Modeling and Role-Modeling:

Bibliography

Editor

Contributing Authors

Preface

Prologue

Look Inside

Stories

Press Release

Related Work

Library of Congress Cataloguing in Publication Data

Erickson, Helen Cook (1936-)

Modeling and role-modeling

Bibliography: 444-470

Includes index

1. Energy. 2. Mind-body-spirit. 3.Healing. 4. Health. 5. Holism. 6. Self-care. Developmental editor: Geeta Erickson, M.A. Copy editor: Geeta Erickson, M.A. Cover and Interior design: Lance Erickson, M.A. Graphics: Lance Erickson, M.A.

ISBN 0-9779203-0-5

All rights reserved. No part of this book may be reproduced in any form or by any means without permission in writing from the authors. Published and distributed by Unicorns Unlimited: Book Publisher, 406 Trail Ridge Dr., Cedar Park TX 78613

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OVERVIEW

Modeling and Role-Modeling: A View from the Client’s World, (Ed. H. Erickson, 2006), expands the underlying concepts of the theory and paradigm of Modeling and Role-Modeling: A Theory and Paradigm for Nursing (Erickson, H., Tomlin, E & Swain, M.A, 1983). It is designed to complement the original book, not to replace it. Health care providers who know the work presented in the original book will find this as an enrichment text; those who do not know that work may wish to read it first.

Both books have been written specifically for nurses. However, since the original text was written in 1983, I have had many other health care providers indicate that the basic concepts are relevant for any health care provider interested in client focused care with an emphasis on the interactions among mind, body and spirit. For information regarding the original book, contact Lance Erickson at mrmbook1@yahoo.com. The Society for the Advancement of Modeling and Role-Modeling can be contacted at mrmnursingtheory.org for additional information.

This book has three sections. The first presents concepts related to holism; the second focuses on basic concepts embedded in the MRM theory and the third addresses application issues.

Section I contains three chapters. The first, Searching For Life Purpose: Discovering Meaning (Helen L. Erickson), describes relationships between our search for meaning in life and our Life Purpose. Factors considered include our Soul-work, life journey, implications of life experiences, and finding our Reason for Being. The second chapter, Energy Theories: Modeling and Role-Modeling ( Mary Brekke and Ellen Schultz) presents energy theories as they are applied to MRM. The human energy system is described. The potential for a Unified Energy Field is presented with consideration of the implications. The authors conclude with a brief discussion of linkages between MRM and energy theories. The third chapter Mind-Body-Spirit Relations (Marsha Walker and Helen Erickson) addresses linkages among the subsystems of the holistic person. The bodymind is presented with an in depth discussion of neuromodulation and the implications. Stored memories, or state-dependent memory is further proposed.

Section II contains five chapters. These include: Self-care: Knowledge, Resources and Actions (Judith Hertz and Linda Baas); Developmental Processes (Margaret Erickson); Affiliated-Individuation and Self-Actualization: Need Satisfaction as Prerequisite (Margaret Erickson, Helen Erickson, and Betty Jensen); Attachment, Loss and Reattachment (Margaret Erickson) and Adaptation: Coping with Stress (Diane Benson). Each chapter builds on information presented in the original book and presents new ways to think about the specific concept. Hertz and Baas offer information about Self-care within the MRM context including stored memories or emotional memory and up-to-date thinking about Hertz’s Perceived Enactment of Autonomy. M. Erickson discusses the stages of develoment and offers two new stages for consideration, one before birth and one at the time of physical death. She also reframes how to think about developmental residual and offers language to articulate healthy residual. M. Erickson and Jensen provide an indepth discussion of need status, framed within the context of Affiliated-Individuation and Self-Actualization. In the next chapter, M. Erickson provides a background for current thinking on the Attachment-Loss-Reattachment Process and includes her work on the Bonding-Attachment Process. The last chapter in this section is dedicated too the coping process. Benson provides literature from other disciplines that complement MRM; differences are discussed when they exist. Benson also provides updated information on the APAM and presents the Benson Group-Adaptive Potential Assessment Model.

Section III contains six chapters dedicated to application of the concepts presented in the first two sections. Kinney offers Heart-to-Heart: Nurse Client Relationships. She includes the role of the nurse-client relationship in the nursing process, and describes the importance of heart-to-heart connections from an energy basis. H. Erickson offers Connecting, a chapter that describes how health care providers can connect with clients and why it is important. This is followed by two additional chapters authored by H. Erickson, Nurturing Growth and Facilitating Development describing each of these basic concepts in depth. Next DaLynn Clayton, Helen Erickson and Sharon Rodgers present Finding Meaning in our Life Journey, a discussion of difficult life events as they interface with our search for meaning. Illness as an opportunity and the crossroads of our life journey are discussed. The final chapter in the book, The Healing Process by Helen Erickson caps the book, bringing the reader full circle, to the beginning of the book. Healing as an inherent aspect of human nature is discussed. The primacy of healing (or healing as the core of nursing) is offered with a discussion of the American Holistic Nurses’ Association and key holistic nurse authors. The book concludes with a discussion about what people can do to enrich their holistic being. Deepak Chopra’s work, Seven Spiritual Laws for Success provides the basis for the discussion.

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BIBLIOGRAPHY

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Parks, P. & Arndt, E. (1990). Differences between adolescent and adult mothers of infants. Journal of Adolescent Health Care, 11, 248-253.

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Erickson, H. & Swain, M. A. (1990). Mobilizing self care resources: A nursing intervention for hypertension. Issues in Mental Health Nursing. Vol. 11 (3), 217-236.

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P. (1983). Modeling and role-modeling: A theory and paradigm for nursing. Englewood Cliffs, NJ: Prentice-Hall ; Second-fifth printing, 1988-2000; EST Co: Austin, TX.

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Erickson, H. (1990b). Modeling and role-modeling with psychophysiological problems. In J.K. Zeig & S. Gilligan (Eds.), Brief therapy: myths, methods, and metaphors (pp. 473-491). New York: Brunner/Mazel.

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P., (1983). Modeling and role-modeling: A theory and paradigm for nursing. Englewood Cliffs, NJ: Prentice-Hall ; Second-eighth printing, 1988-2005; EST Co: Austin, TX.

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Erickson, H. (1990b). Theory based practice. In H. Erickson, C. Kinney (Eds.), Modeling and role-modeling: Theory, practice and research. Vol. 1(1). Austin, TX: Society for Advancement of Modeling and Role-Modeling , pp 178-202.

Erickson, H. Modeling and Role-Modeling with Psychophysiological Problem (1990). In J. K. Zeig & S. Gilligan. (Eds.), Brief therapy: Myths, methods, and metaphors (pp. 473-491). New York: Brunner/Mazel.

Erickson, H.L. & Swain, M.A. (1985) Exploring relations among health conception, clinical judgments and clinical outcomes. Unpublished manuscript. The University of Texas at Austin, Austin, TX.

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P. (1983). Modeling and role-modeling: A theory and paradigm for nursing. Englewood Cliffs, NJ: Prentice-Hall; Second-eighth printing, 1988-2005; EST Co: Austin, TX.

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Branum, K. (1997). Healing in the context of terminal illness. In P. B. Kritek (Ed.), Reflections on healing: A central Nursing construct. (pp. 330-348). New York: NLN Press.

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Dossey, B. (1997). (Corporate Editor). Core curriculum for holistic nursing by American Holistic Nurses Association. New York: Aspen Publishers.

Erickson, H. (1990). Theory based nursing. In H. Erickson & C. Kinney (Eds.), Modeling and role-modeling: Theory, practice and research. Vol. 1(1). Austin, TX: Society for Advancement of Modeling and Role-Modeling , pp. (1), 1-27.

Erickson, H. & Swain, M.A. (1990). Mobilizing self care resources: A rursing intervention for hypertension. Issues in Mental Health Nursing, Vol. 11 (3), 217-236.

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P. (1983). Modeling and role modeling: A theory and paradigm for nursing. Englewood Cliffs, NJ: Prentice-Hall ; Second-fifth printing, 1988-2000; EST Co: Austin, TX.

Fenton, M. (1997). Healing : The underground experience. In P. B. Kritek (Ed.). Reflections on healing: A central nursing construct. (pp. 559-565). New York: NLN Press.

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Frisch, N., & Kelley, J. (1995). Healing life’s crises: A guide for nurses; nurse healer series. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Hall , B. (2005). The art of becoming a nurse healer. Orlando, FL: Bandido Books.

Hover-Kramer, D., & Shames, K. (1997). Energetic approaches to emotional healing. Boston, MA: Delmar Publishers, An International Thomson Publishing Company

Keegan, L. (1994). The nurse as healer. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Keegan, L. (2001). Healing with complementary & alternative therapies. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Keegan , L. (2002). Healing nutrition. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Keegan, L., & Dossey, B. (1997). Holistic nursing. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Kritiek, P. (1997). Reflections on healing: A central Nursing construct. New York: NLN Press.

Landis, B. (1997). Healing and the human spirit. In P. B. Kritek (Ed.). Reflections on healing: A central nursing construct (pp. 72-80). New York: NLN Press.

Nichols, J. (2000). The soul as healer: Lessons in affirmation, visualization, and inner power. St. Paul, MN: LLewllyn Publications.

Nightingale, F. (1860). Notes on nursing: What it is and what it is not. London: Harrison.

Olson, M. (2002). Healing the dying. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Shames, K.(1995). Creative imagery for nurse healers: Nurse as healer series. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Stoll, R. (1989). The essence of spirituality. In V. B. Carson (Ed.), Spiritual dimensions of nursing practice (pp. 4-23). Philadelphia: W.B. Saunders.

Umlauf, M.G. (1997) Healing meditation: Nurse as healer series. Boston, MA: Delmar Publishers, An International Thomson Publishing Company.

Waters, P. & Daubenmire, M. (1997). Therapeutic capacity: The critical variance in nursing practice. In P. B. Kritek (Ed.), Reflections on healing: A central Nursing construst. (pp. 56-68). New York: NLN Press.

Watson, J. (1993). Rediscovering caring and healing arts. American holistic nursing Standard 7 (38).

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Helen L. Erickson, Editor of this work is the primary author of the original book, Modeling and Role-Modeling: A Theory and Paradigm for Nursing (Erickson, H., Tomlin, E., & Swain, M.A., 1983) published by the EST Company. Married to Lance Erickson in 1957, she identifies their family as her inspiration. Together they live in Cedar Park Texas where she holds the title of Professor Emeritus, The University of Texas at Austin.

Erickson, one of four children, was born and raised in a Clare, a small central Michigan town where she graduated from high school with in a class of 39 students. She identifies her early life as a time of learning how to love and respect others, be persistent, value education and work ethics, and to set life goals.

Erickson entered the Saginaw General Hospital, School of Nursing , Saginaw Michigan in 1954 and graduated in August, 1957 with a diploma degree in nursing. August 25 she married and moved to Midland Texas where she held the position, Head Nurse, Emergency Room, Midland Memorial Hospital. Her husband was a geologist for Pan American Oil Company. Their first daughter was born during their two-year stay in Midland Texas. Upon their return to Michigan, Erickson worked for short period of time at Central Michigan Hospital and the State Home for the Handicapped. Their second daughter was born during this phase of their lives. In the fall of 1961 the Ericksons moved to San German, InterAmerican University of Puerto Rico (IAU). Within a few months, Helen had drafted a plan to coordinate the health services for all students in the University, including those in the University’s K-12 elementary-secondary school. As such, she became the Director of Health Services; she held this position until they departed Puerto Rico in 1963 so that Lance could do doctoral work at The University of Michigan. Their third child was born in Puerto Rico during this period.

Their next phase was spent in Ann Arbor Michigan where Lance completed his work and joined The University’s Admissions Office. Helen worked as a staff nurse at St Joesph’s Hospital and then at The University of Michigan Medical Center (U of M). Their fourth child was born during this phase of their life.

In 1972 she entered U of M’s new Baccalaureate Completion Program for RN’s. Although she had taken 30 credit hours of courses at Central Michigan University during her diploma program, too much time had elapsed, so Erickson was required to retake all nursing courses and/or earn credit by examination. She completed her BSN in 1974 and then went on for a dual Master’s in Medical Surgical and Psychiatric Nursing at U of M. These were completed in 1976. Her Master’s Thesis was designed to articulate and study the Adaptive Potential Assessment Model, a key component in the Modeling and Role-Modeling Theory.

In 1975 she accepted a part-time faculty position at U of M, teaching RN in the BSN Completion Program. Upon completion of her Master’s she assumed more responsibility in the School of Nursing, and was ultimately the Assistant Dean for Undergraduate Programs. In 1984 she completed her doctorate, earning a PhD in Educational Psychology at U of M. Her dissertation work focused on the concept of Self-care Knowledge.

Erickson met Mary Ann Swain in the late ‘60s and Evelyn Tomlin in 1975. Erickson, Swain, and Tomlin worked closely together to articulate the Modeling and Role-Modeling theory and paradigm, first published in 1983. Erickson gives her father-in-law, Milton Erickson credit for the concepts, Modeling and Role-Modeling, stating that he was the one that insisted that we needed to understand the world-view of others before we could help them, and that each world-view was unique. She also states credits him with her understanding of key concepts such as seeding, reframing, indirect suggestions, and others.

Erickson has dedicated her professional life to the understanding and advancement of holistic health care. She argues that nurses are naturally inclined to nurture growth and facilitate development in others, even as they take their last breathe, but some have lost their way. They simply need to be reminded of their basic nature and be assisted in application of this knowledge in the care of others.

While Erickson supports the notion of caring as important, she argues that caring emphasizes what health care providers DO, not what they AIM to have happen. She proposes that the aim of health care providers, and nurses in particular, should be to help people grow, develop, and heal when needed. Therefore, she emphasizes the importance of focusing on Intent, rather than actions. Her abbreviated biosketch is provided below.

Helen Lorraine (Cook) Erickson

Professor Emeritus, School of Nursing

The University of Texas at Austin

1700 Red River

Austin, Texas 78701

Helenerickson@mail.utexas.edu

EDUCATION

1984	Ph.D. The University of Michigan, Educational Psychology
1976	M.S. The University of Michigan, Nursing
1974	B.S.N. The University of Michigan, Nursing
1957	Diploma Saginaw General Hospital School of Nursin

EXPERIENCE
1997-	Board of Directors, American Holistic Nurses’ Certification Corporation; Chair, 2003-present.
1997-	Professor Emeritus, The University of Texas at Austin
1988-1997	Professor of Nursing , The University of Texas at Austin School of Nursing; Chair of Holistic Adult Health, 1988-1990 & 1994-1997; Special Assistant to the Dean, Graduate Studies. 1995-1997; School of Nursing Representative to Faculty Senate, 1990-1994 (Vice-Chair: 1990-1992); Professor Emeritus of Nursing, 1998
1986-1988	Associate Professor and Associate Dean for Academic Affairs, College of Nursing, University of South Carolina
1986-1988	Independent Practice in Nursing, Columbia, South Carolina
1976-1986	The University of Michigan, School of Nursing: Instructor, Assistant Professor, Chairman of the Undergraduate Program and Interim Dean for Undergraduate Studies.
1976-1986	The University of Michigan Health Science Center: Psychiatric Nurse Consultant to University Hospital and PNP program ;
1976-1986	Independent Practice in Nursing, Ann Arbor, Michigan

HONORS AND AWARDS
1997	Helen L. Erickson, Endowed Lectureship on Holistic Nursing, The University of Texas at Austin
1996	Fellow, American Academy of Nursing
1996	Honorary Lifetime Certification, American Holistic Nurses Association
1995	Graduate Faculty Teaching Award, The University of Texas at Austin, School of Nursing
1993	Nominated for Sigma Theta Tau International Honor Society in Nursing, Excellence in Education
1990	Faculty Teaching Award, The University of Texas at Austin, School of Nursing
1989	Phi Kappa Phi
1982	Amoco Foundation Good Teaching Award, The University of Michigan
1982	ADARA, Women's Leadership Society, The University of Michigan
1980	Sigma Theta Tau (Rho Chapter) Award for Excellence in Nursing

PUBLICATIONS

Erickson, H. (2002). Facilitating generativity and ego integrity: Applying Ericksonian methods to the aging population. In B.B. Geary and J.K. Zeig, (Eds) The Handbook of Ericksonian Psychotherapy.

