untitled

in New York. It was in preparing for that presenta-
tion, entitled “Toward a Theory of Health,” that the
theory of Health as Expanding Consciousness
(HEC) began to take shape. In her address
(Newman, 1978) and in a written overview of the
address (Newman, 1979), Newman outlined the
basic assumptions that were integral to her theory.
Drawing on the work of Martha Rogers and Itzhak
Bentov and on her own experience and insight, she
proposed that:

• health encompasses conditions known as dis-
  ease as well as states where disease is not present;


• disease, when it manifests itself, can be consid-
  ered a manifestation of the underlying pattern
  of the person;


• the pattern of the person manifesting itself as
  disease was present prior to the structural and
  functional changes of disease; and


• health is the expansion of consciousness
  (Newman, 1979).
  Newman’s presentation drew thunderous ap-
  plause as she ended with “[t]he responsibility of the

“[t]he responsibility of the nurse is not to

make people well, or to prevent their get-

ting sick, but to assist people to recognize

the power that is within them to move to

higher levels of consciousness.”

nurse is not to make people well, or to prevent their
getting sick, but to assist people to recognize the
power that is within them to move to higher levels
of consciousness” (Newman, 1978).
Although Margaret Newman never set out
to become a nursing theorist, in that 1978 presen-
tation in New York City she articulated a theory
that resonated with what was meaningful in the
practice of nurses in many countries throughout
the world. Nurses wanted to go beyond combating
diseases; they wanted to accompany their patients
in the process of discovering meaning and
wholeness in their lives. Margaret Newman’s
proposed theory would serve as a guide for them
to do so.
After identifying the basic assumptions of the
HEC theory, the next step for Margaret Newman
was to focus on how to test the theory with nursing
research and how the theory could inform nursing
practice. Newman began to concentrate on:

• the mutuality of the nurse-client interaction in
  the process of pattern recognition,


• the uniqueness and wholeness of the pattern in
  each client situation,


• the sequential configurations of pattern evolv-
  ing over time,


• insights occurring as choice points of action
  potential, and


• the movement of the life process toward ex-
  panded consciousness (Newman, 1997a).

A NEW PARADIGM EMERGES

In an attempt to acknowledge and define the vari-

ous scientific paradigmatic perspectives and to

eliminate some of the confusion regarding the na-

ture of the discipline of nursing, Margaret

Newman, Marilyn Sime, and Sheila Corcoran-

Perry (1991) collaborated on an article to define the

overarching focus of the nursing discipline and its

prevailing paradigms. They defined the focus of the

nursing discipline to be caring in the human health

experience,which they saw as the common um-

brella under which three distinct paradigmatic per-

spectives fell: the particulate-deterministic, the

interactive-integrative, and the unitary-transfor-

mative (with the first word indicating the nature of

reality and the second word indicating the nature

of change in each paradigm).

The particulate-deterministic paradigm holds

that phenomena are isolatable, reducible entities

with definable, measurable properties. Relationships

between entities are seen as orderly, predictable,

linear, and causal (i.e., A causes B, or atherosclerotic

plaque causes heart attacks). In this perspective,

health is dichotomized with clearly defined charac-

teristics that are either healthy or unhealthy, and

change occurs in a manner that is predictable and

causal in nature.

The interactive-integrative perspective, which

stems from the particulate-deterministic, views re-

ality as multidimensional and contextual. Multiple

antecedents and probabilistic relationships are be-

lieved to bring about change in a phenomenon (i.e.,

A 
B 
C 
D are interrelated in their affect on

E; or diet, exercise, smoking, family history, and

lifestyle are interconnected in their affect on heart

attacks). Relationships may be reciprocal, and sub-

jective data are seen as legitimate.

The unitary-transformative perspective is dis-

tinct from the other two. Here a phenomenon is

CHAPTER 15 Margaret A. Newman’s Theory of Health as Expanding Consciousness and Its Applications 219