Meaning in the Power Threat Meaning Framework

Journal of Humanistic Psychology

This article summarizes the results of a recently published project to develop a conceptual system incorporating social, psychological, and biological factors as an alternative to functional psychiatric diagnosis. The principles underlying the Power Threat Meaning Framework are briefly described, together with its major features and differences from diagnostic approaches. These include the assumptions that what may be called psychiatric symptoms are understandable responses to often very adverse environments and that these responses, both evolved and socially influenced, serve protective functions and demonstrate human capacity for meaning making and agency. We describe how the elements of the Power Threat Meaning Framework interact to restore links between environmental threats and threat responses, and to enable us to outline some probabilistic Provisional General Patterns, grouped by personal, social, and cultural meaning, describing what people do, not the "disorders" they "have." We conclude by outlining some implications of the Framework for narrative construction and for thinking about distress across cultures.

2019

The British Psychological Society’s Clinical Division (2018) recently published The Power Threat Meaning Framework, an evidence-supported discussion document to promote consideration of alternatives to functional psychiatric diagnosis. I summarize the general content and approach of the framework as a meaning-focused alternative to the psychiatric classification system, the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (American Psychiatric Association, 2013). I comment on the utility of the Power Threat Meaning Framework for the conversational practice of a nonmedicalized approach to counselling.

Canadian Journal of Counselling and Psychotherapy, 2019

The British Psychological Society’s Clinical Division (2018) recently published The Power Threat Meaning Framework, an evidence-supported discussion document to promote consideration of alternatives to functional psychiatric diagnosis. I summarize the general content and approach of the framework as a meaning-focused alternative to the psychiatric classification system, the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (American Psychiatric Association, 2013). I comment on the utility of the Power Threat Meaning Framework for the conversational practice of a nonmedicalized approach to counselling

Journal of Constructivist Psychology, 2020

The Power Threat Meaning Framework (PTMF), published by the British Psychological Society (BPS) in 2018, is an attempt to address the question of how we might understand what Harry Stack Sullivan called 'problems in living' other than by using psychiatric diagnostic systems. How might we best conceptualize emotional distress and behaviour which might concern or trouble others? We describe the context within which the PTMF was developed and explain some of its key elements before giving an overview of the articles in this special issue.

Published by the British Psychological Society, this document sets outs a coherent alternative to psychiatric diagnosis

Power Threat Meaning Framework (PTM), 2020

The Power Threat Meaning Framework (PTMF) is a recent, cutting edge concept that was developed over the course of five years of study by a group of researchers from the British Psychological Association (Johnstone & Boyle, 2018). Their goal was to find an alternative to the biomedical model and the traditional Diagnostic Statistical Manual of Mental Disorders (DSM) model for helping people experiencing mental distress (Johnstone & Boyle, 2018). First, I will describe the concepts that make up the PTMF, then compare the PTMF to mainstream biomedical approaches. Then I will describe its benefits and limitations and the reasons why it may not receive general support. Finally, the implications for social work practice will be discussed.

FPID Bulletin: The Bulletin of the Faculty for People with Intellectual Disabilities

Easy read summary■The Power Threat Meaning Framework was written to help make sense of distress in terms of people’s experiences. It asks ‘what has happened to you?’, NOT ‘what is wrong with you?’■The Power Threat Meaning Framework could be useful for people working with people with learning disabilities and autism■We describe how we have adapted the Power Threat Meaning Framework for use in learning disability services.■More resources need to be developed with people who use these servicesThe Power Threat Meaning Framework (PTMF) was launched by the British Psychological Society in 2018 to offer an alternative classification system to pseudo-scientific practises of psychiatric diagnosis that regard certain ways of thinking, feeling and behaving as ‘symptoms’ of unevidenced ‘mental disorders’. In this article, we summarise what appealed to us about the PTMF and we describe some of the work we have undertaken to highlight how the Framework can be applied to support understanding of t...

