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Healthcare has historically been dominated by a pathogenic perspective, where the emphasis is on the etiology, diagnosis, prevention, and treatment of disease. This philosophy is often thought to be considered “Western medicine.” However, an alternative approach, called salutogenesis, focuses instead on the promotion of health and well-being rather than on disease prevention, treatment, or cure. Salutogenesis, a term coined by Aaron Antonovsky, is derived from the Latin word “salus,” meaning health and the Greek word “genesis,” which means the origin or mode of formation. It revolves around the understanding that health is a continuum and encompasses ideas such as an improved sense of well-being rather than viewing health as merely the absence of disease. It emphasizes factors that support human health and well-being rather than factors that cause pathology. Salutogenesis seeks to answer and explore how health is generated, maintained, and improved. This perspective has significant relevance in various healthcare settings, including the field of chiropractic.
Central to salutogenesis are the Sense of Coherence (SOC) and General Resistance Resources (GRR). SOC consists of three components: comprehensibility, manageability, and meaning. Comprehensibility refers to the extent to which events are perceived as making logical sense, that there is order, consistency, and structure. Manageability refers to the extent to which a person feels they can cope with the problem. Meaning is the extent to which one feels life makes sense or has meaning. It is the driving force that propels an individual to face obstacles with resilience. Other factors that contribute to a salutogenic lifestyle include spirituality, happiness, humor, social support, and love.
When looking at SOC within the context of chiropractic care, the comprehensibility component is enhanced by the chiropractors’ clear explanations and the practice members’ understanding of health and “dis-ease.” This assists practice members in understanding their health status and how chiropractic care can aid in their well-being. Chiropractors often educate on the relationship between structure and function and how structure dictates function. This shows and empowers the practice member to make choices that impact their health and puts them in the driver’s seat of their own health journey. These conversations can lead to improved health and enhance their comprehensibility.
In the context of manageability with chiropractic care, practice members often see improvements in their health while under chiropractic care, and through the chiropractic philosophical concepts of innate intelligence and salutogenesis, they begin to have a deeper understanding of their own bodies and true health. This enhances the practice members’ belief that they can manage their own health. This can empower them to make healthy choices like choosing to be under lifetime maintenance chiropractic care and other lifestyle modifications to enhance their well-being.
Encouraging practice members to take an active role in their well-being can increase their sense of meaning. When the chiropractor listens and provides education and validation of the practice member’s past experiences, the practice member can start to understand the interconnectedness of their body and all the systems of their body. When the practice member understands true health comes from above, down, inside, out (ADIO), they will see the value and the importance of their individual involvement and the value they add to their own health trajectory. This engagement can transform the practice member’s perception of their health from being a passive recipient of care to an active participant. Thus reinforcing the “meaning” component of SOC.
In the salutogenic model, general resistance resources (GRRs) represent the resources an individual possesses to cope with stressors, thereby maintaining or enhancing their health. GRRs encompass a range of factors, such as genetic endowment, intelligence, selfesteem, social support, traditional health behaviors (diet, exercise, etc.), and coherent life experiences. These resources enable an individual to perceive their life as more manageable, understandable, and meaningful.
Chiropractic is founded on the principle of working with the body’s innate healing abilities, which aligns with the salutogenic approach. The primary focus of chiropractic is to optimize the function of the nervous system, which can enhance the body’s self-regulation and healing potential. Chiropractic is inherently salutogenic because of its focus on enhancing the body’s inherent capacity for self-healing and health promotion. Here, the chiropractor acts as a conduit of health, promoting empowerment, autonomy, and participation; this helps to identify and foster the practice member’s GRRs, leading to a better SOC.
Chiropractic care supports the salutogenic perspective. A practice member-centered approach creates a supportive environment that values and respects individual health goals and preferences, which is crucial for strengthening SOC. This includes ensuring a safe and inclusive environment. Through the practice member/chiropractor interactions, the chiropractor can create a supportive social environment that strengthens the practice member’s belief in their capacity to improve their health.
Furthermore, chiropractors can explain principles such as ADIO and Innate Intelligence, so the practice member has a deeper understanding of their body and its capacity to heal and adapt. The chiropractic adjustment is also grounded in the salutogenic philosophy. This is because the adjustment aims to enhance the body’s inherent capacity to heal and maintain health. In educating practice members about these procedures and their role in health, chiropractors can help improve practice members’ SOC and facilitate the utilization of GRR.
It is important to know most people are inundated with the pathogenic model. The chiropractor can create a safe place to support people in their journey toward salutogenesis. Over the past several years, we saw this a lot. While much of the world seemed to be going to dark and extreme places, many chiropractors chose to stay open. They maintained that people should continue doing things that promote their health, including chiropractic care. Chiropractors empower their patients and teach them that their bodies have a remarkable innate ability to adapt, repair, and heal.
Another way chiropractors can promote the salutogenic model is through how they answer medical questions they receive from patients. For instance, chiropractors are often asked about their thoughts or recommendations regarding childhood vaccinations. Giving medical advice on vaccination is arguably outside of the scope of chiropractic. However, this creates an opportunity to teach chiropractic philosophy and the salutogenic perspective. The chiropractor will often explain that they cannot advise them whether to vaccinate, but that both infections and vaccinations carry a risk of causing harm to some people in some situations. No matter what decision the parents make, they should be proactive about doing things to promote their child’s health such as getting them checked and adjusted as needed on a regular basis. This will give them the best chance to successfully adapt to disease and toxins. By answering in this way, the chiropractor has both “stayed in his or her lane” and given the practice member a salutogenic frame of reference.
Chiropractic’s alignment with salutogenesis underscores its unique role in health promotion and empowering practice members to take charge of their health journey. By weaving the salutogenic perspective into its fabric, chiropractic care serves as an embodiment of this health-enhancing philosophy, contributing to the overarching goal of sustainable health and well-being.
-Jen Santos, DC
Appears in Pathways to Family Wellness Magazine Issue #79
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