For too long, the understanding of human distress has been individualized, ignoring the context for people’s behaviors and symptoms. But an exciting new framework from the British Psychological Society (BPS) holds promise for shifting how people living with behavioral health conditions understand themselves and their experiences. It also has the potential to positively impact clinical practice, if it were applied to therapeutic relationships. The Power Threat Meaning Framework (PTM) was developed as a partnership between clinicians and peers.
As internationally-known trauma expert Dr. Gabor Mate notes, the traditional medical model creates two separations: it separates the mind from the body, and the person from the environment. The PTM framework is a way to begin undoing these two separations created by the traditional medical model. As the Framework’s authors note: “The individual does not exist, and cannot be understood, separately from his/her relationships, community and culture; meaning only arises when social, cultural and biological elements combine; and biological capacities cannot be separated from the social and interpersonal environment.”
According to one of the PTM creators, Dr. Lucy Johnstone, the main aspects of the Framework are summarized in these questions, which can apply to individuals, families or social groups:
- “What has happened to you?” (How is Power operating in your 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?)
As the authors note, “The PTM Framework can be used 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 sick. 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.”
Consider answering the above questions for yourself, and see what story emerges! For more information on the Framework, check out the links below.
- Power Threat Meaning Framework: Summary (2 pages)
- Power Threat Meaning Framework: Overview (139 pp)
- The Power Threat Meaning Framework: A New Approach Challenges Traditional Psychiatric Models (Mad in America)
- My mother took her own life – and now I know a different mental health approach could have saved her (The Independent)