Whose occupational balance is it anyway?
Research
The challenge of neoliberal capitalism and
work–life imbalance
Teena J Clouston
Key words:
Work, life stress,
quality of life,
activities of daily living,
time factors.
Correspondence to: Dr Teena J Clouston,
Senior Lecturer and Director of Learning
in Practice, Cardiff University, School of
Healthcare Sciences, College of Biomedical
and Life Sciences, Cardiff.
Email: cloustontj@cf.ac.uk
Twitter: @teenaclouston
Reference: Clouston TJ (2014) Whose
occupational balance is it anyway? The
challenge of neoliberal capitalism and
work–life imbalance. British Journal of
Occupational Therapy, 77(10), 507–515.
DOI: 10.4276/030802214X14122630932430
© The College of Occupational Therapists Ltd.
Submitted: 27 May 2013.
Accepted: 23 July 2014.
Downloaded from bjo.sagepub.com at CARLETON UNIV on June 18, 2015
Introduction: Occupational therapists/scientists maintain that achieving occupational
balance through participation in ‘doing’ and ‘being’ occupations enhances
personal and social wellbeing. However, the influence of paid work on occupational
balance is not well researched. The purpose of this study was to explore the
influence of workplace cultures on the lived experience of occupational balance
for occupational therapists.
Method: Two representative workplaces were accessed: one health and one
social services setting, both in Wales. Twenty-nine occupational therapists took
part, 18 from healthcare and 11 from social services. The study was qualitative in
design, using in-depth interviews and interpretative phenomenological analysis.
Findings: The study identified a potent link between neoliberal capitalism and
occupational imbalance for occupational therapists as a consequence of the
pressures of paid work on the rest of life, the social hegemony of paid work, and
a sense of individual responsibility for both performance in paid work and
success or failure in personal occupational balance.
Conclusion: Occupational therapists can live unbalanced lives as a consequence
of the pressures of the neoliberal workplace on ‘doing’ and ‘being’ activities
outside of paid work. Individuals can experience a sense of personal responsibility
about success or failure in work–life balance that can affect their achievement of
wellbeing through occupational balance.
Introduction
Changes in the United Kingdom (UK) labour market have been profound over
the last decade. Branded as ‘capitalism with the gloves off’, neoliberal principles
have introduced a free market economy and pushed competition and con-
sumerism as tools of growth (McChesney 1999, p8). As a consequence of this
economic model, the pressures of paid work have intensified, with increased
workloads and higher performance targets expected with fewer resources.
Associated ideologies driving individualism and a personal sense of respon-
sibility for performance and success in paid work have eroded collective values
and, specifically in the public sector, disenfranchised unions, strengthening
the power of employer over employee (Scott 2004).
These changes have led to higher levels of stress and job insecurity, corre-
spondingly increasing the sense of responsibility, time, and effort individual
workers put into the paid workplace, frequently to the detriment of time and
energy in other life domains (Costea et al 2008). This skewed juxtaposition
between the amount of time and energy spent on the so-called ‘obligatory’ or
‘necessary’ tasks of paid work, in comparison to the rest of life’s activities, not
only precludes the spending of personal resources on other necessary activities,
such as caring and domestic tasks, thereby creating conflict between them
(Guest 2002), but also erodes the individual’s resources of time and energy for
the more personally chosen or non-obligatory types of activities asserted as
essential for wellbeing in the concept of occupational balance (Wilcock 1999).
British Journal of Occupational Therapy October 2014 77(10) 507
Whose occupational balance is it anyway? The challenge of neoliberal capitalism and work–life imbalance
This brings us to the crux of the problem: if occupational
therapists/scientists are promoting occupational balance
within a framework of neoliberal market economies, so the
demands on the human resources of time and energy will be
predominantly directed toward paid work because, in these
socio-political structures, paid work is the ultimate partici-
patory priority (Levitas 2001). This not only challenges the
concept of achieving occupational balance in social structures
where paid work is valued over other life activities, but also
suggests how the drive for personal responsibility in terms
of managing paid work effectively, which is closely associated
with expectations for the individual worker to be fully involved
in paid work ‘with its whole subjectivity’ (Costea el al 2008,
p672), is influencing how individuals achieve and sustain a
personally meaningful and freely chosen life balance.
As employees of the public sector, the workforce in health
and social care in the UK have not escaped these influences
on paid work, with increased performance targets, limited
resources, and a culture driving financial efficiency over staff
and service user wellbeing openly reported (Francis 2013).
Paton’s (2001) analysis of the role of the British State in
healthcare coined the term ‘a more with less culture’ (p63)
to capture the pressures exerted on workers to achieve a
quality service within a fiscally driven climate.
For knowledge workers like occupational therapists, any
increased use of personal time and energy within paid work
has particular salience in terms of wellbeing because these
resources are embodied skills, requiring not only the use of
physical but also cognitive and emotional assets. Where all
three of these personal reserves are challenged collectively, the
individual’s ability to sustain wellbeing is reduced, pushing
individuals beyond stress to a state of exhaustion and burnout
(Barnes and Van Dyne 2009).
