Abstract
Abstract Introduction Despite struggling to establish itself as an autonomous profession, occupational therapy remains extensively regulated and controlled by discursive authorities inside and outside the discipline. After overcoming the profession’s reformist ideals, the military governance that supported its rapid expansion morphed into civil institutions but both were based on similar grounds: occupational therapists should obey a strict set of rules while disobedience and dissent are consistently repressed or silenced. Objective The objective of this article is to deconstruct dominant (consensual) discourses that shape the status quo in occupational therapy and envision alternative paths for the development of the discipline. Method Drawing on the work of Erich Fromm and Jacques Rancière, we propose a (critical) theoretical analysis of the concepts of disobedience and dissensus as they apply to occupational therapists. Results The concepts of disobedience (Fromm) and dissensus (Rancière) can be used to revisit the consensus shaped by discursive authorities inside and outside occupational therapy and expose the political nature of such processes. We argue that remaining oppressive forces similar to those of a warfare regime persist in regulating occupational therapy practice and knowledge by enacting a form of ‘disciplinary propaganda.’ Rather than threatening the development of the discipline, disobedience and dissensus constitute critical responses to disrupt dominant discourses and give rise to healthier concepts. Conclusion The use of politically charged terms such as disobedience or dissensus can be seen as controversial and unsettling for a profession like occupational therapy but we believe they are necessary for the future of our discipline.
Highlights
Despite struggling to establish itself as an autonomous profession, occupational therapy remains extensively regulated and controlled by discursive authorities inside and outside the discipline
As the military governance morphed into civil institutions, the engagement of most occupational therapists as bureaucrats in widespread government institutions is based on very similar grounds (Aldrich & Rudman, 2020): both require obedience to a strict set of rules while debates and resistance are consistently repressed or silenced
That we have exposed how consensual discourses in occupational therapy often rely on compulsive conformity and can become dogmatic or oppressive, we will turn to disobedience and dissensus as critical responses to overcome such a dominant order
Summary
Occupational therapy has struggled to establish itself as a profession independent of other health disciplines. In regulated contexts like these, occupational therapists could become alienated by the systems in which they practice, in which case they would see their own actions as “an alien power” standing over - and sometimes against - them (Fromm, 1981) This may explain the feeling of dissonance among occupational therapists who struggle to safeguard quality care while meeting accountability expectations deriving from the multiple authorities over their practice (Freeman et al, 2009). Occupational therapy is regulated from the outside, it is controlled from within, by occupation-based models and theories (Reid et al, 2019) imposing their own regimes of truths We believe that these discourses are paralyzing the profession by impeding it from undertaking socially transformative practices. While this paper does not propose concrete ways to practice disobedience or dissensus in occupational therapy, it is intentionally written provocatively and, in line with our theoretical perspectives, could be read as an enactment of disobedient thought or a form of dissensus
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