9

THE MEANING OF PLACE

AS A COMPONENT
OF SELF
GRAHAM D. ROWLES

Kielhofner, Levine, & Neville, 1985; Kiernat, 1982, 1987).

The PersonEnvironment Relationship in It is now widely accepted that full understanding of a person
Occupational Therapy cannot be achieved independently of an appreciation of en-
Place in Human Experience vironmental contextthe place in which he or she dwells.
Phenomenological Perspective Occupational therapists have proposed several recent theo-
Relevance to Occupational Therapy ries of the personenvironment relationship that emphasize
Dimensions of Being in Place this interdependence (Christiansen & Baum, 1997; Dunn,
Using Space Brown, & McGuigan, 1994; Kielhofner, 1995; Law et al.,
Meaning in Place 1996; Schkade & Schultz, 1992). These transactional theo-
Meaning of Home ries are moving away from simple sequential stimulus
Making Spaces into Places over the Life Course response conceptualizations of the individual as inuenced
Transitions and Disruptions of Being in Place by the environment and the environment as modied by
Creating and Re-Creating Place human action and toward directly acknowledging the de-
The Place of Place in Occupational Therapy gree to which the relationship involves the blending of per-
Conclusion son and place in human experience (Chapter 18). There is
growing realization that the self is in and of rather than sep-
arate from the individuals environment and that lives are
intimately and inextricably immersed in place.
There is also increasing recognition that each persons re-
THE PERSONENVIRONMENT lationship with environment cannot be considered inde-
pendently of an historical context and the accumulation of
RELATIONSHIP IN OCCUPATIONAL
experiences of place over time (Settersten, 1999; Wheeler,
THERAPY 1995). Each person is born in a particular location, into a par-
ticular family conguration, into a particular culture, and into
Place in Human Experience a specic birth cohort. Over the course of life, each individual
Increased recognition of the role of the environment in is molded by experiencea melding of physiological capabil-
conditioning human experience began to permeate occupa- ity, individual agency, and circumstancein a manner that
tional therapy during the 1980s (Barris, 1986; Barris, profoundly inuences the person he or she becomes.

111
112 UNIT TWO: Persons Seeking Occupational Therapy
Phenomenological Perspective
Effective occupational therapy practice requires more than
cursory inspection of a persons physical setting and compila-
tion of a brief personal history. Probing deeper, it is impor-
tant to understand each person from the perspective of an
experienced contextthe life world within which he or she
conducts daily activities, denes the self, and receives occupa-
tional therapy intervention. From such a phenomenological
perspective, how does the person experience his or her
world? To what extent has he or she created the physical set-
ting of home, with its familiar furniture, memorabilia, and
photographs, as an expression of self, perhaps over the course
of decades? To what extent is he or she continuing to manip-
ulate the setting in accommodating to changing needs and
abilities in ways that facilitate maintaining a sense of self,
agency, and a meaningful life? Alternatively, in what ways is
he or she a prisoner of space, constrained by the congura-
tion and accoutrements of the setting and trapped in a place
that is increasingly conning and restrictive? In essence,
what is the meaning of dwelling in a particular place and
what are the implications of this meaning for the practice of
occupational therapy? To answer such questions, it is impor-
tant to understand complex dimensions of meaning that
characterize the phenomenon of dwelling and that nurture a
therapeutically desirable sense of being in place (Rowles,
1991, 2000).
Relevance to Occupational Therapy
Developing a sense of each persons environmental, life
course, and phenomenological contexts is of paramount im-
portance to practitioners because occupational therapy in-
terventions are invariably framed against the backdrop of a
persons unique sense of self and of being in place. Interven-
tions that take an individual out of placefor example,
those that occur in a hospital, clinic, or rehabilitation envi-
ronmentare invariably compromised because the agenda
of the person is necessarily expanded to cope with accom-
modation to an unfamiliar setting. In some cases, treatment
in a hospital or clinical setting is inevitable because of the
availability of specialized equipment and personnel. This
does not obviate the need for understanding the dimensions
of a persons being in place. Rather, it makes such under-
standing even more important when designing treatment
settings that create a level of environmental comfort con-
ducive to effective occupational therapy practice.
DIMENSIONS OF BEING IN PLACE
A persons sense of being in place is a complex and dynamic
phenomenon (Rowles, 1978; Rubinstein & Parmalee, 1992;
Tuan, 1977). Several underlying themes or dimensions can
be identied (Box 9-1).