This article discusses the findings from research carried
out with occupational therapists working in health and social
services in the UK. Specifically, it reports a potent link between
the forces of neoliberal capitalism and a pervasive sense of
occupational imbalance for occupational therapists, as a direct
consequence of the pressures of paid work on the rest of life
and a growing sense of individual responsibility about perfor-
mance in the workplace and about work–life balance.
Literature review
Work–life balance
Work–life balance is a term that captures the notion of an
ideological separation between paid work and the rest of life’s
activities. Although this may initially seem to capture the
complex, multidimensional nature of living our modern lives,
in practice the word ‘work’ is associated only with paid work
and ‘life’ principally captures domestic and caring commit-
ments in its meaning.
This rather limited, two-dimensional view of life’s very
complex multiple activities (or occupations) is reflective of
the principles of neoliberal market economies, where these
two domains are categorized as the necessary or obligatory
508 British Journal of Occupational Therapy October 2014 77(10)
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activities in everyday life (Guest 2002). Consequently, the
concept of work–life balance does capture everyday social
values, which identify that all adults of working age, irre-
spective of family commitments, should participate in paid
work and effectively balance this with their home or caring
responsibilities in order to achieve measurably successful
human functioning (Hochschild 2008).
Within neoliberal market economies, achieving even this
limited notion of work–life balance has become problematic.
First, intensified pressures within paid work environments
have driven a more performance-led culture. This expects
more to be achieved with less in terms of human and financial
resources. For workers, this not only creates but proliferates
conflicts between paid work and home life as they adapt their
time and energy reserves to meet the extra demands in the
paid work domain (Paton 2001).
Where these workplace strategies are supported by cultures
that shift the responsibilities of managing workload, work-
place pressures, and performance firmly onto the individual
worker, and demand not only physical but emotional and
cognitive time and energies, ethical and moral tensions are
generated between home and paid work domains (Williams
2001). Ultimately, this challenges not only the worker’s
physical and psychological health and wellbeing but also
that of their family, because physical, cognitive, and emotional
resources are slowly siphoned from the home to work
domains (Bunting 2005).
Second, in neoliberalism, paid work has attained the gold
standard in terms of activity participation and has social capital.
Consequently it is the activity of choice for individual social
actors; this creates a drive to participate in that domain, irrespec-
tive of the pressures this might entail (Hochschild 2008).
Third, and perhaps most insidiously, neoliberal capitalism
has embedded consumerism and market cultures into our
everyday lives. By imbuing the need to purchase both essential
items like food and those associated with social values and
symbolic capital, it has made us become part of the cycle
of consumption; by commodifying the worker through the
exchange of time and energy for money it has made us into
tools in the cycle of production (Hochschild 2008).
Consequently, whilst people do have choices about how
they engage with work–life balance, in the market cultures
of neoliberalism the ultimate priority for successful human
functioning is participation in paid work. These values are
embedded in our social structures and shape and influence
the possibilities and choices we have in how we live our
everyday lives. For occupational therapists/scientists, these
kinds of values are significant challenges to the concepts we
hold about occupational balance and the assumption of the
ability to freely chose to participate in meaningful activities
to achieve wellbeing (Hammell 2009).
Occupational balance
Unlike work–life balance, theories of occupational balance
focus directly on effective participation in a complex variety of
different activities. Commonly categorized as self-care, pro-
ductivity, and leisure (Hammell 2009), other frequently-cited

categories in these theories include rest, play, learning, work,
and personal interests (Backman 2004). Although paid work
is specified as a necessary activity in occupational balance,
it is considered as only one of many possible permutations of
productive activities (Stamm et al 2009, Wagman et al 2011)
and greater emphasis is given to the meaning and purpose
the activity holds for the individual (Primeau 1996, p66).
Whilst this notion of personal meaning in terms of
paid work is not unique to occupational therapy, it is clear
that it is given a greater emphasis within the profession than
in traditional concepts of work–life balance. Primeau (1996)
and Westhorp (2003), however, both argue that occupational
and work–life balance theories do share a common under-
standing in terms of the importance of paid work and assume
it is an occupation of choice. Similarly, Wilson and Wilcock
(2005) suggest the recent media interest in work–life balance
has raised public and professional awareness of occupational
balance as a tool for health and wellbeing. Although there
is little indication in the literature to support this contention,
what is clear is that a link between a state of balance and
achieving wellbeing is assumed in both occupational and
work–life balance theories. Subtle differences between the
two include a greater focus on personal meaning, complexity,
and diversity of activities in the former, and a stronger
emphasis on the hegemony of paid work and its conflicting
demands with home life in the latter.
