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NCBI Bookshelf. The Handbook of Salutogenesis [Internet]. Cham CH : Springer; While the chapter briefly describes these constructs and their place in the salutogenic model of health as a whole, in-depth discussion of them is left to designated chapters. The role of this chapter is to provide an overview of the Salutogenic Model of Health the way Antonovsky wrote about it over nearly 30 years. While chapter three portrays Antonovsky, the man and the researcher, this chapter portrays the SMH and its development along with life events of its creator until the untimely death of Antonovsky in The chapter is based on the authorship of Antonovsky himself.

Papers written in his last years, in which he looks back and comments on how his thinking developed, have been of particular value. These papers come in addition to the publications in which he originally introduced his ideas. In the SMH, there are important concepts the development of which we trace in this chapter: stress, breakdown, resources, Sense of Coherence SOC , and health. The release of Health, Stress and Coping in was a culmination of 15 years of work, during which he came to understand that disease, illness, and entropy decline into disorder are the norm rather than the exception to a rule of otherwise self-regulated homeostatic processes occasionally being disturbed with resulting pathology.

He found it to be a futile task to try to understand and control every single factor that might lead to this or that particular disease. A more fruitful approach would be to focus on what he found to be the overall problem of active adaptation to an environment in which stressors are omnipresent and inevitable. He presented the term negative entropy Antonovsky, , p.

So, negative entropy or negentropy as he also termed it, is actually something positive. This question and the answer constitute the SMH, the development of which is the focus of this chapter. A salutogenic orientation is not likely to take over. Pathogenesis is too deeply entrenched in our thinking. Antonovsky urged, nevertheless, researchers of different professions, and with use of different methodologies, to work together to bring the knowledge of the origins of health increasingly further.

Antonovsky worked on the SMH for more or less 30 years. The first 15 years resulted in his book Health, Stress and Coping in , and the presentation of SMH in its entirety. The next 15 years he was improving, refining, and cultivating the understanding of the model and the elements in it. The release of his book Unravelling the Mystery of Health represented a peak in his career. This release was originally intended to be a revised version of Health, Stress and Coping , but ended up being a whole new book, primarily presenting and explaining the concept of Sense of Coherence, his answer to the salutogenic question.

His second book became a huge success and is translated into several languages. In the preface of his first book, Antonovsky points out that he offers no easy solutions to the salutogenic question, and that he does not shy away from technical discussions when needed. His writings are directed not only to his colleagues in medical sociology, but also to sociologists, psychologists, psychiatric nurses, physicians, healthcare organizers, epidemiologists, architects, community organizers, and even more, who professionally or personally want to understand and enhance the adaptive capacities of human beings Antonovsky, , preface viii.

His rather wide scope of intended audience is also reflected in the cross section of where he finds theoretical and intellectual inspiration. He expresses indebtedness to students, research assistants, and colleagues, without whom he would not have reached as far as he did.

Throughout Health, Stress and Coping especially, but also in Unravelling the Mystery of Health Antonovsky specifies to whom he owes his intellectual debts. As he believes to have broken new ground, he also claims to see echoes of his ideas everywhere Antonovsky, , p. Although he says he finds evidence of the influence of great thinkers in his work, he describes a feeling of relative isolation when introducing the concept of salutogenesis and developing the SMH.

As he narrates every other researcher of the time focused on the need to explain pathology, his feeling of isolation intensified with the introduction of the sense of coherence, the answer to the salutogenic question Antonovsky, , p. In developing the SMH, not only did he detach himself from his earlier work, but also from the work of just about everyone else at the time. Around the time of the release of Health, Stress and Coping he finds, however, that the salutogenic question is increasingly asked, and he is intrigued to notice that serious research studies at least partly congruent with the SOC concept are being performed.

