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The Integration of Mind-Body-Soul and the Practice of Humanistic Nursing

Article  in  Holistic nursing practice · May 2001

DOI: 10.1097/00004650-200104000-00010 · Source: PubMed

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The Integration of Mind-Body-Soul

and the Practice of
Humanistic Nursing

Nursing has shifted the focus of its praxis toward a commitment to holistic care. This holistic perspective suggests
each nurse must bring an authentic self as the essential element of therapeutic participation with another human
being. The art of the therapeutic use of self in relationships involves an aesthetic process of ongoing reflected
action, whereby an individual strives toward a sense of harmony and balance within oneself and with the world.
The artful use of self provides an opportunity for expansion and personal growth and actualizes the potential
to expand the good of all. Key words: aesthetic process, caring, holistic nursing, personal growth, reflective
process

Sharon Ann Cumbie, PhD, RN, CS Nursing is an art, and if it is to be made an art, it
Assistant Professor requires as exclusive a devotion and as hard a prepa-
ration as any painter’s or sculptor’s work; for what
University of Wyoming is having to do with dead canvas or cold marble,
School of Nursing compared with having to do with the living body—
Laramie, Wyoming the temple of God’s spirit? It is one of the fine
arts: I had almost said, the finest of the Fine Arts.
—Florence Nightingale1

Nursing focuses on the holistic care of hu-

man beings and the use of multiple comple-
mentary healing modalities when participat-
ing in a caring-healing relationship. Moore
points out that “care is what a nurse does,
and ‘nurse’ happens to be one of the early
meanings of the Greek word therpeia, or
therapy.”2(p. 5) Webster’s dictionary defines
a therapist as one who is trained in meth-
ods of treatment and rehabilitation other than
the use of drugs or surgery and that a ther-
apeutic is the application of these “reme-
dies” in the treatment of disease.3 Nursing
has shifted the focus of its praxis from these
earlier definitions toward a commitment to
holistic care, health promotion, and concern
for the protection of basic human integrity.

Holist Nurs Pract 2001;15(3):56–62

°
c 2001 Aspen Publishers, Inc.

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Integration of Mind-Body-Soul 57

The nature of nursing from a holistic- might concur that an integrated awareness
relational-contextual perspective suggests of self, other, and environment provides the
that each nurse must bring an authentic self nurse with an understanding and openness
as the essential element to the moment of necessary to authentically and fully partici-
therapeutic participation with another hu- pate with caring-healing intention in a ther-
man being. Montgomery recognizes certain apeutic relationship. Patterson and Zderad6
rhythmic patterns associated with authentic refer to this authentic use of self in practice
participation in a caring relationship as hav- as humanistic nursing. Humanistic nursing is
ing an aesthetic quality. During these mo- described as embracing more than a “benev-
ments, the caring-healing relationship is said olent technically competent subject–object
to feel “effortless and correct, as though the one-way relationship guided by a nurse on
communication is in keeping with a larger behalf of another.” Rather, humanistic nurs-
order.”4(p. 93) ing is defined as dictating that nursing is
When the relationship is right, there is a “responsible searching, transactional re-
a flow, harmony, and easiness to involve- lationship whose meaningfulness demands
ment. Watson maintains that the “capacity conceptualization founded on a nurse’s exis-
of one human being to receive another hu- tential awareness of self and the other.”6(p. 3)
man being’s expression of feelings for one- This existential awareness foremost calls for
self ”5(p. 67) is the basic artistic activity of an authenticity with one’s self. It is through
nursing and caring. The art of the therapeutic an authentic awareness and the reflection on
use of self in human relationships involves an one’s experience in the world that the nurse
aesthetic process of ongoing reflected action comes to truly understand the self and the
whereby an individual strives toward a sense world. Watson proposes that each human be-
of harmony and balance within oneself and ing strives toward a sense of harmony within
with the world. This full and authentic partic- the mind, body, and soul and that this process
ipation in a caring-healing relationship with further integrates, enhances, and actualizes
another is the essence of the art of nursing. the real self.5 She continues by saying that
the more one is able to “experience one’s real
REFLECTED PRAXIS: self, the more harmony there will be within
FOUNDATIONS OF THE ART the mind, body, and soul and the higher de-
OF NURSING gree of health will exist.”5(p. 57)
Disharmony among the mind, body, soul
Expert caregivers must have an awareness or between a person and the world can lead
of themselves that allows them to participate to a disjunctive between the self as per-
fully in a therapeutic relationship, which im- ceived and one’s actual experience.5(p. 56)
plies that a task central to the development This state of disharmony creates a state of in-
of the nurse is the integration of feelings congruence within the person, between the
with knowledge and experience.4 Caregivers “I” and “me” and between the person and
must process their own subjective experi- the world. The implications of the relation-
ence of self within the caring relationship ship between harmony within the nurse and
in such a way that they are able to remain fo- the healing outcome of the caring relation-
cused on the needs of the patient.4(p. 87) One ship are clear. A process of self-awareness
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58 HOLISTIC NURSING PRACTICE/APRIL 2001