Significantly, although occupational therapists identify
choice and participation in a variety of occupations as the
vehicle of wellbeing in everyday life, the profession rarely
challenges the situated socio-cultural context of neoliberalism
that promotes participation in paid work. Rather, the profes-
sion assumes the ‘Anglophone’ ideal of life, as marked by
striving for and maintaining that participation (Kantartzis and
Molineux 2011, p62). As a consequence, the influence and
dominance of paid work in terms of creating a state of occu-
pational imbalance in neoliberal economies is ignored.
Under these circumstances, it is intriguing that as early
as 1922 Meyer identified paid work as challenging to the
attainment of occupational balance (Meyer 1922, p9).
More recently, Wilcock (1999) has advocated that finding
balance and wellbeing requires participation in a variety of
‘doing’ and ‘being’ types of activities, proposing, as Meyer
did, not just the value of paid work but the importance of
restful and aesthetic interests to facilitate individual and
wider social wellbeing. These seminal papers suggest that
thinking about work–life balance in a more interconnected
way, by encompassing occupational theories, would ulti-
mately benefit the individual. However, it is also clear
that these ideologies would need to be contextualized by
wider social structures that, at least in terms of neoliberal
economies, promote paid work and consequently identify
the expected balance or rhythm of occupational life. For
occupational therapists/scientists, the challenge is to recog-
nize the hegemony of this model of paid work in neolib-
eralism and to consider the limitations it places on concepts
of occupational balance, if professional theories of wellbeing
are to be realized.
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Teena J Clouston
Method
The purpose of this study was to understand the influences
of organizational workplace cultures on the individual’s
occupational balance. The objectives were:
■ To understand how occupational therapists constructed
and made sense of their occupational balance;
■ To analyse how participants conceptualized and experi-
enced the relationships between workplace cultures and
their occupational balance;
■ To identify whether workplace cultures could constrain
or facilitate occupational balance and, if so, how.
The approach and methods used were specifically
chosen in order to facilitate this and consequently incor-
porated an interpretivist methodology focused on cap-
turing the individual’s subjective experience of workplace
cultures and the personal meaning of occupational balance
in everyday life.
Semi-structured, in-depth interviews were chosen as a tool
for data collection, and interpretive phenomenological analysis
(IPA) was adopted as a methodological approach and tool
to interpret the data. Occupational therapists were purpose-
fully sampled because of their understanding of lifestyle
balance as a tool to achieve wellbeing (College of Occupa-
tional Therapists [COT] 2006). Identifying that occupational
therapists in the UK work predominantly in health and social
care sectors, one organization from each of these settings
was convenience sampled, accessing a local health board
and a single social services department in Wales.
Interpretive phenomenological analysis (IPA)
IPA propounds a specific methodological approach that
focuses on both the description and meaning of individualized
everyday experience, assumes a connection between people’s
talk, thinking, and emotional states, and emphasizes the
meaning-making process for both participant and researcher
(Smith and Osborn 2008). Considered valuable in occupa-
tional therapy research, IPA aims to explore in detail how
individuals experience and make sense of everyday life
situations in terms of their personal and social worlds
(Cronin-Davis et al 2009).
Interviews
Semi-structured, in-depth interviews are considered the
exemplar for IPA because they offer dialogic flexibility and
provide opportunities to clarify interesting points (Smith and
Osborn 2008). In IPA, skilled questioning is considered
essential to effective application. Smith et al (2009) maintain
that the purpose of questioning is not to judge or challenge
but to probe and clarify in order to facilitate open and reflec-
tive accounts. Consequently, the interview schedule is not
prescriptive but a guide to keep the conversation focused
on the areas of interest. Table 1 presents the schedule used
in this study. The interview schedule was piloted and, as no
changes were made, the data from this pilot interview were
incorporated into the study.
British Journal of Occupational Therapy October 2014 77(10) 509
Whose occupational balance is it anyway? The challenge of neoliberal capitalism and work–life imbalance
Table 1. Interview schedule
Work position, role, and history
How long have you been qualified (as an occupational therapist)?
Tell me a little about where you’ve worked and how long you’ve worked.
How long have you worked in this present position?
What about your pattern of work (your work hours). Has that changed over time?
Personal details, family commitments
What are you family commitments? Children/partners/caring responsibilities.
What’s an average sort of day?
Do you have any interests outside of work? Has that changed over time?
Understanding of occupational balance
What does occupational balance mean to you?
Do you feel you achieve it in your personal life?
How do you feel the organizational work culture has influenced your
occupational balance?
Can you think of examples where the organizational work culture has
facilitated your occupational balance?
Can you think of examples where the organizational work culture has
constrained your occupational balance?
If you were to tell people about the organizational culture of health and/or
social care, what would you say?
Do you feel you achieve your potential at work?
Closure
In situ clarification and summary
Credibility and rigour
In common with all qualitative methodologies, IPA has been
subject to positivist criticisms that contest the reliability and
validity of interpretive methods (Finlay 2006). When con-
sidering these issues specifically in terms of IPA, it is worth
noting that the method prescribes a small and preferably
homogenous sample, which, theoretically, limits the possibility
of generalizing findings to a wider context (Pringle et al 2011).
