Page 132 - Nursing: The Philosophy and Science of Caring

Fr om carative Fa c t o r 5 t o C ar it as ProC e s s 5
The process of being with another in a nonjudgmental way as that
individual expresses his or her feelings generates a mutual trust and
understanding. This process serves as a core foundation that sustains
the authenticity of a caring relationship and affirms the shared human-
ity of both individuals in that moment.
The literature has established that a change in any emotion, behav-
ior, or cognition may cause a change in the other two. The affective
component of an attitude is said to be that aspect that is emotionally
satisfying; this view suggests that a person seeks consistency between
emotions and thoughts, that emotions serve a need as humans seek
to maintain a balance between and among thoughts, feelings, and
behavior.
The earlier work of Yalom (1975) supports the importance of this
factor/process. In his classic clinical studies with patients in group ther-
apy, he found that when asked to recall a single critical incident that
served as a turning point for them, the incident most often reported
was a sudden expression of strong negative feelings (e.g., hatred or
anger). The common characteristics of the critical incident were:

• The person expressed a strong negative emotion, which was new
for him or her.
• The feared or fantasized catastrophe associated with the expres-
sion of the negative feelings did not occur.
• Reality testing ensued in which the person realized that the feel-
ing expressed was inappropriate in intensity or direction or that
the avoidance of the expression of the feeling was irrational (the
person may or may not have gained insight into or psychody-
namic knowledge of the source of the feelings).
• The person was enabled to interact and to explore more deeply.

In this same work, the expression of strong positive feelings had
almost the same therapeutic outcome as the expression of negative
feelings. For example, the common critical incidents related to the
expression of positive emotion were:

• The person was able to express a strong positive emotion, which
was unusual for him or her.

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