Abstract
The purpose of this study was to uncover the nature, experiences, and meaning of personal healing for holistic nurses through their narrative accounts. The study employed a qualitative descriptive design with methods of narrative and story inquiry. Participants were nurse attendees at an American Holistic Nurses’ Association conference who volunteered for the study. They were invited to share a story about healing self or another. Twenty-five stories were collected; seven were about personal healing, and these are the focus of this analysis. Data were analyzed using a hybrid approach from narrative and story inquiry methods. Eleven themes were clustered under three story segments. The themes within the Call to the Healing Encounter are the following: recognition of the need to resolve a personal or health crisis, knowledge of or engagement in self-care practices, and reliance on intuitive knowing. Themes under the Experience of Healing are the following: connections; profound sensations, perceptions, and events; awareness of the reciprocal nature of healing; inner resolution: forgiveness, awakening, and acceptance; use of multiple holistic approaches; and witnessing manifestations of healing. The themes for Insights are the following: gratitude and appreciation and ongoing journey. A metastory synthesizing the themes is presented, and findings are related to existing literature on healing.
The nature, processes, and outcomes of healing are significant areas for scientific inquiry in nursing and other health-related disciplines. Healing is different from curing and has been described in the literature of various disciplines, including nursing, as an integrative process involving the whole person. Although there is a growing body of conceptual and theoretical descriptions of and explanations about healing, there has not been sufficient exploration into the nature, experiences, and meaning of healing from the perspectives of those involved in the process. This study was planned to address this gap. Accessing stories about healing can facilitate an appreciation of the depth and diversity of these experiences. The purpose of this study was to uncover the nature, experiences, and meaning of personal healing for holistic nurses through their narrative accounts.
Background and Significance
Most of the literature describing whole person healing has been conceptual and philosophical rather than research based. Healing comes from the etymological root, haele or haelen, the Anglo-Saxon word meaning whole or having integrity. Quinn (1989) coined the term haelen effect to capture her conceptualization of healing as “the emergence of right relationship at one or more levels of the body mind spirit system” (Quinn, 2013, p. 107). Other definitions of healing include the following: “realization, knowledge and appreciation of the inherent wholeness in life” (Cowling, 2002, p. 23), “an awakening to the wholeness and connectedness that exists” (M. C. Smith, 2002, p. 7), or an “emergent process of the whole system” related to “repair, recovery, renewal, and transformation that increases wholeness and often (though not invariably), order and coherence” (Dossey & Keegan, 2013, p. 60). Dossey and Keegan (2013) describe healing as “a lifelong journey into understanding the wholeness of human existence. . . . It is accessing what we have forgotten about connections, unity and interdependence” (p. xxvii). From a unitary perspective, human beings and their environment are integral; therefore, healing is not seeking or becoming whole “but rather is realizing, knowing and appreciating an inherent wholeness that illuminates potentials of understanding and possibilities of action” (Cowling, 2002, p. 23). In elaborating her perspective on healing, Perkins (2003) asserts that each person has the capacity to experience the source of all creation and to release dis-ease patterns. She describes illness as a wake-up call, and healing as a re-membering of Self, as one becomes conscious of the divine within.
Geffen (2004) conceptualized healing as a process with seven levels occurring in the face of any illness or crisis: (a) seeking education and information; (b) connecting with others; (c) treating the body as garden, referring to seeking and addressing the “roots” of any dis-ease through natural approaches; (d) emotional healing, turning inward to experience the vicissitudes of feelings that accompany any illness or crisis; (e) the nature of mind, addressing the thoughts and beliefs about the illness or crisis; (f) life assessment, developing meaningful goals; and (g) the nature of spirit, or finding one’s essential nature through a process of self-discovery.
A review of the research literature on healing included thousands of references to physical healing, predominantly wound healing. There were fewer studies related to the central phenomenon of this study, whole person healing. Fleury, Sedikides, and Lunsford (2001) examined self-healing through a naturalistic study with 13 women who had experienced an acute cardiac event. Three categories emerged from their data: seeking meaning, creating mastery, and accepting the self. They identified the overarching theme of self-healing as connectedness with others.
In another study (Scott et al., 2008), researchers examined the nature of a healing relationship in primary care and identified three key processes that fostered this relationship: creating a nonjudgmental bond, appreciating and managing clinician power, and a commitment to caring for patients over time. The outcomes of these processes were trust, hope, and a sense of being known, all ingredients of caring identified by Mayeroff (1971).