Opposed as counterintuitive, one argument put forth by IPA’s
supporters is that the methodology’s findings, however specific,
are framed by shared understandings and the notion of being
human at its most essential (Smith et al 2009). To achieve rigour
they suggest a focus on credibility, and maintain the researcher
should think in terms of ‘theoretical transferability rather than
empirical generalizability’ (Smith et al 2009, p51). Pringle et al
(2011) corroborate this claim and propose the effectiveness
of IPA and its transferability should be measured by the
richness and transparency of the account given, the credibility
of its analysis in terms of its links with current literature, and
the light it throws onto the wider context.
Second, IPA is a method that promotes the active involve-
ment of the researcher in the interpretative process; this
often raises concerns of bias. The method attempts to address
these concerns through the rigorous application of both an
idiographic (the in-depth analysis of a small, homogenous
sample) and a questioning approach to analysis, promot-
ing the probing and clarification of participants’ personal
meaning within the interview situation and correspondingly
facilitating the credibility of the researcher’s sense-making
process. Smith and Osborn (2008, p53) maintain that this
510 British Journal of Occupational Therapy October 2014 77(10)
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questioning approach entails the use of a ‘double hermeneutic’
or two-fold sense-making process in which ‘[t]he participants
are trying to make sense of their world; the researcher is trying
to make sense of the participants trying to make sense of
their world’. This approach explicitly acknowledges and
makes more transparent the roles of both the researcher and
the participant in the sense-making process and consequently
challenges bias through that transparency. In the present
study, these tools were supported by the use of direct quota-
tions to clarify how themes were identified from the data,
and by the use of a reflexive approach to challenge my assump-
tions and ‘insider’ perspectives as they arose in the analysis.
These methods were utilized throughout the study to assure
credibility, transparency, and rigour.
Ethical approval
Ethical approval was gained from Cardiff University, the local
research and ethics committee (LREC), the relevant Director
of Social Services, and the appropriate research and devel-
opment board. In both settings, all participants freely gave
their written consent to participate in the study. Twenty-nine
interviews were completed, 18 in the healthcare setting and
11 in social services.
Demographics varied in terms of participants’ age, number
of children, marital status, hours of work, banding, area of
work, and length of employment in the organization. Reflect-
ing the relative cultural and ethnic homogeneity of the wider
occupational therapist population, participants were all
white British and the male to female ratio was approximately
1:4. Each interview lasted between 1 and 2 hours.
Process of analysis
Analysis was simple and systematic. The interviews were audio-
recorded and transcribed verbatim and were then sequentially
examined in detail. In the initial stages, issues of interest were
highlighted in the text and brief annotations made in the
margins. At this point, rather as in free textual analysis, there
were no rules about what could be noted (Smith et al 2009).
As the themes developed they were collated into a simple
list and were continually crosschecked to the data to ensure the
connections made were relevant to the source material. This stage
was integral to the credibility of the findings, assuring that emer-
gent themes could be linked to the data (Pringle et al 2011).
As more interviews were analysed, these lists were com-
pared and contrasted to identify connections and disparities
across different data sources. In the later stages, patterns
were identified and a final table of themes produced. This
identified the key theme of neoliberal capitalism and five
subordinate themes (see Table 2).
Throughout the article, direct quotations are used to clarify
the link between key themes and data sources, evidencing
how the final themes emerged from and were relevant to the
lived experience of the participants (Pringle et al 2011).
It is worth noting that, although two different organizational
settings were accessed, the differences in culture and structure
between the two are not discussed here. This is because the
common themes of neoliberalism were notable in both settings.
 Teena J Clouston

Table 2. The five themes of neoliberal capitalism

1. Pressures and intensification of paid work
1.1 ‘You know the more you’re prepared to give, the more the kind of system will suck out of you basically (Tal).’
2. Lack of control and autonomy
2.1 ‘Wednesday afternoon [managers say] “I need it by teatime”. And you have two home visits booked. And then it’s, “I am sorry I can’t do it” … [they say]
“I need it by teatime. You’ll have to get it to me by teatime”. And what do you do? You know, you’ve promised to go out and sort out your patient’s problem
and take out equipment or whatever. But then, you’re told by your manager they need information. And that’s often because above them, they want it now.
So it’s being sort of passed through the system (Misha).’
2.2 ‘It’s almost as if there’s a kind of culture fear in work–life balance really. And I won’t kind of, dare step out of line for fear of the consequences. And,
you know, possibly with some justification. Because there’s always this kind of implied threat hanging over people. If you step out of line you may not lose
your job but life can be made difficult for you. And your promotion prospects might diminish (Tal).’
3. Work–life imbalance
3.1 ‘I was invariably late picking the kids up. Then trying to get home and cook the tea and taking them off to their swimming and everything else. I used
to be exhausted. Absolutely shattered. Yeah, it took its toll on me I think (Maya).’
