Briefly . . . A Book and A Blog

Two new excellent resources have been passed on to me by colleagues in the UK.  I share them here.

1.  Susan Corr, professor at the University of Northhampton, called our attention to a new book:  Situating Everyday Life, by Sarah Pink.  I have ordered a copy.  The cover of the book — a view into the inside of a loaded dishwasher — grabs my attention. The chapter titles are equally engaging; here is a sample:

Tracing Neighborhood Flows:  Making a Garden Place

Theorizing the Familiar:  Practices and Places

Beyond doing the Dishes:  Putting Kitchen Practices in Place

The Digital Places of Everyday Life.

The author is a Professor of Social Sciences at Loughborough University.  From my perusal of the book online, it appears that the content is couched in the language and theory of sociology.  Coming from that theoretical perspective, i.e. outside the foundations of occupational theory, can be considered an advantage  — offering us a wider and more expanded approach to the study of everyday occupation.  Such new understandings can be thought of as enriching, in the same way that earning a higher degree in a related field is enriching.  Obviously, we need continued depth and expansion in our occupational theory as well; we need both in order to keep our theory, education, and practice alive and moving forward.

2.  In response to the previous posting about Craig Schuff and his blog “Broken Cord”, Suzanne Martin from the University of Ulster sent me the online address for a second blog written by a person about her life and experiences after a spinal cord injury. 

Melanie Reid is a journalist who writes for The Times UK.  In April of 2010, Melanie sustained a riding accident.  From what I viewed on her blog, it seems many of her postings are about her everyday life experiences since her accident, though she also blogs about other aspects of her life as a journalist.  She prefaces the titles for her postings related to her spinal cord injury rather cleverly with the words, “Spinal Column”; a sampling of the subtitles offers the following:

Things that make me forget I’m paralyzed

2012 highs and lows

A moment of triumph

Parties are just too painful

A taste of freedom

Game of thrones

There’s a bit of feistiness in her postings — perhaps a part of her personality that is helpful to her in terms of being able to get on with her life after the riding accident.

The book Situating Everyday Life and Melanie Reid’s blog offer excellent material for teaching and for professional enrichment.  Go for it!

A Word in Your Ear . . . JARGON

The paragraph just below is a description of procedures to be followed in an upcoming  local tournament. The tournament is for players of a specific game — one that I have been playing since I was a teenager.  I got back to this game big time after retirement.  Here is the paragraph:

Planned pairing method is groups of 4, double round robin, with a king of the hill final round.  Should the number of players not be divisible by 4, some groups may have 6 players.  Those groups will play a round robin, a round of swiss, and a final king of the hill round.  Gibsonization applies in final round only.***

Does anyone have any idea what game the paragraph is describing?!

This paragraph (taken verbatim from an e-mail) is a wonderful example of the colorful but incomprehensible language — jargon — that almost invariably develops in connection with  specific daily occupations engaged in by groups of individuals.  The dictionary defines jargon as:  “The technical or secret vocabulary of a science, art, trade, sect, profession, or other special group; a lingo.”  The jargon in the paragraph above is part of the tournament information sent out to a “special group” of people who belong to a club dedicated to playing this game.

In occupational therapy and occupational science, we, too, have a technical or secret vocabulary.  To begin with, our very name contains a ‘secret’ word:  occupation.  To us, the word has a particular meaning, specific to the professional group we belong to, often not understood by people outside the profession.  In Chapter 2 in my book, I review the struggle that has occurred over the years to come up with a definition of occupation that is satisfactory — even temporarily — to all in the profession.  Over and over again in my professional life I have had to explain that the “occupation” in our name does not refer to job training.  Such is the nature of professional jargon and its “secret” meanings.

In the main, the jargon we use in our clinical practice, education and research serves as a good tool for communication within our groups of colleagues.  In fact, one could say that in our academic programs much of our time and energy is devoted to helping students learn the lingo in preparation for later experiences in practice.  But in most areas of practice,  we are also challenged at times to put the jargon aside in order to be effective professionals.

Two examples:

1.  In our classrooms, we purposely foster teaching and learning processes that incorporate our jargon into the educational experience.  Alternatively, in our clinical practice with patients and clients, we often find we need to translate our communications back into everyday language to foster understanding and positive outcomes.  This need to use everyday language exists across the entire therapeutic process:  as we carry out our assessment procedures; in our ongoing conversations with clients, caregivers and families; in our written instructional materials; and often in our written and oral communications with other professionals.