Erickson, H. (1996). Holistic healing: Intra/Inter relations of person and environment. (Guest Editor) Issues of Mental Health Nursing Vol. 17, 3, 1996.

Erickson, H. (1991). Erickson, H. Modeling y Role-Modeling con psychophysiological problemas. Rapport. Journal of Instituto de Hipnoterapia Ericksoniana. Buenes Aires, Argentina.

Erickson, H. (1990) Theory based nursing. In Kinney, C. , Erickson H. (Ed ) Modeling and Role-Modeling: Theory, Practice and Research. Society for Advancement of Modeling and Role-Modeling. Vol. 1(1), 1-27.

Erickson, H. (1990). Self-care knowledge: A exploratory study. In Kinney, C. & Erickson, H. (Ed ) Modeling and Role-Modeling: Theory, Practice and Research. Society for Advancement of Modeling and Role-Modeling. Vol. 1(1), 178-202.

Erickson, H. Modeling and role-modeling with psychophysiological problems (1990). In J.K. Zeig & Gilligan, S. (Eds.) Brief Therapy: Myths, Methods, and Metaphors New York: Brunner/Mazel., 473-491..

Kinney, C. & Erickson, H. (1990). Modeling the client's world: A way to holistic care. Issues in Mental Health Nursing. Vol. 11 (2), 93-108.

Erickson, H. & Swain, M.A. (1990). Mobilizing self-care resources: A nursing intervention for hypertension. Issues in Mental Health Nursing. Vol. 11 (3), 217-236.

Barnfather, J., Swain, MA, & Erickson, H. (1989) Evaluation of two assessment techniques. Nursing Science Quarterly. 4, 172-182.

Barnfather, J., Swain, M.A., Erickson, H. (1989). Construct validity of an aspect of the coping process: Potential adaptation to stress. Issues in Mental Health Nursing. 10, 23-40.

Erickson, H. (1988). Modeling and role modeling: Ericksonian approaches with physiological problems. In J. Zeig, & S. Langton (Eds), Ericksonian pychotherapy: The state of the art.

Erickson, H. (1986). Synthesizing clinical experiences: A step in theory development. Ann Arbor, MI: Biomedical Communications, University of Michigan.

Erickson, H. (1985, March/April). New challenges for nurses. DCCN, 99-100.

Campbell, J., Finch, D., Allport, C., Erickson, H., & Swain, M. (1985). Modeling and role-modeling: A nursing assessment format. Journal of Advanced Nursing, 10, 111-115.

Erickson, H. (1984). Political aspects of compassionate care. Published in proceedings from A Call to Create, Loyola University of Chicago, June 1-4, 1984.

Erickson, H. (1983, March). Coping with new systems. Journal of Nursing Education, 132-136.

Erickson, H. C., Tomlin, E. M., & Swain, M. A. P. (1983). Modeling and role-modeling: A theory and paradigm for nursing. Englewood Cliffs, NJ: Prentice-Hall) Second-fifth printing, 1988-2000; EST Co: Austin, TX.

Erickson, H., & Swain, M. A. (1982). A model for assessing potential to adapt to stress. Research in Nursing and Health, 5, 93-101.

Selected Abstracts:

Erickson, H. Caring, Comforting and Healing. Conference Procedings. The Sixth National AJN Conference on Medical-Surgical and Geriatric Nursing. October 19, 1994.

Erickson, H., Kinney, C., Acton, G., Becker, H., Irvin, B., Jensen, B., & Miller, E. (1994). An Intervention Study: Persons with Alzheimer’s Disease and Their Caregivers. Conference Proceedings. The Fifth National Conference for the Theory of Modeling and Role-Modeling.

Erickson, H. (1993). Intervention Research with Cognitively Impaired Persons and Their Caregivers. Nursing's Challenge: Leadership in Changing Times. STTI 32cd Biennial Convention. Indianapolis, Indians.

Erickson, H & Kennedy, G. (1992). Viewing the world through the patient's eyes. Proceedings: Celebrating Partnerships. AACN NTI. New Orleans, Louisiana.

Erickson, H., Acton, G., Baas, L., Robinson, K., & Rossi, L. (1992). Strategies to humanize care in the ICU. Proceedings: Celebrating Partnerships. AACN NTI. New Orleans, Louisiana.

Erickson, H. (1991). The relationships among self-care knowledge, self-care resources and physical health. The Proceedings of the Fifth Annual Conference of the Southern Nursing Research Society.

Erickson, H. (1990). The McKennell model: using qualitative methods to guide instrument development. Fourth Annual Conference of the Southern Nursing Research Society. p.115.

Erickson, H., Lock, S., & Swain, M. (1989). Continuation of the study of the self-care knowledge construct in the modeling and role-modeling theory. Advances in International Nursing Scholarship. Sigma Theta Tau International Research Congress . Taipei, Taiwan: Sigma Theta Tau International Honor Society. p.84.

Erickson, H. (1989). Study of the self-care knowledge construct. Third Annual Conference of the Southern Nursing Research Society. p.10.

Erickson, H. (1989). Mind-body relationships as a factor in the care of people with diabetes. Third Annual Conference of the Southern Nursing Research Society p.47.

Erickson, H. (1985). Self-care knowledge: Relations among the concepts support, hope, control, satisfaction with life, and physical health. Social Support and Health: New Directions for Theory Development and Research. University of Rochester. pp. 208-212.

Erickson, H., & Swain, M. A. (1977). The utilization of a nursing care model for treatment of essential hypertension. Circulation. (Abstract)

RESEARCH
1995	Principal Investigator. Secondary Analysis of Data. Funded by The Pine Family
1993	Principal Investigator. Interventions with Alzheimer Patients and Their Caregivers: A Follow-up Study. Funded by the Agency of Aging of the Capitol Area.
1991-94	Principal Investigator. Modeling and Role-Modeling with Alzheimer's Patients. Project 1RO1NR03033. Funded by National Institute of Aging
1990-91	Co-Investigator. Study of the Relations Among Self-care Knowledge, Self-care Resources, Self-care Actions, and Physical Well-Being. Unfunded Project. The University of Texas at Austin, School of Nursing.
1989-90	Co-Principal Investigator. Study of the Relations Among Personal Characteristics, Behaviors, and Physical Well-Being. Nonfunded Project. The University of Texas at Austin, School of Nursing.
1989-91	Principal Investigator. Study of Self Care Knowledge and Self Care Resources. Project R-234. Funded by University of Texas Research Institute
1986-89	Erickson, H. (Principal Investigator), & Swain, M. A. (Co-Investigator). Validation of the Self- Care Knowledge Construct: A Healthy Population. Unfunded project. The University of Michigan and The University of South Carolina, College of Nursing.
1985-1986	Erickson, H. (Principal Investigator), & Swain, M. A. (Co-Principal Investigator). Modeling and Role Modeling: Testing Nursing Theory. Funded by Biomedical Research Grant, School of Nursing, University of Michigan.
1983-1984	Swain, M. A. (Principal Investigator), & Erickson, H. (Co-Principal Investigator). Evaluation of Two Nursing Intervention Strategies. HHS: The Division of Nursing
1982	Principal Investigator. The Role of Perceived Support and Perceived Control in Health Phenomenological Study. Unfunded project, The University of Michigan School of Nursing.
1979-1980	1979-1980 Co-Principal Investigator (with M. A. Swain). Life Events, Stress and Health. Partially funded: HHS: Division of Nursing, Grant Number NU-00658.
1979-1981	Co-Principal Investigator (with M. A. Swain and S. B. Steckel). Health Promotion Among Diabetics: Comparing Nursing Systems. Project funded by grant number NU-00658 from the Division of Nursing, Bureau of Health Professions, Health Resources and Services Administration, Public Health Service, U.S. Department of Health and Human Services.
1980	Principal Investigator. Relationships Among Coping States and Hospital Stay. Unfunded project, The University of Michigan School of Nursing.
1978-1979	Research Associate. Health Promotion Among Diabetics: Comparing Nursing Systems. (M. A. Swain and S. B. Steckel, Co-Principal Investigators). Project funded by grant number NU-00658 from the Division of Nursing, Bureau of Health Professions, Health Resources and Services Administration, Public Health Service, U.S. Department of Health and Human Services.

OTHER PROFESSIONAL ACTIVITIES

Selected Papers Presented

Holistic Nursing: Finding Meaning in Chaotic Times. Helen L. Erickson Holistic Lectureship. The University of Texas at Austin, March 4, 2005.

Unconditional Acceptance. Invited lecture. Metropolitan State University, October 2004.

Modeling the World of the person with a Chronic Physical Problem. Presented at the 7^th International Congress on Ericksonian approaches to Hypnosis and Psychotherapy. Phoenix, Arizona, December 8-12, 1999.

Merging the Art and Science of Nursing: Challenges and Opportunities. Keynote presentation. Lambda Mu Chapter, Sigma Theta Tau International. Research Conference at Mankato, Minnesota. October 10, 1997.

Using Hypnosis to Facilitte Psychophysiological Change Invited paper. First International Conference: The Psychology ofConsciousness, Energy Medicine and Dynamic Change. Sponsored by the National Institute for Clinical Application of Behavioral Medicine. Monterey, CA. April 3, 1997.

Treating Psychophysiological Problems with Hypnosis. Invited paper. Seventh International Conference: The Psychology of Health, Immunity and Diseases. Sponsored by the National Institute for Clinical Application of Behavioral Medicine. Hilton Head, SC. December 7, 1996.

Holistic Healing. Visiting Scholar. Indiana University, Southbend . Indiana. April 21, 1995.

Modeling and Role-Modeling: Theory and Paradigm. Paper presented as Visiting Scholar, The University of Pittsburgh, Pa. January 31, 1995.

Making it Real. Paper presented as the Visiting Scholar, The University of Pittsburgh, Pa. February 1, 1995.

Modeling the World of Alzheimer’s Patients and Their Caregivers: Research Findings. Invited presentation. Regional Conference on The State of the Art in Caring for Persons with Alzheimer’s Disease. Sponsored by the State Health Department, Austin Texas. November 4, 1994.

Caring, Comforting and Healing. The Sixth National AJN Conference on Medical- Surgical and Geriatric Nursing, Chicago Illinois. Invited keynote. October 19, 1994.

A Three Year Intervention Study: Philosophical Assumptions, Designs, and Methods. The Fifth National Conference for the Theory of Modeling and Role-Modeling, Arcata California. June 4, 1994

Health, Holism, and Shifting Paradigms: Future of Nursing. Invited paper. The Minnesota State University System. St. Paul, Minnesota. May 16, 1994.

Shifting Paradigms: Implications for Nursing Care Tomorrow. Invited paper presented for Nurses in the Baltimore-Washington, D.C. Metropolitan Area. Greater Baltimore Medical Center, Baltimore Maryland. May 12, 1994.

Shifting Paradigms: Implications for Critical Care Nurses Invited Keynote for American Association of Critical Care Nurses, Regional Meeting. Austin, Texas. April 6, 1994.

Holistic Care and Caring: Implications for Nursing. Invited paper. The University of Texas at Tyler, School of Nursing. March 18, 1994 Tyler, Texas

Relief of Pain, Nausea, Itching and Fearfulness Keynote at Clinical Hypnosis in Nursing. Sponsored by San Francisco Academy of Hypnosis, Education and Research Foundation. San Francisco, California. October 16, 1993.

Research: The Basis for Practice. Keynote address at Second Annual Nursing Research Conference. Sponsored by Iota Una Chapter, STTI. Tyler Texas. April 23, 1993.

Practice Through a Keyhole or By the Seat of Your Pants. Keynote address at Nursing Perspectives Into the 21st Century Sponsored by Eta Eta Chapter, STTI. Harrisburg, Pennsylvania. April 2, 1993.

Modeling and Role-Modeling the Patients' World. AACN, NTI. New Orleans. May 20, 1992.

Strategies to Humanize Care in the ICU. AACN, NTI. New Orleans. May 20, 1992.

Modeling and Role-Modeling: Theory in Practice. Sponsored by Association of Rehabilitation Nurses. Kalamazoo, Michigan. October 11, 1991.

Helping Persons with Diabetes Learn Self-care. Program sponsored by American Association Diabetic Educators, Bluebonnet Chapter. Georgetown, Texas. September 5, 1991.

Transformation: How Do We Do It. Keynote presented at American Holistic Nurses' Association Annual Conference. June 22-25, 1991. Tampa, Florida.

Using the Client's Model of the World as a Basis for Nursing Intervention. Presented to faculty and staff, University of Cincinnati Hospitals, Cincinnati, Ohio. April 24, 1991.

The Relationships Among Self-care Knowledge, Self-care Resources, and Physical Health. Presented at The Fifth Annual Conference of the Southern Nursing Research Society. Richmond, Virginia. February 28-March 2, 1991.

Assessing Coping Ability of the Female Patient with Diagnosis of Breast Cancer. Keynote presented at Obstetrical, Gynecological and Neonatal Nursing . Harvard Medical School Department of Continuing Education. January 28, 1991.

Modeling and Role-Modeling: Clinical Hypnosis in Nursing. Keynote presented at 15th Annual Workshop. San Francisco Academy of Hypnosis. San Francisco California. October 6, 1990.

Self-care Knowledge, Actions, and Resources: Current Research. Presented at Third National Conference: Modeling and Role-Modeling A Theory and Paradigm for Nursing. May, 1990. Austin, Texas.

Study of the Self-care Knowledge Construct in the Modeling and Role-Modeling Theory. Presented at Advances in International Nursing Scholarship: Sigma Theta Tau International Research Congress. Taipei, Taiwan. June 5-6, 1989.

Modeling and Role-Modeling: Implications for Caring in Practice. Visiting Professor Keynote. The Sixth Annual Nurse Recognition Proceedings- Recognizing Nursing: commitment to Caring. Brigham and Women's Hospital. Boston, Mass. May 11, 1989.

Study of the Self-Care Knowledge Construct. Third Annual Conference of the Southern Nursing Research Society. Austin Texas, February 23-25, 1989.

Mind-body Relationships as a factor in the Care of People with Diabetes. Third Annual Conference of the Southern Nursing Research Society. Austin Texas, February 23-25, 1989.

Modeling and Role-Modeling with Psychophysiological Problems. Invited address. The Fourth International Congress on Ericksonian Approaches to Hypnosis and Psychotherapy: Brief Therapy: Myths, Methods, and Metaphors. San Francisco, California. December 7-11, 1988.