BOX 91 DIMENSIONS OF BEING IN PLACE
USE OF SPACE
Immediate physical activity: Range of motion and
functional capability-related movement in the proximal
environment.
Everyday activity: Routine and often repeated daily trips
along familiar pathways involved in the conduct of daily
life.
Occasional trips: Vacations and long-distance trips,
generally involving overnight stays.
ORIENTATION IN SPACE
Personal schema: Physiologically based axial orientation
that enables the individual to maintain balance and
distinguish left from right, front from back, and up from
down.
Specic schemata: Cognitive linear maps of regularly traveled
pathways, including an awareness of environmental cues
that facilitate successfully traversing space.
General schema: An implicit cognitive map of the world as
known, which can be evoked and mentally constituted at
diverse scales and in diverse manifestations that vary
according to the circumstances in which it is invoked.
EMOTIONAL AFFILIATIONS WITH PLACE
Personal: Emotions evoked by personal experiences within
particular locations that imbue settings with meaning
and signicance for the individual may be positive or
negative.
Shared: Mutually developed emotions for place rened
through interaction over time among residents of a
shared environment.
VICARIOUS PARTICIPATION IN SPATIALLY AND/OR
TEMPORALLY DISPLACED ENVIRONMENTS
Reective: Involvement in places of ones past (either the
current environment as it was in the past or previously
experienced places located elsewhere).
Projective: Vicarious projection into contemporary places
that are geographically displaced from the individuals
current location.
Using Space
At its most fundamental and easily observable level, being
in place involves patterns of occupation, of activity in using
space. Space is used on multiple levels. First is the domain of
immediate physical activity or range of motion. This in-
volves activities of daily living; for example, the functional
ability to reach for a high shelf or to crouch without dif-
culty to pin up a skirt. Use of space on this level becomes a
primary focus of occupational therapy when activity be-
comes limited through illness or accident.
On a larger scale, we traverse the physical environment
and trace regular pathways of everyday activity that over
 CHAPTER 9: The Meaning of Place as a Component of Self 113

FIGURE 91. The everyday habit of breakfast at a local eatery forms important relationships.
(Photo courtesy of D, Prince, University of New Hampshire Photographic Services Durham, NH.)

time may become habitual (Rowles, 1978, 2000; Seamon,
1980). Each weekday morning, we walk to the corner of our
street to catch the bus to work. On Sundays, we drive a fa-
miliar route to church. Over time, we tend to develop a reg-
ular timespace rhythm and routine in use of the physical
environment that becomes taken for granted and subcon-
scious as our body adapts to the setting (Fig. 9-1). Recent
occupational therapy research suggests that deeper under-
standing of habits and habituation may hold the key to im-
portant therapeutic interventions (American Occupational
Therapy Foundation, 2000).
The regular routine of everyday behaviors is enriched or
disrupted by occasional trips that take us beyond our daily
round. We vacation in a distant state or make an annual
visit to stay with a relative. After a motor accident, we may
spend a period recuperating in a rehabilitation hospital
some way from our home.
Over the life course, patterns of using space gradually
evolve in concert with changing capabilities and resources.
The infant is restricted to a crib or playpen. The child, un-
der a parent or siblings watchful eye, may be permitted to
play in the garden or in the neighborhood. Access to a rst
automobile signicantly increases spatial range and in adult-
hood may lead to a propensity to travel far and wide. With
advancing years, the space within which we physically re-
side and travel may become limited once again as we be-
come environmentally vulnerable.
Patterns of using space are closely intertwined with the
manner in which we cognitively orient ourselves in the en-
vironment. This involves a physiological orientation within
the axial system of the human body that provides the ability
to discriminate up from down, left from right, and front from
back. This personal schema is taken for granted. Its critical
role may be fully recognized only when we become disori-
ented through a health condition such as Mnire disease
that affects balance, the secondary effects of medication, or
excessive consumption of alcohol.
Physiologic orientation is a necessary but not sufcient
condition for moving around in the environment. It is also
necessary to develop mental images, cognitive maps of the
conguration of the environment that guide us as we tra-
verse space (Downs & Stea, 1973). Over time, we develop
detailed cognitive awareness of paths we trace each day.
This awareness may involve an array of environmental cues,
comprising specic schemata that mark each route we take:
The more familiar the journey, the more implicit the
schemata. The rst time we walk an unfamiliar route, we are
acutely aware of directions, the environmental cues that
114 UNIT TWO: Persons Seeking Occupational Therapy
ETHICS NOTE 91
The Question of Driving Safety
PENNY KYLER and RUTH HANSEN
Louise is a 71-year-old widow who has traveled widely
and been an active and lively participant in the cultural
scene of her small town. In addition, she has driven from
the East Coast to New Mexico several times in the last
few years to attend an opera festival. Six months ago,
Louise experienced a moderate cerebral vascular accident
with resultant left hemiparesis and left side neglect. She
is currently at home living alone. She has grown tired of
having to depend on friends and neighbors for rides to
various places. For the past 2 weeks, Louise has been
driving by herself on the streets of her small community.
She mentioned just at her last therapy session that she
plans to make her trip westward for the opera season.
QUESTIONS AND EXERCISES
1. As her home health therapist, what are your legal and
ethical responsibilities? To Louise, to the members of
her community, and to the public at large?
2. What, if any, are Louises obligations to her
community?
3. How should the therapist handle the information
regarding Louises driving, if she has not gotten the
information directly from Louise?
friends have related mark the places to turn or to cross the
street. But as we repeatedly pass along this way, the need to
use these cues recedes into the subconscious.
Cognitive awareness of regular pathways is embedded
within a general schema. This implicit cognitive map of the
world as we know it is characteristically centered on our
home. It involves detailed awareness of zones of immedi-
ately adjacent space; for example, the surveillance zone
the area within the visual eld in which we may develop
strong visual or mutually supportive relationships with
neighbors characterized by a high level of everyday reci-
procity (Rowles, 1981) (Fig. 9-2). We may also be familiar
with space beyond the visual eld, which becomes identied
as our neighborhood. Moving farther away from home, cog-
nitive awareness of space becomes progressively sketchier.
There may be limited cognitive knowledge of the congura-
tion of spaces beyond our own community, city, or town.
The exception is a limited number of beyond spaces.
These are places we have visited on occasional trips, settings
in which we lived in the past, or familiar places where rela-
tives reside. We may retain detailed images of the congura-
tion of such places.
Life-course transitions in the use of space are paralleled
by evolution in the manner in which we orient in space. In
childhood, the experienced environment may be limited
to our home and surroundings in the immediate vicinity.
As experience increases and we become more geographi-
cally liberated, our cognitive world becomes more exten-
sive. A cosmopolitan mobile pattern of life in adulthood
may lead to familiarity with environments throughout the
world and an acute sense of their conguration and spatial
relationship to one another. If we lead a life focused on a
single urban neighborhood or rural community, our orien-
tation may be equally rich and detailed but more locally fo-
cused. Finally, as we grow older, the tricks of memory and
the sheer volume of accumulated place experiences may re-
sult in complex overlapping cognitive images within
which specic locations may be known simultaneously as
they were during a series of different times in their exis-
tence. Our awareness of a less frequently visited location
may be a residual memory of its past rather than an accu-
rate image of its current conguration. Indeed, when we re-
turn to such a setting we may no longer recognize it and
may become disoriented.
Meaning in Place
Patterns of use and cognitive orientation to place parallel
the development and reinforcement of distinctive place-
related emotions (Altman & Low, 1992; Seamon, 1984).
Some of these are individual and highly personal. They may
express a sense of afnity with places where key life events
transpiredwhere we met our future spouse, made love for
the rst time, or experienced a traumatic event. Mere pres-
ence in such places may evoke memories, the resurrection in
consciousness of key incidents in our lives, and strong vis-
ceral emotions. As life experiences accumulate, frequently
inhabited places where multiple events occurred over an ex-
tended period of time become suffused with an array of emo-
tions, reecting a place biography of self and setting.
Other place-related emotions are shared. They arise from
common habitation of a spacefor example, an inner-city
neighborhoodby a cohort of residents who, through their
interaction and shared experiences, gradually come to imbue
the place with its own personality, identity, and meaning as
a social space (Rowles, 1978; Suttles, 1969). Long-time res-
idents of changing neighborhoods may share complex emo-
tional identication with a collage of the many different
places it has been over the course of their lives, ranging from
vibrant new development to rundown and largely aban-
doned slum.
