Using Metaphor and Imagery for Self-Reflection and Theory Informed Practice
Jackie Levin RN, MS
www.fourshieldsofleadership.com
This paper emerges out of my experience as the program coordinator for an integrative care program at a large urban hospital. In this newly created program and position, my role was to seed and grow Unitary Transformative Nursing throughout the institution which, until this point, had not been widely exposed to a holistic paradigm of care. I reflected on my first year of a two-year grant and found the early days of walking this path of Unitary Transformative Nursing rocky and at times thorny, challenging my sense of self, raising fears, and experiencing a loss of faith in my ability to bring holistic nursing to the medical center. As I encountered the different units and providers from medicine, surgery and critical care, I needed to find a way to understand the diverse microcosms of the institution, the mirrors reflecting my own shadow aspects demonstrating my yet unconscious areas for growth and evolution. I knew from my studies of the Science of Unitary Human Beings, energy-based therapies, and other metaphysical and spiritual practices that there is no difference between what is in the environmental field and my own field patterning. If I could find a way to learn from the environmental field patterning, then I could unfold my own implicate order. I found using the metaphors of nature and the elements, earth (soil), water (rain), fire (sun), and air (wind), for the integral environmental field patterning as well as my own to be helpful in this unfolding. As I observed pandimensionally, my own implicate order and that of the integral environmental field was explicated.
In the early months of the grant funding the Integrative Care program, I judged my practice linearly, based on a causal paradigm. “Success”, following the dominantly expressed patterns in the field, emphasized quantitative outcomes. The grant required quarterly reports documenting the program coordinator’s activities as well as the number of patients who accessed the program and how many physicians were making referrals. Disappointment by the funder that not more patients and physicians accessed the pre-surgery program and with a low priority placed on the nursing educational programs, I went into a downward spiral of self-doubt, self-criticism and confusion as to my role and work. I was lost. I then remembered a poem by David Wagoner (Whyte, 1998, Introduction).
Lost
Stand still. The trees ahead and the bushes beside you
Are not lost. Where you are is called Here,
And you must treat it as a powerful stranger,
Must ask permission to know it and be known.
The forest breathes. Listen. It answers,
I have made this place around you,
If you leave it you can come back again, saying Here.
No two trees are the same to Raven.
No two branches are the same to Wren.
If what a tree does is lost on you,
You are surely lost. Stand still. The forest knows
Where you are. You must let it find you.
I read and reread these words. I sat still, in a place of unknowing and regained my center, found where Here was. I looked deeply at the nature of thorns and of rocky roads; remembered that the unknown can feel uncomfortable only when I am looking for the “known.” With this, I again remembered Self. This deeper practice of holistic nursing is transformative, a sacred art that is informed by theory, science, clinical experience and self-reflection. The latter three have been relatively apparent in the day-to-day practice of holistic nursing. However, theory seemed elusive. To better understand my evolving practice and its manifestation, I returned to the Science of Unitary Human Beings.
History of Experience with Science of Unitary Human Being Theory
As I reread Rogers’ work on the Science of Unitary Human Beings, I was surprised to experience, for the first time, that her words made perfect sense. I began to see how this work is a science and how it now organically informs my whole life. The first time I read Rogerian theory was as a student in my undergraduate nursing program. At the time, frankly, I did not know what she was talking about. I did know without any reservation, however, that she was absolutely right. If someone had asked me to explain why and how, I could not. Was this the first awakening to “unknowing” as a way of knowing (Munhall, 1993)?
I wondered about this. If this informs every aspect of my life, when did this become so? Did it start when I read Rogers as an undergraduate nursing student and then become increasingly integral during my Master’s in Holistic Nursing Program? Certainly Rogerian theory became more accessible through the illumination of my beloved teachers. These were not, however, my first understandings of the Science of Unitary Human Beings. As I looked back, I was living this science long before I ever had the formal teachings.
For example, I used to play in the woods behind my house. I was about five years old, in 1965, perhaps just about the time that Dr. Rogers was explicating her theory. I remember playing with the fairies. They were not made up fairies, and not fairies that I could see either. Rather they were wood fairies, patterns of energy that I knew were there, felt and unseen. Perhaps this was my first conscious pattern appraisal of the unitary field.
