Salutogenesis

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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."

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 Heatlh," 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 either 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 utilization 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 psychology, behavioral medicine and the sociology of health.. The term has been adopted in the medical fields of healthcare and preventive medicine. {{{author}}}, {{{title}}}, [[{{{publisher}}}|{{{publisher}}}]], [[{{{date}}}|{{{date}}}]].

 It has also been been adopted as a term to describe traditional concepts in alternative medicine, naturopathy, homeopathy and anthroposophical medicine.  {{{author}}},  {{{title}}},  [[{{{publisher}}}|{{{publisher}}}]],  [[{{{date}}}|{{{date}}}]].

Further reading

• 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