Recognition of the critical role of time in human experi-
ence allows us to understand being in place as far more than
the physical occupation of a space, the use of orientation
skills, and the development of emotional afliation with
particular locales. Through the uniquely human capacity to
remember, to imagine, and to project ourselves mentally into
spaces beyond our immediate visual eld, we can vicariously
participate in spaces displaced in space and time. We can re-
turn in our minds to the places of our childhood (Chaudhury,
1999). We can project ourselves into the contemporary
 CHAPTER 9: The Meaning of Place as a Component of Self
FIGURE 92. The surveillance zone. (Photo courtesy of G. Rowles.)
environments of family members and imagine what they
might be doing half a continent away as we watch a tele-
vised national weather forecast that informs us it is raining
where they live (Rowles, 1978).
The ability to traverse space and time in our mind and
inhabit an experiential world much larger than the imme-
diate and contemporary physical setting is nurtured and re-
inforced by the artifacts with which we surround ourselves.
Particular items of furniture, treasured personal posses-
sions, scrapbooks, and photographs all serve as cues to the
resurrection or stimulation of place experience in con-
sciousness (Belk, 1992; Boschetti, 1995; Csikszentmuhalyi
& Rochberg-Halton, 1981). Such items convey a sense of
identity; capture essential elements of our autobiography;
and in so doing, help us dene and maintain a sense of self.
We become the places of our liveswhere we live and
what we own.
To summarize, the spaces of our life become transformed
into the places of our life through a variety of physical, cog-
nitive, emotional, and imaginative processes of habitation
that imbue existence with meaning and personal signi-
cance. Contemporary physical presence is only a small part
of being in place. It is merely the overtly observable and
115
most readily apparent aspect of a complex self that has grad-
ually evolved over the life course, with the accumulation
and integration of a plethora of life-shaping and person-
forming experiences in the different places we have occu-
pied from birth until the present.
Meaning of Home
The most intense expression of being in place characteristi-
cally involves our relationship with homeusually, although
not invariably, the dwelling where we reside. In this loca-
tion we nd the most sophisticated expressions of human
relationship with the environment with respect to all levels
of being in placeuse, cognitive orientation, emotional
afliation, and vicarious involvement (Marcus, 1995;
Rubinstein, 1989; Sixsmith, 1986; Zingmark, Norberg, &
Sandman, 1995). Indeed, being in place entails being at
home. Home is territorya place of possession and own-
ership that may be ercely defended. Home is a place of
safety and security. Often, home is the spatial fulcrum of our
life, a place of centering that may become the core of our
being and a location from which we venture forth into a
potentially hostile world outside and beyond and to which
116 UNIT TWO: Persons Seeking Occupational Therapy
we return for shelter. Home is a place of freedom, a loca-
tion where we can let go and be ourselves. Home is a repos-
itory of the items we have accumulated that catalog our
history and dene who we are. Beyond the personal signif-
icances with which such items can be imbued, home often
also becomes a locus of expression as we present ourselves
to visitors, neighbors, and those who pass by, through the
way in which we maintain and decorate the property and
care for our yard. Because of the complex interweaving of
these themes over an extended period of residence, home
may come to be viewed as a sacred place and the seat of a
persons very being and identity (Eliade, 1959). Little
wonder that, for many people, to abandon ones home is,
in a quite real sense, to contemplate a severance from self.
MAKING SPACES INTO PLACES OVER
THE LIFE COURSE
Being in place and its relationship to self is a dynamic phe-
nomenon. Throughout the life course, as we move from lo-
cation to location, we are constantly creating and re-creating
place as a component of personal identity. With every move,
we slough off elements of our past. With every move, we carry
selected elements of this past with us and meld them with
new experiences and the inuence of new environments as
we create a contemporary lifestyle and sense of being in place
in the present. This selective process of transference allows
us to maintain a continuity of self and identity that is rein-
forced by an evolving relationship with the places of our life
(Twigger-Ross & Uzzell, 1996).
Transitions and Disruptions of Being in Place
A variety of circumstances result in changes in an individ-
uals relationship with place that have important conse-
quences for sense of self and well-being. Among the most
profound are changes in personal capability. During the rst
portion of life, such changes are generally liberating. As we
progress from infancy through childhood and into adoles-
cence, the geographical world tends to expand as physical
and mental capabilities develop and access is gained to an
ever-wider array of resources (education, income, trans-
portation). Competence tends to increase within an in-
creasingly diverse array of environments. At the other end
of the life course, as we grow old, physical and sensory decre-
ments may become restrictive and conning, at least with
respect to our physical use of space. It may become more dif-
cult to venture abroad, to maintain our home, even to
climb the stairs to an upstairs bedroom.
