The Power Threat Meaning Framework: Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis

By Johnstone, L & Boyle, M with Cromby, J, Dillon, J, Harper, D, Kinderman, P, Longden, E, Pilgrim, D & Read, J.          [Download Resource]


‘The Power Threat Meaning Framework has the potential to take us beyond medicalisation and diagnostic assumptions. It puts forward alternative ways of thinking about a range of fundamental issues including: What kinds of theoretical frameworks and assumptions are appropriate for understanding emotional distress, unusual experiences and troubled and troubling behaviour? What research methods could be used and what counts as evidence? How could the results of research be interpreted? What is the relationship between personal distress and its wider social, material and cultural contexts? How can we centre people’s lived experiences and the meanings that shape them? What new conceptualisations arise from all these questions, and how can all the implications be translated into practice, both within and beyond services, at all levels from individual to social policy?’


Key Content Areas:

  • Problems of psychiatric diagnosis and the need for a different approach
  • Philosophical and conceptual principles of alternatives to psychiatric diagnosis
  • Meaning and narrative
  • The social context
  • The role of biology
  • Describing patterns within a Power Threat Meaning Framework
  • Service user consultation and feedback
  • Ways forward


This framework for the origins and maintenance of distress replaces the question at the heart of medicalisation, ‘What is wrong with you?’ with four others: ‘What has happened to you?’ (How has Power operated 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?)
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