3.2 ‘It does [cause stress]. I mean, so much so that my husband, he’s desperate for me to find a different job. He’s saying “You aren’t happy at work”. Because
when I go home from work all I want to do is sit and not talk. Because I’ve had it all day. And I just want to sit down and unwind. And he thinks I’m unhappy
and depressed (Saffi).’
3.3 ‘I find myself not having a full lunch break and working till 5.30, 6 o’clock [pm] to try to get the work done. I’ve been just feeling exhausted. So 7.45 am
till about 6 o’clock, 6.30 pm I’m out of the house. So I have four waking hours a day for my own time. So I get back at 6 o’clock, I go to bed at 10, read till
10.30, ’cos I’m too tired after, and go to sleep by 10.30 (Seren).’
4. Occupational imbalance
4.1 ‘Well I think [occupational] balance is about having a healthy balance between work, leisure, and personal commitments. And I personally find that a
struggle … But now I find that I’m sacrificing my personal time for my husband, my child, for work. And there’s hardly any left at all for me. And so any sort of
personal goals that I’ve got, you know, even if it’s something simple like learning to speak Welsh or learning to ice skate, I just haven’t got the time for (River).’
5. Personal responsibility
5.1 ‘It has sometimes [caused worries] because you don’t want to be seen not to be doing enough. But I think I do, do enough, and I always seem to be busy
and I never find time that I haven’t got nothing to do. I’m never just sitting at my desk with nothing to do because there’s always something in the tray that’s
just waiting there to be done (Rhiannon).’

Findings This was associated with tales of multitasking, with paid

Emergent themes identified that cultures and structures in the
paid workplace created work–life and occupational imbal-
ance for occupational therapists, and that these cultures and
structures were driven and /or shaped by the wider socio-
political drivers of neoliberal capitalism. These were cate-
gorized under five subordinate themes: the pressures and
intensification of paid work; limited control and autonomy;
work–life imbalance; imbalance in occupations; and personal
responsibility.
To support transparency, Table 2 gives examples of direct
quotes under each of these themes; quotation numbers are
given in the text to support the ensuing descriptions and
discussion.
Theme 1: The pressures and intensification
of paid work
In both settings, respondents described how pressures in paid
work appeared to be increasing, with a sense that this created
a continuous impact:
You know, maybe it’s rose-tinted glasses, but I’m sure I can
remember a time when you had peaks and troughs … You’d have
really busy periods and then you’d have quieter periods. And
that just doesn’t happen anymore. It’s like it’s relentless (Dylan).
work described as ‘a constant juggling act (Rhiannon)’ or
‘like spinning plates … rushing from one to the other to keep
things going (Misha)’. In all reported cases, this created a
sense of stress, with paid work consuming increasing time and
space, seeping into personal life, taking time and energy away
from other activities in physical, cognitive, and emotional
senses, and leading to stress and ill-health.
Descriptions of ‘sleepless nights mulling things over
(Tal)’ and other associated psychological disturbances were
endemic, recounted even by those who identified work as
a preferred occupation:
And I don’t mind working hard. And I don’t mind giving the
hours. It’s when it impacts on other things and I feel I’m not
being able to cope with it. That’s when I get stressed. Because
I think I’m not actually coping with this. And when you wake
up at sort of 3 o’clock in the morning and you’re planning out
treatment plans for people, that’s the time you know it’s really
getting to a point where it’s a bit of an overload (Carys).
This sentiment was accompanied by a belief that these
overwhelming pressures were unrecognized or unsupported
in the workplace, with more and more expected within a
day’s work (Table 2: 1.1). Interestingly, although participants
identified the pressures of paid work as causal to their stress

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Whose occupational balance is it anyway? The challenge of neoliberal capitalism and work–life imbalance
and imbalance, a second emergent theme was a sense of limited
control over this, and consequently a reported inability to
change these pressures in the workplace.
Theme 2: A lack of control and autonomy
There was a strong sense that externalized organizational
drivers, such as pressures on beds or the need to reduce wait-
ing lists, were creating work-based stresses and that little
could be done by individual respondents to address them.
Rehabilitation services, for example, were given a ‘ten-day
snapshot’, meaning that ‘to get things sorted out you’re going
some (Misha)’. Similarly, working on acute medical wards
meant ‘that’s a 48 hours stay. You’ve got to work within that
context … within those confines, really (Arial).’ Others
railed that external pressures on workload management
nullified personal autonomy and increased hours of work
exponentially (Table 2: 2.1).
Comparably, respondents in social services described
the need for rapid response to urgent cases causing limited
control over workloads: ‘It’s about keeping control of the
little bits. And that’s almost impossible to do in this envi-
ronment. It’s actually quite frustrating. It’s actually quite
stressful because you can’t actually do it (Jenna).’ There was
a strong sense that these kinds of pressures were causing indi-
viduals immense stress as they battled to complete seemingly
irreconcilable competing tasks:
But that puts horrendous pressure on. And I’ve been known
to be here until 9 o’clock at night just finishing data, which is
wanted for the next morning. Because I haven’t wanted it to
impact on patient time (Rhiannon).