At six a friend of mine explained, in vain, to me the concept of sin and the certain punishment from God as well as parents. I challenged her; I knew there was no separation between God and myself. After all, if I came through this universe then the information inside me was universal, including God. I also maintained that I had free will and was responsible for the choices I made. Was this an early expression of my own power as knowing participation in change? (Barrett, 1997).
As a teen, I spent time in mutual process with the trees, feeling soothed by their timeless rhythm, much different than the rhythm of humans. I would ask questions of the old trees (not the young saplings—what did they know?), cradled in their arms, often waiting hours in linear time for their slow, deliberate answers.
Later, when I was 25 years old, I experienced an insight into manifestation of patterns as a volunteer advocate for our Domestic Violence Hotline. It was the middle of the night, and I received a call from a woman needing shelter for herself and two children. When I arrived, I recognized her. Twice before I had been through this “routine” with her. Tired and knowing that I had many miles to drive over dark country roads to the safe home and then back to my bed, I thought, “When will the woman learn?” This was not a very enlightened or compassionate thought. Then in that moment, I remembered it takes a woman, on average, 7 times of leaving a violent relationship before establishing herself and children in safe relationships and homes. Rogers writes, “pattern is not directly observable. However, manifestations of field patterning are observable events in the real world” (1992, p. 30).
Kabir writes:
The guest is inside you, and also inside me;
You know the sprout is hidden inside the seed.
we are all struggling; none of us has gone far.
Let your arrogance go, and look around inside (Blye, 1997, p. 57).
I did not and could not know how many times this pattern manifestation of leaving-returning-leaving would enfold and unfold. When I looked deeper, I could see that this exodus, though seemingly the same as the previous two, was different. Her pattern manifestation would be unpredictable and continuously evolving. My role, during our mutual process, was to be simultaneously present, non-judgmental, and to support its unfolding while field patterning courage, hope, ability to find new and diverse ways of being. The experience then shifted from one of frustration with repetition and stagnation to participating in something magnificent and beautiful.
Science Transforms into Practice
The Science of Unitary Human Beings is not how I practice nursing, rather, it is how I practice life. It informs every aspect of my day, making holistic nursing my sacred expression of all my diverse facets of self.
Seeding and growing Unitary Transformative Nursing in a traditional hospital setting would require me to view not only what is visible and obvious but also that which is hidden in the shadows as influences in the integral environmental field. Exploring my own patterns revealed, not for the first time, limiting beliefs and behaviors. At times disheartened, confused, frustrated, and angry, I questioned myself, who I was and what I was doing. Looking through the lens of the causal worldview, what had I accomplished in my first year? What thriving gardens now existed from my work?
In fact, not much had taken root, much less grown and flourished. How much seeding, nurturing, and tending needs to take place before something takes hold? Then I realized that I am not the broadcaster of the seeds, the planter, or the germinator. Jean Shinoda Bolen writes, “What comes into being depends on the nature of the seed” (1979, p. 70). It also depends on the environmental field in which this seed is integral. To widen my view, I began to assess each micro ecosystem within the larger dimensional macrocosm, using the imagery of a garden and the energy of the elements: earth (soil), air (wind), water (rain), and fire (sun). These metaphorical pattern appraisal tools revealed the unique implicate order as well as my role in the integral environmental field patterning. The relationship of the element to the seed is alchemical.
Assessing what elements were in excess or in scarce supply revealed enormous information into the system, expanding consciousness (Newman, 1994), as did assessing the inner cycle of growth for the seed, and looking within to my own internal landscape as part of the alchemical process.
Pattern appraisal was subtle. Irene Dowd (1995), a neuromuscular anatomy and dance professor describes accessing pattern manifestation of the nervous system. “The nervous system can be perceived by fingers in the way that the wind can be perceived by my eyes: only indirectly. I see the tree branches moving to the south, but not the north wind that blows them in that direction”. (p. 84)
I thought about wind. I thought I could know much more than simply which direction it blew. Wind has many qualities: it might be a moderate wind, cool, but not chilly. It can be whipping, fierce and biting. It might be just what is ordered on hot summer day, or it can bring disaster to an area under several feet of snow. If it is absent it is choking, and if it is excess it can literally blow you away.
I investigated this another step further. Newman (1994) describes the ring-like wave pattern emanating from two pebbles dropped into a still lake. Each pebble’s ring eventually “radiate[s] toward one another…and the interference pattern spreads and is part of the whole of each of the previous patterns” (p. 105). Wherever these pebbles are “dropped” in the relative present, the radiating waves create interference patterns in the relative future. This, too, is an alchemical process and I was curious what it would be like to imagine myself as the interference pattern, emanating an element energy within me to balance what I perceived lacking or in excess within the unique environmental field.
