Meditation: A case study from an occupational science stand point.

In this essay the link between activity and well-being will be looked at through the lens of meditation and mindfulness practice. Firstly the concept of well-being will be defined for use in this analysis. This definition, whilst not necessarily fact and open to interpretation, will form the basis of what will be considered ‘well-being’ and thus govern how activity impacts on the specific criteria determined by this definition and also how meditation and mindfulness practice can be a conduit for promoting these aspects.

Well-being can be defined as ‘a person’s subjective perception of his or her health and encompasses feelings about physical, mental and social health’ (Schell et al., 2014). This is continued within a cultural context stating ‘In Western societies, in which individualistic values prevail, well-being is commonly associated with self-esteem, happiness, a sense of belonging, and personal growth and having a sense of community.’ (Schell et al., 2014). Since this essay is written within the setting of a western society it is these values that shall mainly be focused on, although there is one additional criterion that is worth considering; that being how well-being is linked to the environments individuals find themselves in (Schell et al, 2014).

Moving on, meditation and mindfulness are also hard to define. Mindfulness can be seen as being present in the moment and meditation the practice by which the individual attains this specific state of mind (Puddicombe, 2012). Mindfulness denotes having an awareness of oneself without judgement or emotional reaction to what is happening in our minds and external environments at any given moment whilst cultivating an acceptance of it. It is a process of non-attachment and releasing identification with things, be it thoughts, feelings or environments etc., in an attempt to see how things really are. Meditation can induce these states of being through practices like specific breathing techniques, gratitude giving or mantras among many others (Wellings, 2015).

The notion that activity affects well-being can be grounded in the base ideas of occupational science, put simply, occupational science is the study of what people do (Hocking and Clair, 2011). One of the core concepts of occupational science is that human beings are essentially occupational beings; we have an inherent drive to engage in and express ourselves through activity. Furthermore through this activity we can either promote or negate our health and thus our well-being (Hocking and Clair, 2011). Meditation and mindfulness practice has been shown numerous times to promote health and well-being. New research being conducted by Dr Joe Dispenza has shown that gratitude practice (embracing an elevated positive emotional state whilst meditating such as the feeling of being grateful) can upregulate gene expression within an individual and combat disease. In this study participants were able to increase the expression of certain genes associated with things like neurogenesis, regulating cell repair and building cellular structures through engaging in frequent meditation in which gratitude or another positive emotion was evoked during the practice (Dispenza, 2017). With increasing knowledge from the science of epigenetics it is being shown that the environment causes certain gene expressions that then create disease. Our cells produce proteins that are responsible for our physical make up and function, in order for these proteins to be made, the ‘code’ for them must be expressed using a gene. Heightened stress responses and negative emotional reactions to both external and internal stimuli (thoughts) produce negative chemical feedback loops in our bodies which signal the body to down regulate (turn off) certain gene expressions that can then result in disease (Dispenza, 2017). The idea of meditation and mindfulness is to switch the body from the stress response (sympathetic nervous system) to the relaxation response (parasympathetic nervous system), ahead of the external environment i.e. using the internal environment of the mind, so it can go from a catabolic to an anabolic state which promotes growth and repair and homeostasis.  Emotional responses are the signals through which the body determines the environment and thus either promotes or negates a person’s health (Dispenza, 2017).

Gratitude practice, through being in a positive emotional state, produces a positive signal that then upregulates certain genes and promotes health. This is demonstrated in another study of Dispenza’s where over the course of four days participants were asked to engage in meditations evoking particular positive elevated emotions to see how immunoglobulin A (IgA) a ‘protein marker for the strength of the immune system’ was affected. The results showed that IgA in participants at the end of the four days increased by an average of 49.5% whilst cortisol (a stress hormone) decreased by an average of 16.25% (Dispenza, 2017, p. 42).

Meditation and mindfulness has also become a key tool for psychotherapy when dealing with trauma. Newer therapies such as EMDR, sensorimotor psychotherapy and somatic experiencing use mindfulness techniques to enable the individual to develop a better relationship with the traumatic experience, without reliving and overly identifying with the experience which allows it to be worked through (Wellings, 2015). Through these examples a link between activity and well-being can clearly be seen and, more specifically, the use of meditation and mindfulness as a positive influence on an individual’s well-being is demonstrated. Increasing immune system response is certainly an aid to physical health and overcoming trauma is likely to improve mental health which fits with the definition of well-being explored earlier. Neuroticism is a personality trait associated with decreased satisfaction and well-being for people who have experienced sexual abuse (Whitelock et al., 2013). Mindfulness meditation actively looks to silence the analytical mind and thus neuroticism so people can move beyond over-thinking and improve their sense of well-being (Dispenza, 2017).

One of the ways the concepts of occupational science have attempted to be encapsulated, generalised and then applied in order to produce predictable results, one of the processes that underpins science as a whole, (Schell et al., 2014) is through Wilcock’s paradigm the Occupational Perspective of Health (OPH) (Hitch et al., 2018). In this paradigm four elements of occupation are discussed; doing, being, becoming and belonging from which both health and illness can be explained and the ultimate aim of ‘healthy survival’ is to be attained (Hitch et al., 2018). Through these elements an attempt is made to categorise the dynamics of how occupation affects human beings and their well-being (Hitch et al., 2014).

