Salutogenesis
Encyclopedia
Salutogenesis is a term coined by Aaron Antonovsky
, a professor of medical sociology. The term describes an approach focusing on factors that support human health
and well-being, rather than on factors that cause disease. More specifically, the "salutogenic model" is concerned with the relationship between health, stress, and coping.
Antonovsky's theories reject the "traditional medical-model dichotomy
separating health and illness". He described the relationship as a continuous variable, what he called the "health-ease versus dis-ease continuum".
In his 1979 book, Health, Stress and Coping, he described a variety of influences that led him to the question of how people survive, adapt, and overcome in the face of even the most punishing life-stress experiences. In his 1987 book, Unraveling the Mysteries of Health, he focused more specifically on a study of women and aging; he found that 29% of women who had survived concentration camps had positive emotional health, compared to 51% of a control group. His insight was that 29% of the survivors were not emotionally impaired by the stress. Antonovsky wrote: "this for me was the dramatic experience that consciously set me on the road to formulating what I came to call the 'salutogenic model'."
In his theory, whether a stress factor will be pathogenic, neutral, or salutary depends on what he called generalized resistance resources or GRRs. A GRR is any coping resource that is effective in avoiding or combating a range of psychosocial stressors: resources such as money, ego-strength, and social support.
Antonovsky's formulation was that the GRRs enabled individuals to make sense of and manage events. He argued that over time, in response to positive experiences provided by successful use of different GRRs, an individual would develop an attitude that was "in itself the essential tool for coping".
In his formulation, the sense of coherence has three components:
According to Antonovsky, the third element is the most important. If a person believes there is no reason to persist and survive and confront challenges, if they have no sense of meaning, then they will have no motivation to comprehend and manage events. His essential argument is that "salutogenesis" depends on experiencing a strong "sense of coherence." His research demonstrated that the sense of coherence predicts positive health outcomes.
, behavioral medicine
, and the sociology of health. The term has been adopted in the medical fields of healthcare and preventive medicine
. It has also been adopted as a term to describe traditional concepts in alternative medicine
, naturopathy, homeopathy
, nursing, psychiatry, anthroposophical medicine
, and healthcare architecture. The salutogenic framework has also been adapted as a method for decision making on the fly; the method has been applied for emergency care and for healthcare architecture .
Aaron Antonovsky
Aaron Antonovsky PhD, was an Israeli American sociologist and academician whose work concerned the relationship between stress, health and well-being....
, a professor of medical sociology. The term describes an approach focusing on factors that support human health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
and well-being, rather than on factors that cause disease. More specifically, the "salutogenic model" is concerned with the relationship between health, stress, and coping.
Antonovsky's theories reject the "traditional medical-model dichotomy
Dichotomy
A dichotomy is any splitting of a whole into exactly two non-overlapping parts, meaning it is a procedure in which a whole is divided into two parts...
separating health and illness". He described the relationship as a continuous variable, what he called the "health-ease versus dis-ease continuum".
Derivation
The word "salutogenesis" comes from the Latin salus = health and the Greek genesis = origin. Antonovsky developed the term from his studies of "how people manage stress and stay well". He observed that stress is ubiquitous, but not all individuals have negative health outcomes in response to stress. Instead, some people achieve health despite their exposure to potentially disabling stress factors.In his 1979 book, Health, Stress and Coping, he described a variety of influences that led him to the question of how people survive, adapt, and overcome in the face of even the most punishing life-stress experiences. In his 1987 book, Unraveling the Mysteries of Health, he focused more specifically on a study of women and aging; he found that 29% of women who had survived concentration camps had positive emotional health, compared to 51% of a control group. His insight was that 29% of the survivors were not emotionally impaired by the stress. Antonovsky wrote: "this for me was the dramatic experience that consciously set me on the road to formulating what I came to call the 'salutogenic model'."
In his theory, whether a stress factor will be pathogenic, neutral, or salutary depends on what he called generalized resistance resources or GRRs. A GRR is any coping resource that is effective in avoiding or combating a range of psychosocial stressors: resources such as money, ego-strength, and social support.
Antonovsky's formulation was that the GRRs enabled individuals to make sense of and manage events. He argued that over time, in response to positive experiences provided by successful use of different GRRs, an individual would develop an attitude that was "in itself the essential tool for coping".
Sense of coherence
The "sense of coherence" is a theoretical formulation that provides a central explanation for the role of stress in human functioning. "Beyond the specific stress factors that one might encounter in life, and beyond your perception and response to those events, what determines whether stress will cause you harm is whether or not the stress violates your sense of coherence." Antonovsky defined Sense of Coherence as:- "a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that (1) the stimuli deriving from one's internal and external environments in the course of living are structured, predictable and explicable; (2) the resources are available to one to meet the demands posed by these stimuli; and (3) these demands are challenges, worthy of investment and engagement."
In his formulation, the sense of coherence has three components:
- Comprehensibility: a belief that things happen in an orderly and predictable fashion and a sense that you can understand events in your life and reasonably predict what will happen in the future.
- Manageability: a belief that you have the skills or ability, the support, the help, or the resources necessary to take care of things, and that things are manageable and within your control.
- Meaningfulness: a belief that things in life are interesting and a source of satisfaction, that things are really worth it and that there is good reason or purpose to care about what happens.
According to Antonovsky, the third element is the most important. If a person believes there is no reason to persist and survive and confront challenges, if they have no sense of meaning, then they will have no motivation to comprehend and manage events. His essential argument is that "salutogenesis" depends on experiencing a strong "sense of coherence." His research demonstrated that the sense of coherence predicts positive health outcomes.
Other fields of application
Antonovsky viewed his work as primarily addressed to the fields of health psychologyHealth psychology
Health psychology is concerned with understanding how biological, psychological, environmental, and cultural factors are involved in physical health and illness. Health psychologists work alongside other medical professionals in clinical settings, work on behavior change in public health promotion,...
, behavioral medicine
Behavioral medicine
Behavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness...
, and the sociology of health. The term has been adopted in the medical fields of healthcare and preventive medicine
Preventive medicine
Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...
. It has also been adopted as a term to describe traditional concepts in alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
, naturopathy, homeopathy
Homeopathy
Homeopathy is a form of alternative medicine in which practitioners claim to treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient...
, nursing, psychiatry, anthroposophical medicine
Anthroposophical Medicine
Anthroposophical medicine is a complementary approach to medicine that integrates the theories and practices of modern medicine with homeopathic medicines, physical and artistic therapies and biographical counseling...
, and healthcare architecture. The salutogenic framework has also been adapted as a method for decision making on the fly; the method has been applied for emergency care and for healthcare architecture .
Further reading
Becker, C. M., Glascoff, M. A. , & Felts, W. M. (2010). Salutogenesis 30 Years Later: Where do we go from here? International Electronic Journal of Health Education, 13, 25-32. Can access at: http://www.aahperd.org/aahe/publications/iejhe/upload/10_C_Becker.pdf- Studying Health vs. Studying Disease - Aaron Antonovsky. Lecture at the Congress for Clinical Psychology and Psychotherapy, Berlin, 19 February 1990.
- Coping with Existential Threats and the Inevitability of Asking for Meaningfulness - Peter Novak. A philosophical perspective
- http://usyd.academia.edu/JanGolembiewski/Papers/290160/Start_Making_Sense - Start Making Sense; Applying a salutogenic model to architectural design for psychiatric care - Jan Golembiewski. A method of appliying salutogenic theory.