son’s benefit. For this nurse, involvement

A process of self-awareness through with another is described as an “overflow
reflected action contributes to of her inner plentitude, of her richness of
increasing unity of mind-body-spirit being.”7(p. 501) Because this nurse is able to
with a resulting impact on the state of give fully of self, she or he must face the
harmony. potential for suffering inherent in any close
relationship. But this gift of self actually
gives back to the nurse who chooses a stance
of full participation in that it opens the po-
through reflected action contributes to in- tential for his or her own personal growth.
creasing unity of mind-body-spirit with a re- Through a process of fully engaging in the
sulting impact on the state of harmony. This life experience of a caring-healing relation-
harmony, then, enters into a caring-healing ship with another, the nurse brings to the
relationship through the authentic and artful moment a sense of a calling, a higher pur-
use of self. pose of being. This level of commitment to
Nursing is an experience lived between authentic participation, then expands and in-
human beings.6 All therapeutic action ini- creases the state of harmony within the nurse
tiated by the nurse in the care of another and with the world-at-large, promoting and
human being occurs through a self in ac- manifesting great healing potential for both
tion, but this is not necessarily through the the nurse and for those with whom the nurse
therapeutic use of self or the art of nursing. engages. Watson defines this artful use of
Clemence points out that for some nurses, self in nursing as transpersonal caring and
the therapeutic use of one’s self may be sim- proposes that the concept of professional in-
ply the implementation of a nursing tech- volvement requires the participation of the
nique such as the administration of oxygen entire self, using every dimension of one’s
and not the giving of one’s self. This kind of self as a resource in the professional rela-
nursing is described as the “lending” rather tionship between the nurse and the patient.5
than “giving” of one’s self.7(p. 500) The diffi- A transpersonal caring relationship, a spiri-
culty with this “lending” perspective is that tual union occurs between the two persons
although the nurse may be technically com- in which both are capable of transcending
petent, she or he remains aloof and the deeper self, time, space, and the life history of each
existential needs of the patient remain unad- other.5(p. 66)
dressed. While possibly providing increased The nurse enters into the experience of an-
personal comfort to the nurse, the avoidance other, and the other person enters into the
of the risk of deeper emotional engagement experience of the nurse. This shared experi-
also risks losing the opportunity for personal ence creates its own phenomenal field, thus
growth and fulfillment when the nurse does becoming a particular moment in a “larger,
not fully participate in life experiences. deeper, complex pattern of life.”5(p. 76) In
But there is another reality of the nurse other words, the artful use of self for the
who is committed to full participation in the benefit of another has the potential of being
caring-healing relationship, one who is will- therapeutic for the nurse as well by providing
ing to give of one’s self for another per- an opportunity for expansion and personal
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Integration of Mind-Body-Soul 59

