3.1 Rogerian Cosmology
Rogers’ classic 1970 text, The Introduction to the Theoretical Basis of Nursing, begins with a series of cosmological questions: “How did the universe begin? Or did it have a beginning? Are its dimensions finite or infinite? Whence came this planet we call home? In what hidden past did life emerge? From what shrouded long ago did the family of man arise to portend a future that would one day reach beyond the stars?”(p. 3). Butcher (2006) points out Rogers must have clearly understood that ultimately her theoretical system or any other “does not develop out of a vacuum” (Rogers, 1970, p. 4) but rather is embedded in a larger understanding of the nature of the universe. Rogers understood that our choice of cosmology not only determines our image of ourselves, but also the nature of nursing. In other words, nursing mirrors the fundamental characteristics of the universe, or at least how we choose to understand the universe.
All conceptual systems and their corresponding research and practice methodologies are derived from or lead to a cosmology. Barrow (1987) explained that cosmology is the science of the universe, its size, age, shape, wrinkles, origin, and contents. Over time, cosmology has been transported from the realm of metaphysics into the human domain of physics, where speculation is not unbridled, and where ideas must confront observations. Today, cosmology is viewed as more of a branch of science, rather than as a branch of metaphysics. What is significant is that recent advances in the fields of astronomy and quantum cosmology provide support to Rogers’ postulates of energy fields, openness, pandimensionality, and her principles of helicy, resonancy, and integrality. M-theory, formerly known as super string theory, postulates that all subatomic particles are different modes of vibration of tiny one-dimensional strings of energy that require 10 dimensions of space. Quantum cosmology also postulates the possibility of multiple or parallel universes, infinite number of histories, infinite inflationary expansion, nonlocality, entanglement, uncertainty, and spacetime warps (Greene, 2004).
Rogers, in creating the Science of Unitary Human Beings, set forth a new cosmology for nursing that is a synthesis and re-synthesis of a wide range of theories derived from contemporary science, philosophy, and art. In essence, Rogers drew on: a) Einstein’s ideas about relativity and the unity of spacetime as a foundation for her postulate of pandimensionality; b) Heinsenberg’s principle of uncertainty to describe a universe of unpredictable nature of change; c) von Bertalanffy’s General Systems Theory to describe a negentropic universe of open systems which evolve toward increasing innovation, creativity, and diversity; d) quantum theory to postulate energy fields as the fundamental unit of the living and non-living; e) cybernetics and system theory to support the notion of a universe characterized by integral irreducible wholes that are more and different than the sum of parts; and f) a wide range of sciences to support notions of evolutionary unity, patterning, and rhythmicity. For example, Rogers attributed her unique synthesis to many sources including Nightingale, Teilhard de Chardin, Heisenberg, Alfred North Whitehead, Darwin, Toulmin, Bertrand Russell, Frankl, Polanyi, deBroglie, Whyte, and Popper to name just a few.
The synthesis of these ideas leads to a Rogerian cosmology that views the universe and human beings as integral, irreducible pandimensional energy fields identified by pattern, evolving rhythmically and unpredictably toward infinite diversity and innovativeness. The essence of the Rogerian cosmology is the fundamental unity of the universe. “A whole cannot be understood when it is reduced to its particulars . . . The unitary nature of environment is equally irreducible (Rogers, 1992, p. 29). Thus, the universe and all that exists are understood as an irreducible and indivisible energy field, different and more than the sum of parts. Rogers maintained that an individual’s boundaries are imaginary and that the human field is infinite, integral, and co-extensive with the universe. The universe is postulated to be pandimensional, meaning the universe is a union of all dimensions and is an infinite domain beyond special or temporal attributes. A universe characterized by pandimensionality provides an understanding of nonlocality, acausality, unpredictability, infinite realities and dimensions, and paranormal phenomenon (Butcher, 1998b). Philosophies emerge within cosmologies. Furthermore, the manner in which one interprets a particular cosmology filters down to the level of practice/research or action (see Figure 3-1).
