1. Yamashita, Mineko RN, PhD
  2. Tall, Franklin D. PhD

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To the editor:


We welcome the letters of Dr Margaret Newman and Dr Emiko Endo 1,2 regarding our article titled "A Commentary on Newman: Theory of Health as Expanding Consciousness." 3 Newman has pointed out some important clarifications, which we refer to below. However, indeed we do have some disagreements with her and with Endo, so we should like to defend our point of view.


1. Issue of paradigm. Newman states that "The problem lies mainly in the paradigm from which the authors speak. They examine initial parameters of the theory with knowledge from other fields [horizontal ellipsis] My understanding of scientific criticism is that it proceeds from within the paradigm of the theory being evaluated." Endo writes, "The authors violated the essence of this nursing theory, the wholeness, by dividing it into pieces and evaluating it from the perspective of other disciplines." We beg to differ. We believe that Newman's theory is illuminated by comparing and contrasting it with other theories. This cannot be done from within the theory. This is certainly legitimate criticism. For example, even a follower of Marxist economics may criticize Marx's treatment of female labor in the light of feminist ideas. As for dividing into pieces, this is unavoidable in any systematic exposition. Even the Buddha expounded the Four Noble Truths of His unitary transformative theory one by one.


2. Analogy to alternative medicine. We have drawn numerous analogies between Newman's theory and other disciplines. We did not mean to suggest a precise fit of Newman's theory with these other paradigms. Newman pointed out that these analogies are not perfect, and we never meant to suggest that they were. Her distinctions are helpful clarifications, but we still claim our analogies are useful in understanding her theory by putting it in a broader context.


3. Interpretations of assumptions on causal terms. We stated "psychic imbalances can create the conditions for disease to manifest." We agree with Newman that from a unitary transformative paradigm this is not appropriate language. It would have been better to say that "psychic imbalances are associated with conditions for disease to manifest."


4. The definition of health. Newman's theory offers a revolutionary conception of health. According to Newman, health is the process of transformation to higher levels of consciousness. She considers health and illness as a unitary process, which she identifies with "expanding consciousness." Thus, Newman's concept of health differs significantly from the one that defines health as the absence of disease or another which places health and illness on a continuum. It should not be inferred from our critique that we do not accept the basic premises of the concept of health as expanding consciousness. However, we do indeed intend to emphasize that the use of the word "health" with all its usual connotations in a setting wherein those connotations are strongly contradicted can cause difficulties. We would suggest that calling the theory "health/illness" as expanding consciousness would avoid the problem.


5. Equilibrium. Moving on to lesser issues, we did not mean to imply that a search for equilibrium entails more than the instantaneous pause at the equilibrium state required by her postulate of a movement between equilibrium and disequilibrium.


6. Human energy field. Since Newman does not say anything about the nature of the human energy field in her writings and yet ascribes physical reality to it (personal communication, March 26, 1996), our lack of understanding of the field as she conceptualizes it may, we trust, be forgiven. We hope that she will explicate it further. Meanwhile, we have tried to understand it by looking at how other disciplines deal with such fields. And we did not mean to suggest energy exchange rather than a field effect.


7. Neurolinguistic program. Our neurolinguistic programing psychotherapy example was meant to show that insight does not necessarily lead to action. Whether insight in the specific context of Newman's theory does lead to action should be an empirically drawn or testable assertion. However, if "action" is defined sufficiently broadly, with "no way of knowing in advance what that will be or what action will be indicated," there is a danger of failing Popper's 4 falsifiability criterion for scientific theories.


8. Difficulty and obscurity. Endo objects to our claim that "Newman's theory has a reputation for difficulty and obscurity." This claim is of course impossible to precisely verify, but it is based on the first author's North American experience. Endo argues against this by the non-sequitur of giving some anecdotes of nurses who have been enlightened about nursing when they became acquainted with Newman's theory. Indeed, the first author counts herself among such nurses.


9. Origins. Endo finds the origins of Newman's theory in Newman's experiences with her mother rather than in the work of Martha Rogers and modern physics. There is a semantic difference here: Endo is referring to what psychologically primed Newman to formulate the theory, while we refer to the theoretical precursors which influenced her.


10. Research as praxis. In our article, in an effort to elucidate the construct research as praxis research, which involves the researched in a process of inquiry characterized by negotiation, reciprocity, and empowerment, 5 we merely expounded on that construct in terms of those three concepts; which Newman 5 noted were derived from Lather's 6 work. Newman's theory has come a long way from its early publications. 7,8 Dr. Newman is, of course, the final arbiter as to its current formulation, but as we observe with interest the evolution of her thought, we shall continue to view it from a wider perspective.


-Mineko Yamashita, RN, PhD


Professor, School of Nursing; Saitama College of Health Sciences; Saitama, Japan


-Franklin D. Tall, PhD


Professor, Department of Mathematics; University of Toronto; Toronto, Onatario, Canada




1. Endo E. Letter to the editor. ANS. 1999; 21(3): vii. [Context Link]


2. Newman M. Letter to the editor. ANS. 1999; 21(3): viii-ix. [Context Link]


3. Yamashita M, Tall FD. A commentary on Newman's theory of health as expanding consciousness. ANS. 1998; 21(1): 65-75. [Context Link]


4. Popper K. The Logic of Scientific Discovery. London: Hutchinson; 1959. [Context Link]


5. Newman M. Newman's theory of health as praxis. Nurs Sci Q. 1990; 3: 37-41. [Context Link]


6. Lather P. Getting Smart: Feminist Research and Pedagogy with/in the Postmodern. New York: Routledge; 1991. [Context Link]


7. Newman M. Newman's health theory. In: Clements I, Roberts F, (eds.). Family Health: A Theoretic Approach to Nursing Care. New York: John Wiley & Sons; 1983. [Context Link]


8. Newman M. Health as expanding consciousness. In: Proceedings of Seventh International Conference on Human Functioning. Wichita, KS: Biomedical Synergistics Institute; 1983. [Context Link]

Section Description


Letters to the editor should be addressed to Editor, ANS, Aspen Publishers, Inc., 200 Orchard Ridge Drive, Gaithersburg, MD 20878. Unless otherwise stated, we will assume that letters addressed to the editor are intended for publication with your name and affiliation. As many letters as possible will be published. When space it limited and we cannot publish all letters received, we will select letters reflecting the range of opinions and ideas received. The editor reserves the right to edit letters. If a letter merits a response from an ANS author, we will obtain a reply and publish both letters.