Lives are also lived within the context of constantly
changing environments. New roadways disruptively slice
through neighborhoods, the physical landscape changes
with the addition of new buildings or the deterioration and
demolition of old ones, new populations migrate into formerly
stable residential enclaves, and both natural and human-
made disasters transform the landscapes of our life. In youth,
such change may be a source of stimulation and new oppor-
tunity; but as we grow older, we may become less resilient in
accommodating to such external environmental changes.
Regardless of its source, change in peoples relationship with
the environment, whether in situ change or relocation, has
become a predominant motif of life in contemporary Western
societies.
Creating and Re-Creating Place
A fundamental human tension exists between the need for
familiarity, security, and a sense of continuity and an urge
to explore and to venture forth into the unknown (Balint,
1955; Buttimer, 1980). This tension is expressed in se-
quential habitation of the environments of our life
through processes whereby we constantly create and re-
create place as an expression of an evolving self (Rowles &
Watkins, In press). Most people exhibit residential inertia
and reluctance to move. The intensity of this inertia may
vary over the life course and among different generations
with many young people exhibiting greater enthusiasm for
relocation and many elders expressing a desire to age in
place (Callahan, 1992; Tilson, 1990). However, when re-
location does occur, there are certain constancies in the
manner in which people accommodate to change.
People with a history of frequent relocation often be-
come experienced place makers. With every relocation they
become more adept at sustaining links with places of their
past even as they accommodate to opportunities provided
by new settings. The process involves several overlapping
elements: Each serves to preserve a continuity of self. First,
there is a tendency for holding on manifest in routine ways
of accommodating to the stress of separation from environ-
ments of our past. Contact with previous settings may be
maintained through periodic return visits, telephone calls to
former neighbors, or maintaining ongoing correspondence.
Maintaining links with the places and the self of the past
may also involve transferring treasured artifacts, including
photographs and memorabilia that serve as cues to key
events and locations in personal history (Boschetti, 1995;
Paton & Cram, 1992).
A second element of creating and re-creating place is a
recurring process of moving on; personal growth through ac-
tive investment in each new setting. Often this involves
lifestyle change because of accommodation to illness, dis-
ability, or other changed circumstances. The process may
involve the use of learned strategies for making new friends
and becoming involved in the local social milieu, such as mak-
ing conscious efforts to visit new neighbors or co-residents
(Reed & Payton, 1996). It may entail efforts, sometimes
subconscious, to re-create elements of the familiar in each
new setting. For example, some people re-create place and
facilitate the maintenance of a comfortable routine in the
use of space by arranging their furniture in a conguration

similar to that which existed in their previous residence
(Hartwigsen, 1987; Toyama, 1988). The re-creation of place
may also involve the selective transfer of artifacts and pos-
sessions and their arrangement within a new space in ways
that serve to dene and reinforce an evolving sense of self
(Belk, 1992; Boschetti, 1995).
Creation and re-creation of place are lifelong processes.
During the rst part of life, acts of accumulation tend to be
dominant motifs within this process. Thus, as a student
apartment gives way to the condominium of the young pro-
fessional, the rst single-family home, and a series of pro-
gressively larger dwellings in parallel with changing needs as
we nd a partner and establish a family, we tend to accumu-
late more and more possessionspossessions that may come
to dene our persona. There is preliminary evidence that as
we grow older and, in many cases, are obliged to move from
spacious dwellings to residences with progressively less
space, this process may gradually give way to a process of di-
vestiture that involves a carefully reasoned but emotionally
taxing reduction of inventory and placing priority on re-
taining items of particular personal and self-dening signi-
cance (Morris, 1992). For elders, a continuing sense of being
in place may be closely related to the ability to accomplish
this process in a manner that facilitates the retention of
ongoing identity.
THE PLACE OF PLACE IN OCCUPATIONAL
THERAPY
This chapter suggests that understanding a persons sense of
self and well-being is intimately linked to a phenomenolog-
ical life-course-based understanding of an evolving person
environment relationship. Within this rubric, denition of
person is expanded to emphasize the role of autobiography in
dening the self. The concept of environment is elaborated
and recast as the experiential notion of place. This recong-
uration is more than semantic novelty. Rather, it provides
the basis for deeper understanding of aspects of the experi-
enced world of the client that have important implications
for practice.