The most insidious element of this spiralling sense of
limited control was that participants felt they had little or
no ability to challenge the status quo because of a pervasive
sense of fear about repercussions in the workplace should
they do so (see Table 2: 2.2). In essence, this meant that
occupational therapists felt compelled to meet organizational
demands however great they were. This sense led on to
conflicts in the interconnected theme of work–life imbalance.
Theme 3: Work–life imbalance
Supporting the notion that reciprocity across life domains
is essential for achieving a sense of satisfaction in work–life
balance (Guest 2002), occupational therapists from both
settings, irrespective of whether they worked part time or
full time, described how their drive to perform in intensify-
ing paid work contexts created conflict scenarios between
organizational demands and family commitments outside
of paid work. Portraying what Williams (2001, p488) has
defined as a lack of ‘care time and space’ to achieve ‘work time
and space’, respondents described how they were unable
to function and participate in family life as effectively as they
would like because work pressures prevented them from
spending quality time at home: ‘I certainly don’t feel as I’m at
home as much as I want to be. As much as I’d feel happy
doing (Saffi)’. For many this caused significant personal
(Table 2: 3.1) and family stress (Table 2: 3.2).
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Brannen (2005, pp116–7) has described how constant
busyness at work can follow people home and overlay the
focus on family concerns and responsibilities that charac-
terize this domain. Her work, in tandem with that of others
(such as that of Hochschild 2008), clearly identifies how the
conflicting demands between paid work and home reduce
individual and family wellbeing but also create such personal
pressures, both physically and psychologically, that they
actually prevent individuals from having the time and space
to resolve these conflicts and find solutions. In essence, this
extinguishes what Wilcock (1999) would term ‘being’ time;
the space to think, reflect, and plan for a future self.
The absence of this kind of activity was a common theme
in this study (Table 2: 3.3) and is notable in terms of Wilcock’s
(1999) and Meyer’s (1922) visions of occupational balance.
Paid work did, physically, cognitively, and emotionally, get in
the way of spending meaningful time and energy on other
‘doing’ occupations, whether classified as obligatory or as non-
obligatory, freely chosen activities. ‘Being’ pursuits were accord-
ingly lost to the busyness of ‘doing’ activities, and specifically
of paid work, followed to a lesser extent by home commitments,
challenging the balance between ‘doing’ and ‘being’ occupations
because paid work was prioritized as a taken-for-granted way
of life. As Lefebvre (2004, p74) has aptly put it:
There is not time to do everything but every ‘doing’ has its
time. These fragments form a hierarchy, but work remains to
a large extent essential … the reference to which we try to
refer everything else back.
Theme 4: Imbalance in occupations
All occupational therapists spoke of experiencing occupational
imbalance in one way or another and no-one spoke of a fully
balanced or harmonious lifestyle, though there was variation
in the levels of dissatisfaction, conflict, or stress experienced.
In general, the causes of imbalance identified concerned
the idea of paid work, and to a lesser extent unpaid home
commitments, taking up too much personal time, with a
resulting loss of time and space available for meaningful
and/or freely chosen pursuits of both ‘doing’ and ‘being’ types:
‘And what you start to do then, you start to cram everything
into the weekends. And you know, I notice things I enjoy,
like impulsive things, don’t happen anymore (Lowri).’
Participants also noted exhaustion as a barrier to partici-
pation in personally meaningful pursuits: ‘And things outside
of work for myself, personal things you know, keep fit, things
like that, I just don’t have the energy to do when I get home
… I feel, you know, tired (Mhari).’
The absence of these occupations was associated with a
lowered self-esteem and sense of identity. In one respondent’s
words, she was not ‘a rounded person’ because she could
not partake in activities she enjoyed:
I just can’t see me being able to fit in those leisure pursuits
that I’d like to fit in. And I think it affects your self-esteem.
It certainly affects my self-esteem. I don’t feel I’m a rounded
person because I’m giving a lot of myself away to others
really, I suppose (River).

Although one or two respondents spoke about having
choice in terms of their balance, as previously discussed,
reflective ‘being’ types of pursuits were notably absent from
all accounts and there was a strong sense that prioritizing paid
work created an enforced sense of monotony that was stressful:
And it’s the routine of work wears you out. Every now and again
I start to feel as if I’m on a hamster wheel. You know, I’m getting
out of the bed. I’m getting in the shower at the same time. I’m
slapping on the same makeup. I’m wearing the same suit. I’m
getting in the car at the same time. I’m going down the same
drive and going down the same motorway and seeing the same
cars. And I’m going into the same car parking space … I’m
not one for routine when it’s enforced on you. So I find that
quite stressful you know? I don’t like that, you know (Lowri).
