Occupational therapists have a touchstone when determining the goals we have for our clients. I don’t mean the measurable and observable goals we write for insurance reimbursement- I mean our deeper, unwritten goals.
This touchstone was given to us by a pioneer in our profession, Ann Wilcock. We may operate within the healthcare system, but she helped us think about how to support our clients to achieve a greater sense of wellness through four core tenets: doing, being, becoming, and belonging.
Doing: acting in ways that are uniquely meaningful to us
Being: developing a sense of who we are and how we feel
Becoming: experiencing positive change and development
Belonging: fostering connectedness with ourselves and others
To work towards these goals, we have to consider how our clients use their sensory system to connect with the people and places that are meaningful to them. So much about how this works becomes clear when we consider its role in helping us survive in our environments. Noises that are out of the ordinary get our attention because they could indicate a threat. Our alertness goes up in wide, open spaces because we are more vulnerable to predators. We look to see if the people around us appear calm to know if we can also relax and let our guard down.
For our clients, a supportive environment is designed in a way that allows them to feel safe enough to do, be, become, and belong. But what about those who are neurodiverse? When your sensory system is wired differently, you attend to your surroundings in a different way. You may focus on particular objects that others don’t even notice, fail to pick up on the demeanor of others, or have a strong aversion to certain sights or smells. Often times, the mismatch between their sensory system and the built environment creates an invisible barrier to feeling fully safe.
As a therapist turned design consultant, I still use doing, being, becoming, and belonging as my touchstone tenets. I think about each, deeply, and what they mean for a particular project. I question not only how the client is wired to experience their surroundings, but also how each particular design supports them in doing so.
Doing: Does the space support the client’s sensory needs and preferences enough to engage in various activities?
Being: Does the space address the client’s sensory arousal level enough to promote feelings of ease and peace?
Becoming: Does the space allow the client to attend to objects and people that will help them change and grow?
Belonging: Does the space provide the sense of familiarity needed for the client to feel comfortable with themselves and others?
We have only just begun to realize that there is a mismatch between the built environment and the ability of neurodiverse people to thrive within it. Imagine the possibilities for wellness when they fit. For me, that’s the ultimate goal.