Cooperstein (1992) explored the psychological experiences of transpersonal healers. These healers told researchers about subtle states of altered consciousness in which consciously directed thoughts became less rational, and subconscious processes yielded sudden intuitions that seemed to come from some place other than the self. Healers experienced a sense of transcendence from a body-bound self to one of expansion and enhanced empathy.
In another study of the experience of healing, Verhoef and Mulkins (2012) interviewed 35 persons who reported that they had recovered from a chronic illness, infectious diseases, or mental healing issue. The researchers’ content analysis yielded four themes that provide some insight into the multifaceted process of healing: healing is a personal and subjective experience, healing involves moving toward a sense of wholeness, healing is self-directed requiring positive intention, and healing is experienced in varying degrees and levels within each person. These researchers identified levels of physical healing, mental healing, social healing, and transformative healing. The healing outcomes identified by participants varied and included relief from symptoms, achieving goals, changes in social support and mental outlook, and subtle but significant life changes.
Zahourek (2012) completed a secondary analysis of data gathered in a previous study on intentionality that focused on how participants described healing. The six nurse healers in her study were motivated by an “inborn” need to help another, a “call,” and an ability to fulfill their need to care in the manner they felt was most therapeutic. This often meant taking risks or making significant changes in their lives. The four specific themes included dealing with one’s past and learning to live fully, letting go and detaching from old issues to promote their own self-care, becoming aware of and appreciating a shift as essential for healing, and realizing that healing is dynamic, unpredictable, and reciprocal.
Method
Design
This study employed a qualitative descriptive design that incorporated methods of narrative and story inquiry. Narrative inquiry is an approach to studying how people structure meaning in their lives through remembering and recounting stories. Clandinin and Connelly (2000) define narrative inquiry as a method that uses a variety of data sources such as autobiographies, conversations, journals, and letters. Stories are one source of data for narrative inquiry. “A narrative method accepts that idea that knowledge can be held in stories that can be relayed, stored and retrieved” (Fry, 2002, p. 166). People by their nature live storied lives, and narrative researchers capture and re-present the structure of these experiences (Connelly & Clandinin, 2002). In this research, participants were asked to share accounts of personal healing and to reveal the meaning behind these accounts through relating a story (Lyons & Kubler, 2002).
In this study, the researchers created a hybrid methodology through synthesizing aspects of narrative inquiry (Clandinin & Connelly, 2000) and story inquiry (Liehr & Smith, 2007, 2011). A compelling reason for this design is that it offers the ability to re-present the depth, diversity, and uniqueness of individual stories, while at the same time allowing analysis and interpretation across stories. Narrative inquiry requires a caring relationship between the researchers and participants (Connelly & Clandinin, 2002). The participants become teachers, in that they witness themselves sharing lessons through their narrations and learning lessons as they do so (Coles, 1989). The researcher listens to the story and re-stories it, becoming part of the process of knowledge construction. In narrative inquiry, there is an attempt to preserve the whole while sharing particulars, because it is through these particulars that readers connect emotionally with the story. Narrative truth is judged by criteria such as adequacy, plausibility, apparency, verisimilitude (authenticity) and transferability, continuity, closure, aesthetic finality, and a sense of conviction (Connelly & Clandinin, 2000).
Five investigators in four different regions of the country and three different time zones were coinvestigators in this study. These investigators were members of the American Holistic Nurses’ Association (AHNA) Research Committee, and the study grew out of the Committee’s interest in promoting inquiry into the phenomenon of healing. Meetings for study planning and analysis were conducted primarily through conference calls with one face-to-face meeting.
Participants
Participants were nurse attendees at the AHNA 2009 Conference. Holistic nurses were a logical population because of their familiarity with the concept of whole person healing and because of their experience with using a variety of modalities for their own self-care and in their nursing practice with others. Also, holistic nurses have a professional interest in the study of healing, and many are committed to advancing knowledge of the phenomenon. AHNA gave permission to recruit participants at their conference.
A volunteer sample was used for this study. Participants were recruited through a flyer and announcements at the conference. The study was described at the opening session, and attendees received information about it with their conference materials. Those who wanted to participate were directed to a consent form that included detailed information about the study procedures, investigators, risks, benefits, and contact information. They were informed that their decision to provide their stories indicated their consent. The study was reviewed and approved by the institutional review boards at both Florida Atlantic University and the University of Texas Health Science Center Houston.