He no longer feels alone as elements, variants, and alternative understandings of health and illness in the social sciences are surfacing Antonovsky, , p. Antonovsky humbly credits this development primarily to the serious research of colleagues, and not so much to his own work. He dedicates a chapter in his book to convergences, discrepancies, and disagreements of the research of Suzanne Kobasa, Thomas Boyce, Rudolf Moos, Emmy Werner, and David Reiss and demonstrates once more how his ideas and theories develop in interaction with the theories of other scholars.

In all his writings about the SMH, Antonovsky gives a somewhat personalized account of how he came to work on the subject at hand, he presents challenges he encounters on his way and he clarifies and explains how he moves ahead and reaches the point at which he stands when writing this particular book or paper.

Apparently he learnt this approach from Oriental scholars Antonovsky, , prologue 1. Being so detailed about his research process makes a very interesting read, and gives the impression of a humble scholar, on his way, inviting other researchers in on his reflections.

On a hopeful note, in Health, Stress and Coping he expresses a wish that the salutogenic question is convincing enough for researchers to take up the gauntlet and develop the model further; of which this book is a clear demonstration. At the outset Antonovsky was not particularly interested in stress Antonovsky, Nonetheless, at the time he found them peripheral to his main interests, and he did not believe he would spend most of his career studying the stress process.

Growing up as he did in New York, being the son of Jewish parents, one can assume this interest was awakened by his exposure to both Jewish and North-American culture, cultures which he contrasted in several publications see for example Antonovsky, Minority groups and marginal social situations were the focus of his doctoral research. He continued down this path for six more years, though his focus shifted to the organizational response on a group level to immigration and the stressors of low income and discrimination Antonovsky, This shift was brought on by his work on the history of the Jewish labor movement in the United States Antonovsky, , and as a director of the New York State Commission Against Discrimination.

So although he also worked in a series of projects in the s not connected to his main interests an experience well known to many a young researcher , stressors and coping responses on both individual and group levels were of particular interest to him.

In retrospect, in his Odyssey article Antonovsky, , he presents himself as a sociologist of health involved in studying the stress process, and he returns some 25 years describing the starting point as being his work on life stressors.

In , he was invited by colleagues in neurology to take part in the design of an epidemiological study on multiple sclerosis, mainly because he had experience in survey research. Antonovsky joined because the study questionnaire included items on this particular area of interest for him—sociocultural factors Antonovsky et al.

Included among the items was a list of stressors in objective form, such as social class and poor living conditions. Studies from this period show his commitment to hypothesizing a direct link between stressors and disease, and especially social class and disease. He defined stressors objectively as those experiences that anyone anywhere would agree were stressors, pointing to going hungry for a long period of time as his illuminating example.

His primary concern at this stage was to bring the data of stressors and disease together rather than going deeper and behind the data and ask Why? Antonovsky, a , b , The Why question started forcing itself to the front of his interest. Reflecting about this period of his work Antonovsky recounts this is the time he starts to depart from what he calls the pathogenic orientation Antonovsky, Not only were the stressors important, Fried argued, the poor had fewer resources to battle these stressors Antonovsky, , p.

The book clearly stated the link between poverty and poorer health, bringing the sociological insight that poorer health was not only due to lower quality of health services to the poor, but also to the conditions to which the poor were exposed. In addition, there was another characteristic of the stress of the poor, and the minority groups, that gave insight to the Why question: namely the constancy of the stressors.

To understand the link between stressors and disease, Antonovsky recounts struggling with the methodological problem of getting the right list of life events or stressors to ask about in a survey. At the time, research focusing on stressors tended to assume life as inherently stable and smooth with major stressors only occasionally occurring. Antonovsky claimed, however, this view not helpful and rather inadequate in understanding the stress process. A more fruitful vision is to see life as turbulent and inherently full of conflicts and stressful.

Once again, he drew inspiration from Fried and what he called chronic life strain, referring to long-lasting structural and cultural situations such as poverty, unemployment, marginality, etc, a sad fact of the lives of many persons Antonovsky, , p. It is important, Antonovsky argued, to understand the ongoing strain of such situations as these are also the sources of many of the major life events, as well as of the daily hassles, which people face.