Mobilizing coping Resources Related to Basic Need Status in Young, Healthy Adults. Co-presented with Barnfather, J. & Swain, M.A. Excellence in Nursing Science., 12th Annual Midwest Nursing Research Society. April 24-26, 1988.

Modeling and Role-Modeling: A Theory and Paradigm for Nursing. Invited paper, The University of Wisconsin, Madison, Wisconsin. May 7, 1987.

A Nursing Perspective on the Role of Stress in Health and Disease. Keynote Presented at Third Annual Primary Nursing Symposium, The University of Michigan, Ann Arbor, Michigan. April 23, 1987.

Stress Management in Everyday Life. Presented in the Health Science Series, University of South Carolina, Sumter, South Carolina. March 12, 1987.

Modeling and Role Modeling: Erickson Techniques Applied to Physiological Problems. Invited paper, Presented at the Third International Congress on Ericksonian Approaches to Hypnosis and Psychotherapy, Phoenix, Arizona. December 3-7, 1986.

Modeling and Role-Modeling: A Theory for Nursing Practice. Co-Presented with C. Kinney, E. Tomlin, & T. MacLean, at Lausanne Graduate School of Nursing in Lausanne, Switzerland. August 14, 1986.

Self-Care Knowledge. Presented at The First National Symposium on Modeling and Role-Modeling. A Theory and Paradigm for Nursing, The University of Michigan, Ann Arbor, Michigan. May 7-9, 1986.

Modeling and Role-Modeling: A Theory and Paradigm for Nursing. Co-Presented with M. A. Swain and E. Tomlin, at The First National Symposium on Modeling and Role-Modeling. A Theory and Paradigm for Nursing, The University of Michigan, Ann Arbor, Michigan. May 7-9, 1986.

Science Theory Development and Commitments of the Profession. Keynote, South Carolina Academy of Science Annual Meeting, Nursing Science Section, Clemson University, South Carolina. April 17, 1986.

Modeling and Role-Modeling: A Theory in Practice. Invited Pfizer Lectureship, McGill University and Montreal General

Self Care Knowledge. Presented at A National Research Conference, Social Support and Health, Rochester, New York. April 19, 1985.

CONSULTATION

2/17-18/99 Onsite consultation: Using Modeling and Role-Modeling with Open Heart Clients. Little Rock Heart Hospital, Little Rock,AK.

10/9/1997 Onsite consultation: Using philosophy to drive clinical practice. Immanuel St. Joesph's Mayo Health System, Mankato Minnesota.

10/8/1997 Onsite consultation: Theory Based Curriculum; Planning, Developing and Implementing. St. Catherine's College of Nursing. Minneapolis, Minnesota

1/30-2/1, 1995 Onsite consultation: Implementing theory based nursing. The University of Pittsburgh Hospitals, Pittsburgh Pa.

1/24-25, 1994 Onsite Consultation Visit to Evaluate a Collaborative Master's Degree Program Sponsored by Mankato State University and Metropolitan State University. The Minnesota State University Systems. St. Paul, Minnesota.

9/19-20, 1991 Establishing a Research Program based on Theory Based Practice. Brigham and Women's Hospital. Boston, Mass.

1/28-30, 1991 Moving Toward a Model of Professional Nursing Practice. Implementation of Theory Based Nursing. Brigham and Women's Hospital. Boston, Mass.

10/3-5, 1990 Building a Curriculum Based on Modeling and Role-Modeling. Humboldt State University, Arcata California.

8/21-22/89 Curriculum Development and Evaluation: The Florida State University, Tallahassee, Florida

6/2-3/89 Curriculum Consultation. Foo Yin Junior College of Nursing and Medical Technology. Kaohsiung Taiwan.

5/9-12/89 Modeling and Role-Modeling: Theory, Research and Practice. Visiting Professor for Nurse Recognition Activities. Brigham and Women's Hospital, Boston, Massachusetts.

3/14-17, 1989 Modeling and Role-Modeling: Theory, Research and Practice. Veterans Hospital, Hot Springs, South Dakota

1/13-5/7, 1989 Modeling and Role-Modeling: Theory, Research and Practice. Weekly teleconferences to facilitate implementation of theory based nursing and identification of research problems. Brigham and Women's Hospitals, Boston, Mass.

9/8-11, 1988 Implementation of Theory Based Nursing and Related Research Issues. Brigham and Women's Hospitals, Boston, Mass.

6/24-/25, 1987 Modeling and Role-Modeling: Theory, Research and Practice. Veterans Hospital, Hot Springs, South Dakota

5/18, 1987 Curriculum Development and Evaluation: The Florida State University, Tallahassee, Florida

5/7-8, 1987 Implementing Modeling and Role-Modeling in Clinical Practice. The University of Wisconsin Hospitals and Clinics, Madison, Wisconsin.

4/24-25, 1987 Implementation of Modeling and Role-Modeling. University Hospitals, The University of Michigan, Ann Arbor, Michigan.

5-6, 1987 Health Education in the Public Schools. Detroit Public System, Detroit, Michigan.

5/3, 1986 Curriculum Development: Issues and Process. Vanderbilt University, Nashville, Tennessee.

1981-1986 Implementation of a Nursing Theory, Surgical Unit 7W University Hospital, The University of Michigan.

1976-1977	Project Director. Management of Hypertension Utilizing a Nursing Model. Project funded by grant number HL-17045, Influencing Compliance Among Hypertensives (M. A. Swain, Principal Investigator), from The National Heart and Lung Institute, U.S. Department of Health and Human Services.
1974-1976	Principal Investigator. Identification of States of Coping Using Physiological and Psychological Data. Unfunded project, The University of Michigan School of Nursing.

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CONTRIBUTING AUTHORS

Linda S. Baas, RN, PhD, ACNP

Professor and Coordinator of the Acute Care Graduate Program, University of Cincinnati College of Nursing; Nurse Practitioner.

University Hospital Heart Failure Center

Cincinnati, Ohio

BAASLS@UCMAIL.UC.EDU

Diane Benson, RN, EdD

Associate Professor of Nursing

Humboldt State University

Arcata, California

dsbrn@cox.net

Mary Brekke, Ph.D., RN, CHTP, AHN-BC

Metropolitan State University, School of Nursing

St. Paul, Minnesota

maryebrekke@earthlink.net

Da'Lynn Kay Clayton, Ph.D., RN

Imagine Nursing, Consultant in Holistic Nursing;

Associate Professor

College of Nursing

Harding University

Searcy, Arkansas

dclayton@harding.edu

Margaret E. Erickson, PhD, RN, AHN-BC

Imagine Nursing, Consultant in Holistic Nursing;

Executive Director, American Holistic Nurses’

Certification Corporation

Cedar Park, TX

mickyandray@austin.rr.com

Judith E. Hertz, PhD, RN

Associate Professor

Director of Graduate Studies

School of Nursing, Northern Illinois University

DeKalb, Illinois

r60jeh1@wpo.sco.niu.edu

Betty Ayotte Jensen, PhD, RN

The University of Texas at Austin

drbjensen@earthlink.net

Carolyn K. Kinney, RN, PhD, AHN-BC

Integrated Health Care Therapist and Wellness Consultant; Associate Professor of Nursing,

The University (Retired)

Austin, Texas

ckkinney@aol.com

Sharon Rodgers, PhD, RN

Assistant Professor

Patty Hanks Shelton School of Nursing

A Consortium of Hardin-Simmons University

Abilene Christian University & McMurry University

Abilene, Texas

Imagine Nursing, Consultant in Holistic Nursing

srogers@phssn.edu

Ellen D. Schultz, PhD, RN, CHTP

Professor of Nursing

Metropolitan State University

St. Paul, Minnesota

ellen.schultz@metrostate.edu

Marsha Jelonek Walker, PhD, RN, AHN-BC, RMT

Mindbody Health

Educator and Private Practice

Austin, Texas

walkerj@io.com

BUY NOW

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PREFACE

In the early 1980’s I was fortunate to be part of a group that met in monthly seminars with authors Erickson, Tomlin, and Swain, prior to the publication of their seminal work, Modeling : A Theory and Paradigm for Nursing (1983). The participants were nursing faculty, students, and practicing nurses interested in learning, growing, and sharing our ideas about nursing, stretching our views, and digging deeply into what we knew as we explored the foundational elements of the theory. We knew then that the Modeling and Role-Modeling (MRM) theory synthesized an important new way of thinking about and implementing nursing that was on the frontier of conceptualizing nursing. Yet, it also embraced truths about human needs and behavior that were both universal and timeless.

Health care and the world at large have changed significantly since the publication of MRM in 1983. Yet, one thing remains the same. In spite of the tremendous advances in treatment options and increasing acceptance of adjunctive, alternative, and integrative types of care, nursing’s focus remains on the human being receiving the care. MRM has been steadfast in its emphasis on understanding all dimensions of the individual client’s perspective (modeling his or her world) as a prerequisite to providing nursing care.

This book’s goal of expanding and elaborating upon the underlying philosophical foundation and the concepts and components of the MRM theory challenges us to push even further the boundaries of what Nursing is and can be. With Helen Erickson’s inspiring and untiring guidance, the contributors provide direction for contemporary nursing practice and scholarship and for the next era in nursing’s unfolding history. Some of the most expansive and thought-provoking ideas in the field are explicated, along with elaboration of nurses’ roles as facilitators of our clients’ growth, development, and transformation of mind, body, spirit, and soul. As a result, this work provides guidance for what it means to be human, personally and professionally, and for sustaining nursing’s holistic and comprehensive approach to fulfilling our commitment to our clients and our contract with society.

Carolyn K. Kinney, PhD, RN, AHN-BC

Integrated Health XE "Health" Care Therapist and Wellness Consultant

Associate Professor of Nursing

The University of Texas at Galveston (Retired)

Austin, Texas

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PROLOGUE

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It was 1989 when I was first introduced to the Modeling and Role-Modeling Theory. I was about to take a new position as Chair of the Department of Nursing at Humboldt State University (HSU) where the faculty were engaged in curricular revision are were about to make Modeling and Role-Modeling the basis of all of their teaching. One of my colleagues gave me a copy of the 1983 book and said “Here - you have to read this. You’ll see that it really makes sense. It explains exactly what we’ve all been doing all these years, and it if isn’t what we’ve been doing – it is what we should have been doing!”

I considered myself a rather diligent student of nursing theory and I was surprised that there was a theory about which I knew nothing. I was intrigued and very impressed that an entire faculty were so committed to this particular point of view. Needless to say, I did read the book and not only did it make immense sense, it gave me a new perspective on care and new language to use in describing important nursing observations and activities. Modeling and Role-Modeling is a theory that helped me put nursing in perspective, particularly in relationship to our clients. It includes concepts of adaptation, adaptive states, human development, basic human needs, growth, and healing. It sets out guidelines for nursing practice – the five aims of intervention. It explores the concept of nurturance as a basic nursing intervention and gave voice to the distinction between nurturance and care. The theory provides a structure and a framework for care that is easily understood and that can be practiced intuitively. There is an easy ‘fit’ between what we know as experienced nurses and what Modeling and Role-Modeling says. There is also an easy ‘fit’ between what very new novice nurses want desperately to do (care for and help others) and this theory, as every sophomore student at HSU found when they learned nursing from this model and immediately applied it to their beginning nursing practice.

The theory also requires something I’ll call faith for lack of a better descriptor. We have to believe in the process, we have to trust that the client knows deep down why he or she is sick and what he or she needs to get better. We have to believe that the human being innately strives for health and healing. We have to believe it is appropriate for professional nurses to give up control and render control to the client him or herself. We have to believe that we can assist best by asking the client what he or she needs and then listen and act on the client’s responses. The theory directs nurses to be humble, compassionate, responsive, nurturing, knowledgeable, and courageous human beings. – people who are willing to enter into nurse-client relationships that will inevitably leave both the nurse and the client changed for having had the personal encounter with one another. From my perspective, that means the theory requires commitment to holistic nursing – providing care that has one and only one main goal: healing the whole person.

This new text: Modeling and Role-Modeling: a view from the client’s world, is a long-awaited book that enhances the original work. It is not an ‘updating’ of a theory, nor is it an attempt to bring the theory into a modern, contemporary context in ways that would change the basic tenets of Modeling and Role-Modeling. Further, and quite thankfully, it is not an attempt to place Modeling and Role-Modeling in competition with other current theories for purposes of ‘finding its place’ in our current array of nursing theories. This is a book that provides depth, science, and grounding for each of the constructs of the original theory.

My first impression of the theory was that it made sense and that it could be practiced intuitively. Practicing by intuition and applying the theory by intuition will work for both nurse and clients. But our current environments emphasize evidence-based practice, the need to know, evaluate, and prove efficacy, and need to demonstrate and explain outcomes through data or theory. These environments make it essential that nurses understand the depth, the data, and the practice decisions they make while putting this theory into use. For me, that is exactly what this text does.

This book explores the concept of holism – the nurses’ and the clients’ ways of being. It explores the body-mind-spirit connections and the connections between two people – one the healer, the other the person striving to be healed. In reading we are compelled to explore the human spirit and to understand the spiritual drive at the core of every person. We are provided with the science and the data that underpin energy theories, psychoneuroimmunology, and the physiology of the human heart. We are asked to take a new look at human development. Also, we are asked to review our notions about stress, stress states, self-care knowledge, self-care actions, and role of the body as an unconscious memoir for all past history and events in a person’s life. The reader will explore the differences between development and growth, connections and relationships, nurturance and facilititation, holistic care and complementary modalities, presence and professionalism, and spirituality and emotions and thoughts.

This new text is by no means a replacement for the original work on the theory. Quite the contrary, basic knowledge of the theory is required to understand the chapters that follow. Without basic knowledge of the theory, and even with it, reading this book may seem for some like coming into a movie that has already begun. Each chapter stands alone providing important content. Together they stand as a thorough exploration of the meanings of Modeling and Role-Modeling. This text provides a summary of pertinent data, theories, constructs and concepts that guide holistic nursing care. Each chapter contains personal stories and narratives of client situations illustrating the ideas set forth. Helen Erickson writes “this book is about helping people to grow, develop, and, when needed, heal” (chapter 14). This book is also about the growth, development and healing of contemporary nursing. Read it with pleasure!

Noreen Frisch, PhD, RN, FAAN, APHN-BC

Cleveland State University

Cleveland Ohio

2006

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EXCERPTS DRAWN FROM SELECTED CHAPTERS

The following paragraphs are examples of the text in each of the chapters. Where you see..., there is a break in the text.

CHAPTER 1

He was just a little boy, perhaps five years old, when he looked at me and asked, “Where is myself?” Looking down at him, I pointed and said, “Right there; you ARE yourself.” He responded, “No, that is Me. Where is my SELF?” We had recently moved, so I interpreted this as symptomatic of some nervousness about the move and where his “things” might be. Some were still in boxes waiting to be unpacked. The other possibility was he wanted to know, "What is myself?"…

If we are Soul first, and the body is chosen as a “home” for us to do the work of the Soul, to carry out our Reason for Being, then there must be a force that pulls the two, the Soul and the body, together. The work of this force is to fulfill our inherent need to integrate Soul and body. I think this force is the spiritual drive.

