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CHAPTER 32 Phil Barker 629

need to build, creatively, a means of reaching the per- living, merely pragmatic strategies for living with
son; crossing in the process, the murky waters of such problems. The influence of Denny Webster and
mental distress (Barker & Buchanan-Barker, 2004b). her colleagues in Denver in the early 1990s, introduc-
The Tidal Model may be viewed through the lens of ing de Shazer’s ideas into nursing practice, signifi-
social constructivism, recognizing that there are mul- cantly shaped the development of the Tidal Model
tiple ways of understanding the world. Meaning (Webster, Vaughn, & Martinez, 1994).The Tidal
emerges through the complex webs of interaction, Model draws its core philosophical metaphor from
relationships, and social processes. Knowledge does chaos theory, where the unpredictable yet bounded
not exist independently of the knower, and all knowl- nature of human behavior and experience can be
edge is situated (Stevenson, 1996). Change is the only compared to the flow and power of water (Barker,
constant, as meaning and social realities are constantly 2000b, p. 54). In constant flux, the tides ebb and flow;
renegotiated or constructed through language and they exhibit nonrepeating patterns yet stay within
interaction. Barker believes “all I am is story; all I bounded parameters (Vicenzi, 1994). Barker (2000b)
can ever be is story.” As people try to explain to others acknowledges the “complexity [of] both the internal
“who” they are, they tell stories about themselves universe of human experience and the external uni-
and their world of experience, revising, editing, and verse, which is, paradoxically, within and beyond the
rewriting these stories through dialogue. Barker first individual, at one and the same time” (p. 52). Within
discussed this idea with his mentor, Hilda (Hildegard) this complex, nonlinear perspective, small changes
Peplau in 1994, who agreed that “people make them- create later unpredictable changes; a hopeful message
selves up as they talk” (Barker, 2003a; Barker & that directs nurses and persons to identify small
Buchanan-Barker, 2007b). changes and variations. Chaos theory suggests that
Barker credits many thinkers with influencing his there are limits to what we can know, and Barker
work, beginning with Annie Altschul and Thomas invites nurses to cease the search for certainty, em-
Szasz. His view of mental health problems as problems bracing instead the reality of uncertainty. Know that
of living popularized by Szasz (1961, 2000) and later “change is constant,” one of the Ten Tidal Commit-
Podvoll (1990) is a perspective he prefers to diagnos- ments, identifies and celebrates change in people,
tic labeling and the biomedical construction of people circumstances, relationships, and organizations
and illness (Barker, 2001c, p. 215). He agrees with (Barker, 2003b; Buchanan-Barker & Barker, 2008).
Szasz that it is futile to try to “solve problems in This perspective also presents challenges in trying to
living.” Life is not a problem to be solved. Life is understand people, relationships, and situations. It
something to be lived, as intelligently, as competently, directs inquiry in qualitative, nonlinear ways, such as
as well as we can, day in and day out (Miller, 1983, action research, grounded theory, phenomenology,
p. 290). The challenge for nursing is to help persons and critical theory (Barker, 1999a).
live “intelligently” and “competently.” Annie Altschul, the Grande Dame of British psychi-
Travelbee’s (1969) concept of the Therapeutic Use atric nursing (Barker, 2003a, p. 12), along with Hilda
of Self flows through the Tidal Model and provides an (Hildegard) Peplau, was one of Barker’s mentors.
anchor for the “proper focus of nursing.” The follow- Altschul’s influence, especially her early appreciation of
ing three main theoretical frameworks underpin the system theory, is evident in the Tidal Model, as is her
Tidal Model: interest in understanding rather than explaining mental
1. Peplau’s (1952; 1969) Interpersonal Relations Theory distress and her belief that people need more straight-
2. Theory of Psychiatric and Mental Health Nursing forward help than many psychiatric theories suggest.
derived from the Need for Nursing studies Barker credits Peplau, the mother of psychiatric
3. Empowerment within interpersonal relationships nursing, with his becoming “an advocate for nursing
The pragmatic emphasis on strength-based, solu- as a therapeutic activity in its own right” (Barker,
tion-focused approaches acknowledges the important 2000a, p. 617). Peplau introduced her interpersonal
influence of Steve de Shazer’s solution-focused ther- paradigm for the study and practice of nursing in the
apy, although, as noted above, Barker does not believe early 1950s and defined nursing as “a significant,
that there can be any “solutions” for problems in therapeutic, interpersonal process” (Peplau, 1952,