, oral history groups, and other writing groups picked up some of the ideas and began working with people to develop critical literacies and literatures They started writing and publishing their own stories. Have a look at Morley and Worpole, or ask Nick later.
As we said before, the political perception of occupation emerges from the daily experiences of the wider community with whom we work. These experiences are the basis of our questioning of the status quo, of the direction of occupational therapy’s goals of social transformation, or our agency for social change.
But, our training comes from here… And we might carry out our occupational lives here… … or perhaps here…. Brenda Beagan (2007) found that working class students often feel the pressure to be ‘middle class’, both from the dominant culture or the lack of comprehension from their student peers. When they talk in the academic environment about everyday things that arise from their social background this pressure silences them.
Professional culture…
…is distinct from a working class culture.
If that is the case, what can you really offer us?
A popular occupational therapy? Occupational therapists might seek to occupy the popular discourse more effectively, position themselves and what they offer in the popular awareness of health and social care services. More popular awareness of the value of occupational
therapy will create more consumer demand for what OT provides. Pow!
We can challenge
lack of occupational choice, lack of things to do, be, or become or belong to – this surely reduces self worth, promotes depression, slows recovery and decreases the horizons of people in virtually every care environment. We know this, its common sense.
It's something everyone talks about...
Intercultural or 'One-size-fits-all' ?
...So an intercultural practice has to incorporate vernacular elements from the occupational forms found in the community. We want to enact our own decisions according to our own needs,
…a one-size-fits-all approach to healthcare doesn’t work.
Through their engagement with human occupation, occupational therapists could be transformational agents, using intercultural dialogue to develop appropriate and negotiated interventions with marginalised groups. Occupational therapists are largely concerned with what people want to do – but we need to argue for the space in which to do it, e.g. with our employers in health and care systems. (See Hammell 2007)
Doing, being, becoming and Belonging (D+B3), and the intercultural tensions of belonging to more than one culture Wilcock d+b to the power of three, it’s the basis of culture.
There is a tension between our professional philosophy and the risk limitation and micro managed culture of our health systems - we often spontaneously
engage our clients, having recognised the need to respond to a situation we have identified with them. One of the keys to this transformational agency is in the narrative element of occupational therapy culture itself. Occupational therapists are aware of the significance of occupations from listening to service users’ stories. Yet as Hocking (2007) and Wilcock (2002) have suggested, we have felt pressured by a demand to prove the medical value of occupation.
Narratives of doing Community publication and worker writing reproduce vernacular forms of English (French, Spanish etc) about ordinary lives. Many of the books have ‘working’ (rather than 'occupation,' or 'occupational') in the title. They describe what people do in their working day and the domestic life they return to in the evening. Many concern ideas of community. This
usually refers to a form of belonging which is expressed through the kind
of things that people do with each other. d+b to the power of three, it’s the basis of culture.
The ways that different occupations underpin the local community
Collectively, such narratives show the way that different working class occupations underpin the local community, from the mortician to the man in the chip shop. As occupational therapists we are also part of that
community. like the hegemonic alliances we form,
the aspects of our culture that we are aware of, own or feel that we belong to are really multilayered Folk lore consists of many such alliances, layerings, or borrowings, people adopt songs for example and reinterpret the lyrics, or adapt the themes of traditional tales to some immediate situation that concerns them. Similarly many aspects of ‘high brow’ culture as well as popular culture consist of borrowings .These are examples of occupations in flow, in a synergistic relationship, rather than a series of vacuum sealed activities.
Occupational therapists as literature sponsors and practical persuaders
Writing, or story telling is about the use of everyday occupational objects and representatives of occupational forms to develop narratives. It involves reflection about purpose and the meaning of doing.
In facilitating such activity an occupational therapist is becoming a “permanent persuader,” someone who is getting people to think about change.
I've called us ‘practical persuaders’ because it suggested doing… …another idea from the field of community literacy is the “literacy sponsor”. This means anyone or any institution which encourages people to develop their use of the written word, whether in their reading or in their thinking about the world around them, that enables them to access literature.
Deborah Brandt
Occupational therapists engaging in an intercultural dialogue
As a literacy sponsor, or a practical persuader the occupational therapist is engaging in an intercultural dialogue. We often encourage people to write about their experiences for therapeutic purposes, but why not write simply because it is about the expression of doing. Such a literature would be testimony to the experience of doing rather than a fictional doing (Ragon 1986; Vincent 1981). People describe their own experiences directly, and their experiences direct the course of the story they tell. Such experiences are often tales of that creative essential aspect of everyday life, De Certeau learning to make do. David Vincent says that rapid changes in human occupation over the last 170 years have encouraged people to record their experiences because their early life was so different to that which was being lived by their grandchildren.
An occupational history without significance? The occupational history of the working classes has not only often been seen as lacking significance, but the pace of change has been such that not only has it been difficult for working people to organise themselves systematically to represent their culture, but much of it has simply been obliterated by progress. Thus a real problem of vernacular culture that Gramsci talks about – a predominantly oral culture, a folk knowledge, is that it is ephemeral and can
appear insignificant. The loss of the oral tradition led middle class folklorists and folk song collectors to record it. It also stimulated working class people to record their experiences, their way of life and the culture that went with it, but this writing has been appropriated by those with more power, access to education, often professionals who assumed authorship of their working class tutee’s work (Vincent 1981, Landry 1986), or the experience has been represented as past history, not current (Bromley 1988).
The problem of the power differential remains though the problems express themselves in different ways.