This spiritual drive starts before our biophysical existence, continues through our lifetime, and culminates during Transformation. It is always present, and pervades our subsystems even though we may not be consciously aware of it. It inspires us to search for our Life Purpose.

That is, we become holistic beings because we have to do Soul-work within the context of this lifetime; this is our Life Purpose. While Life Purpose is linked to the Soul and our Reason for Being, it is different. Our Life Purpose is the work we have to do in human form in this lifetime to enhance the Soul. Our Reason for Being is why the Soul chooses to integrate with a human body….

We might think of life as a string of single-colored pearls. The core of each pearl represents an important experience and the outer layer represents the life decision made about the experience. Some decisions are proactive; others are reactive. Some are purposeful steps taken to initiate action; others are secondary to life events we unexpectedly experience. How we interpret these experiences, how we react, and what we do with what we’ve learned, determines the color of the pearls. Some are bright and shiny; some are not.

Each pearl has significance; each adds to the one before and paves the way for the next. When examined individually, we see multiple, single-colored pearls (or life experiences), some more interesting than others, and some more fulfilling. Examined as a whole, however, a new picture emerges. A string of unmatched pearls, previously seen as separate and unrelated to one another, suddenly, reveals a pattern….

We have an inherent drive to know our Self, and to be connected with others in fulfilling ways. We search for meaning in our lives, hoping to find a purpose for our existence. But, sometimes we forget we can only discover our Life Purpose by finding meaning in day-to-day experiences. Sometimes our experiences are fulfilling and sometimes not. Our search takes a lifetime. Often, we look back on previous experiences, hoping to put them in context. Sometimes we are successful in this endeavor and sometimes not. Usually, persistence pays off! When we give ourselves time to discover, assimilate, and understand, our Life Purpose becomes obvious.

However, life is like a kaleidoscope: just as the “picture becomes apparent”, the scenery changes! And with each change, a new picture emerges. We are constantly evolving; our grasp of purpose evolves with our day-to-day experiences. Tomorrow we will be different from what we are today. We will have new experiences and find new meaning in them. Nevertheless, it is possible to discover our life journey has direction and purpose. We just have to stay true to our inner voice….

Discovering one’s Reason for Being and Life Purpose does not happen overnight. It comes with years of introspection, years of searching for meaning in experiences sometimes too painful to think about, sometimes too trivial to be important, and at other times, too joyous to have deep meaning. It is a personal, private experience, which happens as you interact with those you love, those you don’t like, and those you don’t know. It is not a metamorphosis, but more of an unfolding. It happens when you listen to your inner voice and be true to your Self. It doesn’t come with a big ah-h-h, but with a gentle seeping of nourishment into your Soul until it awakens with new knowledge.

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CHAPTER 2

When nurses seek to fully understand their clients’ model of the world are they attempting to match the vibratory level of the client? What do they mean when they say that they are trying to “…get on the same wave length” with their clients? According to Gerber (1988), during the process of resonance, electrons move to a new vibration in order to be consistent with energy fields surrounding them. Expressions such as, “I really resonate with that theory”, “We’re on the same wave length” are used in daily conversations. Perhaps they indicate that we not only experience energy and changes in energy levels, but we also possess an “inner knowing” that is not always consciously identified or articulated, but changes how we experience our lives. How exciting it would be if we were able to consciously, proactively use these ideas to make differences in our lives as well as the lives of those with whom we live and work!…

Simply stated, energy is the capacity to do “work” and “work” occurs when something changes. Sarter (2002) said,

Energy is the capacity to create change. Whenever there is change, or the potential for change, there is energy. By this definition, energy is not only a physical phenomenon. It is also the foundation of the emotional, mental, social and spiritual spheres (p.1)….

While we used to think that protons, neutrons and electrons were the smallest atomic particles, we now know better! The theory of quantum physics holds that protons and neutrons are each made up of very small particles called quarks. They are held together by even smaller particles called gluons, which collect together to make glueballs! They are so small that we cannot observe them directly—they are subatomic particles….

Ancient cultures believed that there was an energetic “life force” (Bruyere, 1989) or a “life energy” (Gupta, 2001) that came from the Universe, was necessary for human life and returned to the Universe upon physical death.

Many believed that two opposite ends of the spectrum--yin, the energy of earth and yang, and the energy of heaven—combined in humans to create this vital force. There were various names for this “life force”. It was known as Mana in Polynesia; Prana in India; Ki in Japan; Chi, Chee or Qi in China; Ruach in Hebrew and Barraka in Islamic countries. Despite the difference in terms used among these cultures, they shared a common belief: “…one thing underlies existence…there is a vital energy (or force) unique to and inherent in things…” (Todaro-Franceschi, 1999, p. 14). Some call this subtle energy (Eden & Feinstein 1998; Gerber, 2001). Gerber stated that we are energy first and that subtle energy is an expression of the Soul….

A related aspect of energy transformation occurs when chemical molecules stored after a specific life experience are later excreted during similar life experiences, flooding the body with chemicals that create feelings similar to those experienced during the first life event. This is called cellular memory (Pearsall, 1998). This type of stored energy provides information about the “memories” and is an ongoing, dynamic process that provides insight into mind-body relations. …

Gerber (1988) described research undertaken to validate the existence of energy points in rabbits, salamanders, frogs, and chick embryos, stating that embryonic chick meridian ducts were formed within 15 hours of conception, well before the formation of rudimentary organ structures. Some say that all things start as energy first--that our existence comes from energy, which dictates how our cells grow, and from the energy comes matter (Bruyere, 1994; Chopra, 1990; Emoto, 2004; Gerber, 2001; Pert, 2003; Hunt, 1995.) Research with the “Kirlian phantom-leaf-effect” has demonstrated that the energy field of leaves (taken from trees) remain even after half of the leaf is amputated (Gerber, 2001, p.26). This idea of energy first is quite intriguing when you think of the implications. Energy before matter suggests that there is something to us before we become biophysical-psychosocial beings! …

But, if we are energy first, where does it come from? Many from the healing professions have argued that there is Universal Energy (Chopra, 1990; Dyer, 1989, Grayson, 1997 or a Life Force (Gordon, 2002). Gerber (2001) calls it the “life energy” or “spiritual energy” (p16-17). …

Another way of thinking about a common source of energy is derived from those who argue for a Unified Field of Energy that reconciles the four types of energy forces, bringing them together in a common space where they simple transform into one of the four forces. Einstein first proposed this idea, but was unable to provide evidence. Nevertheless, many have continued to pursue the idea. Greene, (2003) stated, “Einstein was simply ahead of his time. More that half a century later, his dream of a unified theory has become the Holy Grail of modern physics” (p. 15). …

Some argue that the solution to this question of a Unified Field lies in a better understanding of the Zero Point Field. McTaggart (2002) describes it like this:

The Zero Point Field is a repository of all fields and all ground energy states and all virtual particles—a field of fields. Every exchange of every virtual particle radiates energy. The zero-point energy in any one particular transaction in an electromagnetic field is unimaginably tiny- a photon’s worth (p. 23)….

The relationship developed between nurse and client can also be expressed in terms of an energy field. Watson (1999), one of health care’s key leaders in holistic nursing, stated that a caring field is created when the nurse, is fully present with the client. She said that the nurse and client connects on an energetic level, creating a caring field. She describes this as the creation of a Caring Field, a new field of consciousness and possibilities. She states, “The transpersonal caring field resides within a unitary field of consciousness and energy that transcends time, space, and physicality (unity of mind-body-spirit nature universe)” (2005, p. 222).

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CHAPTER 3

Neurotransmitters are chemicals that carry “messages” from cell to cell. Every neurotransmitter has a specific molecular make-up, which means it carries a specific “message”. “Messages” are carried in small sacs, called synaptic vesicles, clustered at the tip of the axon. When the vesicle receives the electrical impulse from the neuron body, neurotransmitters are excreted into the synaptic cleft. Some move to adjacent neurons; others enter body fluids and are taken to other neurotransmitter receptive cells throughout the body. …

Neuromodulation is the primary way we are able to have a dynamic, interactive web of continuous feedback loops of communication among all parts of the body, organ-to-organ, system-to-system, including the immune system. Rather than affecting a single neuron, neuromodulators tend to impact groups of neurons. For example, the cells in the limbic system are thought to respond as a group of cells rather than as individual cells. Although neuromodulation can happen in milliseconds, it can take longer, sometimes minutes to days. It usually has a longer effect. …

Neuromodulation occurs when neurotransmitters are released directly into one of the body fluids such as the blood, spinal fluid, or lymph fluid. These molecules are then carried throughout the body. In some cases, they connect with cells of other organs, carrying their messages with them. In others, they move into the cellular space around neurons, attach to the receptor sites used in neurotransmission and, therefore, interfere with messages sent neuron-to-neuron. But remember, receptor sites are discriminating, so how do they decide which messages will be accepted and which rejected? …

When messenger molecules are released, they move through the body vibrating and creating energy fields around them. When they approach a receptor, they gently bounce against the receptor site to test its receptivity. When the two energy fields are able to “vibrate in synchrony”, the messenger molecule is able to bind with the receptor site. Depending on the information carried in the messenger molecule, the function resulting from “binding” can either depress or stimulate cellular function (Pert, 2003a, p. 23). …

The process of communication, or flow of information, throughout the organism is evidence that the body is the outward manifestation of the mind. Neuropeptides are the main biochemicals of emotion linking the major systems of the body into one unit—the bodymind, and emotions are involved in translating information into physical reality (Pert, 1997, p.27).

We have an inherent need to be connected, spirit with mind and body. This need motivates us to find meaning in our existence, better understand who we are, and realize our reason for being. The model of holism (shown in Figure 1.3) indicates our spiritual drive helps integrate spirit, mind, and body. It draws from the Universal Field, and permeates our biophysical-psychosocial being bringing “Universal information” with it. We send energy back into the environment by way of spiritual energy although the nature of the energy sent back depends on how fully integrated we are as human beings. …

Because all things are connected, these complex interactions within the body also interact with the environment. As a total, Universal Intelligence is created by a merging of all energy fields, human, and other. Gerber (2001) called this intelligence Consciousness and considered it the source of all information. …

Deepak Chopra (2004) offered another way of thinking about such intelligence, defining it as “the potential for all creation” (p. 34). According to him, “The universe is a mirror of consciousness” and “The physical world mirrors a mind; it carries intention and intelligence in every atom” (p. 102). He argued that we have the potential to affect others in positive and negative ways because of Consciousness--Consciousness is much greater than we are, but it is in and around us. …

Distant healing, under the larger umbrella of distant intentionality, attempts to benefit another, rather than to simply have an effect. Distant healing is defined as “a consciously dedicated act of purposeful thinking aimed at benefiting another person’s physical or emotional well-being, at a distance” (Sicher, Targ, Moore, & Smith, 1998). It includes prayer, directed thoughts and feelings, and spiritual healing techniques. Distant healing also involves energy-based therapies like Therapeutic Touch, Reiki, and Healing Touch. Studies have provided considerable evidence that purposeful thought has a significant effect on the well-being of those on the receiving end of the connection. …

Some describe the Unified Field as universal energy where all “knowing”, all “intelligence” resides (Chopra, 1989, 2000, 2004; Dyer, 1989; McTaggart, 2002). According to these authors, the Unified Field—an energy field of pure intelligence—is thought to be the core of the universe, i.e., the core of life. We believe Universal Energy gives rise to The Universal Force.. Some call this a Life Force (Gordon, 2002), others call it the Divine (Dossey, 1993), God (Lesser, 1999), and Consciousness (Chopra, 2000; Gerber, 2001). …

The potential for understanding how the Soul connects with our mind and body may lie in understanding Zero Point Energy and its connection with other types of energy fields.

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CHAPTER 4

Our Self-care Knowledge not only includes awareness of psychosocial and emotional stressors, stress responses and resources, it also incorporates knowledge of the physical self. Many people, for example, know what makes their bodies feel good or strong. These may be psychosocial or biophysical factors. Many people can identify which foods, when consumed, make them more awake and alert, and which make them drowsy. Others recognize overeating makes them uncomfortable, even before having that extra dessert. Many know how their bodies respond to stress: some develop a stiff neck; others may have stomach pain. Regardless of the specifics, many people know how they will react physically because they have learned the response from repeated life experiences. They have developed Self-care Knowledge and are aware of it. …

An interesting aspect of SCK is we have knowledge, which is not consciously known. We know things about ourselves that are forgotten or buried, things important for us as we grow or heal. This “knowing, but not knowing what we know” is not unique to nursing. Other disciplines label this phenomenon as emotional memory (Charles, Mather, & Carstensen, 2003; Witvliet, 1997) or state-dependent memory (Rossi, 1986; Rossi & Cheek, 1988) and describe how memories of events can arouse emotions and affect a person’s current behavior and learning. …

The memory of these events is stored in such a way that later, when we have experiences which even remotely remind us of the original event, or any part of it, we tend to have reactions very similar to those of the first experience. Our heart may beat faster; we may breathe hard, become fearful or excited, and so forth. Since the type of “storage” depends on the meaning of the event to the individual, the type of response we have also depends on the meaning. However, the meaning of the event may stay buried until the individual is ready to address it, rework the experience, and use it as a resource. …

Self-care Resources help us through difficult situations and provide foundations needed for growth. Often, they create resources we can use at a later date under similar (and sometimes different) circumstances. These resources enable us to face challenges with confidence. When we perceive we have the resources, the perception itself becomes a resource. This perception of adequate resources helps us live to the fullest and look to the future.

