CHAPTER 15 Margaret A. Newman’s Theory of Health as Expanding Consciousness and Its Applications 225PART TWO
Applications
Margaret Newman’s Theory of Health as Expand-
ing Consciousness is being used throughout the
world, but it has been more quickly embraced and
understood by nurses from indigenous and Eastern
cultures, who are less bound by linear, three-
dimensional thought and physical concepts of
health and who are more immersed in the meta-
physical, mystical aspect of human existence.
Increasingly, however, the theory is being enthusi-
astically embraced by nurses in industrialized na-
tions who are finding it increasingly difficult to
nurse in the modern technologically driven and
intervention-oriented health-care system, which is
dependent on diagnosing and treating diseases
(Jonsdottir, Litchfield, & Pharris, 2003, 2004).
Practicing from an HEC perspective places what is
meaningful to patients back at the center of the
nurse’s focus.
RESEARCH
Margaret Newman (1994a) describes her research
methodology as hermeneutic dialectic—hermeneu-
ticin that it focuses on meaning, interpretation,
and understanding; and dialecticin that both the
process and content are dialectic (Newman,
1997b). Guba and Lincoln (1989, p. 149) describe
the dialectic process as representing “a comparison
and contrast of divergent views with a view to
achieving a higher synthesis of them all in the
Hegelian sense.” Hegel proposed that opposite
points of view can come together and fuse into a
new, synthesized view of reality (Newman, 1994a).
It is in the contrast that pattern can be appreciated.
For example, one cannot fully comprehend joy
unless one has fully comprehended sorrow, and
vice versa. Although they seem to be opposites,
these two emotions are two manifestations of
human connectedness. If you want to see a dark
pattern more clearly, you would put it against a
light background. The dialectic aspect of this
methodology permits a nurse to be present to a
client whose life circumstances are very different
from those of the nurse. For example, the pattern-
recognition interaction for a homeless 16-year-old
teenage boy from Solna, Sweden, with a female
nurse from a very intact, loving family in Somalia
may provide clearer insight than with a young
Swedish male nurse from Solna, who himself had
been homeless, because less will be assumed and
taken for granted. The Somali nurse will have to ask
more clarifying questions and seek to understand
that which has not been her experience. No matter
what the background of the nurse and patient, the
clarifying process, if done in an open, caring, and
nonjudging manner, provides great insight for both
participants in the pattern-recognition process as
the nurse and the patient realize their interconnect-
edness. When the nurse-patient interaction is fo-
cused on attending to meaning, it transcends
barriers of culture, gender, age, class, race, educa-
tion, and ethnicity. The HEC theory focuses on the
interconnectedness and common humanity of all
people, and research from the HEC perspective
seeks to understand the whole, rather than predict
cause and effect (Newman, 2002).
The Health as Expanding Consciousness
Research Process
After several years of positivist research (Engle,
1986; Newman, 1976, 1982), which attempted to
isolate and manipulate variables seen as basic to
HEC theory (movement, time, consciousness),
Susan Moch, who was working as a research assis-
tant with Margaret Newman, suggested they ask
participants about the most meaningful experi-
ences in their lives (Newman & Moch, 1991). In a
pilot study, Margaret Newman, Jim Vail, and
Richard Cowling devised a method of pattern iden-
tification by asking people to describe meaningful
people and events in their lives. They then looked at
sequential patterns of people’s lives, which facili-
tated recognition and insight into pattern, and in-
volved the nurse-researcher-practitioner in the
movement toward higher consciousness (Newman,
1997b). The pilot study informed the methodology
used by Newman and Moch (1991) in their re-
search with people with cardiovascular disease.
Susan Diemert Moch (1990) went on to inter-
view 20 women diagnosed with breast cancer, cen-
tering the nurse-patient dialogue on the pattern of
the whole. Moch asked the women in her study to
describe what was meaningful to them and found
that in talking about meaningful people and events,
the sequential patterns of interaction between peo-
ple and their environment become apparent. The