Helping People Overcome Emotional Distress: The Power Threat Meaning Framework

After nearly twenty years working as a neuroscientist, I closed down my university research laboratory at the beginning of the millennium. I no longer believe in the biomedical approach to helping people overcome addiction and mental health problems. I believe that long-term use of psychiatric drugs causes more harm than good. It’s not ‘what is wrong with you’, but ‘what has happened, or is happening, to you.’

In January 2018, the Clinical Psychology Division of The British Psychological Society produced a very important paper, titled The Power Threat Meaning Framework and subtitled ‘Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis.’

In my opinion, this document is a major breakthrough in the field, and the approach it describes makes so much more sense and is far superior to the biomedical approach to helping people overcome emotional distress (or so-called mental health problems).

The British Psychological Society website has a wealth of information about the Power Threat Meaning Framework (PTMF) which I can recommend highly. I include here two short sections taken from the PTMF pages.

‘Over the course of five years a group of senior psychologists (Lucy Johnstone, Mary Boyle, John Cromby, David Harper, Peter Kinderman, David Pilgrim and John Read) and high profile service user campaigners (Jacqui Dillon and Eleanor Longden) developed the Power Threat Meaning Framework as an alternative to more traditional models based on psychiatric diagnosis.

They were supported by researcher Kate Allsopp, along with a consultancy group of service users, carers, and others who supplied examples of good practice not based on diagnosis.’

‘The Framework applies not just to people who have been in contact with the mental health or criminal justice systems, but to all of us.

It summarises and integrates a great deal of evidence about the role of various kinds of power in people’s lives, the kinds of threat that misuse of power pose to us and the ways we have learnt to respond to those threats.

Dr Lucy Johnstone, one of the lead authors of the Power Threat Meaning Framework, said:

“The Power Threat Meaning Framework can be used as a way of helping people to create more hopeful narratives or stories about their lives and the difficulties they have faced or are still facing, instead of seeing themselves as blameworthy, weak, deficient or ‘mentally ill’.

It highlights and clarifies 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, whether it is confusion, fear, despair or troubled or troubling 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. “

In traditional mental health practice, threat responses are sometimes called ‘symptoms’.

The Framework instead looks at how we make sense of these experiences and how messages from wider society can increase our feelings of shame, self-blame, isolation, fear and guilt.

The approach of the Framework is summarised in four questions that can apply to individuals, families or social groups:

  1. What has happened to you? (How is power operating in your life?)
  2. How did it affect you? (What kind of threats does this pose?)
  3. What sense did you make of it? (What is the meaning of these situations and experiences to you?)
  4. What did you have to do to survive? (What kinds of threat response are you using?)

Two further questions help us think about what skills and resources people might have and how they might pull all these ideas and responses together into a personal narrative or story:

  1. What are your strengths? (What access to Power resources do you have?)
  2. What is your story? (How does all this fit together?)’

Please check out the British Psychological Society pages on the PTMF.

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