Meditation and mindfulness as an activity fits neatly into this perspective. There is a doing element; for example a specific breathing technique that requires the participant to be actively engaged both overtly and tacitly (Hitch et al., 2014). A being element; meditation and mindfulness’ focus on the present moment perfectly captures the notion of being as essence, the idea of who someone is, with regards to identity, in that moment and reflection upon this (Hitch et al., 2014). A belonging element, for instance through association to a religious group such as Buddhism or spiritual connection to a transcendent force or creator type figure (Wellings, 2015) which promotes interpersonal relationships, connection to something greater than oneself and a sense of mutuality and community (Hitch et al., 2014). Finally there is also a becoming element exemplified in the meditation and mindfulness’ practices of not attaching yourself to your thoughts, emotions or environment and focus of getting beyond ways of being and identities that we may have become too entrenched in and could be causing us problems. This is linked to the change and growth of a person over time (Hitch et al., 2014).

However the OPH model is far from agreed upon as a universal paradigm through which occupational science can inform the practices of occupational therapy. As Hitch states ‘currently, occupational therapy remains in a Kuhnian crisis, without a consensus or common vision to guide its diverse domains of practice’ (Hitch et al., 2018). One of the main barriers preventing the OPH from being applied is its overly complicated language written from a public health viewpoint, which makes it difficult for occupational therapists to understand and translate to practice in diverse settings (Hitch et al., 2018). Another problem arises from the terms doing, being, becoming and belonging themselves as they are very generally defined in the OPH. As Hitch argues ‘Operationalizing the occupational dimensions of doing, being and belonging to narrow understandings restrict the application of these dimensions’ (Hitch et al., 2018). This could be exemplified when the belonging element of meditation and mindfulness is attained through connection to a spiritual force that doesn’t necessarily exist in a tangible or measurable way. This idea of a spiritual component of occupation is underdeveloped in the OPH (Hitch et al., 2018). Furthermore it could be argued that mindfulness meditation could quite easily be overlooked using this model as its ‘doing’ element is rather passive and doesn’t necessarily fit with traditional western conceptions of productive activity which are heavily centred around the idea of physically doing something (Hitch et al., 2014).

These incidences also relate to the concept of occupational justice and how well-being is linked to the wider eco-system (including urban environments and societal constructs) that people find themselves in. As explored earlier one of occupational science/therapy’s central assumptions is that participation in occupation impacts well-being. The conception of well-being and occupational therapy’s involvement in promoting this is intricately linked therefore to human rights. ‘Rights’ being understood in this context as ‘conditions that enable or constrain people’s actions’ and the resources and opportunities people have to act and what they should expect (Hammell and Iwama, 2012). The World Federation of Occupational Therapists affirms ‘all people have the right to participate in a range of occupations that enable them to flourish, fulfil their potential, and experience satisfaction congruent with their culture and beliefs, along with equitable access to participation in occupation’ (Hammell and Iwama, 2012). Thus occupational therapy has to increasingly acknowledge individuals’ subjectivity and independence, how this relates to wider societal mechanisms that decide how resources should be allocated and the scope in which people can act, according to the acceptable moral principles of the society, along with the inevitable injustices and inequalities that arise from this in day to day life (Hammell and Iwama, 2012).

From this we can see how any particular societies’ conception of right and wrong can inform, through things such as legislation and cultural norms, and create barriers to an individual’s engagement in occupation. The ideas of occupational alienation, occupational marginalisation and occupational deprivation are directly linked to the idea of occupational justice and therefore the understanding of human needs and thus well-being (Serrata Malfitano et al., 2016). Meditation and mindfulness as an activity is quite durable in getting around the problem of occupational deprivation. The simplicity of the activity when it comes to what is required to do it means that few external factors, bar having access to the knowledge of what you need to do, can get in the way of an individual practicing (Serrata Malfitano et al., 2016). This assessment being based on current developed societies that generally offer the necessary level of social stability, personal freedom, accessibility of resources and physiological need fulfilment required to their populations for most people to be able to take part in meditation and mindfulness (Schell et al., 2014).

Occupational marginalisation could also be a barrier to the use of meditation and mindfulness as a legitimate therapeutic intervention due to its spiritual connotations. Kang states that ‘Health-care literature, especially in the areas of medicine, nursing, psychology and social work, shows evidence of increasing concern with the interface of health, wellness, and spirituality and with how health professionals should address spirituality in their day-to-day patient care’ (Kang, 2003). This could be even more prevalent when the person in question identifies with a form of spirituality that isn’t necessarily recognised by wider society. For instance the author of this essay doesn’t align their spiritual practice through mindfulness meditation with a particular religion. Spiritual well-being has been linked to reduced risk of hypertension, heart disease and cancer (Kang, 2003). If this is to go unnoticed by occupational therapy practitioners then it could be a detriment to overall well-being.

To conclude we can clearly see a link between activity and well-being, whether the given activity affects well-being negatively or positively depends largely on the activity itself and the definition of well-being. In the case of mindfulness meditation I think an argument has been made throughout this essay that it mainly exerts a positive influence on an individuals’ well-being. However this is subject to an understanding of occupational balance and patterns of daily occupation as well as the environment activities take place in, both of which relate to health and well-being (Eklund et al., 2017). It is very difficult to determine a causal relationship for one particular activity and to generalise this to all people as everyone is different and the circumstances in which people find themselves are unique to each individual. That being said, Meyer referred to finding occupational balance within the context of work, play, rest and sleep (Eklund et al., 2017). Stress associated with the activities of our busy lives in the modern western world is a huge factor in occupational imbalance (Schell et al., 2014) thus finding 20 minutes a day to practice mindfulness could have a big impact on readdressing this in a western context.

#Meditation #Consciousness #Spirituality #OccupationalScience


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