Speaking to our spiritual, psychological and emotional wellness needs, in relation to health, Aaron Antonovsky, in the early 90s, published an article about the six Cs: complexity, conflict, chaos, coherence, cohesion and civility.
“My barn having burned down, I can now see the moon.”
– Mizuta Masahide (17th century Japanese poet and samurai)
Salutogenesis, the idea of focusing on the medical causes of health and well-being as opposed to a pathogenic model which studies the medical causes of disease, looks at the relationship between stress and health. Antonovsky analysed the relationship between the individual and their interaction with their environment. Our research into salutogenesis led us into a rather deep reflection on the relationship between wellness, happiness and resilience; concepts which further introduced very interesting studies from as far back as the 1950s, focused on wellness as a philosophy, rather than a destination.
Writing as consumers of wellness knowledge, our Team had no idea of the undertaking we were committing to, let alone the personal journey we would be taking as a result. Late night YouTube videos, medical articles and even journals, were consumed in order to get an understanding which was broad enough to (we hope) effectively represent what a salutogenic model presents; essentially, how the six Cs directly impact your ability to be well.
- Complexity refers to the level of organization of a system, the more complex, the more potential for conflict but also the greater the ability to re-organise the system or community.
- Conflict refers to tension, internal as a human being as well as tensions between individuals and the supra-systems they exist within and between.
- Civility, a basic value of salutogenesis and how we relate to one another, the opposite being cohersion
- Chaos, the stressors which give rise to the question of coping through coherence
Our traditional understanding of health and wellbeing has been that of a pathogenic model which approaches from the angle of determining what causes illness as opposed to what causes health and wellbeing. As Antonovsky put it, the health care system is predominantly a disease care system (Antonovsky, 1996) and implementing a salutogenic model in a traditional medical setting in which pathogenic paradigm is followed, is quite a stretch for most. Simply put, the notion of prevention seems to be less acceptable than that of a cure and we are left with the idea that we need to be reactionary as opposed to preemptive in our commitment to our personal health.
Now before we get ahead of ourselves, we would like to note that the start of this research journey was structured according to answering some questions we had. Questions such as “why do I feel this way? I get to work from home, wear pajamas and avoid stilettos!” or “I love my kids, why do I want to hide in the furthest corner of the garden every morning?” or, one we personally relate to on many levels, “I always wanted the opportunity to manage my day, now that I can, why do I feel so desperately unhappy?”; essentially, why is the national lockdown making us sad, were we sad before and can we change how we feel?
These questions lead us to question happiness, what it means and where it can be found. We were dutifully reminded that this was in fact not the topic of the Issue; it did however point out that most of us blur the line between happiness and wellness, assuming one is happy when one is well and that if we achieve one, we will achieve the other.
“We are coming to understand health not as the absence of disease, but rather as the process by which individuals maintain their sense of coherence (i.e. sense that life is comprehensible, manageable, and meaningful) and ability to function in the face of changes in themselves and their relationships with their environment.”
– Aaron Antonovsky
If the concepts of happiness and wellness seem so closely aligned, why do we treat wellness in isolation? Perhaps our Dutiful Reminder needs to be let in on the secret: happiness and wellness may find their connection to one another in the notions of resilience and adaptability, or as Antonovsky put it, the sense of coherence.
According to him, the concept of health moves on a continuum of ease and dis-ease (Antonovsky, 1993) and according to Susan David, Ph.D, a highly acclaimed South African Psychologist on the faculty at Harvard Medical School, “discomfort is the price of admission to a meaningful life”. The ability to understand this and respond to such ebbs and flows based on the resources available to you is what contributes to your sense of coherence.
Antonovsky also rejected ideas that life was in balance, homeostatic, that in its unnatural state, life was thrown out of balance. Rather, he impressed that life is chaotic, marked by on-going and ever present stressors and that understanding the coping process is what allows us to understand the health consequences of chaos.
- Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass.
- The Handbook of Salutogenesis US National Library of Medicine – Monica Eriksson (September 2016)
- Discomfort Is The Price Of Admission To A Meaningful Life Youtube, Susan David, PhD (March 2018)
- Culture in salutogenesis: the scholarship of Aaron Antonovsky US National Library of Medicine – Carina Benz, Torill Bull, Maurice Mittelmark, and Lenneke Vaandrager (December 2014)
- Professor Aaron Antonovsky (1923–1994): the father of the salutogenesis The JECH gallery – Bengt Lindström, Monica Eriksson (May 2005)
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