The Philosophy of Salutogenesis

Why are we healthy – and how can we stay that way? This central question is the basis of the philosophy salutogenesis, the holistic concept for body, mind and soul at Hotel Saltus in Jenesien, South Tyrol.

What is salutogenesis?

The term is composed of the Latin “salus”, which can be translated as health, well-being, but also life or existence, and the ancient Greek “genesis”, which means birth or emergence. The science of the emergence – and also the maintenance – of health is therefore called “salutogenesis.”

Its founder, Israeli medical sociologist and stress researcher Aaron Antonovsky, once commented on his work:

It’s probably better to focus on what keeps people healthy than to spend immense resources researching their diseases.

He explored the question of why people stay healthy – and others get sick – under sometimes the most adverse conditions. In doing so, he made a fundamental shift in perspective: away from classical medicine, which looks for the causes of an illness in a deficit-oriented view and toward a resource-oriented perspective, which rather wants to know what keeps us healthy.

The river of life

There is a good image that illustrates this perspective: Let us imagine life as a river in which man swims. In this river there are branches that lead to easy currents on one side and dangerous rapids and whirlpools on the other. So naturally the question arises What makes man a good swimmer?

According to Antonovsky, health is not a self-evident state of equilibrium, but a continuous process that must be worked on constantly. He called this the “health-disease continuum” and chose to represent it as a horizontal axis with health at one end and disease at the other. If we now span this axis in thought over our life river, the two banks represent the end poles. And since in life we cannot swim to one shore and stay there forever, we are constantly moving somewhere between the two shores as the river of our life carries us along.

Sometimes we are closer to one shore, sometimes to the other – and it depends on our abilities as swimmers whether we drift more toward health or illness. Sometimes it is stronger, sometimes weaker rapids – called “stressors” in Antonovsky’s model – that affect us. Stimuli and adversities from inside and outside – risk factors that cause states of tension in us that disturb our inner balance.

What are stressors?

These can be “physical stressors” such as accidents, environmental pollution, heat, wetness, malnutrition or lack of exercise, “biochemical stressors” such as pathogens, drugs or toxins, or “psychosocial stressors” such as anxiety, work overload, social conflicts, personal crises, etc. Whatever it may be, it requires our strength and energy to counteract them.

Stressors are reinforced by so-called “personal stress amplifiers”. These are primarily negative beliefs that have arisen from the evaluation and processing of earlier experiences or statements; often already in childhood, e.g., by our parents, grandparents or teachers. They function like a kind of “background program in the head” that we usually do not even consciously perceive, but which immediately reacts to external influences and situations and evokes thoughts, feelings and actions.

If, for example, one is convinced on the basis of earlier experiences that one is rather weak and that one’s own body is not resilient, it may be that one reacts involuntarily much more anxiously and thus more despondently when the smallest symptoms occur than someone who believes in his body and his inner strength. What can we do to not to simply drift away, to not let ourselves be helplessly swept along and fight against these rapids?

Generalized resistance resources

These are factors that are available to every human being to cope with states of tension and stress. On one hand, we can draw on internal resources – physical ones such as a good immune system, a good physical constitution, fitness or a healthy diet, and psychological ones such as emotional stability, knowledge and intelligence, or even the ability to relax.

On the other hand, we can draw on external resources. These include material resistance resources such as the availability of money, goods or appropriate services. Or social resistance resources such as an intact family or a stable circle of friends. They also include sociocultural resistance resources – society’s values and norms, beliefs and philosophy.

The concept of salutogenesis stresses that for us to properly apply and use all of these resources for ourselves, we need something very basic. Something that grows out of our basic will to live, our zest for life, and our attitude toward life.

Sense of coherence

According to Antonovsky, this zest for life arises when three factors are met:

– Understandability: I can understand what is happening inside me and around me.
– Manageability: I have the feeling that I can cope with the demands placed on me and that the necessary resources are available to me.
– Meaningfulness: I have the feeling that it makes sense to be involved – I see requirements as a positive challenge that is worth committing myself to. I feel proud of what I do – and feel part of a whole.

When we feel a deep sense of coherence within us, we can trust and powerfully use the resources available to us in such a way that we always swim toward the shore of “health” rather than allowing ourselves to drift toward the shore of “illness.”

* Learn more about the concept of salutogenesis at Eco Hotel Saltus in Italy.

** For further reading: Health, Stress, and Coping, by Aaron Antonovsky, 1979