The drive to build resources exists within us, but their development is influenced by our past relationships. For example, personal traits, attitudes, or activities developed as a result of our experiences with family, friends, and acquaintances become Self-care Resources. Examples of activities that can be used as Self-care Resources include knowing how to slow our breathing, calm our minds, stimulate “happy neurotransmitters” and so forth. …

Sometimes Self-care Resources seem in opposition to what another person would consider helpful. Take for example, second day postoperative patients who need to walk, but think they require the nurses to help them get out of bed, walk, and simply move around the room. While nurses may perceive these patients are just fine and can get along without them, if the clients perceive they need someone to be with them, then they probably do! They may be physically able, but need someone to help them feel safe, or valued. Their asking is a type of Self-care Resource. Our challenge is to find alternative ways of helping clients meet their needs--ways that are better for both of us. …

In MRM theory, Self-care Action is based on personal meaning to the individual. This is crucial to health and healing. Since individuals have different meanings for the same word, how they perceive the concept, “being healthy” determines which Self-care Actions they deem helpful in order to get healthy and maintain health. For example, health is defined broadly in terms of need satisfaction, including meeting self-actualizing needs (Smith’s eudemonistic health, 1981), growth and development (Erickson et al., 1983), coping and adaptation, and a sense of well-being that is more than the absence of physical and mental health problems (World Health Organization, 1948). …

Healing, a related concept, means to make whole and therefore, denotes holism and holistic health processes. All aspects of the individual, from genetic endowment, spiritual drive, to physical, social, and psychological functions are part of this holistic health and healing. Health and healing and trying to become the best you can be are inherent drives common to all human beings (Frankl, 1985). So, Self-care Actions vary by the person’s world-view, their health problem, and how they think of possible outcomes. …

Building on this idea that all people have an inherent drive to become the best they can be, Self-care Actions was expanded to include the concept of Perceived Enactment of Autonomy (PEA) (Hertz, 1991, 1996). PEA is the perception of doing what is best for oneself based on personal values, needs, goals, strengths, and resources, in order to influence health processes and healing. However, doing what is best for one does not mean one must always act independently; it is possible to rely on others (i.e., to be dependent) as a means of doing what is best for oneself. …

When using Self-care Knowledge as the primary source of information (Erickson, et al., 1983, p.183) you start by asking clients to describe their situation and organize your data around the four categories for data collection: Description of the situation, Expectations, Resource Potential, and Goals and Life Tasks. After you have collected information from your client that is Self-care Knowledge, you may want to go on and collect additional information that is considered Secondary Source of Information. …

In the original work, Self-care Knowledge was described as the basis for one’s personal model of the world. This model reflects the individual’s interwoven perceptions that include all three components of Self-care: Knowledge, Resources and Actions. Self-care Knowledge takes many forms. It includes cognitive, biophysical, emotional, social, and spiritual aspects. The cognitive component is the factual information they have about health, disease, treatment, and themselves. The psychosocial aspect is related to past experiences that shape their reactions and needs in the present. The biophysical aspect focuses on body cues and perceptions of physiological changes. Some physical cues may be normal, while others are abnormal. Regardless of the person or situation, what the individual knows about their health and what they need to attain or maintain health, includes all three components of Self-care. …

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CHAPTER 5

It is always amazing to watch the ongoing, interrelated processes of growth and development. When babies are born, they are unable to hold up their heads, reach for a toy, hold a crayon, use the toilet, understand another person’s point of view, hold a job, make choices regarding right and wrong, or understand the importance of values and ethics in our daily lives. Nevertheless, when they are loved and cared for, physical, cognitive, and psychosocial growth occurs, and soon they are able to accomplish and perform physical and social activities impossible at birth. By the time they are five or six years of age, they will have grown and changed so much it is hard to remember a time when they couldn’t hold up their head. Development is a natural aspect of the human being. “Survival of the human being is dependent upon some growth. Without some growth, we cannot survive as human beings. Furthermore, growth is a prerequisite to healthy development. Interestingly, as we develop, we also grow. We grow, so we can develop and as we develop, we grow!” …

Development is age-related. People go through stages at specific times in their life. However, there is some variation, because each of us is a unique human being with a personality and Life Purpose. While we will all be challenged with the same developmental task, at approximately the same time in life, each of us will approach it based on our previous experiences, our genetic makeup and our personality. Some of us will have more difficulty or take more time in one task and then speed through a task others struggle with. While we all travel a similar path, we have our own journey to complete. …

The beauty of an epigenetic model is people always have the capability of growing, integrating, and becoming. There is always a possibility of reworking an earlier task and achieving a more favorable balance of residual as an outcome. A stronger, more positively balanced residual helps us be stronger and healthier. As human beings, we can always maximize our potential and be all we can be. It is never too late. That is the nature of epigenesis. …

Developmental residual is like a bank account. There is a savings account where we have stored information we can draw from and use as positive resources. There is also another account, sometimes seen as a deficit account, where we have stored other information. The two are not really separate, but intermixed, so we have a balance of stored information that determines the total residual or task-work product of each stage. This means there are two types of developmental residual: positive and negative. …

Some of us believe we are spiritual beings, with a Soul before birth. If so, we can assume our spirit connects to and integrates with our biophysical psychosocial body at some point before birth. I support this notion. I think we have the potential to be holistic beings before we are born. We are not just biophysical beings, we are also psychosocial beings and spiritual beings, all integrated to create a holistic being. If that is the case, psycho-social-spiritual development in humans must begin before birth, continue through the lifespan, through the death process and after. …

Based on the assumption that psycho-social-spiritual development starts before birth, continues through the lifespan, and even after physical death, two new stages of development are proposed. The first is Integration, the stage in which the spirit connects to the biophysical-psychosocial body. The second is Transformation, the stage in which the spirit leaves the body. …

Since spiritual energy (drawn from the Soul) might vibrate at a higher level than biophysical-psychosocial energy, the two energy fields have to merge in order for us to be holistic beings; to do this, they have to synchronize their vibrations. I support these assumptions. Having witnessed the birth of many babies, it is clear that most babies can be thought of as mind-body-spirit beings at birth. …

Children who repeatedly experience positive outcomes when they take initiative learn to feel good about their decisions. They seek social interactions, enjoy competition and take pleasure in a contest and in winning. The pleasure is in being successful in their endeavors rather than “beating” someone else. They continue, during this period of development, to become more adept and competent with their fine and gross motor skills. Manipulation of tools such as a crayon, a pencil, or a mixing spoon, when baking with an adult, allow them to gain pleasure in their mastery of skills, which in turn allows them to seek out new experiences and activities. When primary caregivers support and encourage exploration, independent thinking, and decision-making, children are purposeful in their lives. Goal-directed, thoughtful, and purposeful choices are made. …

The ninth and final stage of life as a holistic human being starts shortly before or at the end of physical lifetime. While some call it the time of death, I do not. We do not believe the ‘person’ dies, only the human form dies. We prefer to call it “passing on”, “moving on”, or “transforming”. We think this stage of life is yet one more type of attachment-loss-reattachment as described in Chapter 7. Rather than thinking about death and dying, we choose to think about transforming. The first implies the end while the other implies a new beginning. …

The strengths derived from satisfactory work in this stage are peace and freedom, combined with cosmic understanding and compassion. Cosmic understanding and compassion involve a Knowing and Loving that extends beyond our physical life. Soul Knowledge is knowledge shared with others in the Universal Field and Loving is that which goes beyond the physical and emotional parts of an incarnate life. It is the basis for compassion in human form and the essence of Soul fulfillment in spiritual form.

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CHAPTER 6

As human beings, we have an inherent drive to be independent, to discover our Self, and be the best we can be. At the same time, we have an inherent need to develop relationships, interact with others in meaningful ways, and experience a healthy sense of connectedness. These needs interface to create an inherent need for affiliation and individuation, which can be satisfied when our needs are met repeatedly and consistently across the lifespan. When affiliation and individuation are in balance, we are able to find meaning in our life, work on our Life Purpose, and self-actualize. …

When it comes to need satisfaction, no two people are alike because there are many ways in which needs can be met. Many people with a lifetime of unmet needs don’t thrive; others learn to get needs met in unhealthy ways, and still others somehow manage to get by. However, of this latter group, most are never able to develop close loving relationships. They often appear to be “pulling themselves up by the bootstraps”, but are unable to maintain the momentum. They just don’t have the internal resources needed for healthy affiliated-individuation, a prerequisite for Self-actualization. …

Need satisfaction is a crucial part of life. It determines what happens to us every day and in every phase of our lives. Yet, we often discount the importance of our needs. We have all heard children being told, “You don’t need that, you just ate!” or adults who discount their own needs saying, “I don’t need that, I just want it!” Sometimes, both these statements are true reflections of what the individual is feeling, but not always. Sometimes, we use the word need when we really mean want or desire. Other times, the word appropriately expresses what the person is experiencing. The difference is the mandate for a response. While needs mandate a response, wants and desires do not. People will not become deprived if wants and desires are not attended to, but they will if needs are not addressed. This is because needs are part of our basic nature; they drive our behavior. …

Need satisfaction is necessary for survival, but ironically, it is also temporary. While we may feel fully satiated at one moment in time, it is always possible those same needs are unmet a few minutes later. Erickson, H. (1996) proposed that we might think about needs satisfaction as an ongoing process and need status as a dimension (or as a scale) from need deprivation to need assets. Since unmet Basic Needs create tension, we have a drive to decrease the tension: the greater the deficit, the greater the tension. She proposed that as the tension reaches a threshold (probably at point 2 on a 0-5 point scale as shown in Figure 6.1), we typically initiate behavior to decrease the tension related to the unmet Basic Need(s). …

Healthcare providers frequently make the mistake of assuming they understand or know the client’s needs. This is particularly true when it comes to teaching people what they should do to take care of themselves! Usually, this happens when people are labeled as a medical disease or a health problem, such as a diabetic or a hypertensive. Such an approach often leads to frustration on our part and a lack of learning on theirs.

When we have our own agenda and presume to know what is needed without first asking our clients, we miss the opportunities to connect with them. We may assume our clients have a need to know, and therefore, we will teach them. It is like two ships passing in the night. Neither is affected, even though the potential was great. …

Past experiences with need satisfaction also influence how we respond to unmet needs. People who are accustomed to getting their needs met respond as though they expect to get them met. Furthermore, if they trust others care about them and will look out for their welfare, not only do they respond with behavior that indicates trust and positive expectations, they also demonstrate willingness to compromise. …

Sometimes, people who don’t perceive they have resources actually have them, they just don’t know it. They need help in discovering their abilities and learning that they can use past learning in new situations. They just don’t know what they know! …

On the other hand, need satisfaction in one subsystem may have a negative effect on need status in another subsystem. For example, adolescents who feel filial love may also experience feelings of inadequacy because the task of adolescence mandates they learn how to direct their own lives. What happens depends entirely on how the love is expressed, what conditions are associated with it, and to what degree the love allows both affiliation and individuation. …

Unmet needs in one subsystem of the holistic person have the potential to create greater need deprivation than unmet needs in another, depending upon the client’s perceptions of what is needed, what will help, and how to get help. We realize, of course there are times when physical needs take priority, and, usually, these are the times when physical life is threatened. However, even in those circumstances, the needs of the holistic person should be considered. …

Persons with Being Motivation often transcend the physical plane; they are able to see potential good in others and in the world. They simply seem to have a storehouse full of need assets, so it takes little to get unmet needs satisfied. It takes little for them to change a negative experience into a positive one, and little to find the strengths in their significant others. They are happy people with a high level of well-being. …

Deficit oriented people can be easily threatened when they perceive the actions of their significant others are not aimed at meeting their needs. For example, Janice, who has a deficit-type orientation toward relationships, is married to Tim. When Tim decides to return to school to seek a BS degree and find a better job, Janice may see this as a rejection, a threat to her personal need status. While Tim may try to explain this decision will make it better for both of them, Janice can only imagine Tim is “moving away”, finding new friends, changing, and developing new personality characteristics. These perceptions result in more unmet needs, and possibly a feeling of deprivation. …

Conflict is part of every day life, and conflicts occur because we have an inherent drive to survive and protect ourselves, as well as an inherent need to grow. Confronted with situations that require choosing between two or more outcomes, and faced with a conflict, we don’t always find ourselves in a win-win situation. However, how we perceive a situation, our past influences, and our current perceptions, determine the kind of conflict we experience. A simple conflict for one person may be seen as a major catastrophic conflict for another. While conflicts create unmet needs and interfere with our ability to mobilize resources, they also offer opportunities for need satisfaction. It all depends on how we perceive the situation. …

We all have needs that exist across our lifetime. We need to be affiliated and individuated. With our affiliation, we need to know we are loved and that we have loved, that the Essence of our Self is safe with those who love us, and that we can grow and become the most that we have the potential to be without threat of loss of love and acceptance. With our individuation, we need to know that we are accepted for who we are without façade, pretense, or conditions. We also need to be able to pursue our Life Purpose, to discover our Reason for Being.

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CHAPTER 7

Attachment objects are a necessary part of life. They serve as a vehicle for need satisfaction, a precursor for growth. Usually, discussions focus on attachment objects that satisfy biophysical-psychosocial needs. That is, we discuss how these objects meet needs deemed important in the Modeling and Role-Modeling theory: physiological, safety and security, love and belonging, esteem, self-esteem, affiliated-individuation, information, and various types of growth needs. …

Attachment objects are as varied as human beings. The same object may be important to several people, but for different reasons—it may meet different needs for each individual. Or, an object might be very important to one person, but viewed as junk by another. …

Attachment objects are very personal and related to specific developmental tasks. That is, at each stage of life we have specific tasks to work through. Therefore, needs are met in specific ways depending on the stage-related task. What meets our needs becomes an attachment object, so attachment objects are both personal and age-related. What works at one stage is not usually helpful at another. …

Sometimes our first encounter with an object affects us profoundly. It meets many needs at one time. Multiple chemicals are produced in response, and when the experience is intense multiple chemicals, neurotransmitters, and hormones are excreted. …

Recall of the experience depends on reconnecting with the object or something associated with the object that initiated the response. When we reconnect with the same experience either through the object, by thinking of it, or associating with it, we stimulate a similar cellular response. …

The purpose of transitional objects is twofold: first, they meet needs in lieu of the attachment object, which they represent or symbolize, and secondly, they facilitate normal, healthy developmental processes. That is, they help people let go of attachment objects acquired in one stage of life, so they can move on to the next stage. They enhance transitions! …

Although we typically talk about attachment and transitional objects that meet our biophysical, psychosocial or cognitive needs, H. Erickson suggested (2002) there are also objects that meet our Soul needs. She proposed that some objects may be more important because they represent factors that support the Self. In a personal conversation she expanded on this stating, …

According to philosophers like Zukav (1989), the Soul is the seat of the Self. Needs related to our Self help us discover and fulfill our Life Purpose because we connect our human body with the Soul through our spirit. Needs related to our biophysical-psychosocial being support our mind and body as we take our life journey. These are body-emotion-mind needs. Attachment objects that meet these needs nurture our biophysical, social, emotional, and cognitive needs. Satisfaction of spiritual needs (which connect us with our Soul) helps us find meaning in our lives. While satisfaction of all types of needs is important and must be repeatedly achieved across a lifespan for maximum health and well-being, needs that help us connect with our Soul are probably much more important.

Objects that help us meet our Soul-related needs (or spiritual needs) are very different from those that help us meet our biophysical-psychosocial type needs. Our attachment to objects that meet our spiritual needs might take on more meaning than we had ever imagined. While it might seem that Soul-related needs emerge more in the later stages of development, I have seen many children who exhibit signs of spirituality.

