46 NOVEMBER/DECEMBER 2008

A Holistic Approach

Transcending D i f f e re n c e s

By Lucia Thornton

C a ring for patients from different culture s ,social backgro u n d s , and ideologies offers awonderful opportunity for nu rses to expandtheir world view and a p p reciate life’s dive rs i t y.

Sometimes, however, the diff e rences that exist become barriers to eff e c t i v ecommunication and the delivery of compassionate nursing care. Using toolsand practices of holistic communication can help you navigate through thesed i fficult times.

Engage Your ObserverEngaging your observ e r is a helpful process used when confronting a

s i t u ation or communication that is particularly d i fficult and emotionally charg e d .It also helps the nurse be p re s e n t to a person and/or situation with clarity andwithout bias. This is very useful when the nurse’s personal, social and cultural

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beliefs are in conflict with those of theperson he or she is caring for. Using apractice that can allow the nurse tosuspend judgment and set aside i n t e rf e r-ing beliefs is crucial in creating a car-ing and healing interaction.

The observ e r, or witness, is a non-judgmental aspect. Some perceive thisaspect as a Higher Self, which can belikened to a wise grandparent thatlooks sensibly upon the thoughts andreactions of our childlike minds. Itgives us the ability to observe lifewithout engaging our past patterns ofreacting emotionally.

The observer acts as a thirdp a rty that allows us to separatef rom personal feelings in situationsso that communication can occurf rom a space of clarity and wisdom.Using this technique enhances self-knowledge and self-awareness as itp rovides constant feedback re l a t e dto our responses and reactions tos i t u a t i o n s .

The observ e r, while embracing thewhole of the moment, is able to transcend the ego so that we re s p o n dwith wisdom rather than reacting fro mconditioned response.

Engaging the observer involvescentering (or grounding) oneself, beinga w a re of internal reactions, acknowl-edging these reactions, and re s p o n d i n gf rom the Higher Self. This is a tech-nique that allows us to access ourHigher Self and move from that placeof higher consciousness in our inter-a c t i o n s with another person. This iscentral to the transpersonal caringp rocess and communicating from aholistic perspective (Thornton, inp ress). See “Engaging Your Observ e rin a Difficult Situation” above.

C L E A RC o m m u n i c a t i o n

Sometimes an acronym is usefulwhen trying to aquire new skills. TheC L E A R a c ronym has been used bynurses to help them remember someof the processes involved in holisticcommunication. See “Holistic Commu-nication: Be CLEAR” on page 53.

Connecting withYourself : C o n n e c t i n gwith Others

Holistic communication is distin-guished by the depth and pro f o u n dquality of p re s e n c e. Jean Wa t s o nspeaks of the “full use of self” in thetranspersonal caring process (Wa t s o n ,1999). A nurse that becomes heart -

c e n t e red has the capacity to connectwith another person at a deep psy-chosocial, heartfelt and spiritual level.This is a difficult concept to describeand remains more of a felt experience.As nurses, we must be able to accessand rest in the depth of our own lifeb e f o re bringing this transcendent,c a ring, and healing presence into arelationship.

E n g a ging Your Observer in a Difficult Situation

S I T U AT I O N : A patient’s family member

a p p roaches you angrily, accusing you in a

v e ry loud voice of neglecting to administer

a medication on time.

• Center yourself and create an intention. Ta ke a bre a t h ,b ring your attention to the area around yo u rh e a rt , and connect with a feeling of love and c o m p a s s i o n . Think to yo u rs e l f, “I am here for thegreater good of all.”

• Observer relates your internal reactions —emotionally, men -tally and physically. “This person really scares you.Youwant to run away from this person.Your chest is starting to feel constricted and your heart is startingto race.”

• A cknowledge these reactions, set them aside and engageyour Higher Self. “ Ye s , anger makes me uncomfort-a bl e.”Ta ke another deep breath and silently repeat,“I release these thoughts and feelings, I am here forthe greater good of all.”

• Focus on the Person/Situation. Be fully present tothe p e rson/situation from a place of wisdom andc o m p a s s i o n .

This entire process takes about five seconds anda l l ows the nu rse to set aside thoughts and feelingsthat interfere with a healing-caring interaction(Thornton, 2 0 0 0 , 2 0 0 6 ) .

CENTER LISTEN EM PATHY ATTENTION RE S P E C T

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T R A N S C E N D I N G D I F F E R E N C E S

r e f e r e n c e s

1. Rankin, E and De Lashmut, M (2006).

Finding spirituality and nursing presence:

The student’s challenge, Journal of HolisticNursing, 24 (4) 287.

2. Thornton, L (in press). Evolving from therapeutic to holistic communication. Dossey,

B. and Keegan, L (in press). Holistic Nursing: AHandbook for Practice (5th ed.), Sudberry, MA.

3. Thornton, L (2000, 2006). Self-published

course materials.

4. Watson, J (1999). Nursing: Human Scienceand Human Care - A Theory of Nursing. Jonesand Bartlett Publishers: Sudbury, MA.

C E N T E R Y O U R S E L F

• Pause for a moment.

• B reathe deeply.

• Connect with a feeling of love and compassion.

• C reate a silent intention that thoughts, words, and actions will be

for the greater good.

L I S T E N W H O L E H E A R T E D LY

• Set aside your own thoughts, emotions, and feelings.

• Focus on the person’s agenda.

• D o n ’t judge or analyze.

• Open your heart to what is being communicated.

E M P A T H I Z E

• Come from a place of genuine concern .

• Have the ability to feel with a person, not sorry for.

• Empathy involves an understanding that comes from sensing into

the being of another.

A T T E N T I O N : B E I N G F U L L Y P R E S E N T.

• Be aware of what you are feeling and sensing. Stay present to yourself.

• Bring the fullness of yourself to every moment—emotionally, mentally,

p h y s i c a l l y, and spiritually.

R E S P E C T

• Respect all that is.

• Respect yourself—set boundaries if needed.

• Respect person—honor cultural, social, ontological, and ideological

d i ff e re n c e s .

• Welcome diversity.

Lucia Thornton, a

holistic nurse educator

and consultant, currently

serves as President of

the American holistic

Nurses Association.

Her work in transform i n g

hospitals into “healing

environments” has received national, state and

local recognition. Lucia can be contacted at

luciat@csufresno.edu.

Holistic Commu n i c a t i o n :B e CLE A R

Being able to communicate fro mm o re profound levels of presence isthe result of experience and engagingin processes of deep reflection andi n q u i ry. Cultivating this type of pre s-ence, however, is something that canbe learned through direct experienceand role modeling (Rankin, 2006).

Including various self-re f l e c t i v epractices such as journaling, medita-tion, relaxation, contemplation, dre a manalysis, narrative and storytelling inour personal daily practice can helpcultivate a deeper relationship withthe essence of our existence that canthen be brought into a re l a t i o n s h i pwith a n o t h e r. We must be able to con-nect with our own transcendentn a t u re before we can establish thatc o n n e c t i o n with others.

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