Experience of Occupations among People Living with a Personality Disorder

Personalitydisordersarecommonmentalhealthdisorders,withanestimatedlifetimeprevalenceof4to15%.People livingwithpersonalitydisordersareextensivelyseekingmentalhealthservices,yetfewpapersfocusontheiruniqueoccupational needsoreffectiverehabilitationinterventionsthatmayalleviatetheoccupationalissuestheyface.Occupationaltherapistsare encouragedtosupportengagementinsociallyvaluedoccupations,whilepreventingengagementindamagingones,despitea lackofevidenceonthemeaningandthelivedexperiencesofpeople.Objectives.Thispaperdescribesthemeaningattributedby peoplelivingwithpersonalitydisorderstotheirmainoccupationsandtheunderlyingneedstheystrivetofulfillthrough occupationalengagement,whetherornottheseoccupationsaresanctioned.Methods.Thisexploratorystudyrestsona descriptiveinterpretativemethodology.Theparticipantsweretenmenandwomen,agedbetween18and35yearsoldandliving withaClusterBpersonalitydisorder.Asemistructuredinterviewguideallowedparticipantstobuildnarrativesonoccupations thatareimportanttothemanddiscusshowtheseoccupationsshapetheiridentity.Athematiccontentanalysisfosteredthe developmentofacodingstructurethatreflectedafirst-accountperspective.Results.Thenarrativesprovidedbytheparticipants depictavarietyofmeaningfuloccupations,manyofwhicharesociallydisapproved.Manyoftheseoccupationsserveasa copingstrategytodealwithdistressingsituations,toconnectwithotherswhosharesimilarlifeexperiences,ortoreestablisha fragilesenseofcontrol.Otheroccupationsaresociallydisapprovedduetotheoverinvestmentoftheparticipants’commitment. Whileparticipantsdescribedhowthisoverinvestmentallowedthemtocontroldestructiveimpulses,significantothersperceived itascounterproductiveandunnecessary.Participantsperceivedself-careoccupationsaspainfulandtediouschoresor meaninglessoccupations.Engaginginproductiveoccupationsallowedsomeparticipantstogainrecognitionortoidentifytheir competencies,butalsoconfirmedtheirdifferences,creatingsomeformofalienationormarginalisation.Conclusion.This exploratorystudyinvitescliniciansandresearcherstodevelopamoreresponsiveunderstandingofoccupationalengagementfor thispopulation.Theresultshighlighttheimportanceofsituatingoccupationsintheircontext,whileendorsingafirst-account perspective,tobetterunderstandtheforcesthatshapeoccupationalengagement.Ultimately,occupationaltherapistsshould criticallyappraisetheirassumptionsaroundhealthyandunsanctionedoccupations,inordertorespondwithsensitivitytothe needsandexperienceoftheirclients,withoutperpetuatingthemarginalisationanddiscriminationtheyface.