At the most fundamental level there is a need for occupa-
tional therapy practitioners to become more intimately at-
tuned and sensitive to the complexity of each clients being in
place. It is not enough solely to observe a persons contempo-
rary architectural setting and identify the physical barriers
that interfere with the performance of daily occupational
tasks. Admittedly, it is important for practitioners to become
advocates for client-centered environmental design that en-
hances occupational performance through design modica-
tion and the use of assistive devices. But while this may be
necessary as a rst step in seeking interventions to improve
functional performance, it is not sufcient if the goal is to en-
able the client to realize his or her full potential for attaining
the highest possible quality of life. To accomplish this more
CHAPTER 9: The Meaning of Place as a Component of Self 117
sophisticated objective, it is necessary to embrace a broader
understanding of place as a component of therapyto de-
velop place therapy (Scheidt & Norris-Baker, 1999).
What would an occupational place therapy look like?
More than a rigid set of prescribed procedures, such a ther-
apy would focus primarily on attitude and the practitioners
manner of relating to each client. It would focus on identi-
fying customary patterns in the use of space, the role of habit
and routine in these behaviors, and ways in which interven-
tions can minimize disruption of habits and routines or cre-
ate new ones consonant with a clients personal history. It
would focus on identifying the manner in which clients cog-
nitively orient their daily behaviors in relation to the places
of their lives and normatively use such constructions in ac-
commodating to personal or environmental change. Such
information would enable the practitioner to provide appro-
priate support and re-orientation in response to changed cir-
cumstances. It would explicitly focus on the implications of
disrupting longstanding emotional attachments to specic
environments and to the artifacts contained in those envi-
ronments and seek ways of compensating for such disrup-
tions; for example, facilitating the transfer of key personal
possessions when relocation is necessary (Wapner, Demick,
& Redondo, 1990). And it would focus on framing inter-
ventions within the constraints and opportunities provided
by the myriad environments that clients vicariously inhabit
in their mindsenvironments displaced in space and/or
timethat often are key elements in their denition of self.
In this domain, key occupational therapy intervention
might include reminiscence therapy or other types of activ-
ity that serve to maintain the connection of clients with the
places of their lives that constitute their experiential world
(Burnside & Haight, 1994; Chaudhury, 1999).
Translating such lofty aspirations into practical terms in
the context of home and relocation, possibilities for facili-
tating adjustment to either reduced physical capability in
situ or a needed relocation include preparation strategies,
ranging from anticipatory modeling of change (Hunt &
Pastalan, 1987) through processes of constructing familiar-
ity (Reed & Payton, 1996) to psychotherapy based on
ecoanalysis of the home (Peled & Schwartz, 1999). Such
strategies are designed to prepare clients to deal with the
consequences of separation from familiar place and routine
and to facilitate the re-creation of place in a manner consis-
tent with changed circumstances.
It is important to add words of caution at this point. First,
for some people, expressions of self and of being in the world
derive from dimensions of life other than place and home. It
can be argued that such placeless persons may be alienated
from their environment and perhaps, by extension, from self.
Nonetheless, it is important to avoid the dangers of romanti-
cism and to avoid a stereotypical view of the role of place in
peoples lives. Second, occupational place therapy may be
more appropriate for some clients than for others. For exam-
ple, persons with lengthy histories and multiple experiences of
accommodating to change both within their indigenous
118 UNIT TWO: Persons Seeking Occupational Therapy
environment and through experience in place-making gained
from frequent relocations may be adept at accommodating to
lifestyle and behavioral changes necessitated by a needed oc-
cupational therapy intervention. But what of those who have
been more residentially stable and who have been accus-
tomed to lifelong routines of using a single space and relating
to only a few places? Such individuals may experience great
difculty in abandoning familiar routines; adjusting the na-
ture of their being in place in a familiar residence; or, should
relocation be necessary, transforming a new space into a place.
For these individuals change may be particularly traumatic.
