unless they did so below their social class. Others perhaps found that with the general level of ignorance of sexual matters and rising number of cases of venereal diseases, marriage was not a good prospect (Marr, 2009). These women were trying to find something purposeful to do at a time when disparities and consequent social injustices were increasing with population growth and migration. What came out of these social dynamics were in part the development of Christian socialism and the growth of evangelical religious movements (Jones, 1984) in which some of these women became involved. This was the context within which a number of key health and social care professions such as nursing, social work and subsequently occupational therapy were developed (Frank & Zemke, 2008; James, 2006; Pearsall, 1983; Pollard & Walsh, 2000; Sakellariou & Pollard, 2008; Trollope, 1994). These emerging professions gave women career structures which were unavailable elsewhere in strongly male ordered societies (Frank, 1992). Thus, a continuing theme of the pursuit of life meaning was that people in the working class aspired to the values of the dominant middle class culture (Haylett, 2003; James, 2006), and these aspirations began with middle class attempts to find meaning for themselves in response to changing social circumstances. While the social inequalities of the 19th and early 20th century were an important part of the context which gave birth to a range of health and social care professions, it is ironically possible that the economic problems of the first decade of this century generated a depletion of resources in the public sector affecting many of these health and social care workers and a resurgence of similar injustices (Dorling, 2011).
A perennial search for meaning
Frankl’s (1992) diagnosis of a social illness of meaninglessness may be appealing to those who are sensitive to the unjust consequences of economic changes, but the search for meaning by human beings involves much broader questions. Adams (1979, p. 125) points out that of the ‘problems connected with life […] some of the most popular are: Why are people born? Why do they die?’ Most people will have considered questions of this nature at various points in their lives. The search for meaning is a perennial human quest, and therefore should be a concern for occupational therapists and occupational scientists as part of their consideration of holism, client centeredness, meaningful and purposeful doing, and human functioning in relation to the environment. Occupational therapists in particular need to facilitate the process of answering these questions by their clients in order to optimize meaningful living. Frankl’s promotion of hope through transcendentalism provides the kinds of answers that would be available in religion. In this chapter, meaningfulness will be discussed as it has been defined by philosophers, psychologists, sociologists, theologians, and scholars from other disciplines. This definition will be a basis for exploring in subsequent chapters: how human beings have gone about searching for meaning throughout history; and how they can learn to live meaningfully through what they do (their occupations) every day of their lives.
About meaning
Philosophical definition
In the first section of this chapter, we made the point that human beings are, and always have been in search for meaning in their lives, and this search has always been connected to the development of society, culture, and community. In this section, we will go further and try to clarify what we mean by ‘meaning’, ‘meaningfulness’, and ‘meaninglessness’. At the outset, it is important to point out that the notion of meaning is a vague construct. As the authors have repeatedly experienced in their research, when asked what the meaning of their lives might be, people may be embarrassed, answer with a blank expression on their faces, or ask what is meant by ‘meaning’. This ambiguity is clearly apparent in the philosophical and social science literature. Some authors define life meaning mystically as pertaining to one’s relationship with God, or with one’s soul, or both; others relate it to creativity and the benefit this has to other people. At the same time, there is no consensus regarding whether the meaning in life is subjective (experiential) or objective (has observable characteristics beyond individual experiences), or both.
General propositions
McNamee (2007) defines life meaning concisely as ‘a sense that a person has that life is worth living’ (p. 1 of 15). Many other scholars consider meaning to be a much more complex phenomenon which emerges out of an individual’s total experience through ‘the interaction of subjects, objects, elements or situations’ (Peterson, 2000, p. 1 of 24). This experience has a narrative: it consists of preceding actions (either on the part of the person who is experiencing or other people or environmental elements around the individual), and is followed by consequences. In this sense, meaning is existential since it comes out of choices, actions, and consequences; it is phenomenological, since it relies on the individual interpretation of events; and according to Frankl (1969), it depends on concrete actions geared towards fulfilling a specific mission in life, making it experiential.
As the existential aspect of meaning ‘relies on definitions of truth manifested in action and then tested by the consequences of such action,’ (Peterson, 2000, p. 1 of 24) it is also motivational in the sense that it relates to practical needs. The search for food, shelter, warmth, and security is existentially meaningful since it pertains to a person’s need to construct and destroy things, rejuvenate the being, and inhabit the world; growing food, burning fuel, and building dwellings as part of the strategy for survival. This relationship between survival (an existential need) and meaning is reflected even in childhood play. Winnicott (1971) suggested that play (as a concrete action) is naturally connected to reality in the sense that it fulfills a natural need arising from the process of human development. The playful interaction between a child and her mother engenders a process of primary socialization. The child develops a bond with the mother and comes to realize that she is not alone in the world. The child begins to appreciate boundaries to her existence. Developing an awareness of the environment enables the child to develop increasingly subtle ways of communicating with her mother. A key stage of this development is the ability to symbolize the continuity of the mother’s presence in order for the child to feel secure. When the mother is temporarily absent the child has to understand that she will return to nurture her and that her continued existence is not in jeopardy. This recognition makes further exploration of the environment possible enhancing the possibility of encountering more meaningful experiences. Thus the child’s sense of meaning is derived from the assurance of continued existential survival.
Peterson (2000) and Frankl (1992) suggested that meaningfulness is associated existentially with goal setting, or with worthwhile goals towards which to aspire. Goal setting is based on knowledge of the objective world and its challenges, and the evaluation of previous actions to achieve articulated goals geared towards meeting them. One of the occupational therapy approaches to goal setting developed by du Toit (2009) consisted of a stepped understanding of recovery. Recovery was conceptualized to progress from a positive ‘tone’ (du Toit, 2009, p. 23) indicating the undeveloped potential for action, through to stages of increasing participation. In her work, Du Toit (who was partly informed by Frankl’s ideas) was concerned with the idea of ‘creative ability’ (2009, p. 22) and a spiralling capacity and potential which increased with experience and the ability to anticipate the pleasure that could result from taking up opportunities for engagement. A key component of this idea was the relationship between volition, motivated by setting goals which were just within the capacity of the recovering individual, and performance. The goals would not be motivational if they could not be realised. Ikiugu (2005) and Ikiugu and Rosso (2005) describe such goals as occupational life trajectory attractors because they provide meaning to, and therefore organize, patterns of performance as individuals interact with and act within the environment. For example, if a person wants to become a doctor then it is probable that he or she will prefer to engage in the kinds of actions that are consistent with the achievement of this goal, such as studying, volunteering in appropriate tasks, looking for opportunities at careers fairs to find out details about suitable university courses, etc. (Ikiugu, 2005).
Ikiugu (2005), and Ikiugu and Rosso (2005) suggest that this occupational pattern forms a trajectory for an individual’s