There were 25 volunteers, all nurses with educational backgrounds ranging from associate to doctoral degrees. Ages of participants ranged from 31 to 73 years (M = 53.58; SD = 9.6). Of the 23 participants who provided demographic data on sex, 21 were females. Participants worked in inpatient and outpatient settings including educational institutions and private practices and were predominantly White (72%), with only a few Hispanics (8%), Asian Americans (4%) and American Indians (4%); four participants (12%) provided no data on race/ethnicity. Participants had been practicing nursing from 6 to more than 40 years. As holistic nurses, they integrated a variety of healing modalities into their practice. Table 1 provides the most common modalities listed by the participants.
Modalities Used by Participants for Self-Care (N = 23)
The 25 narratives were divided based on their focus on either personal healing or healing with another. The focus of this analysis is on the seven stories related to personal healing.
Setting and Procedures
Nurses who wished to participate were directed to a quiet room where they received the consent form, a demographic questionnaire, and the instructions on writing their stories. The instructions read:
Tell us a story about a time when you experienced a healing encounter with self or others that was transformational. Stories have beginnings, middles and endings. As your story begins, describe what led up to this healing encounter. Then tell about the events that occurred such as what you and/or others did, what happened to you and/or others, and descriptions of your and/or others’ experiences (thoughts, feelings and perceptions). At the end, describe reflections, insights or lessons learned related to this encounter. Write as much as you need in order to tell your story in the way that fully describes your unique experience.
Participants anonymously submitted their stories by placing them in a drop box, submitting a jump drive, or sending them by email attachment to a researcher.
Narrative/Story Analysis
A structured and detailed process of analysis was developed; it is elaborated in Table 2. Data were analyzed using guidance from narrative analysis and story inquiry (Clandinin & Connelly, 2000; Liehr & Smith, 2007, 2011) that included the following principles: preserving the integrity of each story, reconstructing the stories preserving details and aesthetic appeal, capturing the essence of the stories through individual researchers’ perspectives, identifying narrative threads within the stories, identifying themes across stories by synthesizing the narrative threads, and weaving together a metastory of healing self from the identified themes.
Procedures for Analysis
Unique analytic challenges arose with five researchers involved in the process. Researcher dyads agreed on one reconstructed story, but retained each reflective synopsis that at times represented a particular interpretation of the story. In a group meeting, all five researchers reviewed each reconstructed story and the two reflective synopses and added any additional perspectives for consideration. During the group meeting, all five researchers agreed on narrative threads within each story. This was accomplished through focused dialogue until consensus was achieved. At times researchers disagreed, but agreement occurred through listening to all points of view, carefully reviewing the data, and at times refining language to accommodate any subtle differences. Each researcher individually analyzed the narrative threads in each story to arrive at themes across stories. These individual analyses were shared in a group meeting, and all five researchers agreed on the common themes across stories. Once again, this occurred through a process of dialogue and compromise until consensus was achieved.
Findings
In Table 3, a sample reconstructed story, two reflective synopses, and sample narrative threads are provided for one of the study participants. This story is reflective of the data from which the researchers derived the themes. The researchers provided a structure for the participants composed of three story segments: Call to the Healing Encounter, The Experience of Healing, and Insights.
Example of Reconstructed Story, Reflective Synopses, and Narrative Threads
Call to the Healing Encounter
Three themes describing the call to the healing encounter emerged from the analysis: (a) recognition of the need to resolve a personal or health crisis, (b) knowledge of or engagement in self-care practices, and (c) reliance on intuitive knowing. Each will be elaborated.
Recognition of the need to resolve a personal health crisis
Participants recounted that the call to healing involved the need to resolve a personal or health crisis. This need led the participants to search for some resolution. For example, the personal crisis for Devan was her mother dying from cancer, and her need to be with her in her final days. Devan characterized her relationship with her mother as conflicted and “superficial,” describing their “opposite personalities,” and her mother’s perception that Devan was “like her father.” For years Devan could not understand this tension between them. In spite of this, Devan was drawn to be with her mother as she was dying, and this was a call for her own personal healing. Devan’s mother revealed the reasons for her alienation from Devan, leading to understanding and reconciliation. Other personal or health crises included difficulty conceiving, a shattered ankle from an automobile accident, feelings of self-doubt and self-criticism, a suspicious breast lump, a diagnosis of colon cancer, and necrotizing fasciitis.