This notion of tedium was common, with the focus on
doing only obligatory tasks a recurrent theme in terms of
occupational imbalance (Table 2: 4.1). Whilst occupational
theories advocate routine as an essential tool in creating a
sense of safety and providing a meaningful structure to every-
day life (Kielhofner 2008), this study identified that where
people were subject to the pressures of paid work squeezing
out other ‘doing’ as well as ‘being’ occupations so that spon-
taneity, joy, and creativity were lost, this generated not only
a of lack of engagement and meaning but also a loss of self-
esteem and sense of self, ultimately leading to stress.
In Wilcock’s (1999) theories, ‘doing’ is the essential con-
cept of occupational therapy/science, but notably requires
balance with ‘being’ pursuits in order for the individual to
‘become’ or achieve potential and wellbeing. This study revealed
that individuals’ ability to realize this balance and becoming
was sorely challenged, because paid work was commonly
prioritized over other ‘doing’ types of activities and ‘being’
occupations were seemingly absent. As one respondent put it,
the challenge to occupational balance was:
… getting the balance right between things you have to do
and the things you enjoy doing, which I’m sure in this day
and age is balanced more toward the things you have to do. I
think we should be doing this (Maya).
Theme 5: Personal responsibility
Respondents talked extensively about a sense of being ‘shackled’
by the demands of paid work and by the intensifying expec-
tations in the workplace causing occupational imbalance. Yet
there was also a theme of acceptance, or at least of the idea
that these demands were a fait accompli, however excessive
and constant they might be. This was accompanied by a strong
sense of commitment to actively giving the majority of one’s
time and energy resources to the workplace. Whereas this may
be expected in professional practice, it was strongly associated
with concerns about whether or not one was doing ‘enough’
to satiate organizational requirements (Table 2: 5.1), and
opportunities to do more were taken when they arose: ‘I’m
sounding a bit like Les Dawson really [laugh]. My mother-
in-law stays home at our house for two days. So I’ve a tendency
to work a little later on those days [laugh] (Dylan).’
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Teena J Clouston
This lack of identifiable measures in terms of what was
sufficient time and energy to spend in the workplace not
only subjected employees to long working hours but also
fashioned a sense of personal responsibility about one’s own
performance and concerns over whether one was worthy
in a quantifiable way:
So I did something a bit cheesy [laugh]. I wrote out on a
Post-It note ‘Are you giving value for money?’ And I stuck it in
front of me on the wall opposite and I refused to take it down
until I thought that I could answer that question ‘yes’ (Huw).
This notion of ‘doing’ the job in an effective way also
influenced what respondents described as a sense of respon-
sibility for managing their own occupational balance and
a feeling of failure when this could not be successfully
achieved:
If you’re bringing [work] stuff home at night, you’re gonna
do that first while you still got the energy. Everything then gets
shifted to the weekend and that’s a guaranteed failure really
… So it’s [occupational balance] got a messy big F written all
over it. Failed. Try harder (Lowri).
Others described how the drive for ‘benefits realization’
or monetary gain in organizations underpinned the need
for staff to demonstrate financial acumen and ensure that
investments in staff resources were returned:
You know … the whole Agenda for Change system … is
supposed to properly reward people. But the other part of it
is actually getting back some of that additional money that’s
gone in. What’s called ‘theory of constraints’ (Morgan).
Whereas one could argue that these individuals made
choices about how their paid work was balanced with life
to achieve their lived experience of occupational balance,
those choices were clearly shaped by organizational limita-
tions, both in terms of expectations and decision-making
in the workplace and of wider social and individual value
systems concerning participation and performance in paid
work. These forces, shaped by neoliberal principles, biased
choices towards participation first in paid work, then in
the home domain. Time and energy for personally mean-
ingful and freely chosen occupations, essential for a balance
between ‘doing’ and ‘being’ activities, was absent, creating
occupational imbalance.
Discussion and implications
To summarize, in essence it seems that the occupational
therapists in this study experienced work–life and occupa-
tional imbalance because paid work, as a socially classified,
obligatory task, not only commanded the greatest use of
human time and energy for ‘doing’ activities, reducing variety
and choice in everyday occupations, but also precluded time
and energy for ‘being’ pursuits, impeding opportunities for
self-actualizing and achieving wellbeing through a balance
of occupations.
British Journal of Occupational Therapy October 2014 77(10) 513
Whose occupational balance is it anyway? The challenge of neoliberal capitalism and work–life imbalance
In theories of occupational balance, ‘doing’ activities require
not only a sense of purpose but also personal meaning and
engagement, which, in turn, requires variety and choice in
how time and energy is spent in everyday activity (Fidler
and Fidler 1978). For wellbeing and self-actualization to
be achieved, active ‘doing’ occupations have to coexist with
‘being’ pursuits, as these provide time for contemplation, rest,
and a sense of belonging to the natural as well as social worlds
(Meyer 1922, Rowles 1991, Wilcock 1999). It is this kind of
bricolage, in tandem with everyday social constructs, that
creates the experience of occupational balance.