Figure 3-1. Updated/Modified from Butcher (2006). Originally adapted from Phillips (1997)
3.2 Rogerian Philosophy
Philosophy typically includes metaphysics (ontology), epistemology, aesthetics, and ethics. Butcher (2006) explained that Rogers’ cosmology provides a “canvas for drawing a philosophy of Rogerian nursing science.” (p. ). Much has been written about the relationships between ontology, epistemology, and methodology (Guba, 1990; Morgan, 1983; Parse, 2001). Explicating the ontological, epistemological, aesthetic, and ethical tenets not only provides a deeper understanding of Rogers’ conceptual system but serves as a guide for the development of approaches to Rogerian practice and scientific inquiry.
3.2.1 Unitary Ontology
Ontology is the branch of philosophy that deals with the nature of reality and “being” or existence in the broadest sense. Ontology focuses on questions concerning being/becoming, actuality/potentiality, real/apparent, change, time, essence, and existence/nonexistence (Angeles, 1981). The Rogers’ ontology is drawn from the definitions and philosophical implications of her postulates for energy fields, pattern, openness, and pandimensionality, and the principles of integrality, resonancy, and helicy. Those wanting to learn more about Rogers’ ontology need to study her original works (Rogers, 1970; 1988; 1992). In addition, an in-depth analysis of Rogers’ ontology may be found in the works by Butcher (1994), Carboni (1995a), as well as Sarter’s (1988) seminal philosophical inquiry. Since both cosmology and ontology are aspects of metaphysics, there is some overlap between Rogers’ cosmology and ontology. According to Butcher (2006), the key ontological tenets emerging from Rogers’ definitions of the postulates and principles maybe summarized as follows:
- Human beings and their environment (universe) are irreducible energy fields characterized by pattern.
- Energy fields are dynamic, in constant motion, continuously open, and have no boundaries.
- Human and environmental energy fields are inseparable and engaged in continuous mutual process.
- Appearances are patterns that emerge rhythmically, acausally, and unpredictably from the human/environmental energy field mutual process.
- Human beings and their environment are pandimensional, meaning reality is nonlinear, nontemporal, and nonspatial and connotes the relative nature of spacetime, the presence of infinite realities, and nonlinear change.
- Change is always continuous, unpredictable, creative, and evolves toward increasing innovativeness and diversity.
- Human beings and the universe are continuous, engaged in a mutual process of unfolding potentials.
3.2.2 Participatory Epistemology
Epistemology is the study of the origins, presuppositions, nature, and extent of knowledge (Angeles, 1981). Within the Science of Unitary Human Beings, pattern is knowledge; and the origins, presuppositions, nature, and extent of pattern provide clues to Rogers’ epistemology. Butcher (1994) completed an analysis of Rogers’ conceptual system to arrive at the following epistemological tenets:
- Apprehension of manifestations of patterning emerging from the human/environmental energy field mutual process is the source of information and knowledge.
- Pattern is apprehended in the form of experiences, perceptions, and expressions.
- Pattern is irreducible to parts and is unique to each human and environmental field.
- Pattern emerges from the human/environmental mutual field process with “kaleidoscopic uncertainty” (Rogers, 1970, p. 91). Thus, pattern is dynamic, rhythmical, continuously changing, nonlinear, and therefore, unpredictable.
- Multiple modes of awareness including intuition, mystical experience, tacit knowing, and other emergent and extraordinary pandimensional ways of knowing including telepathy, clairvoyance, and remote viewing, are additional ways to grasp knowledge that extend beyond the five senses.
Awareness, apprehension, and interpretation of pattern are, then, the sources of Rogerian knowing. Pattern must be interpreted and understood within a unitary context. Because of the integral nature of human and environmental energy field patterning, the source of knowledge (known) and the apprehender of knowledge (knower) are inseparable. The inseparability of knower and known suggests a participatory epistemology, whereby human beings co-participate in the creation of pattern.
