Independently Dependent

“I get by with a little help from my friends” 

– The Beatles

Last week I read this fantastic post. It made me reflect on the effect occupational therapists have when we talk about ‘independence’ to clients, families, caregivers, educators etc. Are we sending mixed messages and unintentionally being ableist?

As OTs we are trained to promote and support independence and encourage the development or rehabilitation of independent living skills. The American Occupational Therapy Associations handout on occupational therapy discusses how therapy can “maintain or rebuild independence”. The OT Australia website states occupational therapy can improve independence and support individuals to “develop skills to live more independently”.

In her post, Lydia discusses the unfair expectations on people with a disability to “live independently”. She reflects on the stigma and negative attitudes attached to needing alternative supports to participate in a meaningful and fufilling life. As occupational therapists, it is our primary goal to “enable people to participate in the activities of everyday life”. Oftentimes, this includes utilising supports that may not be embedded into the natural or social environment. Part of our role is to advocate for the inclusion, development and funding for these supports. So is all our talk about independence undermining our work to increase individual and societal acceptance of alternative supports?

The definition of independence (taken straight from Google) is:

1.  free from outside control; not subject to another’s authority.
2.  not depending on another for livelihood or subsistence.

In occupational therapy, independence also seems to mean “can do by themselves”, or “doesn’t need assistance from another person”. Assistance isn’t only physical, it also refers to verbal, gestural or visual prompts. But this seems contradictory to what independence means for a person without a disability. Everyone needs assistance from other people, and when we see someone doing something all by themselves, they often rely on supports we haven’t even given consideration too. So in truth, no one is actually ‘independent’.

For example, I have been living in Japan for the last two months. I would be lying if I said I’ve been doing it independently, or that I could! My lists of supports includes: portable Wi-Fi, Google (including Maps and Translate), Facebook, my ability to speak English, my partner, my school, the similarities between Japanese and Australian infrastructure and technology, my phone, my tablet, the list goes on! These supports have allowed me to buy food when I can’t read what’s for sale, find my way around, cross the road safely, learn about cultural expectations, contact friends and family for social support, listen to music, watch TV, have the confidence to try new things or go to a new place and learn a new language.

I read a post from a guy who has been living in Japan for the past 15 years saying how easy foreigners have it these days compared to 15 years ago, and I would absolutely agree. I could not imagine living in a country where I don’t speak the language and being able to do the things I want to without easily accessible information via the internet. I can’t imagine walking into a supermarket and not being able to identify anything. I can’t imagine trying to catch public transport and not being able to.

So it could be easy to look at me and think, yep she’s successfully independently living in Japan, but that is only due to readily available, accessible and socially accepted supports. And being in a different country has only highlighted these for me. There are many, many supports that allow me to participate and live ‘independently’ back home in Australia too.

To wrap up, I completely agree with Lydia, that supports and interdependent living is natural and the norm for everyone, regardless on precence or absence of a disability. Yet I still love seeing the joy on the face of a child who is successful in doing something all by themselves. And I know that I like being able to “do things myself” too! I’m not yet sure if these two concepts are mutually exclusive or not.

Perhaps the difference is our perceived independence. While we live our lives so interconnectedly, depending on others for so much and with many supports (noticeable or not), we still like to feel as though we are independent. Maybe we need a new word to describe this “supported independence” to shift societal aims from valuing minimal supports to maximum participation.

What supports can you identify in your life?