Knowledge of or engagement in self-care practices
This was the second theme under the Call to the Healing Encounter. Elan, a woman who had been sexually abused, was trying to conceive. As a holistic nurse and Healing Touch practitioner, she learned about the self-care practice of journaling to herself. Elan wrote a letter to her “gatekeepers,” the dimensions of herself that were inhibiting her pregnancy as a way of protecting her. In her letter, she assured the “gatekeepers” that the pregnancy was desired and that it was “rightful use” of her body. She became pregnant, and attributed this, in part, to her journaling. Other participants described a variety of self-care modalities or rituals that they drew on as they began their journey of healing such as Reiki, shamanic practices, prayer, imagery, and meditation.
Reliance on intuitive knowing
This theme appeared in the call to the personal healing encounter. Participants described a sense beyond logical reasoning or empirical evidence that led them to feel that something was wrong or that they needed to take a particular course of action. After a “routine” appendectomy, Pat received a call stating that she had an adenocarcoid tumor that required additional surgery. Pat had a strong sense that she should not have the surgery, but she questioned this intuitive knowing, so she prayed for guidance. Shortly after her prayer, Pat’s sister called her to tell her that she had received a “message” (from within or beyond) for Pat saying, “Trust yourself . . . and do nothing.” Pat reflected on this saying: “For the first time in my life I asked for and received answers outside of myself. I learned to trust wisdom other than what I thought . . . my body spoke. I listened and I was transformed.” Other examples of intuitive knowing were the following: Hermes experiencing an intuitive knowing that her ankle could be returned to full function despite health care providers’ assessments that she was not improving and Noemi deciding to delay the biopsy of a breast lump until she could pursue self-healing modalities.
The Experience of Healing
The experience of healing was the second segment of the story structure. Six themes emerged in the analysis of the experience of personal healing: (a) connections; (b) profound sensations, perceptions, and events; (c) awareness of the reciprocal nature of healing; (d) inner resolution: Forgiveness, awakening, and acceptance; (e) use of multiple holistic approaches; and (f) witnessing manifestations of healing. Each will be described with examples from the stories.
Connections
Connections were significant in the experiences of self-healing. This theme took different forms as participants described meaningful relationships with others such as their healers, communities, family, friends, and even strangers, as well as entering into a deeper relationship with self. Hermes described the important relationship she had with a Reiki healer, who was working with her to facilitate the healing of a serious fracture of her ankle. After three surgeries to her ankle with slow progress, Hermes was still unable to walk without crutches and had exhausted known conventional medical treatments including physical therapy. Her physical therapists were reluctant to continue to work with her. Working with a Reiki therapist for 3 years, she formed a close relationship experiencing her sessions as healing and restful. Hermes described her connection with the Reiki healer in the following way: “I felt the energy flow and drifted into the peace of it . . . we stopped speaking in words.”
Zell described in detail her experience with a devastating Methicillin-resistant Staphylococcus aureus (MRSA) infection, necrotizing fasciitis, and a lengthy hospitalization, requiring isolation. Friends in her Healing Touch network connected with her through sending flowers, creating a healing environment, talking to her over phone, visiting her in person. The network connected with her through Healing Touch, prayer, music, and singing (one sang “Alleluia” over the phone!). Her companion changed dressings and said he was doing them out of love; in this way they became less painful.
In her story, Laurel captured the mysterious power of connecting with others, even with strangers. Faced with self-doubt and perfectionism, Laurel attended an AHNA conference in which the opening exercise involved a circle dance where participants were asked to acknowledge the person across from them in the other circle with a look of loving kindness . . . Laurel mused,
It was amazing. I felt such unconditional love and was easily able to give the same . . . in fact a colleague later told me that I was very healing to the depths of her being . . . so I was healed while healing others . . . I often look back to the dance to help me take the next little step forward.
Stories of personal healing included a change in the experience of connecting with oneself. Several of the accounts articulated healing as expanding an understanding of or deepening the relationship with self. Noemi and Pat described experiences of listening to their own bodies. They discovered a profound connection with their bodies and trusted this new form of wisdom.