A key to the Rogerian epistemology is that pattern has unitary meaning only when it is interpreted within a unitary context. Interpreting pattern information within a unitary perspective means: a) understanding all data and information is unitary or irreducible, therefore, is a manifestation of the whole, and not particularistic; b) pattern is understood as pandimensional, meaning pattern information arises in a relative present where the past and the future are experienced all-at-once; c) pattern information does not exist separately from other pattern information; d) since human and environmental fields are integral, inseparable, and engaged in continuous mutual process, all pattern information is simultaneously a reflection of both the human and environmental fields; and e) while there are universal themes or similarities of pattern characteristics among individuals, pattern information is specific and unique to the individual (Cowling, 1990).
The basis for a Participatory Universe: Matter is both a wave and a particle. What it is depends how you chose to observe it.
3.2.3 Unitary Aesthetics
Aesthetics is concerned with the art of nursing. Rogers’ addressed the art of nursing in stating “the art in nursing is the imaginative and creative use of knowledge” (Rogers, 1988, p. 100) for the purpose of human service. Thus, she linked knowledge to art. The art of nursing becomes an expression of knowing in practice. Other than the works of Butcher (1998, 2006), little else has been written about Rogerian aesthetics.
Aesthetics is the branch of philosophy that focuses on the nature and expression of beauty (American Heritage Dictionary, 2000). Within Rogers’ Science of Unitary Human Beings, value judgments, such as what is beauty, are deferred. Rogers (1980) repeatedly emphasized “values are continuously changing” (p. 336). Rather, Rogers would more likely have agreed with Margaret Wolfe Hungerford’s (1878) famous quote that beauty resides in the eye of the beholder and ear of the listener. However, just as beauty is found in nature and in science, there is an inherent beauty in the Science of Unitary Human Beings. The major ingredients of aesthetics that inform Rogerian-praxis may be found in Rogers’ use of artistic and musical metaphors and in Cowling’s (1993, 1997) explication of the unitary appreciative practice method. Within Rogerian-praxis, aesthetics is the appreciation of kaleidoscopic and symphonic manifestations pattern emerging from the human-environmental energy field mutual process.
Rogers frequently relied on aesthetic metaphors to describe the nature of field patterning. Butcher (1994) originally identified kaleidoscope and symphony as epistemological metaphors embedded in Rogers’ writings. Each metaphor describes the nature of pattern. However, the kaleidoscope and symphony metaphors convey a particular sense of beauty and therefore, may be viewed descriptors of unitary aesthetics. Rogers consistently used a number of aesthetic musical metaphors to describe the nature of pattern. She used the kaleidoscope metaphor in such phrases as: “organization of the living system is maintained amidst kaleidoscopic alterations in patterning” (p. 62) and “pattern evolves with kaleidoscopic uncertainty” (p. 91). Rogers’ kaleidoscopic nature of pattern signifies the dynamic, rhythmical, continuously changing, unpredictable, flowing motion of pattern. In a kaleidoscope, “unitary transformation” occurs when “endless patterns are produced by moving a few fragments of colored paper in front of a prism or mirror” (Peat, 1991, p. 126). Continuous changing and unpredictable patterns of color and light are brought about by the unique relationships among the bits of colored paper or glass and reflecting surfaces. In practice, appreciating the kaleidoscopic beauty of pattern means embracing, participating knowingly, and flowing with the dynamic, unpredictable, sometimes dissonant, sometimes turbulent, sometimes harmonious, and always continuous nature of change.
