Parse’s Theory of Humanbecoming in Nursing Practice
Debra A. Bournes and Gail J. Mitchell
The assumptions and principles of humanbecoming incarnate a deep concern for the delicate sentiments of being human and show a profound recognition of human freedom and dignity.
History and Background
In the video series Portraits of Excellence, Parse (1990b) shared that the humanbecoming theory, now an aspect of the Humanbecoming School of Thought (Parse, 1998, 2007b, 2012a,b), was created over many years as she grew and matured with others and as she considered the values and ideas she engaged while living and learning. Her values led her to question the medical model as a suitable knowledge base for nursing. Parse found the medical model limiting and inconsistent with her experience of how people make health decisions. Accordingly, she searched for a different way to know and practice nursing. From the beginning, Parse chose to focus on people’s experiences and their unique views of health. She believes that people co-author their health, and she asserts that nurses do not have control of people or of their health choices. Nearly 35 years ago Parse had a vision of nursing that was based on dialogue, presence, and participation. That was well before either the Theory of Humanbecoming (1981, 1987, 1992a, 1998) or the Humanbecoming School of Thought (Parse, 1998, 2007b, 2011b, 2012a,b) was fully formed. Parse knew that she wanted to contribute to the development of nursing as a unique science. The nursing science she envisioned is consistent with basic tenets of the human science tradition (Bunkers, 2002; Cody & Mitchell, 2002) and supports practices that truly honor the freedom and dignity of human beings (Parse, 1990a,b, 2007b, 2010).
Parse’s work, originally called man-living-health, appeared in print in 1981. The name was officially changed to human becoming in 1992 (Parse, 1992a) and then to humanbecoming in 2007 (Parse, 2007b). Parse (1998, 2007b) explicitly presents the Humanbecoming School of Thought as a perspective grounded in human science—distinct from medicine and other sciences. Parse (1981, 1987, 1995, 1998) references Dilthey (1961), regarded as the architect of human science, as a person who influenced her thinking about science and about the possibility of systematically exploring the connectedness of life and the unity of human experience. The Humanbecoming School of Thought focuses on humans’ living experiences and the meanings and patterns that create individuals’ unique processes of life. For Parse (1998, 2007b, 2012b), humans are indivisible, unpredictable, and everchanging, and they make choices while living paradoxical patterns of becoming.
Parse (1981, 1998) also named other authors who influenced her development of the Humanbecoming School of Thought. Martha Rogers (1970, 1986, 1994), who conceptualized the Science of Unitary Human Beings, had a major influence on Parse’s thinking—as did the existential-phenomenological philosophers Sartre (1966), Merleau-Ponty (1963, 1973, 1974), and Heidegger (1962). Parse developed a novel theory that is different from Rogers’ work and more expansive than existential-phenomenological thought, yet the insights inspired by these authors are visible in humanbecoming. The Theory of Humanbecoming itself, which consists of three principles and nine concepts, was developed in deductive-inductive ways during the 1970s as Parse pondered the possibilities of a different kind of nursing (Parse, 1990b).
Parse (1981, 1998, 2007b, 2012a,b) has continually expanded and clarified humanbecoming over the past three decades. Several developments are noted in this chapter, including the refined assumptions and principles of humanbecoming (Parse, 2012b); specification of the postulates of humanbecoming (Parse, 2007b); development of teaching-learning (Parse, 2004a), mentoring (Parse, 2008b), leading-following (Parse, 2008c, 2011a), community (Parse, 2003a, 2012b), and family (Parse, 2009) models; development of the humanbecoming research and practice methodologies; and multiple conceptual additions and clarifications. For example, in order to advance thinking about the idea of indivisibility, Parse (2007b) deleted the physical space between the words human and becoming and human and universe to create the words humanbecoming and humanuniverse. The words provide an image, as well as explicit meaning, of the indivisibility of human experience. In addition, Parse (2012b) introduced new conceptualizations in 2012 that further specify the meaning of the all-at-onceness of human experience from a humanbecoming perspective. She said that the belief system (ontology) underpinning humanbecoming “specifies that with humanuniverse the human is an august presence, a seamless symphony of becoming, living the emerging now. Becoming visible-invisible becoming of the emerging now is the living moment that brings to the fore the idea that meaning changes with each unfolding living experience incarnating the remembered with the prospected all-at-once” (Parse, 2012b, p. 44).