I’m convinced spiritual needs exist across the lifespan. When they are satisfied, we experience transcendence. If this is the case, an object that helps us meet these needs would be important at any stage of life. For example, I decided to be a nurse when I was around five years old and never deviated from that decision. I think nursing is my “calling”, it is an attachment object for me; it is a way of thinking and a way of being. ‘Nursing’ helps me find and define meaning and purpose in my life, and has helped me define my relationship with my family, an important part of discovering my Life Purpose. (personal communication, October 20, 2005), …

The relationship between bonding and attachment is comparable to the relationship between growth and positive residual. Growth always precedes developmental residual, but growth can happen without creating residual. Furthermore, developmental residual can be enhanced throughout the life-time as we grow. Likewise, bonding continues even after attachment occurs because the object repeatedly meets the same needs, meets new needs, or because the object meets needs from a different developmental perspective. As bonding continues, the strength of the attachment increases. …

In Chapter 1 Erickson, H. posed the question, “Which comes first: body or Soul?” What if the Soul comes first? Erickson posed that the Soul does come first. She went on to say that the spirit is energy derived from the Soul, vibrating at a lower level, so it can integrate with the human form. I built on this idea in Chapter 5 when I described the stage of Integration, saying that our spirit integrates with our body before or shortly after birth. If these ideas resonate with you, then it is possible to believe that the first incidence of bonding is the integration of spirit with biophysical body. The implications for such a consideration are immense. But let me start with the idea of attachment of the spirit with the biophysical-psychosocial being, …

I think bonding of spirit with body comes before integration of spirit and body. Integration is a type of attachment, spirit to human form and vice versa. Although the spirit might bond with the body prior to or at the time of birth, bonding doesn’t assure Integration. Integration is a two-way process: spiritual energy has to synchronize with the body-mind energy field and the body-mind has to synchronize with the spiritual field before integration can occur. It is a complementary process. When the two synchronize, we can assume bonding has occurred, and integration of body-mind-spirit has been initiated. …

Being Oriented mothers are more likely to connect with the baby since the anticipated relationship meets their belonging and growth needs, while Deficit Oriented mothers tend to connect with the baby because they hope the baby will meet their love and self-esteem needs. Imagine how disappointing it is for Deficit Oriented women when they are nauseated during the pregnancy, gain weight, lose physical agility, or are unable to go out with friends; these do not meet the need to be loved or feel good about one’s self. Unless the mother is future oriented and can imagine the relationship several years down the road, she might have trouble bonding with her baby. As indicated above, this would affect the maternal environment. …

The loss of an object that meets our basic needs for safety, love and belonging is often the most difficult to resolve. For example, the loss of a parent during infancy can have a life-long effect. This is not a loss due to normal developmental processes; it is a situational loss humans are not prepared to cope with, even with help. Situational losses are very different from developmental losses, since usually, there is no opportunity for growth prior to the loss. …

Threatening losses are more difficult to resolve. Let’s use an example of what happens when we have to move, because we lost our job. This is a real loss, which can be perceived as threatening. Instead of anticipating our self in a new role, feeling good (self-esteem) about the change, and being excited about the opportunities, we have lost our image of ourselves as a productive, valued worker, to that of one without value. The loss of the job is not only a real loss of employment that can create unmet safety needs, but it also has, embedded in it, numerous other losses that can result in unmet needs at other levels such as feelings of belonging, esteem and self-esteem. These are real experiences and can have serious implications. …

A loss can only occur after an attachment has been established and all losses produce a grief response. As indicated above, a loss is sometimes minimal; we may have an opportunity to anticipate it, it is seen as an opportunity or a challenge, so the grieving process is completed fairly rapidly. Rather than feelings of sadness, we might express nostalgia. Nostalgia is a “tug to the past” and often precedes letting-go of the lost object. …

We need to remember prolonged morbid grief can exist, even when others don’t recognize the original trauma. Trauma, as with all other things is personal; it depends on the individual’s perspective.

As health-care providers we have opportunities to share in the most private, intimate moments of peoples’ lives. Frequently our nurse-client interactions are related to current or past losses experienced by our clients. Sometimes they are suffering grievous physical injuries or are dying. Physical cures or “fixing it” for them is not a possibility. However, during our time together, we do have the chance to facilitate them in the healing process, to help them achieve higher states of well-being. This requires that we model their world, protect their current support systems, unconditionally accept them as well as their attachment objects, and help them recognize, deal with, and accept feelings related to present or past losses.

Only then are we able to help people learn to let go of things meaningful to them and reattach to people, objects, or ideas that will meet their needs. As nurses, we are able to intentionally act as spiritual bridges, allowing people to connect their past with their future, in a positive, growth-oriented manner. It is our duty as well as our privilege to be part of this lifetime process and journey.

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CHAPTER 8

We experience Eustress when we enjoy, seek, or welcome the stimuli (events or experiences). We experience Distress when the stimuli are unwelcome, threatening, or overwhelm the individual’s ability to cope. Both types of stress use resources, so both are important in managing our lives. Sometimes what starts as eustress becomes distress. According to Erickson, et al. (1983), “a stressor becomes distressful when it is prolonged or exceeds the individual’s ability to mobilize adaptation energy. The result from Selye’s perspective is a disease of distress” (p. 83). This non-specific pattern of symptoms that emerges with prolonged distress is the precursor to inflammatory diseases, immune system problems, and many diseases of the kidney, heart, blood vessels, which Selye called diseases of adaptation. He theorized this as the result of depletion of adaptive energy (1976, p.114). …

The hypothalamus releases corticotrophin-releasing hormone (CRH) which then produces pituitary secretion of adrenocorticotropic hormone (ACTH); ACTH stimulates cortisol production by the adrenal glands–a sequence termed the HPA axis. CRH is both an endocrine regulator, as described, and a neurotransmitter (Porth, 2002) with receptors throughout the brain and a number of peripheral sites (See Table 8.1). CRH has been found to have a broader role in the stress response than previously thought. Overall, the physiologic stress response has been extensively studied and is much more complex than is presented here, involving vasopressin and fluid balance, endogenous endorphins and pain perception, and growth hormone, for example. …

While short-term stress response increases levels of cognitive function through stimulation of the sympathetic response and the reticular activating system, repeated stress affects the limbic system, particularly the hippocampus, which has high concentrations of cortisol receptors (McEwen, 1998). In the short term stress response, the hippocampus helps turn off the HPA axis, bringing the body back to homeostasis. The hippocampus also participates in short-term and contextual memory. Contextual memory provides the time and place for remembered events, particularly those with strong emotional significance (especially fear). In the long term stress response, cortisol and excitatory neurotransmitters suppress the mechanisms used in short-term memory, and eventually produces atrophy of the dendrites of neurons in the CA3 region of the hippocampus (McEwen, 1998). Thus short term memory and cognitive function are impaired. …

Coping outcomes have been described by some as adaptive or maladaptive. Zeidner and Saklofske (1996) reviewed the literature related to coping and found that the notion of coping effectiveness has been implicit. Interested in this topic, I did an online search in the social science, psychology, and medical literature and found 292 articles related to adaptive or maladaptive coping published over the past ten years. The majority of these articles addressed maladaptive coping (Densten, 2001), prescribed more effective coping techniques (Folkman, 1997), or demonstrated correlations between coping and health, physical, or emotional outcomes (Kaba et al., 2000; Landrum, 1999; Leidy, 1989; Leidy, 1990, 1999; Leidy & Darling-Fisher, 1995; Leidy, Ozbolt, & Swain, 1990; Leidy & Traver, 1995; Welch & Austin, 2001). …

The APAM, designed to categorize individuals into states according to their ability to mobilize resources, has demonstrated reliability and validity. This raised the question in my mind, Can groups also be categorized into adaptive potential states? If so, assessment of these states could form the basis for framing leadership interventions with groups. Leaders could channel and direct the group to improve coping and effectiveness of the group task function.

As I considered this question, I revisited the three states, and determined that a model designed to predict the type of group intervention needed to differentiate Adaptive Equilibrium from Maladaptive Equilibrium. I believed a group in Adaptive Equilibrium would be stable and functioning, whereas, a group in Maladaptive Equilibrium would need to be moved into Arousal in order to improve its effectiveness. An Impoverished group would need to be supported until it was able to function on its own and become effective. While the APAM model has been applied to work groups (Frisch & Bowman, 2002; Frisch & Kelly, 1996), no research had been undertaken to develop a model specifically for groups. The Group Adaptive Potential Assessment Model (G-APAM), designed to meet this need, is the product of a Delphi study looking at the assessment of adaptive potential in groups (Benson, 2003). Figure 8.3 depicts this model. …

G-APAM uses coping potential and stress level to create quadrants of group behavior within an encompassing context. Each quadrant contains a constellation of behavior since both axes are continua. Stress and coping produce group movement as context, stressors, and coping resources change. Stress tends to produce movement toward higher stress and less effective coping potential (down and left); and coping tends to produce movement toward lower stress and more effective coping potential (up and right). Panel member comments include the possibility of additional Group APAM states when groups are viewed as complex adaptive systems.

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CHAPTER 9

Through the years, I have come to believe that when nurses and clients share deeply meaningful relationships, they connect heart-to-heart. These interactive, interpersonal relationships take on what Martin Buber, philosopher-theologian, called an “I-Thou” (Buber, 1970) or sacred nature. They facilitate growth in mind, body, spirit, and Soul in client and nurse alike. The more conscious we are in our intent to create heart-to-heart relationships, the more effectively we connect spirit-to-spirit with our clients, facilitate their ability to connect with their Soul, and experience holistic growth and healing. However, this requires that we embrace our spiritual nature, recognize we are spiritual beings first, and be fearless in sharing our spirit with others. I began this chapter with Williamson’s inspiring prose-poem as a reminder that when we “...let our own light shine we consciously give other people permission to do the same. As we are liberated from our fear, our presence automatically liberates others.” …

The term heart is defined as “a hollow, muscular organ of vertebrate animals that by its rhythmic contraction acts as a force pump maintaining the circulation of the blood” (Merriam-Webster’s Collegiate Dictionary, 2001). However, in everyday language the word heart has broader connotations. Many idioms and commonly used phrases, such as after one’s own heart; from one’s heart; get to the heart of; heart and soul; in one’s heart of hearts; heart-to-heart, reflect an intuitive knowledge of the heart as the source of meaningful ways of thinking and being. …

Their research revealed that disharmonious heart rhythms are inefficient and lead to increased stress on the heart, and this in turn affects other body systems. A typical HRV pattern of someone feeling angry or frustrated is irregular and disordered because the two branches of the autonomic nervous (sympathetic and parasympathetic) system fail to work in synchrony. In contrast, when the person has feelings of caring, appreciation, love, and compassion, the opposite is created. “These heart-based feelings generate the smooth and harmonious HRV rhythms that are considered to be indicators of cardiovascular efficiency and nervous system balance” (p. 37). …

Researchers at the Institute of HeartMath concluded the heart has a mind of its own. According to Childre & Martin, (1999) “it directs and aligns many systems in the body so that they can function in harmony with one another” (p. 4). Using the term heart brain to describe this heart intelligence, Armour (1991, 1999) reported that with each heartbeat neural information is sent from the heart brain to the brain in the head, as follows: the heart brain senses hormonal levels, rate of heartbeat, and pressure information, internally processes this information, translates it into neurological impulses, and then communicates with the brain in the head via the vagus nerve and spinal column nerves. In turn, these neurological signals have a regulatory influence on the autonomic nervous system impulses sent from the brain back to the heart, the blood vessels, other glands and organs, as well as the cerebral cortex, “…that part of the brain that governs our higher thought and reasoning capacities” (p. 30).

The heart also influences neural activity in the amygdala, the area of the brain related to emotional experiences. Thus, the neural activity of the heart has a continuous effect on our perceptions and emotions. As Armour (1991) maintains, “The existence of communication pathways linking the heart with our higher brain centers helps explain how information from the heart can modify these mental and feeling states, as well as performance” (p. 30).

Today, we know “The heart and brain maintain a continuous, two-way dialogue, with each influencing the other’s functioning. It is also known that the signals the heart sends the brain can influence perception, emotional processing, and higher cognitive functions” McCraty, R., Atkinson, M., & Tomasino, D., 2001). While the heart is a pump, it is also a vital communication organ. It interacts with the entire body not only by way of pumping blood, but also by way of chemical communications that affect the neurological system throughout the body. …

Heart, spirit, and soul are literally, energetically, and metaphorically linked in a cyclical, reciprocal way. Awareness through our heart facilitates our ability to relate heart-to-heart and, in turn, enables us to experience spirit-to-spirit connections. These linkages can occur simultaneously and automatically whether or not we consciously label them as such. …

Nurses can and do connect spirit-to-spirit whether or not they are consciously aware of doing so. When we experience acceptance and compassion in our heart for our clients, we send verbal and nonverbal messages transformed into energy that tell them we can be trusted. If we build on this and support them to trust themselves and listen to their inner voices, we increase their potential for spirit-to-spirit connections.

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CHAPTER 10

Some nurses have said they “know all about Modeling and Role-Modeling (MRM) and believe in it, but just can’t connect with the clients.” There are several reasons this might happen. For example, although they believe in the MRM way of nursing, they may still be focused on “doing something”. They haven’t learned being is more important than doing. They haven’t learned, yet, that their spirit and the energy disseminated from their spirit can be a more powerful intervention than any other technique or treatment. They haven’t learned that energy which comes from their spirit is often what is needed to “jump start” their clients’ own healing resources. …

These nurses have to learn Being is more important than doing and doing without Being is often ineffective. I think some of these nurses connect when they first interact with their clients, but as soon as they focus on doing, they inadvertently disconnect. That is, they focus on doing the task and that changes the energy patterns. Rather than transferring energy into the client’s energy field, they transfer it into the field of the object they are attending to. Clients can often feel the difference between the two types of energy experiences although they are usually not able to express it. Instead, they simply say the nurse “cared” or didn’t “seem to care”. …

I know we can connect and we can disconnect: we can also choose to NOT connect. It makes a difference in how we interact with our clients, how we relate to them, and what happens to them. …

Our choices also make a difference in what happens to us. Our own emotional and spiritual growth is either enhanced or hindered by our choices. Our choices are influenced by how we think about people. …

We’ve said synchrony of energy fields is necessary if we want to build trusting relationships. One way to facilitate synchrony of energy fields is to consider communication theory. Watzlawick (1967) proposed four key communication axioms listed in Figure 10.1. …

While I’m sure many strategies can be used, when practicing Modeling and Role-Modeling, I always use three that I have found to be most useful: Establishing a Mind Set, Creating a Nurturing Space, and Facilitating the Story. …

The feelings, attitude, behavior, and language used by one member will influence those of the other. Together, two people create a unit (or a dyad) that is greater than the sum of the two individuals. Each person has a significant role; each makes a contribution to the process, and each influences the outcome. However, as healthcare providers, we have to bring to the relationship resources that will complement those of the client, and sometimes counterbalance the lack of resources of the client. When we enter the dyadic relationship with depleted resources, it is very difficult to reinforce those of our clients. We need to learn to take care of ourselves first. There are several ways we can do this. …

We have to “open” our energy field, so it is receptive to the energy field of another. When we do that, we prepare ourselves to hear and understand what the other person wants to communicate. It is important we be willing to hear what is being said, and know that people do the best they can, given their circumstances. …

We also have to remember that nature or the Universal Field connects all people. We are all part of a larger energy field, so when you open yourself to your client and your client’s story, you are connecting with not only your client, but with others through the Field. When you do this, you send positive energy into the world--energy that is needed by many, energy that will help many even without their knowing and even without your knowing. …

While it appears that developing Presence might take too much time, once you have learned to Center, Focus, and Open yourself, you can do it all within seconds. Soon it will become natural, a way of Being. You will do it without thinking. As this happens, you will gain comfort in your role as nurturer of growth, and discover that the healing process takes less time. It will no longer be the focus of your interactions; it will be the byproduct! The focus of your work will be the working relationship between the two of you. As described in Chapter 9, that, in itself, facilitates growth and healing in both members of the dyad. …

The bottom line for this strategy is: We cannot force growth in another person. We can only create an environment that nurtures growth. With sufficient growth, people will heal themselves.

