Last week we were having the usual debate about the difference between rehabilitative and occupation-focused practice, or biomedical and social occupational therapy. I am less than satisfied with this distinction.
If there is now a subject called social occupational therapy, then there seems to be a space opening for a parallel subject called biological occupational therapy, followed rapidly by spiritual occupational therapy. However, the problem is that this seems to be based on a dualism of mind and body, which is precisely what a focus on occupation seems to magically avoid. Descartes articulated a dualism between mind and body and proposed that the mind works on the body within the pineal gland of the brain. This dualism continues to play out in our language about bio-psycho-social models. Even the WHO defines health as state of complete physical, mental and social well-being, not merely the absence of disease or infirmity.
Yet, we know that there is no real distinction between the realms of ‘bio’ and ‘psycho’. What we call consciousness emerges from the prefrontal and posterior occipital cortices and the claustrum; what is called perception involves the secondary and tertiary cortical areas of the occiptial, parietal and temporal areas of the bring; Learning leads to an increase in the number and size of synapses. It is proposed by Mureriwa (2017) that the reason why different forms of psychotherapy work is because they all work on the autonomic nervous system. This is not dissimilar to the way that psychiatric medications work to reduce adrenergic activity which leads to calmness and relaxation.
Biopsychology is also called behavioral neuroscience. It involves the study of many areas that are directly related to occupational therapy:
- Sensation and perception
- Motivated behavior (hunger, thirst, sex)
- Control of movement
- Learning and memory
- Sleep and biological rhythms
- Reasoning and decision making
Behavioral neuroscience also contributes to our understanding of medical disorders, including:
- Parkinson’s disease
- Huntington’s disease
- Alzheimer’s desease
- Clinical depression
- Drug abuse
Unfortunately, the ways of making discoveries in this field are characterised by biological experiments, which means that either the dependent or the independent variable is biological. I say unfortunately, because the experiments involve either permanent or temporary alterations of nervous systems, which are generally non human and therefore problematic to the ethical vegetarians among us.
Each of these has a specific epistemology associated with it and there is much to be done to explore what a biological occupational therapy might be look like.