Steve Hoppes, Ruth Segal; Reconstructing Meaning Through Occupation After the Death of a Family Member: Accommodation, Assimilation, and Continuing Bonds. Am J Occup Ther 2010;64(1):133–141. https://doi.org/10.5014/ajot.64.1.133
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© 2021 American Occupational Therapy Association
Reactions to death have been studied extensively from psychological, behavioral, and physiological perspectives. Occupational adaptation to loss has received scant attention. Qualitative research was undertaken to identify and describe occupational responses in bereavement. The constant comparative approach was used to analyze and interpret the occupational responses. Adaptive strategies of occupational accommodation and assimilation were used after the death of a family member. Desire to sustain bonds with the deceased motivated specific occupational engagements. These occupational responses served to reconstruct meaning after the death of a family member. These findings contribute to understanding adaptation after death by adding an occupational perspective to previous theories. Occupational therapists’ abilities to support clients after loss can be enhanced through appreciation of occupational accommodation and assimilation and the role of continuing occupational bonds after the death of a loved one.
After she passed away … I left the job I'd been at for 13 years. I thought, “You know, I don't need this.” You just look at the world differently. I didn't know what I was going to do. I left and didn't worry about it. I wanted to be happier. I wanted to fulfill myself more. I think [my loss] is really the reason I came to the university. It got me away from the business sector and back to a place where I felt I was doing the world some good.
I think I was looking for something that meant a little more. I didn't want to do just any organization. That [Race for the Cure] was the organization I felt connected with. It has been extremely meaningful because of my experience of taking care of my mom. It's nice to give some of that back, and it's nice to have a positive memory rather than just this is someone who died, and that's all there is to it. All the pain you went through and all the things that were suffered are now constructively put to use for a good purpose in the larger scheme of things.
When I lost him, I kind of lost the meaning to my life. I find myself getting more involved every year in different types of classes. Last fall, I took two pottery classes. I've taken photography classes. I'm very good at photography now. At the end of the class, my husband and I had won every category in the class, which was amazing. I've taken dancing lessons. I'm into stain[ed] glass now. I just keep finding new things I want to learn. It kind of brought some meaning back into my life.
After her death, I didn't put things off like I used to. Work was always there. Suddenly, leisure needed to be there just as often. I was always exercising, but different modes of exercise. I started doing yoga, more meditative types of things. Spirituality, I definitely spent more time reading more poetry. My grandmother really liked reading Walt Whitman, Robert Frost. It was a way to connect with things she liked to do. My spiritual life changed. I went to church more often. I was keeping a journal about a year before she died. I definitely made some significant entries in the journal about her death. Exercise shifted toward some relaxation, meditative stuff, some church stuff a little bit more regularly, and a fair amount of reflection.
I met [my future husband] when I came back to school. I guess I'd been back in school about a month and a half. My roommate set me up. I didn't play games; I was very honest about a lot of stuff. He came along when I really needed to laugh and have a good time. Maybe I was just more open to something. He was around a few times when I had a meltdown from nowhere, and it didn't freak him out. It may have, but he didn't show it. He knew what had gone on, knew everything about it. He came along and made me laugh and made me feel safe being around somebody. He focused on just me.
Over this same period, before and after my father's death, I was trying to come to grips with [the fact] that I was attracted to a woman. I hadn't dealt with that before. I may lose the intimacy of loving my father, but there is a linkage, it's what you make of it, what you learn from that, it doesn't end here. It's been an interesting journey.
I'm the type of person that if I have too much time on my hands, I think too much, and it doesn't do me any good. I start thinking about all of these things that you can't answer. I would say it was helpful, in a sense, to work because it keeps you from dwelling on the negative so much that you become depressed. I think if I didn't have work, I would've been home and my wife would've been listening to me vent or listen to me talk about just feelings that, you know, can just be overdone. You have those feelings that you feel bad about, but it can be redundant to focus on those feelings and think about them until it just drives you crazy. I would say definitely getting back to work was helpful.
After my son passed away on a Friday, and after a 7-month haul and everything that had gone on, I thought I'd take a month off and go have a margarita on the beach. After the funeral on Monday and being at home all week with my wife and daughter and friends, I came to the realization that I needed to go back to work.
I must have increased the amount I was swimming. I have lots of memories of that year and on into the next year or two of the Northside Y. Because I have all of these memories, I must have been going all the time, four or five mornings a week. Now that I think about it, I was there all the time.
In fact, the day my son was dying, I went out for a jog. I really didn't want to go, but being out there in the open and fresh air opened me up to the world. It gave me a breather and reenergized me so I could go back in and deal with what I had to deal with.
The socialization we have now has probably become more important. My son's friends, I think in their loss, derive a lot of comfort from being with my wife and me and being at our house. I think a lot of their recovery and working through that is to keep a close tie with our family. There's hardly a weekend that goes by that we don't have a handful—sometimes a lot more—of my son's friends over at our house. Socially, that is tremendous for us. Doing things with our friends has always been a priority and continues to be. We derive a lot of strength from that. Our friends now are closer to us. We all lived that situation together. We all experienced the highs and lows and the grief and coping. We're still coping through it with them.
When I think about who I am now, the most important thing to me is relationships. I love the relationships I have with the people I work with. It's that connectedness. Maybe because I don't have parents anymore, there's a need to be connected to others in some other way.
I went to NASCAR. I'd never done that before. I thought, Mom would love this. She would love the fact if I called her and said, “Mom, I'm going to NASCAR. I'm going to make a day of it.” I think about her when I do those spontaneous jaunts, and I'm there and I think, “She would have loved this.”
I played softball all through college. That was very important to me, and the grandfather I was very close to came to all my games. So that was really important after he passed away that I continue to do that. He was always in my mind when I was playing because I shared that with him. It almost had more importance afterwards.
that we are connected to something greater than ourselves; that we belong, and are at home, in this world; that it is a safe, orderly, and trustworthy world; that there is a point to going on day to day, pursuing purposes, caring, loving, hoping, and aspiring; that living a human life is ultimately meaningful and worthwhile; that there is a reason to continue and act in the world, however elusive that reason may be. (p. 45)
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