The becoming invisible-invisible becoming of the emerging now is the universe of histories and experiences and hopes and dreams that co-create each moment, as humans live and shape their lives with their illimitable, unbounded knowing.Human living experiences surface moment to moment like waves surfacing on an ocean. What is becoming visible in human experience can be described as what is happening in the moment that can be explicitly known and described by the person living it. It is like the waves that are swelling to the top of the ocean—visible for a moment, yet always shifting and changing and being co-created with what is happening in the entirety of the ocean, invisible beneath the surface yet co-creating the waves that are becoming visible with their invisible becoming (Bournes & Mitchell, 2013).
Since the original publication of Man-Living-Health in 1981, Parse has published many articles and has authored, co-authored, and edited several texts that have contributed significantly to the discipline of nursing (see Morrow, 2012b). A book on qualitative research (Parse, Coyne, & Smith, 1985) presents research studies guided by humanbecoming. That text was published before Parse (1998, 2001, 2005, 2011b) had developed research methodologies consistent with her theory. Further development of practice and research methodologies appeared in print in a general text on nursing science. The book Nursing Science: Major Paradigms, Theories, and Critiques presented various nursing theories and described their alignment with two nursing paradigms (worldviews) named by Parse: the totality and the simultaneity paradigms (Parse, 1987). And in 2012, Parse (2012a) added a third, humanbecoming paradigm, to the schema. In 1995, Parse edited Illuminations: The Human Becoming Theory in Practice and Research, that contains contributed works by various authors about the humanbecoming theory in practice and research. Several evaluation studies are included in the Illuminations text and also a hermeneutic research method, consistent with humanbecoming, as developed by Cody (1995) in his hermeneutic analysis of Walt Whitman’s Leaves of Grass. Parse (1998, 2001) further articulated the humanbecoming hermeneutic method specifying three processes: “discoursing with penetrating engaging, interpreting with quiescent beholding, and understanding with inspiring envisaging” (Parse, 2001, p. 172).
In 1998 a revision of Parse’s theory was published in her book The Human Becoming School of Thought: A Perspective for Nurses and Other Health Professionals. This marked an important development in the Theory of Humanbecoming as she formally defined the humanbecoming school of thought as a belief system with interrelated concepts offering a view of the humanuniverse process of how humans co-create their own becoming in unique pathways of situated freedom. Three texts followed the 1998 publication: one on hope research (1999), one on qualitative inquiry (2001), and a third on community (2003a). Her book on qualitative inquiry as sciencing offers a comprehensive view of different research methods consistent with several nursing theoretical perspectives. The text describing the humanbecoming view of community offers an innovative integration of art and metaphor to conceptualize a novel approach for working with community and change (Parse, 2003a).
Currently, within the humanbecoming school of thought, are assumptions; postulates; principles; concepts; practice and research methodologies; models of teaching-learning, mentoring, leading-following, family, and community (Parse, 2003a, 2004a, 2008a,b, 2009, 2011a, 2012b); and ethical tenets of human dignity (Parse, 2010a). The phrase school of thought is more comprehensive than thehumanbecoming theory itself, and development of methodologies, models, and ethical tenets indicates the potential of the belief system to support study, knowledge development, and work in multiple arenas. The school of thought may provide guidance for professionals and scholars from other disciplines who are interested in developing a human science consistent with the vision of Dilthey (1961) and those who seek a belief system that truly honors human experience and human mystery. Serious students of humanbecoming will want to study each of the postulates, concepts, principles, methods, models, and ethical tenets of the school of thought in order to know the integrity of the ideas and their potential contributions.
Numerous publications describe the difference that the Humanbecoming School of Thought makes in practice and how research enhances the understanding of living experiences while expanding the knowledge base of humanbecoming. It is not possible to note all the contributions of authors in this brief history and background of humanbecoming. Readers can access additional references in the text Nursing Theorists and Their Work (Alligood, 2013) and through online indexes and search engines. To represent the scope of work affiliated with the Humanbecoming School of Thought, selected examples of recent publications that illustrate the breadth of practice, research, education, and leadership activities are cited.