Our aim is to create an environment that promotes a sense of safety, security, and connectedness in our clients. We can do this in any setting, as long as we focus first on the client’s needs and sources of stimulation. …

Whenever you enter your client’s space (and all space is theirs unless it is your office or personal space), you need permission to arrange or rearrange the environment. While it may seem appropriate for you to close the door, pull a room divider, turn down the radio, open windows, fluff pillows, light candles, etc., it is not your space to manipulate. Unless you ask your client what would be helpful before you initiate your plans, you may create a feeling of being invaded rather than helped. …

Some people avoid eye contact. There can be many reasons for that. Some are embarrassed, some afraid. Some worry such an intimate interaction might show how unworthy they are or that you might rob them of their line of defense. Others avoid eye contact because they have a Sensory Integration Disorder, so we need to be careful about judging a person’s behavior without first understanding their world. Nevertheless, when we can use eye contact, we help people learn life is about Being, rather than doing. This “knowing” may be fleeting, but even so, it initiates growth. It is a “seeding” of worth and dignity. You build on this “growth” as you move into the next Strategy, Facilitating the Story. …

Connecting and initiating the healing process doesn’t take a lot of time. In fact, I think it saves more time than it takes. But before you will be comfortable with this idea, you need to be fully comfortable with the notion that you have the ability to help another person initiate the healing process, and it can go on, even in your absence. You do this by knowing that you are a source of wisdom because you are connected with the Universe, and therefore, Universal knowledge. Within your being lies the greatest gift that can be offered to any other human. It is the gift of your Self.

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CHAPTER 11

Growth is a strange thing. It is crucial for survival, precedes development, and is necessary before healing can occur. Yet, it comes in tiny increments, sometimes undetected by the observer. Often, we are unaware it will happen, it just doesn’t occur to us. But it does. It shows us where we are and where we have been. It acts like a ray of sunshine, bringing us hope and nurturing our spirit. Without it we wither; we cannot not grow and still survive. We cannot stand still or stay the same over time. Seconds, minutes, hours, days, months, and years all come and go--time marches on, and we either grow or stagnate. Without growth we fall behind, like a withering bud on a vine; a bud that has the potential to grow and develop into a beautiful flower, but is unable to do so because it lacked the resources.

When we think of growth like this—as a positive change toward the expected--it seems easy to know when it has or has not occurred. Still, growth is difficult to assess. Although we might think of growth as a positive change in biophysical, psychological, social, or cognitive, status sometimes what we perceive as a positive change is really not! Rarely do we think of growth as an increase in negative behavior, even though some of the most important growth processes are demonstrated by an increase in assertive behavior perceived to be negative actions! As in everything in life, it is all a matter of perspective. …

Growth is a positive change that occurs as our needs are met. With growth, we build or mobilize resources needed to contend with daily life. Growth can be minimal or extensive. When minimal, it is often difficult for the observer to notice the change, yet it is there. When sufficient growth occurs, the change is more obvious. …

Growth is often viewed as change that is obvious, but most of the time it is invisible. In fact, most of the time we may have difficulty recognizing growth until it has happened repeatedly. This confusion occurs because we mix up the concepts of growth and development. Simply stated, growth usually occurs in minutia, while development is an aggregate of growth over time. Growth can occur and then seem to disappear, while development is a constant. That is, growth is temporary (or a state resource), while development is more stable. Sometimes, we talk about growth when we see it start to “pile up” or aggregate—this is an appropriate way to think about it. But, this type of growth is usually obvious. What is more difficult to observe, assess, or even understand is growth in the minutia; but it is the most important. Without tiny increments of growth, there would not be the opportunity for growth in the aggregate. In other words, people are more likely to grow a little at a time, and over time, accumulate the results (i.e. growth) than they are to grow in big spurts all at one time. When the latter happens, it is usually an integration and synthesis of resources (produced by growth). Such an integration and synthesis usually transpires when development occurs. …

More specifically, we can think of growth as a product when we consider the outcome of need satisfaction. That is, satisfaction of any needs at all levels produces growth. On the other hand, when we talk about growth needs, we are addressing an issue of motivation. People are motivated to not only survive but to thrive, to move toward self-actualization. Growth happens when both types of needs are met. So, hereafter, to avoid confusion, we will call our need to thrive, (previously known as growth needs), higher-level needs to assure the distinction between growth as a product of need satisfaction and the motivation to become the most that we can be—to self-actualize. …

There is another issue related to assessment of growth: learning to recognize growth that “unbinds negative residual”. Often, we think of growth only within the context of a healthy person under ideal conditions. We know everyone is unique in how they exhibit need satisfaction, and, therefore, growth will look different in different people. All we have to do is to learn how to distinguish various forms of healthy growth, as they relate to positive developmental residual. Nevertheless, we forget we have both positive and negative residual as an outcome of developmental processes. When this happens, recognition of growth within the context of negative residual is more difficult. …

A final consideration regarding the nature of growth in human beings is context. We stated in earlier chapters that people live in a context, and that we have to understand their context if we are to help them grow. Our external context includes anything and everything in our environment. From a broader perspective, we could say that context includes everything in the Universe. On the other hand, we can narrow our parameters, discuss context from a more personal perspective, and say it is everything and anything around us that has a direct influence on our lives. …

People have a need to know, so they can grow. What they need is contextual and so is their growth; we cannot understand their need without first understanding their view of the world and we cannot know when growth has occurred without considering the context. …

Nurturing is what we do because of our beliefs about people, our professional goals, and ourselves. When we realize people have an inherent need to grow, growth depends on need satisfaction, and need satisfaction occurs when people perceive their needs are met, then we might be motivated to find ways to meet those needs. When we add this knowledge to our understanding of ourselves as human beings who need to be accepted and valued, and realize that the most important interactions we have with others are when we are able to transcend the physical environment and simply connect at a spiritual level. …

Facilitation requires more active interventions, but does not have to be time consuming, complex, or difficult. It just requires that nurses recognize the power of nurturance, implement the three strategies (Establishing a Mindset, Creating a Nurturing Space, and Facilitating the Story) discussed in the previous chapter, and then address the client’s expressed needs. …

Presence is the holistic existence of an individual who is fully open to another human’s energy system. Intent is the purposeful use of our holistic selves to enhance growth in another person. …

Unconditional acceptance of the person as a human in the process of Being and Becoming, is basic to the Modeling and Role-Modeling paradigm. It is prerequisite to facilitating holistic growth and movement toward eudemonistic health. Unconditional Acceptance of the person as a human being who has an inherent need for dignity, respect from others, and for connectedness—that kind of Unconditional Acceptance is based on Unconditional Love. When we have Unconditional Love, it is only one step more to Unconditional Acceptance.

While we might inadvertently do many things that will interfere with our well-intentioned plans, if we have developed a trusting, functional relationship with our clients, we will be forgiven! And the trust will continue to build as soon as our client’s understand we, too, make mistakes, but we want to help in whatever way we can. It is important for clients, family members, and colleagues to remember that we recognize we have limitations, and that we, too, can grow and learn from our mistakes. When they understand this, it is easier for them to learn from us, understand that our behavior is well-intentioned, and that we are just human beings, doing the best we can. This is all that can be expected, one human to another.

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CHAPTER 12

The developmental process takes time. However, the time frame for specific task work varies. As indicated in Chapter 5, some developmental tasks can be accomplished in 10-12 months, while others take years. While people seem to move from one stage to another as though a switch had been flipped, coming to the point of movement takes a long time. During that period of time, multiple memories are created and laid down in our cells, creating developmental residual. These memories are not just in our brain; they reside throughout our body. They contribute to our intuition, gut knowing, inner voice, and “knowing without knowing we know”—our Self-Care Knowledge! …

While developmental residual is sequential and predictable, the context in which it was built is very important and may vary considerably by groups. For example, some cultures believe dating teenagers need chaperones until they are old enough to marry. Teenagers searching for Identity and living in a home where parents share this belief will behave differently from those living in a “latch key” type of home. It is important for us to understand the motivation behind the needs (which drive the behavior), before we draw conclusions about their developmental residual.…

the MRM logo was designed with a purpose in mind. Looking at it, you will notice the hand (which represents the nurse or the significant other) has a long arm—an arm that seems to go beyond the immediate nurse-client relationship. This is because that long arm was designed to symbolize our ability to impact the future well-being of others. We never know when someone is growing, but we know when we “seed” or plant ideas about another person’s worth, growth may occur--growth that has the potential to change the individual’s life over time. We have “long arms” because people need others to help them find their way in life.…

We have the potential to help people grow; we also have the potential to stilt their growth. We discussed this briefly in Chapter 3. It depends partly on how we think and feel, and how we communicate what we think and feel. It also depends on our intent. When we interact with another human being, we are sending messages. Some messages reinforce their worth, affirm their need for dignity and contributions, and others don’t. No matter what we intend or do not intend to communicate, decoding the message depends on the other person’s perspective. …

Integration is the merging of the spiritual energy field with the physical body (the biophysical psychosocial energy field). When the mother is healthy, feels safe, secure, loved, valued, and connected, we can assume she will produce a different type of energy field. The developing human body will be more receptive to the merging of another energy field, the spirit. All in all, the fetus will have an intrauterine experience different from when the opposite happens: when the mother is not healthy, and does not feel safe, secure, loved, valued, and connected.

With this in mind, the best way to facilitate this developmental task is to do what I heard John Bowlby say one time: “We need to mother the mother, so she can mother the baby” (1977). We need to help mothers learn to care for themselves, be securely connected to a significant other, and welcome the oncoming addition to their life experience. …

Voice tones and volume, facial expressions, touch, and eye contact are all important when building Trust in others. We instinctively know this when working with infants, but forget it also applies to older persons. During the first few months of life, infants need eye contact[viii], soft voice tones, consistent, gentle, comforting handling, close contact (for example, blanket binding and snuggling), and friendly, happy faces to observe. These actions help the infant feel safe and secure. They begin to learn they belong to a group and are loved: actions that meet affiliation needs. This behavior also affirms the babies’ existence, worth, and family membership, and are important as they learn they are not just extensions of their mothers, but unique human beings with a mind and spirit of their own. …

There are several things we can add to our arsenal of strategies when working with people who have excessive negative residual and minimal Autonomy. First, they need personal space and have difficulty if they perceive it has been invaded. They can feel the invasion; it is a matter of change in energy. We need to respectfully request permission to enter it. This means the area around them, the immediate physical space surrounding their bodies, and their bodies. When we do not have time to obtain permission, it is important to tell them in respectful, firm tones what we are doing, so they perceive control. While these are good things to do with all people, they are very important for this type of clientele. Remember, they don’t feel safe unless they perceive they have control. If we are respectful of this need for “space”, they will gradually learn we are trustworthy because we help them feel safe. …

This is the stage of revisiting how we have lived our lives. We can help people with this by reaffirming that we all made mistakes in our past, but that is the nature of human beings. The most important thing is to learn from our mistakes. Sometimes people need help revisiting the lessons and remembering what was learned. They also need help figuring out how they have applied their lessons in later life, most importantly during the stage of Generativity. We can always affirm that they have had productive lives and that they will go on across time by making such statements as, “You have taught me so many things, you will always be a part of my life. And I will remember you as I try to help others.” You can be more specific too, if you understand the individual’s world-view. …

Sometimes health care providers get discouraged because they think the process takes too much time, expertise, or resources. Above I stated that it is important to remember three things: Caring has a long-arm effect, we should aim to Do more good than harm, and remember to Judge a book by it’s contents. The first is important because it suggests that a simple act of compassion has the potential to change a person’s life. A few days ago Oprah Winfrey interviewed a gentleman she’d talked with a number of years before. Both of them acknowledged that they had looked at one another that first day, made a Spirit-to-Spirit connection and that both of them had changed because of that connection. I’ve had numerous people tell me that some simple thing I’ve done has helped them change their lives. Caring can have an effect on others long after the event, and sometimes without our knowing it. We have to believe that simple techniques such as seeding and reframing are often all that is needed to facilitate healthy task work.

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CHAPTER 13

Nothing stands still. Time moves on, and with it, we too must continue down the pathway of a journey--the journey we call life. Each of us will traverse multiple pathways, searching for understanding, acceptance, and love. Sometimes, we actively choose pathways; other times we are thrust in a direction we had never imagined. Sometimes, we purposefully choose a pathway thinking it will help us in our search for meaning; other times we find ourselves on a pathway by serendipity. It just seems to be what we need to do at the time, or it is the lesser of two unattractive options!

But what about the times we are thrust in a direction we had not imagined, had not wanted, and did not know how to handle, and we have no choice! How can we make meaning of this type of experience? What happens when resources are available and what happens when they are not? …

Life is a journey. Illness and alterations in health create chaos and send us into crisis. They can also provide an impetus for growth and transformation. Nurses, who offer theory-based holistic nursing care to persons experiencing health changes, facilitate opportunities for growth and discovery of meaning. People are able to let go, reframe, and move on. This “way of being” with clients and families enhances a person’s sense of self and Reason for Being in this world. …

Life is a journey. We start with minimal awareness of where we are and where we want to go. Still, each of us will discover that we cannot stop time, nor can we reverse our lives and go back to a previous place. Life marches on and we must go with it. If we are to be alive and in physical form, we must take the journey. We must encounter events that have the potential to bring joy and delight. We will also encounter events that have the potential to bring sadness and despair. How we experience the journey varies by person and events.

Many people are able to reframe difficult life experiences with little assistance. When they do, they are often able to assign meaning to the experiences. However, some events are too traumatic for most of us to handle without help. Sometimes health care providers are able to recognize the visible wounds, but miss the invisible wounds. …

Erickson & Swain (1985) conducted a twenty-two month study to explore the relationships among nurses’ conception of health, their conceptual framework for practice, and clinical outcomes. Nurses who worked within the context of the clinical model of health assumed chronic diseases would continue to progress despite nursing interventions. The nurse’s focus was directed towards minimizing disease progression, management of signs and symptoms and related affects. The nurses using the clinical model of health interpreted changes in social roles, adaptation, and a lack of self-fulfillment as affects of their diseases. The second group of nurses worked within the context of the eudemonistic model of health and used the MRM theory of nursing. They focused on the person rather than the disease. These nurses worked to build and restore resources needed to contend with life stressors and aimed at increasing a person’s ability to maintain social roles, adapt, and experience a greater sense of self-fulfillment. The nurse’s conception of health influenced clinical judgment and clinical outcomes. The second group of patients had fewer complications, better disease management, and more satisfaction with life over the period of the study….

Illness is an opportunity for reflection, understanding, and spiritual growth. However, before this can happen, it has to be contextualized. That is, it must be viewed within the context of what is going on in a person’s life at the time of the event and just prior to the event. We are all exposed to viruses and bacteria but only become ill at specific points in time. What makes the difference between health and illness is what else is happening at the time of exposure. It is important for the person, family and health care providers to examine the context of the illness experience. What else is going on? How is the illness event related to other life experiences? What pattern can be seen or identified?…

Each of us will occasionally find ourselves at a crossroad, faced with the dilemma of choosing between alternative pathways. If we have the resources needed to contend with the dilemma, we might be able to move on and make meaning of the experiences encountered along the pathway. If, on the other hand, the event is outside our experience, outside what we know about and how we think or feel, we may have difficulty.

It is during such times that we need others to join us, to help us find meaning, so we can move on. Without such help, we are vulnerable to additional losses. We have more difficulty adapting to the losses, finding new ways to adapt, heal and grow….

We are each on our own journey. Each searching for a meaningful life. While most of us have moments of time where we can pause and reflect, and while doing so, we capture a glimmer of our potential, our strengths, and embrace the Essence of our Self. When we have these transcendent experiences, we know that life is about Being, it is about relationships, learning to love, and to be connected. For those few seconds or moments, we know that our work is to find meaning in every day experiences, both the good and the bad. When we are able to do that, we are able to continue the journey, we are able to keep searching for our Reason for Being. We also know that we cannot do this work without the help of others, others who love us, support us, and facilitate us. Others who unconditionally accept us for all that we are and all that we are not. H. Erickson, 11/29/2005.