I well remember being sent “back to the drawing board” by the chief of rheumatology to rework a handout on joint protection that I had drafted for patients in a rheumatology clinic; the handout was (correctly) declared too technical for the general patient population to understand or use.  To communicate technical information and guidelines for behaviors in an understandable format to the general public takes time and practice.  Do we teach these kinds of patient education skills to our students –in the classroom and on fieldwork?  Or do we focus only on making sure they understand and know the jargon, i.e. the secret vocabulary of the profession?

2.  One of the tenets of qualitative research is the mandate to stick with the participant’s own language when transcribing, analyzing and reporting on interview material.  Two terms are used to describe narrative  data:  emic refers to the research participant’s own words and perspectives; and etic refers to those of the researcher [I know — more jargon].  Not translating the participants’ words into professional jargon is extremely important in qualitative research, based on the belief that any such translation changes not only the words per se but also the intended meanings of the words.  In clinical practice, it is equally important to avoid translation of the patient’s words into occupational therapy lingo.

So, if I, as the researcher or clinician, translate the family caregiver’s statement that the patient “can’t move his arm very well”  to my own statement that the patient has lost “range of motion in the elbow joint of his right upper extremity”, I have hugely medicalized the caregiver’s statement and, in effect, removed the caregiver’s lived experience from the interview data.  I have  reduced the stated experience to a particular measurable loss in a particular joint of a particular arm and have removed the caregiver’s statement of how the arm is experienced in daily life.  Plus, perhaps without realizing it, the translation sends a tacit message to the caregiver that the words he or she originally used are not quite accurate or appropriate, that they need to be translated to be more correct.

In the handout on joint protection referred to above, I can imagine that, at the time, I had worked on that first draft to purposely incorporate medically correct terms into the materials.  Being asked to reconsider the content as it related to the intended audience was a learning experience — one that proved useful to me time and again in my subsequent practice.


Playing Cribbage

2009 fieldwork experience — by Michaela Mangrum

Below is text selected from an e-mail message sent by Michaela Mangrum to her professor/supervisor while on her fieldwork at an adult day care center.  She describes her experience of entering the world of a participant who had dementia, using a game of cribbage to bring about a meeting of minds.  The details and meaningfulness of the everyday occupation of game-playing are expressed so well (shared here with permission).

From Michaela:

“I have been spending time in an adult day center for part of my FW.  Mostly, I have been trying to meaningfully engage the participants there.  Many of them have dementia or some other kind of cognitive deficit.  One woman in particular poses a challenge for the other staff.  When they tell her/ask her to do something, she usually says ‘no.’  She has dementia, but can still communicate, do word searches, play dominos, walk, and many other things.  I heard that she also plays cribbage.  I know how to [play cribbage]  and I looked forward to the next time she didn’t want to do something so we could play!

We sat down at the table, I dealt the cards, and she immediately laid a match down.  Note:  that is not how you play cribbage.  I was confused for a moment, and stuttered over trying to ask her if she meant to ‘throw those in the crib,’ but quickly realized she didn’t remember how to play.  So, I tried to follow her lead.  We drew from the deck (not part of cribbage), laid down matches and runs, and basically played some sort of go fish/rummy.  The other staff were watching and started saying things like ‘Well, if that’s cribbage, I can play cribbage!’ and ‘Aren’t you supposed to say 15 this, 15 that and move the pegs?’. . . Finally, one of the staff realized what was going on, and whispered to the other, ‘If she thinks it’s cribbage then it’s cribbage.’

Okay, so we played a few hands like this and I admit I felt a little disappointed because I thought she would be able to do it.  In retrospect though, cribbage is a very complicated game.  However, after about the 4th time I dealt the cards, she said, ‘Your crib or mine?’ which is a perfectly appropriate question for the game of cribbage.  I told her it was mine, and we played cribbage for about 30 minutes!  Sometimes she added wrong, counted her points twice, or moved the pegs up and down the board instead of in one direction, but we definitely played the essential elements of cribbage!

I would catch myself starting to correct her sometimes, and learned what focus and patience it takes to go with the flow and back down about being ‘right.’  I can not imagine doing this as a 24-hour caregiver . . . It really helped to begin putting things in perspective.

After about 30 minutes, though, I dealt the cards for another round, and she laid down a match.  Cribbage was gone.  I wish I could have seen her brain activity, before, during and after cribbage.  How amazing . . . It was really nice to use what I’ve learned (like following their lead and letting go of being right) and witness the power of meaningful occupation!

One more aside:  Even though the score keeping wasn’t technically accurate, I would say that ultimately, she kicked my butt.  I think that this woman was quite the card shark and I was so glad to give her that opportunity again.”

Thank you, Michaela.  This is what it is all about.  Betty