Profound sensations, perceptions, and events
Descriptions of profound sensations or perceptions and extraordinary events were common in the experiences of personal healing. Often these were described in great detail, bearing witness to the significance of the experience for the participants. Hermes provided an explicit description of profound sensations when receiving Reiki for her ankle fracture: “Occasionally during a session I would have the sensation of another pair of hands on a different place on my body . . . she (the Reiki Master) would just smile and say she did not work alone.” Hermes also articulates in detail the moment during a Reiki session in which she felt a dramatic shift in the healing process.
I recall being very light and having a sense of floating, like a state one can achieve in meditation, no particular thoughts or sense of time. I heard her voice asking me if I sensed anything in particular.I answered “I don’t know I’ll have to come back and see”. I realized that there was a rhythmic, pulsating energy in my ankle under her hands. . . . Words cannot adequately describe this sensation or what I experienced next. The best I can do with words is to reference Star Trek and the transporter beam. It was like my ankle under her hands disappeared from this universe and went somewhere else. It did this regularly and with a pulsing pace. It would disintegrate, disappear, and return—again and again. . . . It came “back” once more and I somehow knew it was the last. I had a perception, awareness of a deep click, deep inside my ankle. This was not truly physical but I knew it happened and felt it in some other way. Right after that, I “heard” (not a physical hearing but perhaps a strong kinesthetic knowing which is my way of imagining) a voice saying something like, “There, that does it.” Then all the special energies withdrew and the Reiki session continued more as usual.
Reciprocal nature of healing
This theme addressed the recognition by participants that healing self and healing others were inextricably linked, that in healing oneself, others were affected, and that often witnessing personal healing influenced others. One example was Laurel’s account of the circle dance in which she experienced unconditional love from another, and realized, “I was healed by healing others.” Devan described her personal healing in the context of caring for her dying mother. The reciprocity of healing was evident in Zell’s story of her healing touch community’s participation in her care.
Inner resolution: Forgiveness, awakening, acceptance
In the stories of the experience of healing self, many of the participants described a sense of forgiveness, awakening, and/or acceptance. Devan centered her account of forgiveness on the reunion with her dying mother:
My gift from this experience is to recognize the value of forgiveness. Anger is an acid with eroding capabilities. As a holistic nurse, I know from experience that negative emotions can be released and cellular memories can be re-written in order to promote health and well-being . . . peace, love and harmony!
Zell’s story offers a classic example of acceptance:“I was peaceful during this whole ordeal within myself. I knew I would recover. It was through prayer and prayer from others that I was carried to a safe place during those 2 weeks in bed.” Zell found a new acceptance of her situation, and she experienced the unconditional love of others. Elan’s awakening was the realization that her inability to conceive was a protection from previous wounding.
Use of multiple holistic approaches
Nurses described using a variety of complementary modalities and approaches. Noemi reported, “I did a whole bunch of natural, alternative, complementary things. I had foot reflexology; I did imagery, watching ice melt that was the size of my lump, and more.” Elan identified additional resources in her quest to become pregnant, “What I did was use a technique recommended by one of the required reading books of my certification programs, Love Miracles and Medicine by Bernie Siegel.” Hermes described her experience with a Reiki Master with whom she worked for 3 years. “I had experienced Reiki twice before; once in the hospital right after the accident when a Reiki Master visited the patient in the next bed. I knew I needed support for my healing.” After having experienced surgery and a diagnosis of cancer, Pat noted, “I continued to use the tools that a shaman had taught me, including prayer, andI began to use imagery and meditation. I also used Reiki and Healing Touch. In dark times, I put out requests for guidance.” Zell, a participant plagued with an MRSA infection, shared, “Healing Touch practitioners came from all over to do energy work on me. As soon as they touched me I relaxed.”
Witnessing manifestations of healing
In each of the stories participants described how they perceived that healing had occurred. Some manifestations were physical and obvious to others, whereas others were more personal and subtle. Regardless of the “outcomes,” their impact was profoundly meaningful to the participants. Some of these manifestations were related to diminished signs and symptoms of physical disease or disability. Hermes described the restoration of function in her ankle after she received Reiki over a period of time. For Noemi, who had a breast lump with possible cancer, healing manifested in the vanishing of her lump. Zell shared the outcome of her experience with MRSA and the support of a community of healers, “It was through prayer from others that I was carried to a safe place during those two weeks in bed.” Through her presence with her dying mother, Devan witnessed healing for her mother and herself through forgiveness.
