I'm happy to present a new article Dr. Christopher Kent, one of America's most respected chiropractors, about the concept of salutogenesis, the very essence of wellness, which mirrors my vision to transform the existing medical paradigm from one addicted to quick-fix style "cures" that do nothing but treat symptoms to one focused on treating and preventing the underlying causes of disease.

By Dr. Christopher Kent

Few have heard of the word salutogenesis, yet it expresses the very essence of wellness. Antonovsky¹ coined the term in 1979. It is derived from salus, which is Latin for health, and genesis, meaning to give birth. As Cowley and Billings² wrote:

Salutogenesis literally means 'that which gives birth to health'. In traditional public health and community medicine approaches, a 'pathogenic' perspective, in which the focus is on disease or illness and its prevention or treatment, most often dominates interventions. Adoption of a salutogenic perspective highlights the importance of starting from a consideration of how health is created and maintained ...

Therefore, salutogenesis is the opposite of pathogenesis. Pathos means suffering, pathogenesis is the birth of suffering. Ironically, most health professions have this term incorporated in their names.

Conventional medicine is known as allopathy. Even alternative medical systems, such as homeopathy and osteopathy, incorporate pathos in their name, and it is implicit in their clinical strategies. The focus is on treating disease, rather than the creation of health and well-being. While disease treatment has its place, it is a dangerously incomplete approach for inculcating and cultivating human potential.

The salutogenic model focuses on the causes of global well-being rather than the origins of specific disease processes. It focuses on strategies and lifestyle choices that empower individuals to experience the full spectrum of the human experience.

A Sense of Coherence

Antonovsky proposed that the key factor in salutogenesis is a person's sense of coherence (SOC). He defined SOC as "a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one's internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected."¹

Kobasa³ described three common factors in people who enjoy health, even when confronted by challenging circumstances.

• Control: The person's belief that he or she is able to influence the course of events.
  
• Commitment: Embracing a curiosity and sense of meaningfulness for life.
  
• Challenge: The individual's expectation that it is normal and beneficial for life to change.
  

Smith⁴ published a comprehensive review of salutogenic mechanisms in the brain, noting that the components of a person's SOC are comprehensibility, manageability and meaningfulness. Other factors that contribute to salutogenesis include social support, spirituality, happiness, humor and love.

Salutogenesis is more than a realization that attitudes affect outcomes. Salutogenic theory goes to the very essence of neurobiology. It has been noted that neurological processes (as well as anatomical structures) are remodeled by sensory input. These processes, collectively termed neuroplasticity, are operative at all levels of the nervous system. Smith⁴ describes the range of these mechanisms:

From the afferent (incoming) activity of peripheral sensory receptors to the efferent (outgoing) activity directed toward neuroendocrine organs, blood vessels, and muscles. Although the selectivity of perception probably makes it impossible to be aware of everything that is happening throughout the body, it is evident that these regulatory processes are essential for one's health, and that they provide the basis for functional salutogenic mechanisms of the brain.

Smith further noted "An organism with a salutogenic brain would experience the world as manageable and coherent ... with a self-perpetuating cycle for enhancing self-confidence and well-being."

From a chiropractic perspective, a salutogenic brain is one that receives information concerning internal and external environments without interference. If this worldview and self-image are not distorted, the brain will issue mental impulses that give rise to qualitatively and quantitatively appropriate responses.

As the process of life unfolds, the human experience sculpts the anatomical and functional mechanisms of the nervous system. Whether the result is a life which gives honor and dignity to our potential, or a grotesque caricature of the life which could have been, is up to us.

As human beings, we have the ability to control the modulating factors in salutogenesis. We can choose to experience social support, spirituality, happiness, humor and love through a nervous system free of distortion and interference. We can exercise control, commitment, and challenge through biomechanisms, which are not compromised.

We also have the ability to empower others to lead salutogenic lives, and move our culture into one of worldwide wellness.

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Touch, Intent and Healing

Six Tips to Choosing a Wellness Chiropractor

Beyond Bad Backs: What Chiropractic Is and How It Can Help You

References

1. Cowley S. and Billings JR: Resources revisited: salutogenesis from a lay perspective. Journal of Advanced Nursing. 1999;29:994.

2. Antonovsky A: Health, stress, and coping: New perspectives on mental and physical well-being. San Francisco. Jossey-Bass. 1979.

3. Kobasa SC, Hilker RR, Maddi SR: Who stays healthy under stress? J Occup Med 1979;21(9):595-8.

4. Smith DF: Functional salutogenic mechanisms of the brain. Perspectives in Biology and Medicine 2002;45(3):319-28.