Humanbecoming has guided nursing practice in community settings, including clinics, parishes, and homeless shelters (Bournes & Naef, 2006; Milton & Buseman, 2002; Smith, 2002; Wang, 2008). Nurses have written about practice in hospital settings (Bournes & Ferguson-Paré, 2007; Bournes, Ferguson-Paré, Plummer, et al., 2009; McCarthy & Aquino-Russell, 2009; Mitchell, Bournes, & Hollett, 2006; Mitchell, Closson, Coulis, et al., 2000; Papendick, 2002), and with persons of various ages, including children (Baumann & Carroll, 2001; Karnick, 2005), adults (Mitchell, 2002; Tanaka, Katsuno, & Takahashi, 2012), and older persons (Hodges, Keeley, & Grier, 2001). Nurses rely on the humanbecoming theory to guide their relationships with families (Cody, 2000), groups (Noh, 2004), women (Kostas-Polston, 2008; Oaks & Drummond, 2009; Smith, 2002), soldiers (Flinn, 2007), persons with hearing loss (Aquino-Russell, 2005, 2006), and persons experiencing disasters (Hayden, 2010). The value of the Humanbecoming School of Thought has been considered from the perspectives of nurses in various practices ( Bournes & Naef, 2006; Bunkers, 2012b; Cody, 2003b; Damgaard, 2012; Doucet & Maillard-Struby, 2009; Gantalao, 2002; Hegge, 2012; Jensen-Wunder, 2002; Karnick, 2007; McLeod & Spee, 2003; Melnechenko, 2003; Mitchell, 2002a; Mitchell & Bunkers, 2003; Morrow, 2012a,b; Peterson-Lund, 2011; Stanley & Meghani, 2001), by nurse leaders (Bournes, 2006; Bournes, Bunkers, & Welch, 2004; Bournes & Ferguson-Paré, 2007; Damgaard, 2012; Karnick, 2007; Mitchell, Bournes, & Hollett, 2006; Morrow, 2012a), and by clients (Williamson, 2000). Nurses have offered comparisons between humanbecoming and other theoretical approaches (Baumann & Englert, 2003; McCarthy & Aquino-Russell, 2009) and others have discussed how Parse’s practice influences notions of listening/bearing witness (Kagan, 2008b; Tschanz, 2006), ambiguity (Mitchell & Pilkington, 2000), and patient-centered care (Mitchell et al., 2000; Mitchell, 2002; Parse, 1996d).
Parse’s work has contributed significant knowledge development in the areas of teaching-learning (Aquino-Russell, Strüby, & Reviczky, 2007; Bunkers, 2003a, 2006, 2008, 2009a,b; Chan, 2005; Condon, 2010, 2011, 2012a,b; Condon & Hegge, 2011; Milton, 2003a, 2012; Norris, 2002; Parse, 2004a; Pilkington, 2002; Ramey & Bunkers, 2006; Ursel & Aquino-Russell, 2010), loss and grieving (Florczak, 2008; Jonas-Simpson & McMahon, 2005; Pilkington, 2005, 2006), ethical relating (Bournes & Flint, 2003; Cody, 2003a; Condon & Hegge, 2011; Milton, 2002, 2003b, 2004, 2005a,b, 2008a–d; Mitchell, 2001, 2002b; Mitchell & Bournes, 2000; Mitchell & Bunkers, 2003; Mitchell & Cody, 2002; Naef, 2006; Pilkington, 2004), listening (Jonas-Simpson, 2003; Jonas-Simpson, Mitchell, Fisher, et al., 2006; Kagan, 2008a,b), and mentoring (Bournes & Plummer, 2011; Carroll, 2004; Letcher & Yancey, 2004; Parse, 2008b; Yancey, 2005). The Humanbecoming School of Thought has influenced state board standards for decision making (Benedict, Bunkers, Damgaard, et al., 2000; Damgaard & Bunkers, 2012) as well as the development of Canadian standards of care for client-centered care and nursing (Bournes, 2000; Nelligan, Balfour, Connolly, et al., 2002; Rodgers, 2000).
