Salutogenesis

This paper explores various integrative frameworks that are contributing to anemerging transdisciplinary meta-perspective on sustainable development. It proposes a holistic/integral strategy based on scale-linking design for human and planetary health: First, ‘Integral Theory’, ‘Spiral Dynamics’ and ‘IntegralEcology’ are briefly reviewed as dynamic mapping methodologies to structure,facilitate and mediate between diverse value systems and perspectives of multiple stakeholders and disciplines. Changes in worldview, value system, andintentionality are crucial to the emergence of a sustainable civilization. Second,design is described as a transdisciplinary integrator and facilitator of informeddecision making in the face of uncertainty. Design for systemic health cancatalyse the sustainability transition. Third, the paper outlines how complexitytheory, combined with a holistic conception of health, informs a scale-linkingapproach to sustainable design. Systemic health is a scale-linking, emergent property of healthy interactions and relationships within complex dynamicsystems. The health of human beings, societies, ecosystems and the planetarylife support system is fundamentally interconnected and interdependent.Sustainability, as a process of community-based learning, is expressed throughdesign that is informed by ecological principles and adapted to local, regionaland global limits and opportunities. In general, sustainable design is synergetic,symbiotic, scale-linking, salutogenic and sacred. There is a need to integrateecological, social, cultural, economic and psychological (spiritual)considerations into a flexible and responsive strategy to facilitate thesustainability transition. Design for human and planetary health requires atransdisciplinary dialogue aiming for appropriate solutions and community-basedvisions of sustainability.
Keywords: scale-linking design, complexity, integral ecology, salutogenicdesign, transdisciplinary integration, health, sustainable civilization, vision

Das Buch ist eine kompakte Darstellung der Salutogenen Kommunikation und der zugrunde liegenden systemischen Psychologie und salutogenen Psychodynamik.
Der Arzt Theodor Dierk Petzold, Therapeut, Ausbilder und Entwickler der Salutogenen Kommunikation, führt aus, wie für unser gutes Leben letztlich Fragen in drei Richtungen entscheidend sind, die unsere gesunde Selbstregulation immer wieder anregen. Bei ungelösten Problemen im Leben können wir mit Fragen in diese Richtungen bewusst die Stimmigkeitsregulation wieder anregen und neue Lösungen finden.
Die erste Frage: „Was ist dir bedeutsam?“ zielt auf positive attraktive Ziele, auf die Motivation ab. Die zweite entscheidende Fragen: „Was willst und kannst du tun?“ gilt dem Umsetzen der eigenen Ziele, der konkreten Mitgestaltung des Lebens. Die dritte „Was willst und kannst du lernen?“ zielt auf die Reflexion und den Wertmaßstab unter dem jemand sein Handeln reflektieren will.
Leben bedeutet Kommunizieren. In diesem Buch wird die Kommunikation reflektiert. Es geht um eine gesunde Entwicklung des Menschen durch die bewusste Mitgestaltung seines eigenen Lebens und der Umwelten.
Petzold beschreibt eine Psychodynamik gesunder Entwicklung in mehrdimensionalen Lebenswelten und vertieft damit das salutogenetische Verstehen bis in unsere neuropsychischen Funktionen. Mit dem systemischen Blick auf Kommunikation sehen wir unser inneres, physisches, emotionales und mentales Geschehen in Beziehung mit unseren Umwelten.
Viele anregende und vertiefende Fragen, die wir uns und unseren Mitmenschen immer wieder stellen können, geben eine Orientierung zur Mitgestaltung der Komplexität des Lebens. Somit gibt das Buch einem Leserkreis weit über das Fachpublikum zur Therapie, Beratung und Pädagogik hinaus einen hilfreichen Leitfaden in die Hand.
Ausführlich werden Lösungen für verletzende Macht-Opfer-Beziehungen beschrieben – wie wir sie im Privaten wie auch im Öffentlichen zur gesunden Entwicklung dringend brauchen.
Der Autor hat diese Gesprächsführungsmethode Salutogene Kommunikation SalKom® vor 15 Jahren ins Leben gerufen und immer weiterentwickelt. In dieser Methode vereinen sich interdisziplinäres Wissen und seine reichhaltigen Erfahrungen als Gemeinschaftsprojektinitiator, Allgemeinarzt und Therapeut, Ausbilder, Supervisor sowie im privaten Leben.
„Mir selbst diese anregenden Fragen zu stellen und zu lesen, dass diese wichtig für meine gesunde Entwicklung sind, war eine tiefe heilsame Erfahrung für mich, die mein Leben verändert hat.“ Mona Siegel

Birey ve toplum ruh sağlığı alanında ortaya atılan çeşitli yaklaşımlar ve öne sürülen türlü hizmet modelleri, dünya çapında gerçekleşen birtakım yeniliklere ve değişimlere bağlı olarak ortaya çıkmıştır. Bu yaklaşımlar temelde biyomedikal/tıbbi (Attepe Özden ve İçağasıoğlu Çoban, 2018) ve sosyal/çevresel (Nişancı, 2019) unsurlara verdikleri önem açısından ikiye ayrılmaktadır. Her iki yaklaşımın da esas amaçları birincil, ikincil ve üçüncül koruma pratikleri (Çiçekoğlu ve Duran, 2018) bağlamında sunulan sağlık hizmetlerinin niceliksel ve niteliksel açıdan iyileştirilmesine dönüktür. Bu makalede ise, söz konusu ruh sağlığı hizmeti modelleri, bu modelleri takiben oluşturulup temelde toplum merkezli ruh sağlığı hizmeti modeline dayanan alternatif ruh sağlığı hizmeti modelleri ve ruh sağlığı hizmetlerini şekillendiren iki temel yaklaşım ele alınarak olumlu ve olumsuz yönleri de hesaba katılarak değerlendirilmiştir. Bunların ardından ise, makale boyunca sunulan tüm bu argümanlar temel alınarak mevcut ruh sağlığı hizmeti modelleri ve yaklaşımları doğrultusunda yeni bir ruh sağlığı hizmeti modelinin taslağı sunulmuştur.
Anahtar kelimeler: hastane temelli ruh sağlığı modeli, hastane-toplum denge modeli, ruh sağlığı, toplum temelli ruh sağlığı, toplum ruh sağlığı merkezi

Parenting a child with autism spectrum disorder (ASD) has never been easy. Research has shown that parenting stress is much higher whose children are diagnosed with developmental disabilities such as ASD than typically developing children. The contributing factors include, but not limited to, the child’s limited social and communication skills and restricted and stereotypical activities (core deficits of autism). Parents lacking knowledge about ASD often resort to other forms of interventions in the hope to find a cure and believe it can help to eradicate the deficits of the disorder. Such treatments are known as complementary and/or alternative medicine and are not evidence-based. As there is no current remedy for ASD, perhaps it is time for parents to stop finding a cure to this disorder. In this paper, the author uses the application of the theory of salutogenesis and with the use of the three salutogenic components – meaningfulness, comprehensibility and manageability, aim to he...

While the current urban public space pays more attention to the physical construction for the promotion of public health, systematic and specific studies on mental health is insufficient. Through the selection of a specified group of users and the analysis of their mental desire, this article explores the possibility of promoting urban mental health by spatial design. The "Tokyo Loneliness Tree Hole Plan" project suggests reconsidering and reshaping the positive perception of loneliness based on the Salutogenesis Theory and proposes a design guideline for tackling urban loneliness. The project utilizes a scenario-based research method to conceive a systematic strategy for establishing an urban "spiritual infrastructure," which offers the lonely individuals a chance to get along with themselves, the space, and the feeling of loneliness. As the new typology of urban public space with publicity and privacy simultaneously, "Urban Tree Holes" create empathy about solitariness between natural landscape elements and humans in oriental design aesthetics, in order to mitigate the urban loneliness and respond to the mental desire. "One Person Park" as an alternative form of future landscape investigating the concept of "private-public space," which might fulfill the new desire of using public space in a post-pandemic era.

Resilience theory, although it has been evolving over the past 70-80 years, has enjoyed a renaissance in the past two or three decades. What started as an enquiry into the childhood roots of resilience has grown into a broad, dynamic and exciting field of study. Resilience theory currently addresses individuals (both children and adults), families, communities, workplaces and policies. There are few domains of life that have not been touched in one or other way by resilience theory, including the military community.
This document serves to review the wealth of literature on resilience and to provide a consolidated summary of this literature. Close to 500 sources are cited in this document, published between 1945 and 2001, and drawing from books, academic journals, masters and doctoral dissertations, released government and military reports, training and family manuals, popular magazines and unreleased research reports. The comprehensive review addresses:
*Individual resilience (including resilience in children, salutogenesis, sense of coherence, thriving, hardiness, learned resourcefulness, self-efficacy, locus of control, potency, stamina and personal causation),
*Family resilience (including family stress research, Hill’s ABCX model of family stress, family strengths research and the various models of family resilience developed by McCubbin and associates – Double ABCX Model, FAAR Model, T-Double ABCX Model and the most recent Resiliency Model of Family Adjustment and Adaptation),
*Community resilience (including social support systems and a number of cutting edge writings in this newly evolving field),
*Resilience-based policy (again with the latest thinking on the integration of resilience theory into policy formulation, and with a detailed section on work-life or work-family policies as an example of resilience-based policy),
*Resilience theory in social work (including an historical review of social work’s inconsistent alliance with resilience theory, the newly evolving strengths perspective and the narrative and solution-focused therapies of Michael White and Steve DeShazer),
*Cross-cultural perspectives on resilience, and
*Deployment resilience (including a detailed review of literature pointing towards families developing the resilience to resist the stress of military separations).
This review does not aim to provide a synthesis of these various fields of study, but rather to bring together in one place a range of writings and perspectives on resilience and strength that have not previously been seen together in one document.

The design of sustainable communities and cities requires conceptual frameworks for contextualization and
transdisciplinary integration. The theory of complex dynamic systems provides a holistic, explanatory frame-
work offering a participatory perspective that recognizes the fundamental interconnectedness, interdependence,
and unpredictability of biological, social, economic, and ecological systems. Building on the tradition of urban
planning within a regional context, to conceive the sustainable city as an emergent property of appropriate
interactions and relationships within a complex, holarchically structured whole, takes contextualization further.
Increased awareness of nature and culture as an interconnected complex dynamic system, and sensitivity to
material and immaterial (psychological) aspects, leads to more sustainable solutions based on transdisciplinary
integration. Worldviews and value systems, and ecological literacy play an important role in the creation of sus-
tainable lifestyles, communities, cities and societies. This article suggests that complexity theory, combined with
aspects of integral theory and integral ecology, when applied through design as a transdisciplinary integrator, can
provide a framework and a methodology that links spatial and temporal scales across all scales of design from
product design, architecture, construction ecology, community design, industrial ecology, to urban and biore-
gional planning. Ultimately, a sustainable city emerges from the interactions among sustainable communities of
ecologically and socially literate citizens who live sustainable lifestyles.

Over the last century, our planet has become far more urbanized, with cities growing and evolving at unprecedented levels. Undeniably we find society struggling with the many crises that have arrived in recent decades. The complexity of the world, and the incomprehensible scale of some of its problems, calls for new means of understanding and operating. Incremental shifts & minor adjustments, in many ways, prove inadequate to respond to unprecedented challenges. Today's ethos demands dramatic measures, including critically those factors influencing and impacting the health of civilization and the planet it calls home. Salutogenesis presents a method of acting + advancing, in many realms including architecture, whereby people are understood in their fullness. Taking into consideration a plethora of facets affecting our wellbeing, a salutogenic approach shifts the emphasis towards health promotion and away from disease management. Architecture's roles in equations of health & wellness prove both profound and rich in potential. Over recent years, and considering current crises, the architectural profession has been increasingly charged with generating building designs that promote individual wellness + public health. The definitions of health are many and diverse. That said, we are coming to understand with far greater clarity the tremendous correlations between health and the environment. Evidence linking the design of buildings and cities to positive health outcomes is significant. Studies in architecture, environmental psychology, social geography and other fields point to positive implications of well-considered and well-designed environments, including access to light, provision of clean air, incorporation of nature, reduced toxicity of materials, provision of social space, and many other design dimensions. Improved natural light can influence productivity. Views of nature can accelerate healing. Avoidance of harmful chemicals can reduce childhood illness. In many ways, the environmental design professions are now grasping design's potential with respect to heightened health outcomes. Medical sociologist Aaron Antonovsky (1923-1994) postulated, in his 1979 book 'Health, Stress and Coping' that a person's ability to manage and thrive in life's journey was related, in part, to the quality of their environments. Health depends, in part, on the environments which we occupy. Psychologists refer to place attachment and place identity, underscoring the remarkable influence place has in our lives. Upwards of 90% of our time, in many countries, is spent indoors, making the significance of health-promoting buildings even more urgent. Likewise, urban design and city planning are poised to better cultivate health. The present research actively explores Antonovsky's thinking, pushing hard to consider, craft and realize strategies to foster an architecture that is in synchronization with individual and community health needs and aspirations. Deploying critical analysis of the literature, case studies, studio education and logical argumentation, the current research proffers novel, bold and potent ways of linking design to wellness. Charles Jencks (2017) stressed that "Architects and doctors both are committed to creating a better future; they project plans and cures onto the horizon and seek to persuade people of their positive outcomes." Salutogenic design presents alternative ways of seeing, knowing and acting that can place us on a path to greater health in the built environment.

Parenting a child with autism spectrum disorder (ASD) has never been easy. Research has shown that parenting stress is much higher whose children are diagnosed with developmental disabilities such as ASD than typically developing children. The contributing factors include, but not limited to, the child’s limited social and communication skills and restricted and stereotypical activities (core deficits of autism). Parents lacking knowledge about ASD often resort to other forms of interventions in the hope to find a cure and believe it can help to eradicate the deficits of the disorder. Such treatments are known as complementary and/or alternative medicine and are not evidence-based. As there is no current remedy for ASD, perhaps it is time for parents to stop finding a cure to this disorder. In this paper, the author uses the application of the theory of salutogenesis and with the use of the three salutogenic components – meaningfulness, comprehensibility and manageability, aim to help parents establish a sense of coherence by identifying, understanding and managing their children with ASD.

The term ‘salutogenic’ is widely used in healthcare architecture, even though very few healthcare architects have much of a handle on what the term means. Here, we clarify the key concepts of salutogenesis, demonstrate how they work and show how they have been designed into healthcare facilities to yield exemplary results. The central idea is that there are three resources that combine to provide a Sense of Coherence—a forward thrust that resists the entropic forces of illness and infirmity. The sense of coherence is made up of resources that improve manageability—the capacity to maintain homeostasis and physical function; resources that improve comprehensibility—an ability to negotiate circumstances in order to maximise their benefit; and resources that enrich a sense of meaningfulness—the desires, causes and concerns that give us the need to resist illness in the first place.

"The prevailing model of psychiatric design (the world over) does not fulfil its potential in supporting the healing process. In order to design for future usability, design teams must have a vision beyond current paradigms and understand the direction healthcare is going.  More importantly still, models of care that will actually improve mental health outcomes instead of just managing patient behaviour must be considered. 

To create this vision, a methodological salutogenic approach can be employed for the project development and management phases – from design of the buildings through to the design of the models of care. This approach advocates taking an interdisciplinary and collaborative approach to actively improve a sense of coherence for all users including patients and staff. This can be done at every decision point by choosing to foster manageability, comprehensibility and most importantly meaning.
"

La salud positiva es una forma de ver las acciones en salud focalizando la mirada hacia aquello que hace que las personas, las familias y las comunidades aumenten el control sobre su salud y la mejoren. En esta forma de planificar y actuar en la salud pública gana valor la idea de los activos para la salud, que avalan que las personas son capaces de hacer cosas por su salud aprendiendo a responder a los retos del ambiente.

Un reto actual es fortalecer la formación de profesionales centrándonos en potenciar la capacidad para colaborar y detectar los recursos, costumbres y elementos culturales y ambientales ya existentes en las comunidades y en las personas que las integran y conectar mejor nuestros conocimientos y habilidades con la ciudadanía y con otras instituciones para responder a las necesidades e intereses de las personas a lo largo de todo el devenir del río de la vida.

Esta obra es fruto del trabajo de un grupo de autores de amplia formación y experiencia en la materia y contiene información teórica y empírica contrastada y de primera mano.

Sommario Il modello salutogenico creato da Antonovsky è qui presentato come un modello teorico aperto alle influenze di altri modelli influenti nella promozione della salute e dell'educazione alla salute. I due costrutti principali, le risorse generali di resistenza e il senso di coerenza, sono discussi attraverso due narrazioni con la finalità di focalizzare le sfide educative e le potenzialità offerte dalla connessione tra apprendimento e Salutogenesi. Parole chiave salutogenesi, apprendimento, pratiche riflessive, connectedness Summary The salutogenic model created by Antonovsky is here presented as a theory guide open to other influent theory models for health promotion and health education. The two constructs, the general resistance resources and sense of coherence, are posed and discussed through two narratives with the aim of focusing the specific educational challenges and possibilities offered by connecting learning and Salutogenesis. Patogenesi e salutogenesi: traiettorie educative per il life long e life wide learning

Esta obra está basada en seminarios formativos del Servicio Andaluz de Salud orientados a facilitar la comprensión de la promoción de la salud mental desde la mirada de los activos en salud, superando la idea de que “salud mental”  es sinónimo de “enfermedad mental”. Una idea que durante años se ha alejado de la concepción de la Organización Mundial de la Salud que ve la salud mental como un componente integral y esencial de la salud, no sólo de “ausencia de enfermedad” sino como estado de bienestar en el que la persona se realiza y es capaz de hacer frente al estrés normal de la vida, de trabajar de forma productiva y de contribuir a la comunidad.

El libro explica cómo se ha realizado la formación de profesionales de salud mental en este campo con una metodología colaborativa en un marco común del modelo de activos en salud. Como resultados, se describen experiencias y prácticas en todas las provincias andaluzas de proyectos de promoción de la salud mental con este enfoque positivo; se identifican activos hallados en la comunidad; y se proponen mejoras para seguir desarrollando programas.

In an interdisciplinary review of twenty-one German- and English-language intervention studies, the effectiveness of spiritually/religiously based interventions is evaluated statistically by measuring the participants' sense of coherence (SOC). Although Aaron Antonovsky considered a change in the SOC-29 score of no more than (+/-)5 points possible, the intentional modification of the SOC-29 median through religious/spiritual interventions ranges from 3.5 to 21 points. In studies using the SOC-13 questionnaire, the SOC increase ranges from about 2 to 7.5 points. Although it is possible that, for example, small sample sizes and biographical factors skew the statistics, the fact that the experimental groups' SOC score was in all cases higher than the control groups' SOC score strongly suggests that the improvement in SOC can be traced to the religious/spiritual practices. However, there seem to be no difference between the efficacy of spiritually/religiously based interventions and that of secular interventions. Moreover, some studies indicate that an intentionally modified SOC might not be stable over time. After reconsidering why I decided to categorize therapeutic programs such as Mindfulness-Based Stress Reduction (MBSR) as religiously/spiritually based interventions, I propose and criticize an ad hoc model of the SOC-enhancing effect of MBSR. I then discuss the potentials and shortcomings of this segment of research and develop perspectives for methodologically more sophisticated investigations.

The design approach advocated in this paper makes one fundamental assumption: the
appropriateness of any design is the extent to which it meets human needs and integrates sustainably
into the life-supporting natural processes of the planetary biosphere.  The author suggests that an
aesthetic of health, based on ecological literacy, can inform the evaluation of the qualitative fit
between design and its environment.  Eco-literacy - a detailed understanding of nature as a complex,
interacting, creative process in which humanity participates – results in a shift in perception toward an
ecological ethics and aesthetics of participation that considers cultural, social and ecological, as well
as economic value.
As perception becomes informed by ecological literacy it can begin to bridge the dichotomy
between the artificial and the natural, as well as between humanity and nature.  Ecological literacy
creates awareness of the fact that a disproportionate amount of the artificial environments,
infrastructures, artefacts and processes that have been created since the Industrial Revolution are
harmful to natural process and decrease the dynamic stability and health of the biosphere.  The
diversity of approaches within the Natural Design Movement affirms that we can create artefacts and
processes that are expressions of appropriate participation in natural process.  Sustainable and
responsible design is a creative possibility and an ecological necessity.
Ecological literacy emphasizes that humanity is an integral participant in natural processes,
which are fundamentally unpredictable and uncontrollable.  Local actions can have far reaching global
effects.  Interconnectedness results in cause and effect relationships within complex systems that are
not linear but circular, multi-causal, and often time delayed.  This awareness confronts us with the
need to assume responsibility for the outcomes of our actions and furthermore changes the perception
of humanity’s relationship to nature.  The aim shifts from control and manipulation to appropriate
participation.  There is therefore an important ethical and aesthetic dimension to ecologically literate
design.
The Natural Design Movement shares an ecological worldview.  The movement unites diverse
disciplines ranging from ecological design, industrial and urban ecology, sustainable architecture and
bioregional planning to ecological economics, eco-literate education and green politics.  Furthermore it
considers the philosophical, sociological and psychological implications of the ecological worldview. 
Design in the 21st century will be grounded in eco-literacy and aspire toward community-based
designs that are adapted to the specific conditions of a particular place and culture.
This paper concludes that long-term sustainable design has to integrate into natural processes
as the basis for planetary and human health.  There is an ecological dimension of ethics suggesting
ecological imperatives that transcend the relativistic moralizing of purely socio-philosophical ethics. 
Eco-literacy creates awareness of these ecological imperatives that will help designers to create
responsible and sustainable artefacts, processes and organizations.  Designing the artificial as an
expression of appropriate participation in natural process has to be based on ecological literacy and
supported by the emerging aesthetics of health, also referred to as the ecological aesthetics of
sustainability and the aesthetics of complex dynamic systems.

Keywords: aesthetics, complexity, diversity, eco-literacy, ethics, health, interconnectedness, Natural
Design Movement, participation, uncontrollability, unpredictability, salutogenesis, sustainability

Traditional sport participation has been associated with improved physical, psychological, and social skill outcomes. Engagement in action sports has increased considerably since the late 1980s, yet associated research is limited. This study examines and compares young adults' health and their participation in action sports, traditional sports, both sports types, or in neither of the sports types. Data were collectedfrom 687 traditional public university students who self-reported their sport participation history, frequency and mode. Health was assessed with the young adult Salutogenic Wellness Promotion Scale (SWPS-YA). While no significant differences, positive or negative, in overall health benefits between sports types were found, differences in the health behavior across the seven measured domains by sport participation were observed. In all cases, involvement in action or traditional sports was associated with greater health benefits than non-participation suggesting youth should be encouraged to participate in either or both sport typesfor health promotion.

This open access book offers a comprehensive view of the phenomenon of volunteer work: it examines motivational factors and questions of corporate organization and the social environment. In particular, this is the first book to present volunteer work in detail as a psychosocial resource and a source of well-being that should not be overused or abused. The book is based on the authors' 15 years of research into volunteer work in Europe. It provides clear instructions on designing volunteer work tasks, and on where boundaries must be respected. The findings include insights into cultural and national differences, and offer practical advice on the organization of volunteer work. This book answers questions like: How do we understand voluntary work? How essential is it that this kind of work remains unpaid and carried out by so-called laypersons with special motives? And what follows from this for the interaction between voluntary work and professionalized, paid employment? The analysis draws on perspectives from wellbeing research, organizational and industrial studies, social work, and related social sciences.

The Fourth Industrial Revolution (4IR) disrupts the world of work, new technologies change the nature of individuals' work and their tasks, and therefore it is necessary to determine how managers cope with these changes, specifically relating to their salutogenesis.

A tanulmány célja a vállalati kommunikáció egy újszerű megközelítésének bemutatása. A szalutogenezis fogalmának megjelenése az orvoslás és a pszichológia tudományterületéhez kapcsolható. Első publikálására 1988-ban került sor. A fogalom értelmezése és az általa kínált értelmezési lehetőségek napjainkra már több tudományterületen megjelentek, lehetőséget kínálva a megszokott szemléletmód felülvizsgálatára. Jelen cikk célja, hogy bemutassa a fogalom kialakulását, értelmezésének meghatározó pilléreit és áttekintse a szalutogén szervezet értelmezését. A gondolatmenet zárásaként bemutatott kommunikációs helyzetfelfogás felhívja a figyelmet a kommunikációs interakcióban tetten érhető szempontokra, melyek figyelembevétele elősegíti a szalutogén kommunikációs folyamatok felépítését. A tanulmány amellett foglal álláspontot, hogy a szalutogén kommunikáció kialakításának egyik lehetséges iránya a szervezeti tagok érzelmi intelligenciájának fejlesztése. Emellett a vállalatvezetés repertoárját újabb technikákkal, szempontokkal gazdagítja, amelyek elősegítik a szalutogén szervezet kialakulását

Salutogenesis indicates promotion of wellness, which is based on a strong sense of coherence derived from comprehensibility, meaningfulness and manageability of life's challenges including illness and disease. Teaching case vignettes are presented to highlight how these factors influence coping behaviour of patients.

Anybody who might think this thesis may be understood by way of reading the conclusion first
short-changes him/herself for two main reasons.  Firstly, this thesis is in itself already a work of
integration and synthesis.  It combines insights from a wide variety of disciplines and
complementary epistemologies.  Its conclusion – a further reduction of complexity and
necessarily a further abstraction – may be difficult to comprehend in its full significance to the
‘world problematique’ out of the context of the interconnected complex whole that is described
through the multifaceted perspective offered in each of the six chapters.
Secondly, while I tried – as suggested in the preamble – to make the meaning of each
part reflect the meaning of the whole as in a hermeneutic circle, there is nevertheless a deeper
intention to the sequence in which subjects are introduced.  I have tried to present and facilitate
a more integral and holistic understanding of sustainability and to increase awareness of the
transformative power of design.  I hope to catalyse and contribute to the emergence of new and
ancient meaning that spurs appropriate participation in natural process – sustainable design.
I make no apologies for the length of this thesis.  The very nature of attempting such a
broad synthesis made habitually or conventionally enforced brevity an inappropriate attitude to
take.  Nor do I believe this thesis contains an unnecessary amount of repetitions, it merely
revisits certain nodes in the web of synthesis in order to make integration possible and
comprehensible.
The work you hold in your hands is a gradual preparing of the soil of understanding, a
planting of the seed of a holistic and integral perspective, and the careful nurturing of ecological
consciousness and new insights about fundamental interconnectedness and the participatory and
co-creative nature of being, to finally harvest empowered designers who are committed to
creating meaningful visions of a sustainable human civilization through appropriate
participation in natural process and salutogenic design for human and planetary health.
This synthesis and conclusion cannot revisit all the diverse strands of the integrative
web that was woven over the last 774 pages.  Chapter six already provides some of that iteration
and further integration of the complex and diverse issues that make sustainability the wicked
problem of design.  It also offered a prescriptive outlook towards a more sustainable future
catalysed by meaningful, global and local visions, created by engaged responsible citizens,
facilitated by design as a trans-disciplinary integrator, and supported by our innate love for life
and a rediscovery of the natural world as the sacred ground of our being.
In the remaining pages I will attempt to, once again, move all the way upstream to the
very source of the river of all design, to that first distinction that identified the conscious,
perceiving and creative “self” in its relationship to the wider process of an evolving Kosmos in
which it participates.
As Maturana and Varela have pointed out, everything that is said, is said by an observer
(Maturana & Varela, 1987).  All form of knowledge about the world, reality, the Kosmos is
therefore an interpretation, based on a particular point of view.  In synthesis, I argue that design
starts with that interpretation – the first distinction, differentiation, and categorisation.

Participating in a welcoming and creative community may mean the world to some. The musical project Kaleidoscope (Fargespill) gives children with minority backgrounds an arena for meaning-making, identity development and agency.
In a time of extensive migration, many young people today grow up across cultures. Often treated as outsiders, it makes a difference to be invited to contribute. This study explores what participation in creative communities means to them. It combines cultural and community psychology in a contextual take on salutogenesis. In a mixed methods design, data were collected through fieldwork, interviews and a survey, involving 200 young Kaleidoscope participants.
The dissertation sheds light on the joys and challenges of growing up across cultural categories. A participatory creative community can provide recognition and freedom of movement. Different approaches to diversity are discussed, along with how young people navigate challenges together. Seip underlines the perks of playfulness, and ways to fight stereotyping with fun and friends. Knowledge about growing up across cultural categories is needed for psychology to take contemporary diversity seriously.

Contemporary workplaces are influenced by rapid changes, high levels of competition, increasing complexities and internationalisation processes. At the edge of the Fourth Industrial Revolution (4IR), insecurities and anxieties are high, and leaders are encouraged more than ever to lead employees with meaningful vision and prudence in order to make use of employees’ strengths, and ensure mental health and well-being. The aim of this article is to present new insights into salutogenesis, particularly sense of coherence (SOC), compassionate love (CL), and coping (C) in leaders with different cultural backgrounds. This study strengthens the idea that CL is a coping mechanism. This coping mechanism can be used by leaders to establish a resilient and salutogenic organisations. This article explores the subjective perspectives of 22 international leaders from five different countries and their views regarding SOC, CL and C through a qualitative research approach, using a qualitative online questionnaire for data collection and content analysis for data analysis. The findings on the perspectives of leaders provide new and original insights into how SOC, CL and C are connected, and how these concepts contribute to healthy organisations which are on their way to the transition into the 4IR. Conclusions are drawn. Recommendations for future research and practice are given.

Health promotion and salutogenesis are embodied in people's everyday lives and in their stories. The assumptions of these scientific theories are similar to Gramsci's theory for better wellbeing in a community, where praxis and capacity building for reflective practice is the way forward for an equal global change. By explaining the road for transformation through narratives, particularly fables, Gramsci manages to reach people from all walks of life, from academics to children. One of these fables, the mouse and the mountain, is here presented as a trigger to health promotion action and as a metaphor for salutogenic thinking. The narrative paradigm for health promotion is the context within which the analogies among 'the mouse's plan', health promotion theory, the salutogenic model, empowerment as well as the practitioners' opinions and experience are discussed and presented. In so doing, a 'storytelling bridge' is created between academics, practitioners and other stakeholders from the health, social and pedagogical arenas in knowledge construction environments. Hence, the article confers the possible contribution of Gramsci's educational perspective within health promotion by presenting a practical example of the use of narratives for capacity building. This is described through the interpretation of the same story in a hypothetical speech told by different storytellers, communicating their personal vision of the mouse's plan and so create a narrative-centered health promotion communication for meaning-making and for embracing theories among scholars and practitioners.

In modern times, medical doctors are being increasingly targeted by the general public for lacking apparently a “humanistic” approach to their patients. One of the possible reasons is perhaps our overemphasis on the role of disease (pathogenesis) as against the overall human well-being, termed “Salutogenesis”. A time has come to shift the emphasis.

In book: Effective Medical Communication, pp.235-245