Insights
Two themes were revealed in the story segments related to transformational insights: (a) a sense of gratitude and appreciation and (b) an ongoing journey.
A sense of gratitude and appreciation
This theme was prominent in all the stories. This gratitude was expressed in the form of thankfulness to God and others who the participants perceived as assistive in their healing. Zell recognized the integral part that her colleagues played in her healing in this way: “I know I would not be doing so well as I am if it were not for all holding me in the light.” Zell’s gratitude extended not just to those who were present but also to her “sacred community.” Noemi was happy and transformed when her breast lump did not show up on her follow-up mammogram. Hermes, who recovered from her severe ankle injury, stated that she was grateful for her blessings and the talented healers who helped her. Devan was grateful for receiving the gift of forgiveness.
An ongoing journey
This theme captured the participants’ realization that healing is not an event but a process that will continue throughout their lives. An example of this was Laurel, who stated, “Those doubts still plague me, but not as much, and I often look back to help me take the little step forward . . . I listened and I was transformed, my life is different now.” Pat stated, “I’m back on a journey to heal my soul—this was a point of such vulnerability that allowed me to find my compassion for myself first and now I am giving back.”
Metastory
Through a metastory the research findings are synthesized and presented in a fictionalized story that embodies all the themes. The following is the metastory for this study:
MJ was a holistic nurse for 12 years. It was her passion. She worked as an educator for a large community hospice and taught nurses about holistic nursing, including integrating a variety of complementary therapies into their care of dying patients. Her daily routine was very hectic, with the weight of responsibilities for her children and older parents, the burden of her job, and the worries about finances at times feeling too heavy to bear. But she dutifully pushed on. During her workday MJ began experiencing heaviness in her chest with some palpitations. At first she ignored the symptoms, but as they began to occur more frequently, she took notice. MJ realized that she had to do something.
As a holistic nurse, MJ was knowledgeable about the importance of self-care and the dangers of unrelenting stress. She had practiced meditation and breathing exercises in the past but not regularly, and lately, not often. She had taken a first level Healing Touch course and sometimes used essential oils for self-care. MJ considered how she might draw on them to support some changes in her life. She experienced an inner knowing that through these symptoms her body was giving her a clear message that she could no longer continue living her life in the same way. She decided to listen and to act.
MJ shared her fears about her health with her friends and family. All were sympathetic and asked what they could do to help. Her nurse practitioner referred her to a cardiologist who determined that although there was no visible coronary heart disease, her cholesterol, triglycerides, and blood pressure were high. She was overweight and had been very sedentary. MJ began walking every day with one of her friends. This time became a sacred ritual of reconnecting and rekindling the friendship that she missed. She began meditating and journaling every day. One day during her meditation practice she experienced an overwhelming sensation of oneness, with a knowing that “I’m not alone.” As she reflected on this profound experience, she realized that she had been living as if she was alone, that she had to take on everything and take care of everyone by herself. This was an awakening for her, and she began to delegate responsibilities to her children and her siblings. She found that her relationship with her children and her siblings grew closer as she was less resentful, and they felt more productive and proud of their contributions. Her son’s grades improved, and the family was more cohesive and loving.
MJ’s symptoms abated. She was grateful that she received these messages from her body that led to changes in her life. As she recommitted to caring for herself so many things were better for her and her family. She felt reborn and renewed. MJ continues her daily rituals of walking, meditation, and journaling, knowing that this is a way of life, not an episode. She started a self-care group at work so that she could share her lessons with her community of hospice nurses.
Discussion of Findings
The findings of this study were related to the conceptual/theoretical and empirical literature on healing. The concepts of healing as right relationship (Quinn, 1989, 2013), realization and appreciation of an existing connectedness and wholeness (Cowling, 2002; M. C. Smith, 2002); and an emergent process of repair, recovery, renewal, and transformation that increases a sense of wholeness, order, and coherence (Dossey & Keegan, 2013) were reflected in the themes of Connections; Reciprocal nature of healing; Inner resolution: Forgiveness, awakening, and acceptance; and Ongoing journey. Admittedly, the participants in this study were holistic nurses who were familiar with the concept of whole person healing. These participants described healing beyond the physical abatement of symptoms or curing of disease, even if these things happened. They were impressed by the larger changes in their life patterns like becoming more self-confident, or trusting in their intuition, or the peace that comes with forgiveness.