CONCLUSION
There is a tendency in contemporary society to assume that
individuals achieve successful rehabilitation merely by re-
turning to former levels of physical functioning and behav-
ioral competence. Such a view is myopic and demeaning
with respect to the richness of human experience. When a
practitioner advocates removal of a potentially hazardous
throw rug from a clients hallway, offers assistance in rear-
ranging the clients space to accommodate a disability, or
provides training in the use of the latest occupational ther-
apy gadget, he or she may be effectively enhancing the
safety of the home and the physical competence of the
client while diminishing the clients sense of control and au-
tonomy. The interventions may mean discarding a rug in-
herited from a favorite grandmother and transported from
home to home over a lifetimean artifact that is an endur-
ing symbol of family history and continuity. Rearranging the
space may move important family photographs beyond the
visual eld of a favorite chair that, itself, was formerly by the
window but has been moved to a safer location that no
longer affords a view of activities in the surveillance zone
outside. The gadget that the therapist nds so innovative
and helpful may achieve its overt purpose but reinforce a
sense of inadequacy and incompetence in an individual who
might be even better served by accommodating to a disabil-
ity through a less overtly intrusive strategy.
Historically, the past few decades may come to be known
as an era in which our technology exceeded our humanity as
humankind lapsed into hedonistic obsession with material
and technological ingenuity. By reinvesting in meaning
through place, it may be that occupational therapy can help
us rediscover our humanity. By seeking new ways to enable
individuals to maintain an enduring sense of being in place
as a component of the self, the practice of occupational
therapy can become elevated to a higher plane.
References
Altman, I., & Low, S. M. (Eds.). (1992). Place attachment. New York: Plenum.
American Occupational Therapy Foundation. (2000). 1999 Habits confer-
ence supplemental issue. Occupational Therapy Journal of Research,
20(Suppl. 1), 2S143S.
Balint, M. (1955). Friendly expansesHorrid empty spaces. International
Journal of Psychoanalysis, 36(4/5), 225241.
Barris, R. (1986). Activity: The interface between person and environ-
ment. Physical and Occupational Therapy in Geriatrics, 5, 3949.
Barris, R., Kielhofner, G., Levine, R. E., & Neville, A. M. (1985). Occupa-
tion as interaction with environment. In G. Kielhofner (Ed.). A model of
human occupation: Theory and application (pp. 4262). Baltimore: Williams
& Wilkins
Belk, R. W. (1992). Attachment to possessions. In I. Altman & S. M. Low
(Eds.). Place attachment (pp. 3762). New York: Plenum.
Boschetti, M. A. (1995). Attachment to personal possessions: An interpre-
tive study of the older persons experiences. Journal of Interior Design,
21(1), 112.
Burnside, I., & Haight, B. (1994). Reminiscence and life review: Thera-
peutic interventions for older people. Nurse Practitioner, 19(4), 5561.
Buttimer, A. (1980). Home, reach and the sense of place. In A. Buttimer &
D. Seamon (Eds.). The human experience of space and place (pp. 166187).
New York: St. Martins.
Callahan, J. J. (1992). Aging in place. Generations, 16, 56.
Chaudhury, H. (1999). Self and reminiscence of place: A conceptual study.
Journal of Aging and Identity, 4(4), 231253.
Christiansen, C., & Baum, C. (1997). Person-environment-occupational
performance: A conceptual model for practice. In C. Christiansen &
C. Baum (Eds.). Occupational therapy: Enabling function and well-being
(pp. 4670). Thorofare, NJ: Slack.
Csikszentmuhalyi, M., & Rochberg-Halton, E. (1981). The meaning of
things: Domestic symbols and the self. New York: Cambridge University
Press.
Downs, R. M., & Stea, D. (Eds.). (1973). Image and environment: Cognitive
mapping and spatial behavior. Chicago: Aldine.
Dunn, W., Brown, C., & McGuigan, A. (1994). The ecology of human per-
formance: A framework for considering the effect of context. American
Journal of Occupational Therapy, 48(7), 595607.
Eliade, M. (1959). The sacred and the profane. New York: Harcourt, Brace &
World.
Hartwigsen, G. (1987). Older widows and the transference of home. Inter-
national Journal of Aging and Human Development, 25(3), 195207.
Hunt, M. E., & Pastalan, L. A. (1987). Easing relocation: An environ-
mental learning process. In V. Regnier & J. Pynoos (Eds.). Housing the
aged: Design directives and policy considerations (pp. 421440). New York:
Elsevier.
Kielhofner, G. (1995). A model of human occupation: Theory and application
(2nd ed.) Baltimore: Williams & Wilkins.
Kiernat, J. M. (1982). Environment: The hidden modality. Physical and
Occupational Therapy in Geriatrics, 2, 312.
Kiernat, J. M. (1987). Promoting independence and autonomy through
environmental approaches. Topics in Geriatric Rehabilitation, 3, 16.
Law, M., Cooper, B., Strong, S., Steward, D., Rigby, P., & Letts, L. (1996).
