Occupational Therapy: The Unexpected Origin Story We Should All Be Talking About
This post is the companion to Episode 2 of the Empowered Futures Podcast. Click on the links below to listen on Spotify, Apple Podcasts, or YouTube.
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Most people don’t think much about where occupational therapy came from. If they think about OT at all, they might imagine a bright rehab gym filled with rainbow TheraBands, a treadmill, foam blocks, and a rogue therapy ball that has absolutely rolled under a cabinet and will not be retrieved anytime soon. Or maybe your friends’ kiddo got pulled out of class once a week to get some help with handwriting, or perhaps your grandma saw an OT after her stroke back in 2012. But the real roots of OT? They’re far more surprising, deeply human, and shaped by circumstances none of us would wish on anyone.
Occupational therapy was, quite literally, forged on the battlefield.
During World War I and II, soldiers returned home carrying injuries that affected their bodies, minds, and identities in ways medicine wasn’t prepared for, and was ill-equipped to handle. Trauma was misunderstood, mental health was dismissed, and the deeper human consequences of war weren’t acknowledged in the way they are today (and I daresay we haven’t come far enough). Into this gap stepped a group of predominantly female “reconstruction aides” who offered something radically different from the medical care of the time. Instead of focusing solely on what was broken, they turned their attention to what could still bring meaning: working with one’s hands, engaging in purposeful routines, and re-establishing the small rhythms of daily life that make someone feel like themselves again.
These early OTs used woodworking, weaving, gardening, self-care practices, and creative activities not as recreational pastimes but as intentional rehabilitation. They understood something we now see reflected in modern neuroscience: humans heal through engagement. Doing, creating, connecting, and participating in the world are not optional, but in fact anchor us to identity and purpose. Long before we had language for trauma-informed care or nervous system regulation, those early OTs recognized that the intersection of mind, body, environment, and meaning was where real healing took place.
And while the context has changed dramatically since those wartime hospital wards, the emotional landscape that people navigate today is not so different. Most of us may not be returning from combat, but we are recovering from, if nothing else, the small yet constant barrage of moral injury that shapes our current moment on this planet. For many, we are also recovering from something more concrete: chronic pain that shapes our days in unpredictable ways; burnout that gradually erodes confidence; medical trauma that lingers long after the crisis has passed; identity shifts that leave us disoriented; or a body that suddenly feels unreliable after years of “just deal with it.”
The modern world has its own battlefields, even if they’re quieter.
What I love most about OT’s origins is how seamlessly they connect to the needs I see in my practice today. In the Level 1 Trauma Center where I first trained, I quickly learned that people rarely show up with a single, neat problem. Instead, they arrive buried under the weight of the experience of Being Human: fear, pain, exhaustion, uncertainty, and the frustration of trying to function in a body that no longer cooperates. The medical system often responds by segmenting these issues into specialties, referrals, and isolated treatment plans. Occupational therapy, however, does the opposite. We ask, How is this affecting the whole of your life? And what do you need to feel like a person again?
That’s why occupational therapy has always resonated with me, from my first introduction in a barn in Oregon to my time spent at dinner tables and garage workshops in my private practice. It isn’t about forcing people to “push through” or handing them a home exercise program as if healing were purely mechanical. It’s about restoring the texture and richness of daily life—routines that are sustainable, roles that feel meaningful, and a sense of internal safety that allows the body to finally relax and shift out of survival mode. It’s about helping someone reconnect with themselves after pain, stress, or illness has taken more than they realized.
As you may recall, my own road to OT was anything but linear—Coast Guard machinery technician, barista, martial artist, costume designer—and yet those experiences now feel strangely aligned with OT’s own eclectic beginnings. When I was injured in the Coast Guard, I suddenly found myself on the “wrong” side of the healthcare system, confronting uncertainty, fear, and an unnerving loss of identity. I had always been healthy, if not accident prone, and at the time was wholly unequipped to navigate the healthcare system competently. (Not to mention the added complexity of being active duty military stationed in a remote area of Washington – if you want to talk about added stress and frustration, consider the 3 hour round trip to drive to the ortho doc for a 15 minute appointment. Oy!) It wasn’t just my body that needed attention; it was the entire ecosystem of my life. And it was actually going to OT school that helped knit those pieces back together.
For better or worse, my lived experience as a patient in the health care system shapes the way I practice now. While I am fortunate to now be in the capable hands of an incredible team at my local VA facility, I recognize that my education, position as a healthcare worker and chosen specialty give me an advantage that other people do not have. And so, when someone walks through my door with chronic pain, a scary new diagnosis, and a sense of being unmoored from themselves, I don’t see a list of symptoms. I see a person who is trying to rebuild, a person who has “tried everything” and feels like a failure, a person who is desperate to come back home to themselves. Just like those early veterans. Just like the patients I worked with in trauma care. Just like me, in my Coast Guard years.
What occupational therapy offers—what it has always offered—is a way back to oneself through meaning, participation, and the things we want and need to do. The tools look different now. We talk about pain neuroscience, central sensitization, autonomic regulation, CBT-I, pacing, and self-compassion. But the spirit is the same: healing happens when people are supported as whole humans, capable of growth, capable of adaptation, and deserving of a life that feels like their own again.
So when we talk about OT’s history, we aren’t indulging in trivia. We’re honoring the lineage of a profession built on the radical belief that people don’t heal in isolation—they heal in context, in community, and in the small, meaningful actions that re-anchor them to themselves. The battlefield may be different now, but the work remains just as vital.
If you want to hear more about this story, Episode 2 of the Empowered Futures Podcast dives even deeper into the origins of OT, how they shape modern chronic pain care, a pain science detour, and why this profession continues to feel like both a science and a homecoming.
As always, I’m glad you’re here.
And I’m honored to walk alongside you on your own path back to meaning.
— Katy