Reeds Self-Transcendence Theory

Elizabeth James

Bethel College




































Reeds Self-Transcendence Theory

Pamela G. Reed was a pioneer in nursing research that led to the development of
her self-transcendence theory. Pamela was born in Detroit, Michigan. She began her
nursing career, graduating in 1974 with her baccalaureate degree from Wayne State
University in Detroit, Michigan. She earned her masters of science in nursing at Wayne
State University in psychiatric-mental health of children and adolescents and in nursing
education in 1976. Reed continued her education at Wayne State where she received her
doctorate in 1982. Her doctorate had a concentration in nursing theory and research and
a minor in adult development and aging. Reed is currently on the faculty at the
University of Arizona College of Nursing in Tucson. While at the University of Arizona,
she has taught, conducted research, and served in administrative roles. This
Self-Transcendence Theory

This paper will explore Pamela Reeds self-transcendence theory and her influences
and applications in nursing today. The self-transcendence theory assists in identifying
individuals who are motivated to evolve to the next stage of their life. The self-
transcendence theory will be explored in the homecare setting as well as in students
who are obtaining their masters in nursing.
The self-transcendence theory itself evolved into the latest 2003 model that involves
three sets of relationships (1) Increased vulnerability is related to increased self-
transcendence; (2) Self-transcendence is positively related to well-being; and (3)
Personal and contextual factors may influence the relationship between vulnerability and
self-transcendence and between self-transcendence and well-being (Coward, 2010, p.
623).
Self-transcendence typically occurs in response to a life changing event which forces
an individual to examine their own mortality. Frankl described self-transcendence as
the inherent characteristic of humans to reach out beyond themselves and thus
discover or make meaning of their lives (Coward, 1996, p.121). Reed stated reaching
inwardly, outwardly, and temporally beyond self-concerns are theorized as being
positively associated with indicators of well-being in persons facing end of life issues
(Coward, 1996, p.116). Self-transcendence is achieved when a person can step beyond
the concrete aspects of an event to derive meaning from the event. The individual then
puts their own needs secondary and reaches out to others in an attempt to share their
knowledge and growth. They want to be needed and valued.