growth through being in touch with the self

and the self within relationship. In creat- Human existence is basic: It is the
ing an authentic caring-healing relationship experience of the individual’s presence
with another, the nurse effects the cocreation and participation in an ever changing
of a healing moment that expands and in- and potentially threatening world.
creases the state of harmony and health of
both nurse and patient. This healing moment,
then, actualizes the potential to expand the self as is and of ideal self, thus establishing
good of all, thereby creating an ontologic harmony within the person’s mind, body, and
circle of healing. soul.5 “The process allows the nurse to re-
flect the self back upon the self.”5(p. 71) In so
THE ART OF BEING HUMAN: FULL doing, the nurse as human being comes to
PARTICIPATION IN LIFE apprehend the contextual relationship of the
self to the world.
How does the nurse come to this authen- From a unitary-transformative view, the
tic state of being in the world? What is the notion of being will take precedence over
process of becoming necessary in allowing that of knowledge in philosophical explo-
the nurse to artfully engage as an authen- ration. Being cannot be made a subject of ob-
tic person in a caring-healing relationship? jective inquiry; it is revealed to the individual
Authentic nursing practice through the art- by reflection on one’s unique concrete exis-
ful use of self as therapeutic agent is far tence within the context of life experiences.
more than a willingness to give one’s self Human existence is basic: It is the experience
in the benefit of another. Upon initial con- of the individual’s presence and participation
sideration of this way of being a nurse, one in an ever-changing and potentially threaten-
might question the demand on the inner re- ing world. Each self-aware individual under-
sources of such a person. But with further stands existence in terms of the experience
reflection, it becomes clear that the full use of self within a contextual-relational whole
of self in artful nursing praxis describes an of self to other and to the world. The self of
existential-ontologic process of human be- which one is aware is a thinking-feeling be-
coming. Yes, the nurse gives fully of self ing who has hopes, beliefs, fears, desires,
but in so doing, opens the potential for re- and the need to find purpose and meaning,
ceiving far more from the inter-relational as well as the will that can determine one’s
experience. Patterson and Zderad describe actions. From a unitary-transformative per-
this process as generative in that one experi- spective, the notion of being can have no
ence opens the door for the next experience.6 significance if viewed impartially or in ab-
Watson states that this authentic way of be- straction; it can only be seen in terms of the
ing in the world allows for release of emo- impact that experiences make on a particular
tions and the evolution of the person’s spiri- individual within a contextual whole.
tual self or soul. A promotion of congruence Each human being will experience a
between the person’s perception and experi- condition of anxiety or discomfort arising
ence occurs, creating a sense of existential from the realization of one’s necessary free-
synchrony, which leads to the promotion of dom of choice, of one’s unknowing of the
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60 HOLISTIC NURSING PRACTICE/APRIL 2001

