seen as a “unitary, self-organizing field embedded
in a larger self-organizing field. It is identified by
pattern and by interaction with the larger whole”
(Newman, Sime, & Corcoran-Perry, 1991, p. 4).
Change is unpredictable and unidirectional, always
moving toward a higher level of complexity.
Knowledge is arrived at through pattern recogni-
tion and reflects both the phenomenon viewed and
the viewer.
Margaret Newman (1979, 1986, 1994a), like
Martha Rogers (1970, 1990), sees human beings as
unitary energy fields that are inseparable from the
larger unitary field that combines person, family,
and community all at once. A nurse operating out
of the unitary-transformative paradigm does not
think of mind, body, spirit, and emotion as separate
entities, but rather sees them as an undivided
whole.
Newman’s theory (1979, 1990, 1994a, 1997a,
1997b) proposes that we cannot isolate, manipu-
late, and control variables in order to understand
the whole of a phenomenon. The nurse and client
form a mutual partnership to attend to the pattern
of meaningful relationships and experiences in the
client’s life. In this way, a patient who has had a
heart attack can understand the experience of the
heart attack in the context of all that is meaningful
in his or her life, and through the insight gained,
experience expanding consciousness. Newman’s
(1994a, 1997a, 1997b) methodology does not di-
vide people’s lives into fragmented variables, but
rather attends to the nature and meaning of the
whole, which becomes apparent in the nurse-
patient dialogue.
Paradigmatic view shapes nursing theory and
research methodologies. The old paradigm pro-
poses methods that are analogous to trying to ap-
preciate a loaf of warm bread by analyzing flour,
water, salt, yeast, and oil. No matter how much we
come to know these ingredients separately, we will
not know the texture, smell, taste, and essence of
the loaf of bread that has just come out of the oven.
The whole is greater than the sum of its parts and
exhibits unique qualities that cannot be fully com-
prehended by looking at parts. Individual qualities
of the whole, however, do give us some under-
standing of the nature of the whole. For example,
the smell of the loaf of bread provides one insight
into its nature, the texture provides another, and so
on. A nurse practicing out of the HEC theoretical
perspective possesses multifaceted levels of aware-
ness and is able to sense how physical signs, emo-
tional conveyances, spiritual insights, physical
appearances, and mental insights are all meaning-
ful manifestations of a person’s underlying pattern.
Newman, Sime, and Corcoran-Perry (1991)
concluded that the knowledge generated by the
particulate-deterministic paradigm and the inter-
active-integrative was relevant to nursing but
that the knowledge gained by using the unitary-
transformative paradigm was essentialto the nurs-
ing discipline. In a later work, Newman (1997a)
asserted that knowledge emanating from the uni-
tary-transformative paradigm is the knowledge of
the discipline and that the focus, philosophy, and
theory of the discipline must be consistent with
each other and therefore cannot flow out of differ-
ent paradigms. Newman states:
The paradigm of the discipline is becoming clear.
We are moving from attention on the other as object
to attention to the we in relationship, from fixing
things to attending to the meaning of the whole, from
hierarchical one-way intervention to mutual process
partnering. It is time to break with a paradigm
of health that focuses on power, manipulation,
and control and move to one of reflective, compas-
sionate consciousness. The paradigm of nursing
embraces wholeness and pattern. It reveals a world
that is moving, evolving, transforming—a process.
(1997a, p. 37)
The unitary-transformative paradigm tran-
scends, yet includes, knowledge from the particu-
late-deterministic and the integrative-interactive
paradigms; it is a more inclusive level of wholeness
(Newman, 2002a). Newman’s call for nurses to
practice and conduct research out of a unitary-
participatory paradigm, which sees the process of
the nursing partnership as integral to the evolving
definition of health for the patient (Litchfield,
1993, 1999; Newman, 1997a) and is synchro-
nous with participatory philosophical thought
(Skolimowski, 1994) and research methodology
(Heron & Reason, 1997).SEQUENTIAL CONFIGURATIONS
OF PATTERN EVOLVING OVER TIME
Essential to Margaret Newman’s theory is the belief
that each person exhibits a distinct pattern, which
is constantly unfolding and evolving as the person220 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration