Promotion

18 MENTAL HEALTH PROMOTION
measure healthy’ (Antonovsky 1987: 3). Salutogenesis sees treatment as enhancing the
coping mechanisms not just to one specific illness but in general, helping people
to move towards the healthy end of the health–illness continuum.
A salutogenic theory of health starts from the assumption that the human and
living systems are subject to unavoidable entropic processes (the damage and deterioration
caused by life and aging), and unavoidable death. In reading the work of
Antonovsky (1987: 90), you will find a metaphor of health based on the idea of a river.
Contemporary Western medicine is likened to a well organized heroic, technologically
sophisticated effort to pull drowning people out of a raging river.
Devotedly engaged in this task, often quite well rewarded, the establishment
members never raise their eyes or minds to inquire upstream, around the bend
in the river, about who or what is pushing all these people in.
But Antonovsky questions the accuracy of this metaphor and redefines the river as the
‘stream of life’. He argues that ‘none walk the shore safely, so the nature of one’s river
and the things that shape one’s ability to swim must all be considered’ (1987: 90).
Therefore, the object is to study the river and to find out ‘what facilitates the capacity to
swim well and joyously for some and, for others, makes even staying afloat a constant
struggle?’ (Antonovsky 1987: 127). Therefore he argues that we are all in the dangerous
river of life.
The question that interested Antonovsky was why some of us do so much better in
the river of life – why did he or she survive despite being so high on risk factors?
Antonovsky (1987) argued that:
• We need to understand the movement of people towards health.
• This movement to health cannot be explained by simply being low on risk factors.
• It is impermissible to identify or equate a rich, complex human being with a
particular pathology, disability or characteristic, or a particular set of risk factors.
• Pathogenic narrowness is simply poor care.
From his research, 6 Antonovsky identified a range of factors that seemed to play a role
in helping the people cope and survive. He called these generalized resistive resources
(GRRs). These are the properties of a person, (or a collective) which have facilitated
successful coping with the inherent stressors of human existence.
What all the GRRs seemed to have in common was that they contributed to or
created something he termed a sense of coherence (SOC). He argued that the GRRs he
identified in his research all fostered repeated life experiences which helped someone to
see the world as making sense cognitively, instrumentally or emotionally. Antonovsky
began using the term in 1979 but refined it in later years to mean,
a global orientation that expresses the extent to which one has a pervasive,
enduring though dynamic, feeling of confidence that one’s internal and
external environments are predictable and that there is a high probability that
things will work out as well as can reasonably be expected
(1987: xiii)