The person-environment occupation model: A transactive approach to
occupational performance. Canadian Journal of Occupational Therapy, 63,
923.
Marcus, C. C. (1995). House as a mirror of self: Exploring the deeper meaning
of home. Berkeley, CA: Conari.
Morris, B. R. (1992). Reducing inventory: Divestiture of personal posses-
sions. Journal of Women and Aging, 4(2), 7992.
Paton, H., & Cram, F. (1992). Personal possessions and environmental
control: The experiences of elderly women in three residential settings.
Journal of Women and Aging, 4(2), 6178.
Peled, A., & Schwartz, H. (1999). Exploring the ideal home in psychother-
apy: Two case studies. Journal of Environmental Psychology, 19, 8794.
Reed, J., & Payton, V. R. (1996). Constructing familiarity and managing
the self: Ways of adapting to life in nursing and residential homes for
older people. Ageing and Society, 16, 543560.
Rowles, G. D. (1978). Prisoners of space? Exploring the geographical expe-
rience of older people. Boulder, CO: Westview.
Rowles, G. D. (1981). The surveillance zone as meaningful space for the
aged. The Gerontologist, 21(3), 304311.
 CHAPTER 9: The Meaning of Place as a Component of Self
Rowles, G. D. (1991). Beyond performance: Being in place as a component
of occupational therapy. American Journal of Occupational Therapy,
45(3), 265271.
Rowles, G. D. (2000). Habituation and being in place. Occupational Ther-
apy Journal of Research, 20 (Suppl. 1), 52S67S.
Rowles, G. D., & Watkins, J. F. (In press). History, habit, heart and
hearth: On making spaces into places. In K. W. Schaie, H.-W. Wahl,
H. Mollenkopf & F. Oswald (Eds.). Aging in the community: Living envi-
ronments and mobility. New York: Springer.
Rubinstein, R. (1989). The home environments of older people: A de-
scription of the psychosocial processes linking person to place. Journals
of Gerontology, 44, S45S53.
Rubinstein, R., & Parmalee, P. A. (1992). Attachment to place and the
representation of the life course by the elderly. In I Altman & S. M. Low
(Eds.). Place attachment (pp. 139163). New York: Plenum.
Scheidt, R. J., & Norris-Baker, C. (1999). Place therapies for older adults:
Conceptual and interventive approaches. International Journal of Aging
and Human Development, 48(1), 115.
Schkade, J. K., & Schultz, S. (1992). Occupational adaptation: Toward a
holistic approach for contemporary practice, part 1. American Journal of
Occupational Therapy, 46, 829837.
Seamon, D. (1980). Body subject, time-space routines, and place ballets. In
A. Buttimer & D. Seamon (Eds.). The human experience of space and place
(pp. 148165). London: Croom Helm.
Seamon, D. (1984). Emotional experience of the environment. American
Behavioral Scientist, 27(6), 757770.
119
Settersten, R. A. (1999). Lives in time and place: The problems and
promises of developmental science. Amityville, NY: Baywood.
Sixsmith, J. (1986). The meaning of home: An exploratory study of envi-
ronmental experience. Journal of Environmental Psychology, 6, 281298.
Suttles, G. D. (1969). The social order of the slum. Chicago: University of
Chicago Press.
Tilson, D. (Ed.). (1990). Aging in place: Supporting the frail elderly in residen-
tial environments. Glenview, IL: Scott, Foresman.
Toyama, T. (1988). Identity and milieu: A study of relocation focusing on
reciprocal changes in elderly people and their environment. Stockholm:
Department for Building Function Analysis, the Royal Institute of
Technology.
Tuan, Y. F. (1977). Space and place: The perspective of experience. Minneapolis:
University of Minnesota Press.
Twigger-Ross, C., & Uzzell, D. L. (1996). Place and identity processes. Journal
of Environmental Psychology, 16, 205220.
Wapner, S., Demick, J., & Redondo, J. P. (1990). Cherished possessions
and adaptation of older people to nursing homes. International Journal of
Aging and Human Development, 31(3), 219235.
Wheeler, W. M. (1995). Elderly residential experience: The evolution of places
as residence. New York: Garland.
Zingmark, A., Norberg, K., & Sandman, P.-O. (1995). The experience of
being at home throughout the lifespan: Investigation of persons 2 to
102. International Journal of Aging and Human Development, 41(1),
4762.