Written by Faye, CBT Therapist

Occupation: “A way of Spending Time”.

When we think of occupation, we often think of jobs or professions, but occupation can refer to anything we do with our time. Occupational Therapists have long known about the benefits of occupation for wellbeing. In fact, they recognise that “engagement in meaningful occupation can promote good mental health, assist recovery and help people achieve personalised outcomes such as being able to care for themselves, engage in work and leisure activities, and participate within the community.” (Royal College of Occupational Therapists 2017)

So why do people who suffer with their mental health often remain isolated, lonely, have a lack of activity or a lack of connection with others? There are many factors at play. 

Anxiety

Anxiety is the primal part of our brain that helps us look out for danger, and it causes our brains to spot threats in things that are not always logical. We might think about joining a gym class, but anxiety brain tells us, ‘you’ll be the most unfit person there, everyone will laugh at you!’ ‘Everyone will be skinnier than you’, ‘You won’t know what you’re doing, you’ll look like an idiot!’. We think about joining a local arts and crafts class, something we’d probably really enjoy, but anxiety tells us ‘No-one will talk to me’, ‘I’ll look like a loner’ or ‘I can’t bear the physical symptoms I feel when I do something new’. 

Depression

Maybe we’ve considered getting back into activities we used to enjoy when we were well,  but depression tells us, ‘You don’t deserve to do something fun, the house is a mess!’, ‘You’re not even that good at painting’. A friend invites you for a coffee but depression tells you ‘They just feel sorry for you’, ‘You’ll drag them down with your depression’, ‘You’ll have nothing to talk about.’ 

All of these thoughts result in barriers that keep us from engaging with meaningful activity, and so, we remain isolated, lonely, anxious, or depressed. We never get the opportunity to see what would happen if we went to that gym class or met with a friend, anxiety and depression don’t let us. They’re like an anchor holding you down. 

Occupation and Substance Use

Occupation is an important factor in substance misuse also. A study by psychologist Bruce Alexander in the 70s studied two groups of rats who had access to plain water and water filled with opiates. One group of rats lived in a standard laboratory cage with little stimulation, and one group lived in a ‘rat park’, full of toys and tunnels (in a nutshell, lots of occupation!). The rats who sat in the standard cages chose to drink the water full of opiates, yet, the rats who had lots of occupation chose the plain water. Occupation was shown to lessen substance misuse, a theory that is being practised now in substance use services, aiming to expand service users meaningful occupation by connecting with others and joining in with sports groups. 

How does CBT support meaningful occupation?

CBT aims to help you recognise your patterns of thinking and behaviour and how it impacts on your emotions. In a vicious cycle of anxiety, we may have lots of thoughts which are creating barriers to us changing our behaviour. Sometimes, the only way to gather new evidence to dispute our thoughts is by experimenting.  Remember in science class in school when you would do practical experiments? (I’m sure we all remember the Bunsen burners!)I don’t remember much of the experiments we did, but what I do remember is that before any practical task, the teacher would ask us, ‘what is your hypothesis?’ meaning: what do you think is going to happen. 

Before we poured any liquid into the other, we had to make a prediction – will the liquid change colour? Will it fizz up? Will it stay the same? Once your prediction or hypothesis was set and written down, we then had to do the experiment to prove or disprove if we were right. If we were right, then great, we knew for sure. If we were wrong, well then, we learned something new. This is how behavioural experiments work in CBT. We put theories to the test, we work on gathering and providing evidence, because this is often what our thoughts lack. 

Most importantly, CBT helps to connect us with what’s meaningful, valuable and important to us. While I can absolutely see the beauty in creative things like painting or drawing, my creative range in these areas is limited to a basic stick man, so if I was told to go and draw for occupation, this wouldn’t be very enjoyable or meaningful for me (Becki, however, creates some beautiful artwork!). 

Overall, occupation is essential for mental health recovery. Whether that’s through paid work, volunteering, engaging in a hobby or connecting with others, it fills our time positively, it gives less time and strength to negative thinking and it gives us a sense of purpose, achievement and enjoyment too. 

 – Faye 

F&B Digital Therapy

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