In 1979, medical sociologist Dr. Aaron Antonovsky developed a new understanding of medicine that aimed to flip the medical model onto its head. That concept is called Salutogenesis. What is Salutogenesis?
Salutogensis as a term that first showed up in Dr. Antonovsky’s 1979 book called Health, Stress, and Coping: New Perspectives on Mental and Physical Well-Being. The book was a distillation of his Ph.D. studies at Yale University and his research at the Hebrew University of Jerusalem and Ben-Gurion University of the Negev. Over 20 years of research caused him to find many faults with modern medicine’s traditional concepts of health and the origin of illness.
The theory developed from his studies on how people managed stress and how it effected their overall health outcomes. His observations noted that even though stress is unavoidable, how an individual manages stress is unique to the person.
The better a person manages and resists stress, the healthier the individual is. This caused him to reject a “pathogenic” or “disease-based” model of medicine. Once he realized that health could be seen through a different lens, a different paradigm was warranted. His Salutogenic model was born.
Salutogenesis literally means “that which gives birth to health.” It is the complete opposite of pathogenesis, which means “that which gives birth to disease.” Pathogenesis is the foundational perspective for the conventional medical model.
For example, when you are sick, medicine talks about the pathology of disease X, Y or Z. Or that a pathogen (germ agent) caused a disease. There are specialists within medicine, called Pathologists, who study the process of disease.
Pathogenesis is the focus on disease or illness and its prevention or treatment. Salutogenesis is the opposite. Salutogenesis asks the question: How do we create and maintain health? In a Salutogenic model, health is the starting point. Disease is the absence of health, not the other way around.
The concept of disease and suffering is so engrained in the culture of medicine, that conventional medicine is also known as allopathy. Conventional medicine coined the term allopathy in an attempt to differentiate itself from alternative medicine, specifically, homeopathy.
It’s interesting to point out that even alternative medical approaches such as homeopathy, naturopathy and osteopathy all incorporated a pathogenic approach into their care, hence the suffix -pathy in all their names. Disease is still their starting point.
Even though the term Salutogenesis wasn’t coined yet in 1895, it wasn’t a coincidence that Chiropractic didn’t use the suffix -pathy in its name. In Chiropractic, health is our starting point, not disease. One of the many reasons why Chiropractic is not considered an Alternative Medicine.
Chiropractic has always embraced the “health first” mentality. Quoting Dr. Lyle Shermanfrom 1957, one of Chiropractic’s pioneers and clinical director at The B.J. Palmer Research Clinic:
“All down through the ages, man has been looking for the cause of disease. Have you stopped to think that maybe there is no cause for disease; that perhaps what we are looking for or should look for is the cause of health...because we know that disease is not due to the presence of something but rather the absence of something. And that something is Innate Intelligence.”
In Chiropractic, a term that is synonymous with Salutogenesis is Innate Intelligence. Innate Intelligence is the inborn wisdom of the body that regulates and maintains health. It is our Innate Intelligence that gives birth to our health.
So what are some factors that differentiate Salutogenesis from Pathogenesis?
With Pathogenesis, the focus is on disease prevention or treatment. Because the focus is on disease, there is an inherent feeling of fear. Since disease is lurking around every corner, you constantly have to be on high alert for a surprise attack from disease. This generates a sense of constant chaos. With only chaos in our sight, it makes both internal and external environments uncertain. Any sense of control in our health or the health of others becomes arbitrary.
Salutogenesis sets in motion a new blueprint. With a Salutogenic model, the focus is on health and well-being. This births a feeling of dynamic confidence in oneself. Health is something that we own and can share. It helps provide a sense of coherence and order to things. Although chaos is ever-present, we can harness that chaos to better ourselves. Internal and external environments become more predictable and manageable.
How do the two approaches look in practice?
Salutogenesis emphasizes adaptation, homeostasis and healing in the individual. The doctor or health practitioner encourages and supports the patient while providing holistic care. Holistic care aims to enhance function and support the healing process.
Pathogenesis, on the other hand, puts emphasis on treatment, symptoms and sickness. The aim of treatment is to try and regulate and control the patient’s condition. It can only do this by isolating the condition and ignoring other aspects of the patient as a whole. Treatment plans involve trying to suppress symptoms. Suppressing symptoms attempts to fix the condition or try and make it better.
While both models are inclusive in their approach, it doesn’t make them at odds with each other. One approach is not better than the other. Thinking of them in those terms is the wrong mindset. They each bring something unique to the table. Even though they both are at the table, the Salutogenic model should and needs to be at the head of the table if we wish to see a significant shift in how our health is delivered.
Chiropractic care embodies the Salutogenic approach completely in practice. Chiropractic care is centered on removing vertebral subluxations. Vertebral subluxations are major disruptions to optimal adaptation and homeostasis. Correcting these disruptions helps promote natural healing. Enhancing neurological function through an adjustment supports the healing process.
Jarek Esarco, DC, CACCP is a pediatric, family wellness and upper cervical specific Chiropractor. He is an active member of the International Chiropractic Pediatric Association (ICPA). Dr. Jarek has postgraduate certification in Pediatric Chiropractic through the ICPA. Dr. Jarek also has postgraduate certification in the HIO Specific Brain Stem technique through The TIC Institute. Dr. Jarek is happily married to his wife Regina. They live in Youngstown, Ohio with their daughter Ruby.