future, and of one’s awareness of manifold ness while it works its mystery on us.”11(p. 20)
possibilities.8 This sense of anxiety or oc- Daring the dark also means allowing pain
casioned dread is sometimes called angst, to be pain and learning from it. This ul-
which is the realization that one’s existence timately describes a self-reflective pattern
is open toward an undetermined future, the whereby one gains self-knowledge through
emptiness of which can only be filled by a self-becoming. Self-awareness is the key
one’s freely chosen actions. Anxiety and to the perception of self within the context
fear often characterize the human state and of human experience. This reflected self-
emanate from a continuing process of con- awareness, then, is the source of all knowl-
frontation with possibility and the need for edge of the self in the world and is an aes-
decision with the concomitant burden of re- thetic process that allows one to develop
sponsibility. Watson describes this unitary- the understanding necessary in choosing and
transformative process as a basic striving “to creating one’s potential within a pattern of
actualize the real self, thereby developing the reflected action. (See Fig 1.) The reflective
spiritual essence of self . . .” and goes on to pursuit of self through awareness is a highly
propose that “each person seeks a sense of creative process. As Frank Barron reminds
harmony within mind, body, and soul and us, “We are all creative, no matter how lim-
thereby further integrates, enhances, and ac- ited. Because we are capable of reflecting
tualizes the real self.”5(p. 57) Dewey adds a di- upon ourselves, we are committed to an artis-
mension to our understanding of this process tic enterprise in the creation of our own
when he describes disharmony as necessary personality.”12(p. 56)
to the achievement of harmony in art and in
life.10 From this perspective, striving can be REFLECTIONS
viewed as holding the tension between har-
mony and disharmony and the acceptance of The creative process of human becoming
both as a natural part of the process of be- must be explored not as a product of fear
coming. Dewey maintains it is the artist who and anxiety but as representing the highest
cultivates disharmonies because of their po- degree of emotional health. The expression
tential for making experience unified and to- of a human being in the process of self-
tal, emphasizing that the reintegration of self actualizing is the art-act of bringing into
and environment is more than a return to sta- being, creating a life. Addressing the req-
sis but is actually an expansion of life. When uisite of courage in this process of human
there is an “overcoming of opposition and becoming, Rollo May states, “In human be-
conflict, there is a transformation of them ings courage is necessary to make being
into differentiated aspects of a higher pow- and becoming possible. An assertion of the
ered or more significant life.”10(p. 14) self, a commitment, is essential if the self
The foundation of a self-reflective process is to have any reality. This is the distinc-
is the willingness to dare the truth, both the tion between human beings and the rest of
light side and dark side of one’s personal re- nature.”9(p. 13) Nursing must move beyond
ality. In Creation Spirituality, Matthew Fox old paradigms that propose (and encourage)
proposed that “daring the dark means en- the idea that an effective health care provider
tering nothingness and letting it be nothing- is one who is able to remain detached and
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Integration of Mind-Body-Soul 61

Fig 1. Reflected self-awareness is the key to the perception of self within the context of human experience.

aloof, “objective,” at all cost. We must not dividual nurse, for we cannot bring a reso-
only give permission for individuals to ex- nance of harmony and healing to another if
plore the totality of their experience, but we we are in a state of disharmony and disin-
must also provide guidance and structure that tegration. Newman proposes that the nurse
will allow each nurse to become comfort- “offers his or her whole self so that the
able with an authentic way of being-in-the- client can resonate with an authentic per-
world and the practice of full participation in son. The nurse is like a tuning fork through
a caring-healing relationship. Two underpin- which the client can begin to resonate with
ning assumptions of such an approach are the the consciousness of the universe.”13(p. 6) If
acceptance that authenticity creates an atmo- one throws a stone into the center of a pond
sphere of health and the belief that human be- and watches closely, a rhythmic interplay
ings have the capability to actualize their full of wave patterns can be noticed as ripples
potential. of water, precipitated by the impact of the
The promotion of a harmonic integration stone, move toward the shore, then back to-
of mind-body-soul must begin with each in- ward the center of the pond in a subtle pattern
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62 HOLISTIC NURSING PRACTICE/APRIL 2001

of wave interaction that creates an endless motes an evolution toward the good of all.
repatterning of interpenetrating energy field Any energy repatterned has the potential of
within the body of the pond. Each step to- affecting an endless universal shift and cre-
ward the harmony of authentic being pro- ating an ontologic circle of healing.

REFERENCES

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and Sacredness in Everyday Life. New York: Harper; Co.; 1953.
1992. 9. May R. The Courage to Create. New York: Norton &
3. Webster’s New Collegiate Dictionary. Springfield, MA: Co.; 1975.
Merriam Co.; 1980. 10. Dewey J. Art as Experience. New York: Putnam & Sons;
4. Montgomery CL. Health Through Communication: The 1934.
Practice of Caring. London: Sage; 1993. 11. Fox M. Creation Spirituality. Minneapolis: Winston
5. Watson J. Human Science and Human Care: A Theory Press; 1991.
of Nursing. New York: National League for Nursing; 12. Barron F. Creativity: The Magic Synthesis. New York:
1988. Basic Books; 1968.
6. Patterson J, Zderad L. Humanistic Nursing. New York: 13. Newman M. Health as Expanding Consciousness. St.
John Wiley and Sons; 1988. Louis: C.V. Mosby; 1986.

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