The term salutogenesis refers to the science of the development and maintenance of a person's health. The word salutogenesis is made up of the two words "salus" and "genesis". "Salus" comes from Latin and means "health", while "genesis" literally means "origin". Salutogenesis thus sees itself as the antithesis of pathogenesis, which focuses on the development of diseases.
In the 1970s, medical sociologist Aaron Antonovsky studied the question of which factors influence health. On this basis, he developed a theoretical model of the characteristics that are necessary for a person to become healthy and maintain their health. This model became known as salutogenesis.
The core ideas of salutogenesis
In summary, there are four basic assumptions in the concept of salutogenesis:
- Antonovsky never regarded health as a state, but always as a process.
- In his view, a person is not simply sick or healthy, but always more or less healthy.
- In his opinion, the extent to which a person can be classified between the two poles of sick and healthy depends on various factors.
- These factors always have an effect on a person's health and can be both protective and stressful in nature.
One example of this is diabetes mellitus. According to the salutogenesis approach, it is more productive to focus on sporting activities that lead to an improvement in general well-being than to concentrate solely on a strict diet aimed at lowering high blood sugar levels.
How did Antonovsky arrive at his findings?
Antonovsky's thoughts on salutogenesis were based on the results of special stress research. This showed that people deal with different situations in their lives in different ways. This in turn has different consequences for a person's health.
Specifically, Antonovsky was involved in a study on the ability to adapt to menopause. One particular characteristic of his female test subjects was that they had been imprisoned in concentration camps during their youth. This meant that they were confronted with extremely negative influencing factors.
Antonovsky examined the ability of the test subjects to cope with the exceptional hormonal state of menopause and compared this ability with a control group that had not been imprisoned in concentration camps during their youth. The control group therefore had no significant negative stressor.
Antonovsky's findings were quite surprising for him. It turned out that women could be described as physically and mentally completely healthy, despite their previous exposure to their youth in a concentration camp. These women obviously had their own resources that kept them healthy despite their negative experiences.
Three special properties for maintaining health
The so-called sense of coherence is an essential concept in the model of salutogenesis. By this, Antonovsky means a deep inner satisfaction and a subjectively perceived sense of belonging. These emotions relate both to the self and to life with other people. The following three characteristics are of particular importance here.
Comprehensibility of contexts
A person must have the ability to make connections between experiences and events in their life and also be able to understand these connections.
Ability to process experiences
The second step involves the ability to deal with these experiences and events appropriately.
Recognize the meaningfulness of events
People should also be convinced that all experiences and events have a meaning. This trust often makes it easier to accept certain events.
A person develops these three characteristics by the age of 20. Depending on how well these characteristics are developed, a person can cope more or less well with difficult experiences and crises. Such crises include, for example, the death of close relatives or a serious illness.
According to the concept of salutogenesis, a person's health depends on the development of these characteristics.
Pathogenesis versus salutogenesis
Before the salutogenesis model was introduced in the 1970s, the focus in health research was on pathogenesis. Pathogenesis deals with the question of why certain diseases develop in the first place and how they should best be treated. The disease is therefore firmly in the focus of pathogenesis.
Gradually, research was then carried out into how a person can remain healthy despite external risk factors and how a person's health can be positively supported in practice.
It quickly became clear to doctors that there are major differences between the approach to a disease from a pathogenetic and salutogenetic perspective. Put simply, pathogenesis aims to prevent or combat a disease. The philosophy of salutogenesis, on the other hand, aims to achieve an attractive health goal.
A simple example can be used to illustrate the difference between the pathogenetic and salutogenetic view. Pathogenesis pursues the goal of rescuing drowning people from a raging river. Salutogenesis investigates who or what actually pushed people into the river.
Pathogenesis therefore asks what helps in the event of illness when the proverbial child has fallen into the well. Salutogenesis, on the other hand, deals with the question of what can be done to prevent a person from falling into the torrent in the first place.
Pathogenesis = What causes illness?
Salutogenesis = What makes you healthy?
Salutogenesis and resilience
Salutogenesis not only aims to help people in the event of illness, but also to promote their personal defenses. These personal defenses are also known as resilience.
How does resilience develop?
If a person is given the feeling from an early age that they can make a difference and achieve something themselves, if they recognize a purpose in their actions and experience a sense of connection with their environment, then they will be better able to deal with adverse circumstances. This then leads to more resilient physical and mental health.
The easiest way to stay healthy is to simply avoid difficult life processes or pathogens. This is the prevailing opinion in conventional medicine. However, in some situations this approach simply cannot be implemented because we are surrounded by potential pathogens at all times and cannot avoid some difficult life processes
For example, we cannot prevent a loved one from leaving us or our job from being rationalized for cost reasons. The concept of salutogenesis believes that life crises and some illnesses are beneficial to health, as a person builds up good defenses and mental stability primarily by dealing with conflicts and health-related stress factors.
How do resilience and salutogenesis influence each other?
The two terms salutogenesis and resilience are closely linked. The term resilience expresses something like resistance. The more resilient a person is and the better their body is able to fend off a disruption, the healthier they will be. Perhaps you know one or two people from your own environment who never seem to be ill or who struggle with certain aches and pains.
In fact, there are people who very rarely fall ill, even though they are regularly confronted with potentially illness-causing circumstances. Other people, on the other hand, have less resilience and lie in bed with pronounced symptoms of exhaustion or fever even in mild stress situations. These people have fewer personal resources to fall back on in critical situations and rarely perceive a crisis as an opportunity for further development.
Is it possible to consciously stay healthy?
Various factors play an important role in consciously staying healthy. Salutogenesis refers to personal resilience resources. These include, among others:
- Intelligence,
- the social network,
- Farsightedness,
- Flexibility,
- the immune system.
So if you have a good circle of friends, a good education and a high standard of living, you have very good prerequisites for staying healthy. According to the concept of salutogenesis, external circumstances play a major role in the level of health. However, working on one's own identity and a positive self-assessment are just as crucial for the quality of one's own health. Only people who are at peace with themselves can remain healthy in the long term.
Conclusion: According to the concept of salutogenesis, health is a process and not a state. There are always phases in a person's life in which health sometimes predominates and sometimes illness. However, a balanced lifestyle strengthens individual resilience resources and, according to the concept of salutogenesis, is a very good prerequisite for staying healthy in the long term.