Humanbecoming has inspired many scholarly papers that clarify connections with human science and views of nursing as a unique science (Arrigo & Cody, 2004; Baumann & Englert, 2003; Bunkers, 2002; Cody, 2003a; Cody & Mitchell, 2002; Northrup, Tschanz, Olynyk, et al., 2004; Paillé & Pilkington, 2002; Parse, 1992b,c, 1993, 2002; Pilkington, 2002) as well as views of evidence, wisdom, and truth (Milton, 2007; Mitchell, 2009; Parse, 2008a). Several articles chronicle the broad scope, challenges, and opportunities with humanbecoming practice and research (Cody, Mitchell, Jonas-Simpson, et al., 2004; Parse, 1996b) and Bournes (2002a) provides an overview of early research evaluating humanbecoming-guided practice.
A review of research studies guided by humanbecoming has been published (Doucet & Bournes, 2007). Humanbecoming studies have enhanced understanding about living experiences of courage (Bournes, 2002b), waiting (Bournes & Mitchell, 2002; Naef & Bournes, 2009), respect (Bournes & Milton, 2009; Parse, 2006), faith (Doucet, 2008), persevering (Bournes & Ferguson-Paré, 2005), joy-sorrow (Parse, 1997), feeling tired (Baumann, 2003; Bunkers, 2003b; Huch & Bournes, 2003; Parse, 2003b), feeling cared for (Bunkers, 2004), feeling unsure (Bunkers, 2007; Maillard-Struby, 2012; Morrow, 2010), feeling confined (Dempsey, 2008a), time passing (Northrup, 2002), changing expectations (MacDonald & Jonas-Simpson, 2009; Thomas, Riggs, & Stothart, 2013), being listened to (Jonas-Simpson, 2003), quality of life (Jonas-Simpson & Mitchell, 2005; Parse, 1994, 1996c; Pilkington & Mitchell, 2004), suffering (Pilkington & Kilpatrick, 2008), feeling respected-not respected (Bournes & Milton, 2009), feeling disappointed (Bunkers, 2012a), living on the edge (Peterson-Lund, 2012), doing the right thing (Smith, 2012), and feeling strong (Doucet, 2012). The research process has been developed with families (Baumann, 2006; Cody, 2000) and children (Karnick, 2008). The humanbecoming hermeneutic method has expanded understanding of wisdom, compassion, and courage (Baumann, 2008), hope (Parse, 1999, 2007a), and lingering presence (Ortiz, 2003). Scholars have examined the artful practice of humanbecoming (Dempsey, 2008b; Parse, 1992c), and have transformed research into art forms (Jonas-Simpson & Mitchell, 2005; Mitchell, Jonas-Simpson, & Ivonoffski, 2006). The theory has global appeal and has provided meaningful direction to many nurses in countries too numerous to list here.
Parse (1990b) suggests that the value of her work will be decided by future generations of nurses who live the theory, by the clients who experience practice with these nurses, and by the new knowledge that accompanies research guided by the theory. By viewing her work as an invitation to think and act differently, Parse provides new horizons for nursing as a human science focused on the experience of indivisible, unpredictable, everchanging human beings. Since the birth of humanbecoming, Parse has published many papers that continue to expand nurses’ thinking. Her commitment to scholarship and knowledge development is evident in her own work, especially as founder and editor of the journal Nursing Science Quarterly, and in the works of nurses who accept her invitation to think and act differently in practice, education, leadership, and research.
Overview of Parse’s Theory of Humanbecoming
The Humanbecoming School of Thought presents an alternative knowledge base for nurses to guide their practice and research activities. When first engaged, humanbecoming may be experienced as familiar-yet-unfamiliar, simplistic-yet-complex, and clear-yet-obscure (Mitchell & Pilkington, 2000). It requires as much willingness on the part of the interested professional nurse and others to unlearn as it does to learn a new way of thinking. The Humanbecoming School of Thought appeals to nurses who, like Parse, find the biomedical model restrictive and dehumanizing. The principles and concepts are abstract, and the language Parse uses is nonlinear and can be both unsettling and uplifting in its fluidity and process orientation. Humanbecoming is a foundation of knowledge that is very deep. Informed by people’s living experiences, the school of thought is a source for dynamic and self-renewing understanding of humanuniverse and health.