Development of Self-Transcendence Theory

Reeds self-transcendence theory originated with Reeds professors, notably Ann
Whall and Joyce Fitzpatrickthe primary non-nursing theory sources were life span
theories on adult social-cognitive and transpersonal development (Coward, 2010, p.
619). It was intriguing that she used both nursing and non-nursing theories when
formulating her work. In her original 1991 paper describing her transcendence theory,
she cites many theorists that influenced her work including Erickson, Lifton, Frankl,
Allport, Parse, Maslow, Watson and Newman (Reed, 1991). She sought to build a
nursing theory that incorporated the well-known work of many of the life span theorists
but with a nursing twist. Reed identified this process stating that deductive
reformulation is a strategy for constructing middle-range theory whereby existing
knowledge, derived from non-nursing theory on the phenomenon of interest, is
reformulated using knowledge obtained deductively from a nursing concept model
(Coward, 2010, p. 619).
Reed used three sources for her theory. She described her first source as
conceptualization of human development as a lifelong process that extended beyond
the attainment of adulthood throughout the aging and dying process (Coward, 2010,
p. 619). This was a ground breaking concept. Previously it was believed that all
growth and development ended in adolescence. Older adults were thought as closed,
non-linear systems.
The second source for Reeds theory incorporated the work of theorist Martha
E. Rogers. Rogerss homeodynamic principles described in her unitary human being
paradigm were congruent with the self-transcendence theory. Rogers theory
identified development as a function of both human and contextual factors: it also
identified disequilibrium between person and environment as an important trigger of
development (Coward, 2010, p. 619).
Reeds clinical experience and research was the third source for her
theory. She researched development in children, adolescents and adults. She studied
healthy and mentally ill individuals. Older adults were regarded generally as closed
systems who, having reached their zenith much earlier in life, were running out of
energy and becoming increasingly disordered to the point of debilitation and death
(Reed, 1991, p. 66). Reed discovered that this was not true and that many people
wanted to expand their boundaries, give back to their communities, and develop their
emotional well-being and hopefulness. Reed revealed that age does not necessarily
lead to self-transcendence. Youth does not necessarily negate self-
transcendence. When children or adolescents face end of life issues they may
experience self-transcendence. Reed stated developmental maturity, irrespective of
chronological age, in which one experiences an expansion of self-boundaries and
orientation toward broadened life perspectives and activities (Coward, 1996, p. 116).
Self- Transcendence in Research
Self-transcendence theory has been used in diverse research studies. The
quest for nursing is to facilitate human well-beingtoward this end, self-transcendence
theory has been used in practice, education and research (Coward, 2010, p. 624). In
a study of women living with rheumatoid arthritis, Neil wrote that it is not just end of
life experiences that may cause self-transcendence but theorized extreme instability
and turbulence in human lives, for example during illness, despair, disablement, or
death precede resolution to a more harmonious state or high level of complexity, known
as expanded consciousness (Neill, 2002, p. 29). Neill documented that acceptance of
the life changing event led to rediscovery and participation in life. The women in her
study demonstrated self-transcendence by connectedness, giving and receiving, and
hope and purpose, especially in end-of-life issuesthere is a connection between self-
transcendence and personal transformation relevant to expanding consciousness, as
both involve entertaining possibilities beyond the self and the present ( Neill, 2002, p.
30).
The self-transcending theory has been utilized in research for women with
breast cancer, AIDS victims and the healthy population. It was revealed that the
broadened perspective and activities characteristic of self-transcendence could be
expected to be found in persons of any age or state of physical health (Coward, 1996,
p.116). Alcoholics Anonymous well known 12 step recovery process and Elizabeth
Kubler-Ross stages of grief both use self-transcendence.
Self-Transcendence in Research
One of the many challenges of homecare nursing was dealing with chaos and
change for the patient. Addressing the patients most basic needs was top
priority. Reed incorporated parts of Maslows theory of human needs that states all
people want to be the best that they can possibly be, unmet basic needs interfere with
holistic growth whereas satisfied needs promote growth (Erickson, 2010, p.
541). Most homecare patients have Medicare that allows homecare nursing to treat for
sixty days. In order to progress, a person must have a sense of wholeness and
health. As the relationship between the homecare nurse and patient progress, it is the
job of the nurse to assess the readiness of the patient to expand their boundaries either
outwardly, inwardly or temporally.
Homecare nursing has many returning patients or frequent flyers. What could
motivate a patient to comply with their health plan? How could nursing assist patients
in their holistic development? Interventions suggested by Reed were self-reflection,
visualization, religious expression, counseling, and journaling to expand the individuals
boundaries (McEwen, 2011, p. 238). Time is always an issue for field clinicians in
homecare. Nursing typically does not talk in patient numbers but rather hours. For
example: Sue did not have five patients today, but Sue had a twelve hour day. This
takes into consideration the drive time, the actual time in and time out, follow up phone
calls and computer charting. Homecare nurses do not leave at the end of a shift
because there is no relief until they are in their car. They do not finish their day until all
of their patients have been seen and all of their computer charting is done. Homecare
nurses are always stressed for time. Unfortunately, the patient may sense this
urgency. It is important that the homecare nurse spend uninterrupted focused time
with the patient. Basic body language was still a way for nurses to express openness
and acceptance, encouraging patients to become involved in their health care decisions
and motivating them to take charge of their lifestyles. Examples would be assisting
with compliance of medications and teaching to set up their own med box. Reminding
them to set up their own appointments is vital to increasing the patients self-
esteem. Providing patients with support group information will assist the patient with
the feeling of belonging. A key point that Reed made was when she clarified a more
foundational definition of nursing that shifted the source of nursing activity from that of
external agent to viewing nursing as an inner human process (Coward, 2010, p.
627).
Self-transcendence can occur at any age. Homecare nursing visit patients from
birth to the oldest of old. Maturity has been seen in younger patients who have
experienced life changing events. A three year old boy was in the end stages of
neuroblastoma. His mother reported that she was with him at all times as he lay in his
bed. The boy was in and out of consciousness. He opened his eyes and asked his
mother if she heard the angels. It was springtime and the mother thought he meant
the birds singing outside. He heaved a heavy sigh, closed his eyes and said, No,
Mommy dont you hear the angels singing, Jesus is calling my name. It is so nice I
want you to hear it too. The mother started crying. The boy opened up his eyes
again and asked her when her birthday was. The mother told him it was in November,
in about six months. The boy said Happy Birthday Mommy, I wish I could be
there. The boy died shortly after this event. This is a true story that demonstrated
how a young child used self-transcendence. He wanted his mother to hear the
beautiful music the angels made and he wished his mother happy birthday since he
knew he would not be there on that day in November.
Self-Transcendence in Masters Students
What motivates nurses to go back to school to get their Masters degree? During
the first day of class, the students each stated why they were going back to get their
advanced degree. Only one said it was because someone at work told her it would be a
good idea. So why now and why Bethel? The first year masters nurses come from
varying backgrounds. There are three in management at extended care facilities. The
other nurses work on a critical care unit, in a cardiac cath lab, dialysis, homecare, public
health department, teaching at a community college, in a walk in non-profit clinic,
hospice care, and rehab unit. The students have all been nurses for a number of
years. Reed stated Self-transcendence moves the individual beyond the immediate or
constricted view of self and the world (McEwen, 2011, p. 237). One of the nurses
travels around the world for mission work. Many of the nurses have children at
home. Some are single mothers. It is thought provoking as to why these nurses have
decided to move outside of their comfort zone and pursue this degree. The nurses are
all experiencing self-transcendence. They want to evolve and become better not only
at their jobs but also to better serve their clients and give back to their communities
and places of work.
Conclusion
Reeds self-transcendence theory is abstract and often difficult to understand. It
may be challenging to identify. It will take skills of the nurse to assess the patient and
assist with their evolvement. The nurse needs to put her own self-centered needs
aside as she supports the patient and implements strategies to support this
evolvement. The individuals basic needs must first be met before they are ready to
progress and mature. Even as an individual uses self-transcendence, they may digress
to a self-centered state. People are not linear nor do they stop growing as they
age. Self-transcendence may be a slow journey, but in the end it will be fulfilling for
the patient and the nurse.
Self-transcendence in the masters students will be interesting to watch as they
continue to pursue their graduate degrees. What has changed in their lives that has
prompted these women into action? Many of them already show signs of
evolvement. An interesting research topic would be inquiring why these students chose
Bethel. It would be fascinating to compare these students motivations with other
masters students in different programs. Following these students after graduation to
determine if they have evolved could be very interesting.










































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