In 2016, The British Psychological Society produced The Power Threat Meaning Framework, which offers a new perspective on why people sometimes experience a whole range of forms of distress, confusion, fear, despair, and troubled or troubling behaviour. It is an alternative to the more traditional models based on psychiatric diagnosis. It applies not just to people who have been in contact with the mental health or criminal justice systems, but to all of us.
Here is a summary of the core principles of the PTM Framework:
The Framework integrates a great deal of evidence about the role of various kinds of power in people’s lives; the kinds of threat that misuses of power pose to us; and the ways we have learned as human beings to respond to threat. In traditional mental health practice, these threat responses are sometimes called ‘symptoms’. The Framework also looks at how we make sense of these difficult experiences, and how messages from wider society can increase our feelings of shame, self-blame, isolation, fear and guilt.
The main aspects of the Framework are summarised in these questions, which can apply to individuals, families or social groups:
• ‘What has happened to you?’ (How is Power operating in you life?) • ‘How did it affect you?’ (What kind of Threats does this pose?) • ‘What sense did you make of it?’ (What is the Meaning of these situations and experiences to you?) • ‘What did you have to do to survive?’ (What kinds of Threat Response are you using?)
In addition, the two questions below help us to think about what skills and resources people might have, and how we might pull all these ideas and responses together into a personal narrative or story:
• ‘What are your strengths?’ (What access to Power Resources do you have?) • ‘What is your story?’ (How does all this fit together?)
Possible uses of the PTM Framework
The Power Threat Meaning Framework can be uses as a way of helping people to create more hopeful narratives or stories about their lives and the difficulties they may have faced or are still facing, instead of seeing themselves as blameworthy, weak, deficient or ‘mentally ill’. It highlights the links between wider social factors such as poverty, discrimination and inequality, along with traumas such as abuse and violence, and the resulting emotional distress or troubled behaviour. It also shows why those of us who do not have an obvious history of trauma or adversity can still struggle to find a sense of self-worth, meaning and identity.
The Framework describes the many different strategies people use, from automatic bodily reactions to deliberately-chosen ways of coping with overwhelming emotions, in order to survive and protect themselves and meet their core needs. It suggests a wide range of ways that may help people to move forward. For some people this may be therapy or other standard interventions including, if they help someone to cope, psychiatric drugs. For others, the main needs will be for practical help and resources, perhaps along with peer support, art, music, exercise, nutrition, community activism and so on. Underpinning all this, the Framework offers a new perspective on distress which takes us beyond the individual and shows that we are all part of a wider struggle for a fairer society.
One of the most important aspects of the Framework is the attempt to outline common or typical patterns in the ways people respond to the negative impacts of power – in other words, patterns of meaning-based responses to threat. This part of the Framework, like all of it, is still in a process of development. However, the evidence summarised in the Framework does suggest that there are common ways in which people in a particular culture are likely to respond to certain kinds of threat such as being excluded, rejected, trapped, coerced or shamed. It may be useful to draw on these patterns to help develop people’s personal stories. These general patterns can help to give people a message of acceptance and validation. The patterns can also assist us in designing services that meet people’s real needs, as well as suggesting ways of accessing support, benefits, and so on that are not dependent on having a diagnosis.
In addition, the Framework offers a way of thinking about culturally-specific understandings of distress without seeing them through a Western diagnostic model. It encourages respect for the many creative and non-medical ways of supporting people around the world, and the varied forms of narrative and healing practices that are used across cultures.
Taking the PTM Framework further
It’s important to note that the Power Threat Meaning is an overarching framework which is not intended to replace all the ways we currently think about and work with distress. Instead, the aim is to support and strengthen the many examples of good practice which already exist, while also suggesting new ways forward.
The Framework has wider implications than therapeutic or clinical work. The main document (see link below) suggests how it can offer constructive alternatives in the areas of service design and commissioning, professional training, research, service user involvement and public information. There are also important implications for social policy and the wider role of equality and social justice. It is a work in progress, offered as a resource for any individuals, groups or organisations interested in developing it further.
The project documents are free to read or download:
Appendix 1 of the Overview Document is a possible ‘Guided discussion’ for one to one work in services or for peer support/self-help. Appendices 2-14 in the Overview Document give examples of good practice in various service or non-service settings. (Please feel free to adapt this summary for your own purposes.)
Our group will aim to be an enthusiastic voice for raising awareness of the Power Threat Meaning Framework and its non-diagnostic approach to personal experiences of emotional distress.