You don’t have to be sick to get better.

The World Health Organization (WHO) still uses the definition of health, which they formulated in 1948, the year the United Nations agency was founded: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This definition is a static view of health. Additionally, for most people this situation is practically impossible to achieve and reduces almost everyone to being a patient. In 2011, Huber and colleagues coined a more dynamic concept: “Health as the ability to adapt and to self-manage, in the face of social, physical and emotional challenges” [1]. This concept was called Positive Health. It is no longer about a condition, but about an ability, a strength or competence. The importance of this strength lies in making it possible for one to lead a meaningful life. This implies that there is no direct link between being sick and striving for a better life. Our idea of ​​positive healthcare, from a solution-focused perspective, therefore does not start with a problem or complaint, but with the preferred future [2].

The concept of Positive Health does justice to the many factors involved in finding our way in life. These are not only physical, emotional and social factors, but also genetic, economic and environmental. The nature of all these factors and the ways in which they interact with each other are constantly changing and are often impossible to unravel. In this sense, the medical model which follows the route problem – examination – diagnosis – treatment does not always apply. In order to be able to have a different conversation about health, a conversation tool for positive health has been developed, the dialogue tool [3]. This tool encompasses six dimensions: bodily functions, mental well-being, meaningfulness, quality of life, participation and daily functioning. The good thing is that it provides us with a broader perspective on health. The bad thing is that, in this way – once more –  a classification is used which requires an evaluation of the various dimensions. This fuels our ingrained tendency to look for causes and repairing what is wrong.

Positive Health describes health as a complex and dynamic subject with infinitely many causes and consequences. Health (and mental health) is an emergent quality. One-to-one correlation can only be recognized in sub-areas. Seen from this angle, an analytical approach aimed at restoring the disorder will not suffice. Adding the synthesis paradigm, creating an outcome that has not been there before, to respond to change, opens up additional possibilities. How can we let new developments emerge through self-organization?

Positive psychology is the scientific movement that focuses on well-being and optimal functioning. It’s about how we can get the best out of ourselves and others. The strengths-based approach is an important pillar of positive psychology. This too is based on the analysis paradigm with a classification system of 24 strengths as opposed to the classification system of mental disorders, the DSM-5; systems that should include everyone and are devised by experts.

When (mental) health is seen as an ability or competence, a competency-based approach might be obvious. A good example is the solution-focused approach. This is a pragmatic and functional approach. It’s about finding what works for this person, at this moment, in this context (see next chapter).