These metaphors also provide insight into the artistry of Rogerian science and practice. For example, Rogers (1970) described life’s complexity as “a haunting melody” (p. 41) and the life process of human beings as “a symphony of rhythmical vibrations oscillating at various frequencies” (p. 101). Manifestations of pattern are “symphonic expressions of unity” (p. 93), and the “rhythms of life are inextricably woven into the rhythms of the universe” (p. 100). Furthermore, Rogers viewed the purpose of nursing practice as the “promotion of symphonic interaction” and as one of the ways for the “realization of maximum health potential” (Rogers, 1970, p. 122). Rogers’ description of the life process as a symphony is much like Peat’s (1991) description of the universe as a “work of art, a painting, a symphony, or a cosmic dance” (p. 141). Peat (1991) explained:
“Listen to a symphony, and you enter a world that unfolds before you: It grows and develops . . . The symphony is an interplay of themes, emotions, sensations, and logical structures . . . Themes and rhythms interplay within each movement, and the movements themselves resonate and reflect each other. A symphony is both richly structured and ever fresh . . . and as with all great works of art, it has the effect on the listener of binding sensation, intellect, emotion, and perception together and making them whole . . . Now imagine a symphony without end, a symphony of the universe, one that is ever fresh and whose unifying forms and structures are never absolute.” (p. 141-142)
Rogerian-aesthetics involves recognizing the quality of, being sensitive to, and being fully aware of the experiences, perceptions, expressions, themes, emotions, and sensations that are the symphony of human/environmental life process. Cowling’s (1990) notion of pattern appreciation further illuminates the Rogerian-aesthetics. Pattern appreciation reflects Rogers’ original notion that the art of nursing is the creative use of knowledge in practice. According to Cowling (1990) pattern appreciation is ontologically and epistemologically grounded in the Science of Unitary Human Beings and is an approach to pattern-based practice involving uncovering wholeness, uniqueness, and reaching for the essence of pattern. Cowling explained that pattern appreciation is a way of approaching and deepening one’s understanding of another and includes being aware of, sensitive to, and grateful for the uniqueness of another’s pattern. Aesthetics is ordinarily associated with art. Creating art involves skill, raw materials, imagination, and the ability to bring these together as an integral whole. Pattern appreciation as a practice modality is an art form; all art has a special beauty. Imagining the whole before it becomes an expression and intuitively bringing elements into an integrated whole is the essence of unitary appreciation (Cowling, 2001). Pattern appreciation uses a process of synopsis, which is a process of deliberately viewing together aspects of the human experience which, for one reason or another, are often viewed as separate. Cowling explained that the purpose of synopsis in unitary pattern appreciation is on sensing an emerging pattern that reflects one’s wholeness, uniqueness, and essence. Synopsis essentially is an aesthetic process that allows for apprehension of the whole. Thus, unitary-aesthetics involves pattern appreciation as a way of apprehending the unitary nature of pattern and then creatively using synopsis to integrate kaleidoscopic and symphonic manifestations of patterning into a unified and meaningful whole.
Butcher (1998) identified 5 process in the art of Rogerian nursing practice. Beauty emerges in the art of unitary pattern-based practice through the grasping of meaning, making meaningful connections, participating knowingly, artfully engaging in nursing activities, and mobilizing ideals of Rogerian-ethics in practice. However, illuminating the artistry in unitary pattern-based practice is only one means of revealing the art of Rogerian Science.
3.2.4 Rogerian Ethics
Reed (1989) rightly describes nurse theorizing as an ethical endeavor because theorizing is inescapably linked to the theorist’s value choices about persons, environment, and health. Similarly, Milton (1999) states, “Embedded in nursing theory are ethical values, principles, and beliefs that coconstitute what it means to be ethical in the human-universe-health process” (p. 20). In addition, the beliefs and values on which a theory is based provide further guidance in using the nursing theory in practice, research, and education. However, it is essential to note that Rogers is careful in distinguishing the Science of Unitary Human Beings from the intrusion and distortion of value systems.
Rogerian knowing encompasses ethical knowing. Rogers (1992) stated that “seeing the world from this viewpoint requires a new synthesis, a creative leap, and the inoculation of new attitudes and values [italics added)” (p. 33). Rogerian ethics are a system of qualities that characterize the mutual enhancement of the integrity of human-environmental fields. Values are expressions or pattern manifestations of the human-environmental mutual field process. Ethics emerge from values. Rogerian ethics are pattern manifestations emerging from the human-environmental field mutual process reflecting those ideals concordant with Rogers’s most cherished values and are indicators of the quality of knowing participation in change.
From a Rogerian perspective, ethics are not normative; therefore, any system of values and ethics derived from the Science of Unitary Human Beings would not focus on what is “good” or “bad,” “right” or “wrong.” Labeling of pattern manifestations is clearly not consistent with Rogerian science because Rogers (1980) repeatedly emphasizes that “values are continuously changing” (p. 336). Rogerian ethics also are not duty-bound or prescriptive. Rather, the focus in studying Rogerian ethics is on understanding the deeper nature of intrinsic values that serve as a foundation for the Science of Unitary Human Beings. Non-normative descriptive ethical inquiry is not prescriptive (Fowler & Fry, 1988) and, therefore, is a more appropriate method for identifying what values are inherent in the Science of Unitary Human Beings.
