Salutogenesis: Building Health, Not Just Fighting Disease

Traditional healthcare often focuses on diagnosing and treating illness — what’s called a pathogenic model. Salutogenesis, first introduced by Aaron Antonovsky in the late 1970s, offers a complementary perspective: instead of asking what causes disease, it asks what creates health (Antonovsky, 1979; 1987).

The Sense of Coherence

Antonovsky’s research with Holocaust survivors revealed that some individuals maintained wellbeing despite extreme adversity. He developed the concept of the Sense of Coherence (SOC) — a person’s ability to perceive life as comprehensible, manageable, and meaningful. High SOC is strongly correlated with resilience, stress adaptation, and overall health outcomes (Eriksson & Lindström, 2006).

The Health Continuum

Health is not a fixed state but a continuum between “ease” and “dis-ease”. Stressors are inevitable, but individuals with strong coping resources can mobilise effectively, moving toward health (H+). This positions salutogenesis as an asset-based approach to health promotion, aligning with modern public health frameworks (Lindström & Eriksson, 2010).

From the River of Health to the River of Life

Traditional models often focus “downstream” — on disease treatment, risk reduction, or prevention. Salutogenesis invites us to look “upstream” at the resources and capacities that generate wellbeing. As Lindström and Eriksson (2008) describe, health flows like a river: we cannot avoid all risks, but we can strengthen our capacity to swim and make use of resources along the way.

Implications for Clinical Practice

At The Flow Clinic, we integrate salutogenic principles into care:

• Manual therapy and sports massage support recovery while promoting resilience.

• Movement training develops adaptability, coordination, and confidence.

• Osteopathic practice enhances the body’s capacity to self-regulate and orient toward health.

By focusing not just on reducing pain, but on fostering adaptability and resilience, we aim to help patients move along the health continuum toward greater vitality and quality of life.

📚 References

• Antonovsky, A. (1979). Health, Stress and Coping. Jossey-Bass.

• Antonovsky, A. (1987). Unraveling the Mystery of Health: How People Manage Stress and Stay Well. Jossey-Bass.

• Eriksson, M., & Lindström, B. (2006). Antonovsky’s Sense of Coherence Scale and the relation with health: a systematic review. Journal of Epidemiology & Community Health, 60(5), 376–381.

• Lindström, B., & Eriksson, M. (2010). The Hitchhiker’s Guide to Salutogenesis. Folkhälsan Research Centre.