Specific Reflections on Seed and Growing Unitary Tranformative Nursing
My initial forays into mutual process were not always as a skilled alchemist and transformation occurs on pan-dimensional levels. I learned not to look for “gold” as the “result” of this alchemical process as the chemical Lead might evolve into something unexpected, much more than what my limited view of relative present may offer.
A Critical Care Unit
I was invited by the staff educator to give stress reduction sessions to the nursing staff in a critical care unit. We identified times and location “convenient” to the staff and the nurse educator would post up signs and work with the nurse manager to inform nurses and nurse assistant staff. I went up at the appointed time. The door was locked. I had to find the key. I sat in an empty room for 10 minutes. I located the nurse manager, who I had only met briefly and who was not directly involved in requesting or planning the programs. She asked me to round up the nurses, whom I’d never met, in an environment completely new and foreign to me. I looked for and found some nurses, let them know the program was available to attend at this moment. A few nurses did partake over the 2 weeks. Getting them there each session repeated the same pattern.
My initial environmental field assessment declared this a barren landscape with no signs of life. Adding nutrients to the soil would take years. Why try to resurrect the dead when, after all, there must be plenty of fields at the Medical Center that have healthy living seeds? This assessment, which was based on frustration, needed a more reflective appraisal. Irene Dowd describes a state of “lucid neutrality” as one way tap into the underlying patterns.
In order to sensitively receive that [underlying] communication, I need to keep myself in a state of lucid “neutrality”: mechanically balanced, emotionally calm, mentally open and without any urgency to succeed. Otherwise, my own internal activities function as a kind of “white noise” that interferes with my ability to perceive the person I am touching. While maintaining a state of lucid neutrality, it is possible to feel contrast and variations in such features as form, temperature, texture, density, viscosity, rhythms, and rate of motion (1995, p. 78).
I took a deeper look, quieting my own inner chatter to feel the energy of this field.
It was dry, in fact arid. Is this the desert? What do the seeds look like? Parched, the soil was hard and cracked. This was not a desert landscape; that would have its own grace and beauty. This environment was desiccating from too much wind and sun. Water was scarce. If my programs were water, they were like a torrential rain, adding no value to a land so encrusted that it either runs off or indiscriminately washes away anything tender struggling to survive. What would harmonize the elements here and in myself, knowing that the critical care unit was as much its own field as a mirror to an aspect of my own inner landscape?
I looked at my own inner arid garden and found that it wanted a warm gentle summer rain. I could give that to myself. What about this unit? Droplets, at first, might make them aware of a thirst not previously noticed. Then in their own way, they might come to request or provide a water source for themselves.
Peri-Operative Nursing Departments
The peri-operative area has been preparing the soil for a healing and caring peri-operative experience for some time. They keep preparing the soil, but not buying the plants. Last fall and early winter, I worked with a small team there and we created a four part educational program for the nursing staff. These programs were completely voluntary and well attended. Focus on presencing, centering, and grounding was primary as were Rogerian theory and concepts. Holistic nursing modalities were taught as theory informed practice.
The time in-between each session was time for the nurses to practice the new modalities? I dropped by from time to time to answer questions, mentor and model the practices.
I observed that my limited presence to support these new initiatives, was like planting a new garden and not providing enough sun, rain or human contact (weeding, staking and pruning). Bugs, the normal pests that pressure a plant to either fight back or be engulfed, infiltrated it.
Upon reflection, I see that I was not tending my own garden. I was not doing my own work to grow well, strong and vibrant. My own fire (sun) was burning, but as a low ember. Without tending, of course, a fire will burn out. I slowly and gently began fanning the small flame and now there is renewed energy and a new program. While a garden needs support, it is the nature of the seed to seek a way to express itself, and be able to live out its growth cycle and bear fruit. This has been occurring in recent months (a year after I initially wrote this paper).
Work with the Attendings
My work with the surgeons has been an internal exploration that I had not foreseen, delving into my own manifestations of pattern with “authority figures,” “the patriarchal medical system,” and “insecurities of my own expression of power”.
