The New Fascism in Occupational Therapy

I am sometimes hesitant to extend my commentary to the academic editorializing that happens in the occupational therapy literature of other countries, but I am unable to remain silent.  Too often the ideas expressed elsewhere slither their way into the thinking of academics in the United States.

And, of course, any objection to these ideas immediately causes one to be branded xenophobic, and usually worse, so I will simply gird myself for that criticism; I know it is coming. 

Over time I have raised the issue of international 'goodness of fit' of philosophical constructs - initially in OT24VX presentations.  I talked about the incompatibility of 'occupational justice' models in societies that had health systems that had elements of free-market construction as opposed to those that are more fully socialized.  For a while I tried to discuss reverse colonialism, thinking that if I spoke the language of those who perceived themselves to be oppressed by Western OT thinking that perhaps they might get the point.  Of course, oppressors can never be oppressed or colonized in their model of thinking - so that was not an effective discussion tactic.  I also tried to express these ideas in a theory textbook, and I blog about the issue as well - even recently.  Still, concerns about the adoption of justice frameworks are largely ignored by the academic elite in occupational therapy.  These ideas are not entertained in mainstream professional literature - and so are relegated to conferences or blogs.  In short, intellectual diversity is not encouraged.

Alternate viewpoints are generally not allowed.  There is very little intellectual diversity expressed in occupational therapy, mostly because of the bullying tactics that are regularly used by those who seek to 'disrupt' and 'replace' the philosophical core of the profession.  Most occupational therapists are simply too afraid to say what I am about to say, but I assure the intellectual elite of the profession that many people disagree with this new philosophical framing.  Many people find it to be negative, divisive, and even a misrepresentation of Truth.

But the new fascism in occupational therapy persists.  The operational definition of fascism that I am using is "a tendency toward or actual exercise of strong autocratic or dictatorial control."  Accordingly, the First Premise of this movement is "All occupational therapists must hold the worldview and philosophy that they are directed to adopt by the academic elite."  This is clear in the recently published agitprop in the Canadian Journal of Occupational Therapy entitled 'Unbecoming Change Agents.'

There are several assumptions and concepts expressed in this article that are particularly offensive to the New Fascists that in their view need to be eradicated in the field of occupational therapy.  First is the abolition of the any interest in the individual - a particularly Western construct that is rooted in Emersonian values of self-reliance.  Individualism formed the core philosophy of the occupational therapy profession since its inception and was celebrated and re-affirmed explicitly in the United States in Mary Reilly's Slagle lecture.  I intentionally link the reprint of the article in the Canadian Journal to demonstrate a core tactic of the New Fascists: they will make their sanctioned ideas open-access (like the article 'Unbecoming Change Agents,' but will paywall the ideas of people they oppose (Reilly's Slagle lecture).  After all, exerting strong autocratic or dictatorial control must be accomplished in order to prevent the proles from looking up information that is counter to the preferred narratives of the New Fascists.  'Oceania has always been at war with Eastasia!'

Another important assumption of the New Fascists is that any historical or current oppression or mistreatment of marginalized groups must form the center and core for all subsequent thinking and action - no matter how disconnected the concern may be to a 'therapeutic encounter' in an occupational therapy context.  Here I will be criticized roundly for daring to believe that historic sins should not mandate a subsequent frame of 'centering' those that were previously oppressed - no matter how long ago or when it happened or who supported the oppression.  We are all still guilty, according to the New Fascists.

The required self-flagellation of thought is to recognize that as occupational therapists we all inherently wield power in oppressive ways - just as a function of our core being.  To be an occupational therapist is to carry the Original Sin of Oppression.  That we even dared to call ourselves 'Change Agents' was a particularly offensive expression of our power.  The example given by the New Fascists is that in Canada there was apparently a group of people with the employment title of 'Indian Agents,' and that we would even use the term 'Agent' in any proximate (???) way is a shameful expression of of our colonial and genocidal tendencies as occupational therapists.

Now I don't know about anyone else, but I guess I never thought that I had colonial or genocidal tendencies.  I like to think I am a pretty sensitive person who understands a lot of sociocultural and interpersonal dynamics and complexity.  But that I won't accept that I am colonially genocidal must be proof that I am not evolved enough, probably. 

Usually I like new ideas, and I am generally open to them, but this seems a little unhinged to me.

Another assumption is that most occupational therapists apparently view themselves as 'saviours' which is reportedly a self-aggrandizing perspective that, of course, strips power away from other people.  Reportedly, the 'Saviour Complex' is an integral part of being "Euro-centric, White-centric, ableist, and middle class.'  Accordingly, the required self-flagellation is to recognize your evil nature and stop trying to save other people because really all that you are trying to do is reinforce your own power, control other people, and perpetuate injustice.

Did you realize that when you were treating your patients that you were really just interested in your own White European Power Trip?  I had no idea!  To think that my driving focus for the last 35 years has been the oppression of other people and the perpetuation of my own power!  

The New Fascists are hesitant to introduce new terminology quite yet - we just have to stop being 'Change Agents.'  We all need to accept our Original Sin of Oppression, we need to self-flagellate and be 'reflexive' - one of their favorite words - and find some way to 'liberate' those people that we have been 'oppressing' all of these years.  And if you object to the language and framing of the New Fascists, that is because you are still on your White European Power Trip.  Shame on you!

Now rank and file occupational therapists, in my view, should always be sensitive to power differentials and should always advocate for the needs of the people they are serving.  In the old days we used to call that Beneficence.  That is no longer enough.  Now we have replaced Beneficence with Social Justice Activism - and the only acceptable remedy is self-flagellation and reparation by adhering to the philosophy and framing of the New Fascists - who apparently have all found a way to transcend their Original Sin.  Please pay your membership fees to their club so you can be fed a steady stream of propaganda about how the rest of us are miserable and oppressive human beings.  Read about it in their sanctioned journals, swallow it whole in their updated Competencies or Practice Frameworks. Maybe one day you will be able to write a textbook and be as enlightened as they are!

There will be no room for dissent!  Disagree and be exiled - and labeled every negative term that the New Fascists can throw in your direction. 'Pick the target, freeze it, personalize it, and polarize it.'  


I entered this field 35 years ago and there was a classic student interview question that was asked of all of us: 'Why do you want to be an occupational therapist?'  Most students had a rather de facto response that went something like 'Because I want to help people. Occupational therapy is a field where I can be creative, and caring, and responsive, and if good fortune abounds, maybe I can make a difference to someone else who needs help.'

What a negative and oppressive White European Power Trip we have all been on, and we never realized it.

Thank God for the New Fascists, who are liberating us all.


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