Being in fact a respondent in his own study, Antonovsky made the observation that yes, he was exposed to stressors—but they did not result in illness, he was coping successfully. This led him to focus on how specific serious stressors were dealt with Antonovsky, , p. I had not, and do not now, deny the potential illness consequences of many stressors. Well into the s, I still tended to regard all stressors as unfortunate and pathogenic.

But I had begun to ask: What really happens when one encounters a stressor? The observation was made that exposure to stressors did not invariably lead to stress and illness. Stressors of various kinds created immediate tension in an organism, but if it was resolved it did not result in stress , which was the health-damaging condition one needed to avoid.

In brooding the why-question he realized that it is not just the stressors that are vital in this picture, also the poor have fewer resources in order to cope. There will be a difference if two people are exposed to the same stressor and one of them has lots of resources, while the other has practically none. Both the experience and its consequences will be different for the two. He presented these findings to an audience and was asked a thought-provoking question by Professor J. This set Antonovsky thinking, and the result was his realization that he was not really interested in any specific diseases, be it cancer or heart disease.

He was interested in the illness consequences of psychosocial stressors, the breaking down process taking place no matter how the consequence was expressed Antonovsky, , prologue 4. By God, Morris is right. I am not interested in heart disease or multiple sclerosis or cancer; I am interested in breakdown. This, then, is the origin of my first major departure from the mainstream.

Antonovsky realized he was interested in a general state, which he wished to call dis- ease. However, he found this term impractical because it would be hard, he believed, to achieve a clear enough distinction from disease.

Antonovsky's point has then not been communicated. Hence, he landed on the term breakdown which Professor Morris had used, and whom he credited in a later paper known as his breakdown paper Antonovsky, It was, for technical reasons, not published until , but the main message in this paper was that stressors, unsuccessfully confronted, lead on to breakdown.

As this outline shows, the late s seem important years to the development of his model. Antonovsky claims and as especially vital years in this respect Antonovsky, , In the years to come, he was committed to conceptualizing his insights, starting with an explicit focus on resources. Because people meet such a variety of demands, Antonovsky found it useful to focus on understanding the generalized resistance resources GRRs because they could be applied to a wide range of demands or stressors.

The latter of these two became his focus. Further he theorized that all diseases have something in common, and that there are GRRs to counteract all of these Antonovsky, However, Antonovsky later calls this mentioning of resources essentially a remark made in passing Antonovsky, , p. In the same paper, he classifies three large groups of resources 1 adaptability on the physiological, biochemical, psychological, cultural, and social levels; 2 profound ties to concrete, immediate others; and 3 commitment of and institutionalized ties between the individual and the total community Antonovsky, , p.

Nevertheless, his formal definition of GRRs was not published until see Fig. In Health, Stress and Coping, he also emphasized the importance of specific resistance resources SRRs , as he found them both numerous and frequently beneficial in specific circumstances of tension Antonovsky, , p.


Unraveling the Mystery of Health: How People Manage Stress and Stay Well

NCBI Bookshelf. The Handbook of Salutogenesis [Internet]. Cham CH : Springer; While the chapter briefly describes these constructs and their place in the salutogenic model of health as a whole, in-depth discussion of them is left to designated chapters. The role of this chapter is to provide an overview of the Salutogenic Model of Health the way Antonovsky wrote about it over nearly 30 years. While chapter three portrays Antonovsky, the man and the researcher, this chapter portrays the SMH and its development along with life events of its creator until the untimely death of Antonovsky in The chapter is based on the authorship of Antonovsky himself.


Unraveling the mystery of health

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Forgot your login information? In: The Health Psychology Reader. Edited by: David F. Subject: Health Psychology. Antonovsky, A. Unraveling the mystery of health: how people manage stress and stay well.

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