I went to speak with a physician about the pre-surgical patient education program. I described the program and he remarked, “Oh, that California stuff.” I replied (smiling), “It has come East.” He made another flippant remark about the “new ageness” of the program. I responded by focusing on the practical nature of the techniques offered the patient. I felt a shift in his pattern manifestation, our fields vibrating on a closer frequency. He then asked, “Were other physicians using this program?” “Yes” I replied. He responded, “Because you know some of us doctors are cavemen.” I took this manifestation of pattern as a generous exposure of his deeper order. I said playfully, “ Well come out, come out of the cave where there is sunshine!” He replied, “Oh no, I like the cave, it is dark and cozy and I can invite women there.” And he looked over his shoulder to the three male residents and fellows behind him. I leaned forward, and gave him a cheeky grin, enunciating each word carefully in a whisper that was loud enough for the men to hear, “Women like sunshine!” The residents smiled, he asked for the program brochures, and I asked for his card.
Reflecting on our mutual process, I wondered what brought him closer to a unified field and what shifted us further apart? It seemed to be cavemen energy, slow moving earth energy. Solid, was it also laden with fear of change? Would this be more mud rather than dry earth energy? He responded to the practical aspect of the program. He was oriented to facts, earth again. What sent him back into the cave, was it my fire and air (wind)? A bright sun on a clear day, and strong wind might dry up the mud too quickly for his comfort level. After all, if you are to step out of a cave after years of darkness, you might need shades to protect you from the glare of the sun.
In looking into the mirror, in this mutual process, I asked myself is there a part of me that is afraid of being in the cave? I typically love the solitude the cave can give me, the quiet and rest from the responsibilities of the world, a place of renewal. My fear of the cave is that I can get stuck in there. It becomes less of a place of renewal and more of a place to hide. Sometimes it takes my big sun energy, to get me back out into the world and so without conscious awareness, this is the energy I assumed the physician needed.
“Remember not even the greatest teacher can speed up the process of change or do it for you. But it is your sustained concentration on your own balance of energy usage, visible and invisible, that will move you to achievement of your full movement potential. There is no “right image” or "right posture” or even “right movement.” There is only a way of functioning that is both unifying and expansive for you in this moment. Furthermore, this way of functioning will change continuously throughout life” (Dowd, 1995, p12).
Reflections
As I walk around my path, winding my way around my own inner garden, I notice I have some well-tended areas, and yet there is great beauty in the raggedness of the areas not tended; the ones that were left to find their way without guidance and support.
Unitary Transformative Nursing has become a sacred art, informed by theory, science, and clinical experience. As a sacred art it is a reflective practice, one in which I look into the mirrors in the environmental field to learn about my own field patterning. It is not always smooth, easy, but as the Science of Unitary Human Beings informs my practice, I can trust that each turn of the spiral is part of increasingly complex unfolding and enfolding manifestation of my evolutionary patterning.
Summary
For those who are considering developing an integrative care program, it is both patience and passion that will serve its growth. The passion sustains us as we offer new concepts and ways of being. Patience provides wisdom in our sense of timing. Offering a paradigm shift with gentleness, compassion and without a specific outcome in mind, pan-dimensional possibilities emerge.
References:
Barrett, EA. (1997). Power as knowing participation in change, theoretical, practice, methodological, issues, insights and ideas (31-46). In Patterns of Rogerian Knowing. Madrid, M (ed.). New York: National League of Nursing.
Bolen, J. (1979). The Tao of Psychology. New York: Harper Collins.
Dowd, I. (1995). Taking Root to Fly. New York: Irene Dowd Pub.
Kabir. (1997). The Book of Kabir. Translated by Robert Blye. Boston: Beacon Press.
Munhall, P. (1993). ‘Unknowing: Toward another pattern of knowing. Nursing Outlook 41(3): 125-8.
Newman, M. (1994). Health as Expanding Consciousness. New York: National League of Nursing.
Rogers, M. (1994). The Science of Unitary Human Beings: Current perspectives. Nursing Science Quarterly 7(8), 33-35.
Rogers, M. (1992). Nursing science and the space age. Nursing Science Quarterly 5(1), 27-34.
Trevino, H. (1999). The Tao of Healing. Novato, CA: New World Library.
Whyte, D. (1998). The House of Belonging. Langley, Washington: Mary Rivers Press.
Permission to reprint provided by the Society of Rogerian Scholars.
Source: Levin, J. (2006). Unitary Transformational Nursing.Visions:The Journal of Rogerian Nursing Science, 14(1), page numbers