Perspectives in Public Health, 2023

Aims: To propose that much of the language and concepts in public mental health is medicalised and to suggest that the Power Threat Meaning Framework (PTMF), can be a useful resource for those wishing to take a de-medicalising approach. Method: Examples of medicalisation are drawn from the literature and from practice and key constructs in the PTMF are explained, drawing from the report which presented its research base. Results: Examples of medicalisation in public mental health include: the uncritical use of psychiatric diagnostic categories; the ‘illness like any other’ approach in anti-stigma campaigns; and the implicit privileging of biology in the biopsychosocial model. The negative operations of power in society are seen as posing threats to human needs and people make sense of such situations in varied ways though there are some commonalities. This gives rise to culturally available and bodily enabled threat responses which serve a variety of functions. From a medicalised perspective these responses to threat are characteristically seen as ‘symptoms’ of underlying disorders. The PTMF is both a conceptual framework and a practical tool that can be used by individuals, groups and communities. Conclusion: Consistent with social epidemiological research, prevention efforts should focus on preventing adversity rather than ‘disorders’ but the added value of the PTMF is that varied problems can be understood in an integrated manner as responses to a variety of threats whose functions could be met in different ways. Its message that mental distress is a response to adversity is comprehensible to the public and can be communicated in an accessible way.

There is so much I can agree with in this paper – it is an insightful piece of work but whether it warrants either the accolades that seem to be expected by some of its authors or the brickbats that have been thrown at it already is, in my opinion, doubtful. I think the paper will be helpful in a public health kind of way, guiding policy makers in putting together a more coherent approach to some aspects of the development of more effective mental health services but whether it will help therapists and clients in the room to work better together for the benefit of the distressed individual is another matter. First of all, it is yet another static model firing at a moving target. It is an improvement on the fixed single barrel sniper rifle of psychiatry whose diagnoses are inevitably going to label the individual, though those labels can be helpful in this current climate of categorisation, litigation and limitation, but it is little better than the " duck foot " gun favoured by security guards in the C18th that sprayed a limited but wider area with several bullets in the hope of hitting a number of targets. I want to make a few observations about the development of the concept of trauma and why I think that this new framework is little more than a yet another particular feature in the view seen from the railway carriage of human development racing through the countryside of social evolution. Human beings as a species have been experiencing trauma throughout their existence. That human beings could experience psychological damage related to traumatic experiences was not recognised in any meaningful way until the beginning of the 20th century. Since then trauma, in the form of the diagnoses of post-traumatic stress disorder, adjustment disorder, et cetera has been increasingly recognised as phenomena experienced by individuals in response to events that are frightening and out of the ordinary. It is necessary to ask the question as to how these behaviours became abnormal and the medicalisation of behaviours in response to trauma occurred. During the 20th century vast social changes took place and particularly after the Second World War the world became a much safer place (Pinker 2011, Harari 2015). For the first time in our lives the majority of human beings could expect to live out their lifespan in relative comfort and safety. As a consequence of this improvement in security and safety, particularly in the West, unpleasant experiences such as war, violence and natural disaster became much less common and when they did occur far fewer people were injured or killed. Furthermore, many forms of trauma and abuse were being exposed, and still are, and thus the commonality of violence and abuse against the vulnerable became less common. It is also increasingly becoming a subject awareness for the population and increasingly disapproved of. Many forms of abuse that have been previously acceptable are now treated as crimes, for example the abuse of women in one form or another for sexual pleasure by men. That more people are now traumatised by abnormal and horrific experiences is not so much a tribute to professionals recognising these events but that they are brought into profile by a much more benign environment that causes them to stand out. There are also the traumas of everyday life such as road traffic collisions, injury at work and other personal injuries that in themselves have become much more apparent due to the increase in regulation of activities that might be considered dangerous but were part of everyday life previously. One only needs to look at the nature of health and safety on building sites, in industrial settings and even in office settings to see how much more