Twinley (2013) challenged readers of this journal to reconsider notions of occupation as a positive and life‐affirming influence. Furthermore, she detailed ways in which the concept of occupation must necessarily include facets of life that are not commensurate with health and wellbeing, as well as those that are antisocial, illegal and/or immoral. The discussion is a critical one as occupational therapy diversifies from the select cultures and caseloads from which many of its theoretical premises were derived. I congratulate the author on a thought‐provoking article and I suggest that such a complex consideration of the relationship between occupation and health is pivotal at this point of the profession's evolution. It is important to test the robustness of these founding notions if we are to expand our theories to include the populations with which we now find ourselves involved.