It is interesting and quite important to appreciate the meaning of humanuniverse and health, especially in light of the idea that nursing’s metaparadigm concepts—human beings, environment, and health—are often described separately. In the Humanbecoming School of Thought, they are not considered separate. It is the idea of the unity of person-with-universe—described by Parse (2012a,b) as the illimitable, indivisible, unpredictable, everchanging humanuniverse—that distinguishes the Humanbecoming School of Thought from other nursing theoretical perspectives. Parse (2007b, 2012a,b) deliberately uses the terms humanbecoming and humanuniverse to demonstrate through language that there is no space for thinking that humans can be separated from becoming or the universe—these notions are irreducible.
Health, according to Parse (1990a, 2012a) is humans’ values becoming visible with their invisible becoming as they live personal commitments and make choices about what to do and who to be with the emerging now (Parse, 2012a). Humans are free to choose the meaning and significance of events, their attitudes, their concerns, and their hopes and dreams. Health relates to ways in which persons live their value priorities during the ups and downs that shape their experiences. In any given moment from birth to death, humans can and do choose their values and thus their health.
With humanbecoming, health cannot be given or taken, controlled or manipulated, judged, or diagnosed. Rather, health is the way people live their valuesin accordance with their desires, hopes, and dreams. Patterns of health are paradoxical, including times of disappointment as well as times of success, and times of joy with times of sorrow. From Parse’s perspective, individuals co-author their health and no outsider can define the values that another person will cherish and live by. This view of health, along with the assumptions and principles of humanbecoming form the foundation for the kind of practice directed by the theory.
The humanbecoming theory consists of three principles and nine concepts that flow from assumptions about humans and becoming. The nine assumptions (Parse, 2012b) are as follows:
1. The human with universe is co-existing while co-constituting rhythmical patterns.
2. The human is open, freely choosing meaning with situation, bearing responsibility for decisions.
3. The human is continually co-constituting patterns.
4. The human is transcending illimitably with possibles.
5. Becoming is human-living-health.
6. Becoming is rhythmically co-constituting humanuniverse.
7. Becoming is the human’s value priority patterns.
8. Becoming is transcending with possibles.
Three themes emerge from the nine assumptions: meaning, rhythmicity, and transcendence. Three principles of humanbecoming (the theory) flow from the themes (Parse, 1981, 1998, 2007b, 2012b):
1. Structuring meaning is the imaging and valuing of languaging.
3. Co-transcending with possibles is the powering and originating of transforming. (Parse, 2012b, p. 45)
Four postulates aligned with the assumptions permeate each of the three principles of humanbecoming (Parse, 2007b). The postulates are illimitability, paradox, freedom, and mystery. Illimitability conveys the unbounded nature of humanuniverse; paradox is the way humans experience patterns of living; freedom is the envisioned liberation of the moment; and mystery is the reverence for what is not knowable. The humanbecoming theory is unique in its identification of paradox as an inherent process of human experience. The three principles of humanbecoming form the knowledge base that shapes the nurse’s view of humanuniverse. Each principle has a central theme as well as paradoxical rhythms that help define humanbecoming. Taken together, these principles are like a landscape that forms the background or fabric of knowledge that prepares the nurse’s thinking and acting with clients in practice and research. These principles are values-based and therefore cannot be tested in the traditional sense of testing a theory. For example, a nurse would not test the hypothesis that people choose meaning in situations or that people reveal and conceal who they are. As in other theories, assumptions are not testable because they are assumed to be true. It is a choice to practice with humanbecoming, a choice made most often because of the fit between one’s personalvalues and the view of humanbecoming nursing. Readers are encouraged to go to the original sources of Parse’s work for a full discussion of the theoretical assumptions, postulates, principles, and concepts because each nurse interprets and lives the theory in consistent and yet unique ways.
Principle One
The first principle of humanbecoming is, “Structuring meaning is the imaging and valuing of languaging” (Parse, 2012b, p. 45). Meaning is the central theme of this principle. This first principle provides one of the three essential frames that shape what nurses think about humans before they approach people in practice. Structuring meaning is what humans do; all people construct a unique view of the world in light of what is becoming visible to them with their invisible becoming in the emerging now. That is, their worldview is co-created with their experiences both explicitly and tacitly in the process of their living and relating with others. The meaning of life situations is connected to the choices persons make regarding hopes, dreams, fears, doubts, and cherished beliefs. Nurses who integrate beliefs contained in the first principle approach people as mysteries who assign unique meanings to their life situations. The first principle contains three concepts—imaging, valuing, and languaging.
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