Rogers (1992) stated that “seeing the world from this viewpoint requires a new synthesis, a creative leap, and the inoculation of new attitudes and values” (p. 33). Rogerian ethics are a system of qualities that characterize the mutual enhancement of the integrity of human-environmental fields. Values are expressions or pattern manifestations of the human-environmental mutual field process. Ethics emerge from values. Rogerian ethics are pattern manifestations emerging from the human-environmental field mutual process reflecting those ideals concordant with Rogers’s most cherished values and are indicators of the quality of knowing participation in change.
Butcher (1999) conducted an ethical analysis of Rogers’ life and her works using Reed’s (1989) process of ethical inquiry into a theorist’s “conceptual frame.” Reed’s process of ethical inquiry into a theorist’s body of work, a non-normative descriptive method of ethical inquiry into a nursing theory, included the following steps:
- examination of intrapersonal factors (worldview, personal, and professional experiences);
- examination of extrapersonal factors (historical context, influential other) as they influence the motives and purposes underlying the conceptual frame;
- assessment of the moral ideals underlying the concepts of human being, environment, health, and nursing practice;
- creative imagining of the consequences of one’s framework;
- depth of personal knowledge;
- moral vision, which is defined as an awareness of the deepest beliefs about such things as the value of life and death, the nature and worth of environment; and
- an openness to undergo a transformation of values when it is determined that the concepts need redefining or theories need reformulating.
A number of sources served as the basis of Butcher’s (1999) ethical inquiry including Malinski and Barrett’s (1994) Martha E. Rogers: Her Life and Her Work. It includes reprints of much of Rogers’s original work, including her frequent editorials, and key chapters of analysis of Rogers’s contributions by Barrett (1994), Barrett and Malinski (1994b), Malinski (1994), Pepper (1994), Phillips (1994), and Reeder (1994). In addition, primary works by Rogers such as Educational Revolution in Nursing (Rogers, 1961), Reveille in Nursing (Rogers, 1964), An Introduction to the Theoretical Basis of Nursing (Rogers, 1970), and Rogers’s (1980, 1986, 1987, 1988, 1990a, 1990b, 1992, 1994a, 1994b) frequent revisions of the Science of Unitary Human Beings were examined for the analysis. Numerous published personal accounts on Rogers by Anonymous (1994), Barrett and Malinski (1994a), Gueldner (1994a, 1994b), Hektor (1989), Malinski (1994), McGuire (1994), Phillips (1997b), and Parse (I997) as well as secondary sources consisting of descriptions and critiques published in popular major nursing theory texts by Fawcett (1995), Fitzpatrick and Whall (1996), Marriner-Tomey and Alligood (1998), Meleis (1997), Parse (1987), and Barnum (1998) were also included. Each work was carefully reviewed by examining the text for implicit and explicit values embedded in Rogers’ writings. Secondary sources were also carefully examined for values attributed to her. Key phrases and statements reflecting values were extracted, coded, and categorized into identifying major values and virtues.The constellation (see Figure 3-2) of values provides a link between ethics and action. Thus, any unitary pattern-based practice in both patient care and research contexts needs to incorporate the values intrinsic to Rogers’ life and work.
Figure 3-2 Rogerian Ethics From: Butcher, H. K. (1999). Rogerian-ethics: An ethical inquiry into Rogers’ life and science. Nursing Science Quarterly, 12,111-117.
Nursing exists to serve people and make a significant contribution toward the betterment of the lives of all. The worth of the environment is no less than the value of human beings.