Vernacular assessment tools The creative elements of occupation, the vernacular form of expressions, are not to be easily rendered in the predetermined categories offered by assessment tools. Instead they are to be discovered in everyday occupations, in forms which are articulated by the communities we work with. Examples might be:
Algado and Cardona's work with Guatamelan Mayan refugees, where different forms of cultural engagement were used to get different generations to work together, for example youths exchanging information about the health effects associated with alcohol with the knowledge older community members had of Mayan traditions. Miranda Pouliopoulou’s theatre work with psychiatric clients in Greece, Kapanadze, Despotashvili and Skhirtladze's work in Georgia with street children, McNulty’s work with local mental health clients in Lincolnshire setting up their own arts organisations, or the Voices Talk, Hands Write group of people with learning difficulties in Grimsby are further examples.
Consciousness raising through intercultural occupations In all of these participants clearly began to set their intercultural occupational agendas, whether:
•adapting the dialogue of the plays they were to perform back in their own villages or •in working a rapport of trust with the OTs and contributing their own poetry and writing to a photography project, or •contributing to the range of arts activities in their own communities. The fulcrum of a process of conscientization can be found in the everyday occupational action of the small p of politics. Cardona (2001) sees politics as expressed through human actions.
Of course, to appreciate this you don’t necessarily need to work through an occupational perception, there are many community organisations run by people with disabilities and cognitive issues, which are just getting on and doing political or consciousness raising work. Not all our service users have this opportunity.
Of 'doing' and 'doing to'… The survival of many vernacular and folkloric practices is largely to do with their utility, perhaps in binding communities together and maintaining their identity, and perhaps also because they are fun. Fun is behind the spread of new folkloric practices involving community giants around Europe. Some of these are related to folk figures such as me, Goliath, at Ath, or other local heroes, and some of them much more modern – one community has a giant customs officer, Henri, and his dog.
Constructing a wickerwork giant and dancing with it around a community would be an ideal occupational therapy and intercultural intervention, and not merely because it would be a revival and reclamation of basketry. Why not a giant occupational therapist?
Practices of Everyday Life Occupational therapists often have trouble in representing what they do with people. It all really seems rather ordinary. Science has to isolate something from ordinary life in order to present it as a science, but this removes it from its context. To make a study of the practice of everyday life is, in effect, to make it other, to create a paradox where the subject becomes an object and loses its point. Occupational therapists do not really have much choice than to work with everyday life. But everyone thinks they can do this.
We should be doing stuff that we really want to do with our clients But what about the paperwork for the management? - we're pushed for time.
Intercultural priorities So - how, what, and with what resources, do we get the messages of occupational therapy practice into the wider everyday world? Given the enormous range of human occupations we might research as treatment media, where do we start? A difficulty in the representation of culture is the range of choice offered by the media available to us. Such is the range of production that there is less onus on us as human beings to do things ourselves and more incentive to buy something pre-packaged. The immense range of personal choices available make it difficult to find common ground with others in the community around us.
In the ‘developed’ world occupation may be becoming less significant than the consumer or ‘lifestyle’ choices that we make and the vernaculars we use as a result. In the poorer sections of the social spectrum it becomes increasingly difficult to catch up with the plethora of choices.
Intercultural communication – or cultural economics?
Doing it naturally Between our vision of change and our ability to implement it is the fact that most of our clients are referred to us by doctors or else have the ability to pay for the services that we offer. The challenge that we continually face is that it is the
ordinary and everyday things that people want to do in order to feel themselves; d+b3 is perhaps ‘doing nothing special’ – but obtaining the level of occupational justice that allows the enjoyment of ‘doing nothing special’ in other words, even to access your own vernacular occupational balance is a significant struggle.
According to D+b3 occupation is natural, part of our human nature and therefore originates in the vernacular experience. Our challenge as ‘new intellectuals’ is to persuade others of the value of the ordinary, the vernacular wisdom that arises from the everyday. We need to empower ourselves and those we work with
through the spontaneous and natural use of what is going on around us. there were no gentlemen around when Adam delved and Eve span. Human beings are naturally constructors, organisers of their environments, they are naturally disposed to lives of action, and actions which are often accommodations, adaptations, or wangles.
Gramsci is often thought of as a rather difficult, obscure theorist, but he can remind us that social transformation through occupation is not an abstract process, it is something that is resourced by the natural skills and abilities that people already possess
Merci!
Dekuji mockrat!
Grazie!
Getting in touch with the vernacular - do this later! Think about your journey here, earlier in the day – perhaps from the time you woke up to arriving here. Write a list (in your preferred language) of ten things you saw, said or smelt, drank or ate, or did. Just write what comes into your head. Then write a sentence for everything in the list –do not think too hard and keep writing even if it is nonsense. Then, on another page, write out a paragraph or a short verse. You can make it rhyme but you don’t have to. Now see what of this you can make into something more considered, but don’t struggle too much for meaning over impression or fit at this stage. Leave your left rational brain out of it and give reign to your creative right brain; once you have another page of writing you need to take the sentences you like and write them out afresh on another page. By this time you are working at your writing, composing, editing, cutting and pasting.
Don’t stop to worry about whether or not it is good, just keep going.
Shush – Mum’s Writing Sit down be quiet read a book Don’t you dare to speak or look Shush Mum’s writing She’s left the dishes in the sink All she does is sit and think Shush Mum’s writing Nothing for dinner nowt for tea And all she ever says to me is Shush Mum’s writing
But what’s all this Mum’s wrote a book Why not buy one have a look No need to shush now we can shout And tell all our friends about MUM’S WRITING
Pat Dallimore