For the participants in this study, occupational balance
was challenged by the everyday assumptions of a socially
structured, neoliberal market culture. Strong pressures to
prioritize paid work were supported by coercive forces to
develop a sense of individual responsibility and account-
ability in determining how one’s own workload and cons-
equently work–life — and, ultimately, occupational —
balance was achieved and sustained. These drives for per-
sonal responsibility included a belief that one had personally
failed when imbalance or conflict was experienced, genuine
concerns that there might be personal consequences if one
did not perform as expected, and a sense of insecurity and
fear that one might fail to achieve workplace expectations
because there was no benchmark in terms of what was
enough to meet those goals.
Costea et al (2008, p666) have argued that where employees
themselves are the resources used in the workplace, they not
only lose the power to control their own workloads, work
patterns, and performance, but are also ‘exhorted to expand
and intensify their contribution as selves (as ‘human resources’)
to enhance production, [and] maximize value, thus leading
the organization to success’.
This sense of giving one’s all to the workplace was strongly
prevalent in this study, despite respondents reporting exces-
sive demands from the workplace and recognizing that this
had negative impacts on personal occupational balance.
Indeed, respondents reported actively compromising preferred
occupations in order to achieve obligatory commitments; in
this sense one could suggest they actively created their own
state of imbalance. This is intriguing when one considers the
informed perspective of occupational therapists in valuing
occupational balance as a tool of wellbeing, because it was
not enacted in their own lives.
Brannen (2005) has argued that work intensification
speeds up the individual’s temporal pressures to such an
extent that there is in fact no time to think about challenging
the status quo and, if this is so, time to reflect upon and
adapt one’s state of balance may be absent in everyday work
cultures. Certainly all participants in this study reported this
kind of experience and, in terms of occupational balance
theory, ‘being’ activities, which could have facilitated time to
reflect on and review one’s own sense of being in the world,
were absent. However, participants seemed to accept this
state of affairs as a fait accompli, something reflected in their
everyday doing, notwithstanding the challenges this entailed
for personal and family wellbeing.
514 British Journal of Occupational Therapy October 2014 77(10)
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When one considers the neoliberal social structures in
which we strive to find our own occupational balance, this
is perhaps not surprising, even for informed professionals
like occupational therapists. We are, as Hochschild (2008)
has remarked, unwitting participants in market cultures,
accepting paid work as the ultimate goal for participation
and engagement, however exclusive in terms of occupations
this may become.
Moreover, and essentially for occupational balance, neolib-
eral economies have no value for activities that cannot be
commodified in terms of profit: ‘in short, [for] the whole
range of activities that make up the fabric of existence and
therefore occupy a primordial rather than a subordinate place’
(Gorz 1982, pp80-81). This is a challenge for occupational
therapists/scientists because these kinds of activities encap-
sulate ‘doing’ and ‘being’, personal meaning and self-fulfilment,
and therefore the essence of occupational balance.
Conclusion
Neoliberal market economies in the UK are supporting not
only work–life but occupational imbalance because paid work
is prioritized as the activity par excellence within those social
structures, legitimately demanding the majority of an indi-
vidual’s time and energy resources, and correspondingly taking
these away from other ‘doing’ as well as ‘being’ occupations.
This kind of social milieu also promotes personal respon-
sibility for managing performance in paid work and conse-
quently for work–life and occupational balance, challenging
the individual to make occupational compromises, invariably
sacrificing personally meaningful and ‘being’ types of pursuits,
because these types of activities are less valued. This is a real
challenge for occupational therapists/scientists who envision a
self-motivated and personally meaningful edge to occupational
balance, and who counsel participation in ‘doing’ and ‘being’
activities to achieve and sustain not only individual but also
family and social wellbeing.
For the occupational therapy profession, perhaps it is time to
broaden our thinking in practice, education, and research,
to explore ways to reconcile neoliberal economies and social
structures with occupational balance, to both achieve and
sustain wellbeing in our everyday lives.
Key messages
■ Neoliberal economies can compromise occupational balance.
■ Individuals can carry a sense of personal responsibility about success or
failure in achieving work–life balance that influences occupational balance.
What the study has added
Recognition that neoliberal economies can increase pressures in paid
work and erode work–life and occupational balance.
Acknowledgement that carrying a sense of personal responsibility
for success or failure in work–life (and consequently occupational) balance
can prevent wellbeing.

Conflict of interest: None declared.
Funding: This research received no specific grant support from any funding
agency in the public, commercial, or not-for-profit sectors.
Research ethics: Ethical approval was granted by Cardiff University, the local
research and ethics committee (LREC), the relevant Director of Social Services,
and the South East Wales Research Ethics Committee (reference 04WSE02178,
09/02/2005).
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