Butcher (1999) compared Henryk Skolimowski’s, (creator of Eco-philosophy and director of the Eco-Philosophy Center), ideas about a new ontology, epistemology, and system of values based on a participatory view of the universe. Skolimowski (1994) asserts that a deep awareness of integrality and participation entails a deep appreciation of empathy, interconnectedness, reverence, and responsibility. Likewise, Rogers’s participatory epistemology implies reverence for human beings and responsibility for the wellbeing of other human beings (Butcher, 1999). To participate with another with reverence is to take responsibility for the whole context in which the well-being of another resides. Participating with reverence is to embrace love as the essential indispensable modality of human existence, to recognize creativity as integral to human nature, to celebrate joy as central to the life process, and to live in humanhood with all (Skolimowski, 1994). Participating with reverence is to experience our evolving unity, compassionately embracing and dwelling with one another while creating a field of healing energy and infusing the universe with love. The principle of integrality also views human fields as a web intrinsically woven with nature. Ecological principles based on a reverence for nature are relevant to Rogerian science. Rogerian ethics as ecological ethics are evolution-centric rather than ego-centric. To participate in the life process with an ethic of evolution-centricity is to act in ways that enhance the dynamic complexity of life unfolding. Human well-being is integral to the well-being of the earth and universe. Reverence stemming from the idea of integrality becomes a pattern of grace, protection, preservation, care, and love (Skolimowski, 1994). Participating with reverence is not luxury; rather, it means taking responsibility for intentionally infusing the universe with love and compassion.
Butcher explained that Rogers’ worldview entails a recognition that there is a deep interconnectedness and oneness of everything, the living and nonliving. Humans are coextensive with the universe and are coparticipating in its continuous creative evolution. Integrality suggests a deep interconnectedness and mutual process of the nurse and client. Nurse and client co-evolve and pattern one another in mutual simultaneous process. This implies a need for deep understanding of the other and oneself.
Rogers (1987, 1990a, 1992) continually asserted that science is open-ended, whereby science undergoes continuous alteration and revision through the testing of theories by scholarly research. New knowledge brings new insights and “the development of the Science of Unitary Human Beings is a never-ending process” (Rogers, 1992, p. 28). One needs only to look toward Rogers’s own revisions, modifications, and clarifications for evidence of her openness for continuous transformation. The notion of continuous change is at the very heart of Rogerian science’s ontology. As new realities emerge, so do new values. Emergence, creativity, and fulfillment of infinite potentials are values inherent to a science that extols continuous change and transformation.
She always referred to the Science of Unitary Human Beings as an optimistic science, not a utopian one (Rogers, 1986, 1987, 1988, 1992). Within Rogers’s optimistic evolutionary view of negentropic unfolding, aging is a process of increasing diversity, creativity, and complexity. Chronological age becomes irrelevant in a nonlinear, pandimensional universe, A greater appreciation of later life emerges. A Rogerian concept of aging means that there is unlimited potential for growth. Later life has just as much value as any other time in the life process. Rogers even imagined the emergence of Homo spatialis, a new species that would transcend Homo sapiens in space environments.
Rogers was influenced by Polanyi’s (1958) writing on “personal knowledge” and placed great emphasis on understanding human experiences, feelings, and thoughts as pattern manifestations and expressions of wholeness. She also placed emphasis on the need to find personal meaning as an expression of one’s humanness. Language, emotion, sensations, imagery, and thoughts not only identify one’s humanness but also one’s uniqueness. Nursing care is viewed as personalized, individualized, and flexible to allow for the uniqueness of each human-environmental field. Critical paths, standardized care plans, product lines, and generalizable diagnostic labels and corresponding treatment plans are not compatible with Rogers’s emphasis on the uniqueness of the human field.
Rogers was a powerful social activist. She cried out against social inequities, inadequate housing, racial discrimination, and poor healthcare in underserved areas and populations (Rogers, 1970). Her humanism and strong sense of egalitarianism meant that she valued justice-creating for the purpose of human betterment.
According to Rogers, compassion and love are values that capture the art of nursing and may be viewed as aspects of the art of nursing. In her later writing, she explicitly made reference to unconditional love (Rogers, 1992) and compassion (Rogers, 1988) as a core Rogerian virtue.
Rogers (1980, 1992) frequently linked the Science of Unitary Human Beings to the fulfillment of nursing’s social responsibility in human service.
Most of all, Rogers often used humor and spoke frequently about the health potential of humor. Humor is an expression based in celebration of humanity.