Geffen’s (2004) seven-level process of healing was visible in the stories. Although the levels were not sequential, the elements were present in many stories. Participants sought information and knowledge through seeking the guidance of conventional and alternative healers as well as through other resources. Connecting with others was a major finding. Participants engaged in getting to the root of the issue through self-reflection and seeking natural approaches of self-care rather than eradicating symptoms. Participants described both the emotions and attitudes that accompanied the healing experience, noting those that were most helpful. In many stories they turned their attention toward a plan or goal of change and finally they were engaged in a journey of self-discovery.
Stories have been used to describe the process and experience of healing. Carlson and Shield (1989) edited a classic compilation in which several noted healers described their ideas about healing. Ideas such as a return to wholeness, love and compassion, empowerment, mystery, transformation, right relationship, and that all healing is self-healing are concepts that resonate with the results of this study.
Similar themes were described by Rosa (2011) in her study of healing chronic skin wounds through the research-as-praxis approach from Newman’s theory of Health as Expanding Consciousness. Themes of developing and deepening self-awareness, finding meaning, and experiencing transformation are consistent with the results of this study.
The theme of profound sensations, perceptions, and events was reported in Cooperstein’s (1992) study of the experiences of healers. In this study of nurse healers, participants reported states of altered consciousness, transcendence, or sudden intuitions that they or others had. These are reported as well in accounts of energy healing and spiritual experiences (Engebretson & Wardell, 2002; Warber, Cornelio, Straughn, & Kile, 2004; Wardell & Engebretson, 2006).
Certainly the themes uncovered in this study corresponded to Verhoef and Mulkins’s (2012) findings that for their participants, self-healing was subjective and personal, moving toward a sense of wholeness, self-directed involving positive intention, and experienced in varying degrees and levels. The stories, although not shared in their entirety in this article, represented the diversity and subjectivity of the experience of healing. The evolving awareness of wholeness and connection was present in most of the stories and resulted in experiencing manifestations of healing that were beyond the physical.
Zahourek’s (2012) study of healing in nurse healers had striking similarities to this study. The participants in this study did address their past to live life more fully. Examples of this were with Devan’s discovery of what was behind her mother’s “dislike” of her, Elan’s realization that her difficulty conceiving was her body’s protective mechanism after her past sexual abuse, and Laurel’s nagging self-doubt. These participants had to let go and move beyond these issues in the process of caring for themselves. In line with Zahourek’s findings, participants expressed an awareness of a shift as unusual and profound as the extraordinary Reiki session that Hermes described or as subtle as the ability to send and receive love that Laurel experienced. The reciprocal and dynamic nature of healing was a theme in both studies.
Consensus building on the nature of whole person healing is essential for continuing efforts in theory development and future research. Jonas and Chez (2003) stated that there were two major difficulties in moving forward in the scientific inquiry of healing: the lack of standard definitions for the terms healing, healing energy, and healing intention; and poor quality of current research. This study contributes to the development of an empirically based standard definition of whole person healing.
The findings of this study contrast the counternarrative of healing with the dominant narrative of curing. The dominance of biomedicine is predicated on knowledge of disease and disorders that interrupt physiological functioning. Although this is vitally important, and has provided a revolutionary understanding of disease and treatment, the concept of healing is more holistic and organic, and these stories of personal healing illustrate several counterpoints to the dominant narrative. In the dominant narrative, the call to healing would originate from the patient experiencing a symptom or dysfunction or a finding on a screening or diagnostic exam. In these stories, the call to healing can also be serendipitous and unexpected. Examples are Laurel’s experience of loving kindness that healed her spirit and Devan’s reconciliation between her and her mother that led to peace and understanding. Next, biomedical expectations are based on research findings that reflect normative statistical inferences. The efficacy of a treatment is anticipated in a fairly fixed trajectory, generally fairly short-term; otherwise the condition is considered chronic or incurable. The time variation for healing in this study encompassed a wide continuum with healing occurring in an instant or over an indeterminate time. This contrasts with the causal orientation related to treatment and cure in the biomedical model. A third point is that healing can be fostered by an intuitive knowing of one’s own body. This contrasts with the biomedical approach of eschewing inner knowing in favor of objective signs. Two participants exemplify this in their intuitive knowing about the treatment to follow with a breast lump and to become pregnant. Finally, healing is linked with connections with others and a deeper connection to Self. This again contrasts with the dominant narrative of curing through surgery or pharmaceuticals. In healing, there is often insight gained about how one lives life. This suggests a more complex phenomenon than “fixing the broken part.” The experience in and of itself reflects change in the whole person as unitary or body, mind, and spirit.