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CHAPTER 14

Healing always involves loss. While some people have experienced a recent loss, those who have long-standing, unresolved losses with morbid grief are the most challenging. They have learned to adapt by drawing resources from one subsystem to contend with losses in another. It has become part of their fabric; the process is no longer acute, and in most cases, the loss is not obvious to the casual observer. This book is about helping people grow, develop, and when needed, heal. This chapter focuses on the healing process. While healing takes place in another person and we need to understand that process and how it works, nurses play a unique role in initiating and facilitating the process, so we also need to understand what we can do to help ourselves as we aim toward facilitating healing in others.

The first section addresses the nature of healing. The second addresses factors related to our ability to facilitate the healing process. The third section focuses on the nurse, and how to think about ourselves, so we can help people heal. Deepak Chopra’s The Seven Spiritual Laws of Success (1996) guides this section. …

Loss is a natural part of life; so are grief and healing. Loss produces a grieving response we have to work through in order to resolve the loss. We also have to work through grief, so we can move-on and find happiness in life. Healing occurs as we work through the grieving process. It is both the means and the end; it creates a link between loss and healthy, holistic being. …

Health care providers frequently talk about healing wounds, suggesting the wound or loss comes first and healing is a way to eradicate or fix it. Other times, common language implies healing is necessary, so we can let-go of the past and grow. Both orientations are accurate; healing bridges the gap between loss and Self-discovery. …

The healing process can be initiated anywhere--in the intensive care unit, at the water fountain in the mall, in a client’s home, in our backyard—anywhere two people interact. The healing process starts with a change in the way we think and feel and continues on through time. It doesn’t happen in split seconds although it can be initiated in split seconds. Sometimes it takes little time, and other times it takes longer. Remember, seeding works, but it takes time. In any case, healing can happen and when it does, it creates changes in the holistic person, changes that move the person closer to Self-discovery, self-actualization, and fulfillment of Life Purpose. This is important no matter what type of loss we are experiencing….

We all need help growing and becoming our unique Self. That is why we are here, in human form. We have to live a physical life, so we can have human experiences as we take the journey. These experiences help us discover our Self, and identify our Life Purpose and our Reason for Being. As humans, we need to be both connected and individuated; we have an inherent drive for affiliated-individuation. Therefore, to gain the most from the journey, we have to attach to people and things; we also have to learn to let go and move on. This means each of us has to experience the joy of attachment, the pain of loss, the emotion of grief, and the hope of new beginnings. We have to experience the peaks and valleys, so we can learn about ourselves, who we are in relationship to others, and who we are as unique human beings. This helps us with our Soul-work; it helps us achieve our Reason for Being.

We cannot do this alone; we have to do it with others. Therefore, loss, grief, and healing are not only experiences each of us must manage in our own time and way, but also experiences we must have by traveling with others as they have similar experiences. To have the full human experience, we need to learn through our own joy, pain, hope, and through the joy, pain, and hope of others. Each of us has to travel our pathway, but each of us needs others to accompany us on our journey. We also need to travel with others as they take their journey. In the first case we learn about our self within the context of our own life journey while in the second we learn about our Soul-work in respect to others We need both types of experiences to fully understand our Self and how we relate to and impact others and the Universe. …

At the other end of the continuum, people often need help letting go of physical life. Several stories, previously reported, describe the healing process at this stage of life. For example, Mrs. Cook (Chapter 1), my brother (Chapter 5), and Mr. M. (Chapter 11) each provide an example of someone who needed help in the last stage of life. Healing, in the last stage of life, does not mean the individual is suddenly, physically revitalized. It means the person has learned we are more than a physical body--we are also spiritual beings. When this happens, people are willing to let go of the physical form and material life, and move on. Reconnected with their spirit, they have achieved the maximum in healing; they are ready to reunite spirit with Soul. Just as the infant needs help learning to come into physical life, people often need help learning to leave physical life. Both the beginning and the end are times of healing because healing is about integration of body, mind, and spirit. …

Fenton (1997) observed some of their behavior during an ethnographic study of Clinical Nurse Specialists (CNS) and described what she called Underground Nursing (p. 560). She states, “Behind closed doors, and sometimes in full view, they used their listening, presencing, comforting, and touching skills in ways that were not always apparent to other professions” (p. 561). She provides an example of a CNS who interacted with a man undergoing chemotherapy and his wife. She describes their fear at the outset of the interaction, the nurse’s attitude and actions, which demonstrated caring, presence, comforting, and active listening. Fenton ends the scenario with, “My last picture of this episode was as they left. The man’s wife stopped and hugged the CNS with tears in her eyes. She was laughing and crying with relief about her husband’s prognosis and for having experienced a truly healing encounter” (p. 561). …

Watson (1993) cautioned us to make certain we maintain a balance between the science of nursing and the “caring and healing arts” (p. 19). This statement is consistent with my belief about the balance between the art and science of nursing. However, I would argue that anything as important to the well-being of human beings as the healing process should not only be considered an art of nursing, but should be thrust mainstream into the science of nursing….

Many people have told me they have limited energy, so they can’t get too involved with others and, when they do, they cannot continue to stay involved. These statements indicate a lack of understanding of the nature of energy fields and our ability to use them. For example, when we perceive we have to give our energy to another to help them, we forget we are connected to the Universe where there is an infinite amount of energy. We don’t have to give our energy away! We simply have to learn how to serve as a conduit. I like to think of myself as a transformation station. I can draw from the Universe, transform energy, so it synchronizes with the fields of others, and pass it on. I really don’t have to do anything, except be open to the Universe and have the Intent to pass on helpful, healing energy. Some would say this is love and loving energy. I think it is learning how to Be. Whatever one chooses to call it, I believe it is powerful.

The second factor related to this issue is the notion of staying “involved”. When we use this language, we imply actively thinking about what we will do next. I rarely do this with clients. Instead, I do two things. First I speak to the Universe (and myself) and ask for healing energy to continue flowing through me to the client, and second, I ask for the wisdom to understand the client’s world-view. Some would say this is an auto hypnotic technique that stimulates my unconscious and subconscious processes to stay alert. I think this is possible, but I also believe it brings me collective knowledge (Consciousness as described in Chapter 3), so I can work more purposefully. Staying involved need not mean you continue spending time doing something, it just means you don’t disconnect your energy from others….

When we connect with others, send healing energy, and have the Intent to unconditionally accept them, we automatically encourage them to express their needs. Affirmation of a human’s needs is powerful; it is the same as affirmation of the essence of the person. Again, most of the time we don’t have to do much—we simply need to connect, stay connected, and occasionally seed possibilities. …

One of the major factors that impedes our capability to initiate or start the healing process is our inability to place behavior in a context. Instead, it is viewed as isolated actions or reactions without any specific meaning. Since all needs drive our behavior, all behavior is contextual. When we understand this simple principle of human nature, we no longer observe behavior in isolation….

Healing always has to start with the original loss. This principle holds true with all situations, including those where maladaptive coping patterns exist. If we don’t start with the original, we may help the person cope temporarily, but we don’t help them heal. The wound remains with all of its stored cellular memories, disrupted energy, and negative residual, impeding growth and well-being. Additional negative residual will build on top of it, creating an even more complex situation. …

One technique that I have found that helps people tell their story is to ask them to tell me something about themselves, any story that just pops into their mind. If they have trouble getting started, I suggest that they might start with something from their childhood. I have found that the story that emerges is nearly always the core of the problem, but it doesn’t always come out directly. However, when they are validated for sharing and remembering, they often tell the rest. Most of the time we don’t have to take a lot of time, or ask a lot of questions. People want to heal and they want help with healing. When they know they can trust us, they provide the information we need to help them. We just have to listen and let them peel away the layers in their own way and their own time….

As we heal, we let-go of the lost object and attach to new objects. This makes it possible for us to mobilize alternative resources and produce different chemical responses which alter biophysical patterns. When this happens, unhealthy physical signs and symptoms diminish while healthy signs increase. Our work with people who have hypertension (Erickson & Swain, 1990) provides an example. We did not cure hypertension, but we did help people heal. As they found alternative ways to handle their stress, they were able to move into more harmonious, synchronous mind-body relationships. Their blood pressure readings decreased and they perceived themselves healthier….

Earlier I said, healing creates changes in the holistic person, changes that move us closer to Self-discovery, self-actualization, and fulfillment of Life Purpose. This implies that healing entails becoming aware of our inner core and discovering who we are as holistic beings. When we connect with our inner core, or our spirit, it helps us better understand our Self, for that is the source of knowing or consciousness….

We make many decisions every day about what we will attend to, where we will put our energy, how we will live the next few moments. Many of these decisions are stimulated by what is happening to us at the time. We need to remember that what is happening to us at any second in time is because of decisions we made in the past. Chopra (1996) says, “Whether you like it or not, everything that is happening at this moment is a result of the choices you’ve made in the past. Unfortunately, a lot of us make choices unconsciously, and therefore, we don’t think they are choices—and yet, they are” (p. 40). This is because our choice to set our intent (or choice to not set it!) is a decision….

I started this book with a chapter describing my thoughts and beliefs about our Reason for Being, Life Purpose, and finding Meaning in Life. I hoped the reader would identify with some aspect of that chapter and realize that as health care providers we have the best of all possibilities. We have chosen careers or pathways that make it possible for us to interact with others in ways most people are unable to do in the course of everyday life. We are privileged to have opportunities, day after day, year after year, to learn about ourselves through our interactions with others and help others learn about themselves. This is a blessing….

We’ve now come full circle. We are at the end of the book and have just talked again about Life Purpose. I hope that you, the reader, were able to learn something about yourself and your chosen profession. I also hope that we have contributed to your understanding of what lies in the gap between beliefs and reality. Only you can choose what you believe and what it means to have those beliefs. Only you can decide what the meaning of life is for you. I wish you well.

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EXCERPTED STORIES

Below is a partial list of stories used in this book to illustrate the concepts. Following the list a few of the stories are provided for your enjoyment. Some are complete, others are not. The rest of the story and explanations are included in the text of the chapters .

List of Stories

Chapter 1

A child, searching for Self

A spiritual child, observed by his teacher

Fear of a can of worms, finding caterpillars

Mrs. Cook’s Transformation

Trusting our inner voice

Learning that we’re here for a purpose

Learning the importance of articulating what we know

Chapter 3

Premature twins and energy therapies

Distant healing

M. Walker and connecting with the Universe or God

M. Walker and an experience with expectations

Chapter 4

Anna Martin, cigarette smoker

Knowing but not knowing we know

Chapter 5

Multiple stories about healthy/unhealthy developmental residual

Bud, transformation, spiritual growth

The Gift of the Magi by O’Henry

Chapter 6

Adam’s life story

But, I have no refrigerator

Jane, learning to transfer knowledge

Jay and Bill, two adolescents

My dog needs food

Faith as a self-actualized woman

Chapter 7

My box of books

My brother’s old shoes

Anne lets go

Old couple that died one year apart

I’ve been sick since my husband died 25 years ago

A Vietnam vet searching for Self

Growth during the last few weeks of life (loss resolution)

Chapter 8

Harvey, a happy man

Chapter 9

Rebecca

Chapter 10

Mr. Brown breaks his hip

Mr. M’s blood pressure goes up

Lance has a cough

Jimmy doesn’t want a zipper

Chapter 11

Mr. M and his son

Zelda searches for her life purpose

Learning about Presence

Chapter 12

Bill comes home from Vietnam

Jim breaks his arm riding a bike

The five month old needs help, he’s bored

Mary sees snow

Janie eats the Snickers bars to get even with mom

He had to move to the farm

Chapter 13

James, shot and wounded

Esther

Avery

Sarah

Nursing students

Mattie Stepanek & Milton Erickson

Chapter 14

Mr. B. a tough old Teddy Bear

It all started with the chicken-attack

Seeding can happen by the water fountain

Who is in trouble here?

Someone is lonely and needs a friend

Mrs. Jones loses her mother again

The lady learns about her beginnings

The veteran is afraid to cry, he might not be able to stop

Selected Stories

Chapter 1: Mrs. Cook’s Transformation

I had been in nursing school about 3 months when my instructor decided I needed to learn to provide “total care” for a comatose patient. I was assigned to Mrs. Cook, an elderly lady dying of cancer. During report, I learned Mrs. Cook was non-responsive, moaned continuously, was not taking nourishment, had a catheter, and was expected to die any time. She needed a full bed bath and total care. I asked about her family and was told no one came to see her.

Immediately after report, I went to the treatment room, prepared my “treatment tray” and started towards her room. Halfway down the hall, I could hear her moaning. Entering her room, I called her by name, explained what I was going to do and did it. She moaned the entire time. When I finished, she was still moaning—a sad, lonely sound of grief and agony. Leaving her room, I, too, felt sad. I knew I had given her good physical care, but it seemed so empty. So I went to her, took her hand gently, and stroked it. Once again, I called her name and told her we had the same last name since my maiden name was Cook. I told her I was with her and would be back to see her several times that day. Stroking her forehead and hair, I quietly hummed ‘Amazing Grace’. Much to my amazement, she squeezed my hand slightly and stopped moaning.

Throughout the morning, she was very quiet. All the nurses on duty stopped to see if she was okay and always came out of her room surprised that she was still breathing, but quietly and without suffering. The wrinkles were gone from her forehead, and she seemed to be at peace. Later that morning, I went back to check her vitals. When I called her name and told her I was there, she reached for me. I took her hand, and she took one last breath. She looked so peaceful as she passed that it was hard to believe she was the same lady I had seen only a few hours earlier.

Chapter 7: Old Couple That Died One Year Apart

Years ago, when I worked as a staff nurse at The University of Michigan Medical Center, we had a wonderful elderly couple who came to us for their care. Survivors of a World War II German concentration camp, they came to the United States in the ‘50s to start over. They had three children, all grown and away from home. Whenever one of them came into the hospital, the other would spend most of his/her time there as well. They were fully devoted to one another. They told me they were able to get through the horrific experiences in the concentration camp because they knew they had each other.

One Fall, Mr. M, the husband was admitted for a work-up to determine why he wasn’t feeling well and to see what could be done. After several days of tests, he was diagnosed with a very rare case of leukemia. The interns and residents were excited because it was the first case ever seen at U of M Hospital. They didn’t expect to ever see another case, so they hovered over Mr. M.

After several months of being admitted, discharged, and readmitted, Mr. M. presented himself for his final visit. His wife sat next to his bed the entire week. She was there when he died. When we finally convinced her to go home with her daughter, we were shocked to note her voice had changed. She sounded just like her husband! She walked like him, and had even taken on some of his mannerisms. All of this had happened in just a couple of hours. Exactly one year later, on the anniversary of his death, she was admitted to the hospital. We were once again shocked to see that she had not only taken on more of his mannerisms, but now she also exhibited the same signs and symptoms he had! Blood work showed that she, too, had a type of leukemia, but before it could be diagnosed fully, she died. She took her last breath on the anniversary of his death. As she took that breath, she looked toward the ceiling, smiled and called his name, then said, “Here I come”. With that she left her biophysical body and moved on.

I often thought about this couple. I suspect the losses they had experienced as young people living in Germany, captured, imprisoned, and tortured were enough to result in morbid grief. However, they had each other. Such strong attachment helped them go on with life. The loss of such an attachment would