A unique method of analyzing stories was developed for this study based on narrative and story inquiry. The use of stories in nursing research is not unusual. Nursing as a human science focuses on lived experiences. Nursing theoretical and research literature contains narrative/story as method for discovering practice-based knowledge (Benner, 1991; Boykin & Schoenhofer, 1991; Cowling, 2004; Duffy, 2007; Gadow, 1996, 1999; Leight, 2002; Sakalys, 2003; Sandelowski, 1991, 1994; M. J. Smith & Liehr, 2005; Vezeau, 1994). Stories assist researchers in gaining insight into how people “understand and enact their lives” (Sandelowski, 1991, p. 163). Narrative descriptions of nursing practice often provide knowledge through the analysis of written stories. Narrative stories can take nurses back to a time when a patient care situation made a difference in the life of a nurse or how a nurse’s action affected a patient (Hudacek, 2008). The power of storytelling lies in the storyteller’s ability to create coherence and congruence, to make sense of a situation or give meaning to an experience (Cowling, 2004). Stories powerfully connect us in ways that transcend rational knowing and promote compassion, empathy, and understanding (Sakalys, 2003). Stories connect us to each other and ourselves (Repede, 2008). Sharing human experiences in day-to-day life through narrative is not only a way to reflect on practice but also a way to provide clinical knowledge about patient care situations. The method used in this study allowed the researchers to preserve the uniqueness of individual stories while acknowledging the common threads across participants’ stories. The researchers were located across the country and conducted this complex research over phone conferences. The challenges were tremendous; the learning about self and each other and spirit of collegiality carried us through, but definitely lengthened the process of analysis.
The findings of this study reveal the complexities of healing. The relationship between healing and curing is one example. This is captured in Figure 1. In some stories, participants experienced healing and curing of disease; in other situations they experienced healing without curing. There can be situations where neither healing nor curing occurs or when curing of disease occurs without whole person healing. Participants who sought to heal in their own way and time outside of the best practices of medicine can be viewed as courageous, self-determined, enlightened, or foolhardy. But these participants were able to choose their own path for healing, and the lesson for health care providers may be to give each person the space and time to do so. The stories presented here were of perceived healing, and it is important to note that those who followed the same path without an outcome that they would label as “healing” were not represented here.
The Relationship Between Healing and Curing
Other insights that emerged in the researcher’s reflective synopses are important to share. Wounds or trauma can be generational, cultural, and historical. In the healing process, locating and gently tending the roots of the trauma are essential to healing. The temporal dimensions of healing are complex. In some examples, the participant persevered for months, for other participants the changes occurred in a relatively short period of time or in a moment. Wonder and surprise were common responses to personal healing. One participant was disappointed that others did not grasp the magnitude of the mystery of healing that she experienced when her breast lump disappeared on a follow-up mammogram. She mused that medicine dismisses these spontaneous remissions and therefore we know very little about them. Healing can happen in an ordinary act. Just a small act of kindness can have a lasting and significant impact on another. Laurel described the look when she met another eye-to-eye, soul-to-soul with a stranger, and how this giving and receiving love was transformational. If a look of acceptance can have this impact on others, we need to seize opportunities to acknowledge and listen to others. This is the power of authentic presence. The nurses in this study used a variety of self-care approaches. Nurses are wounded healers, and we need to bring more awareness of the importance of self-care into the professional and personal lives of nurses.
In this study, holistic nurses shared their stories of personal healing. Although not all could bere-presented in this article, each one is unique, rich, and inspirational. Through a rigorous process of analysis the researchers identified 11 themes in the story segments of the Call to healing, Experience of healing, and Insights. Through story we come to understand and appreciate the complexities and meanings of a human experience like healing. As holistic nurses, we carry this understanding to every caring–healing relationship. This study brings some consensus to the meaning of whole person healing and can inform theory development and future research.
Footnotes
Authors’ Note:
The authors gratefully acknowledge the American Holistic Nurses’ Association who supported this study.