Et alternativ til diagnoser for psykiske lidelser: Makt–trussel–mening-rammeverket

Abstract

The article presents the Power Threat Meaning Framework (PTMF), which was developed by a working group under the British Psychological Association in 2018 as an alternative to traditional diagnostic systems such as DSM and ICD. PTMF criticises conventional diagnostics for being overly simplistic and based on an implicit assumption of individual vulnerability as the main cause of mental health problems. Instead, PTMF emphasises the importance of social conditions and life events in the development of emotional pain and mental health problems. This perspective entails viewing people’s responses as attempts to deal with threats to their basic life conditions rather than as symptoms of underlying illnesses. The framework is based on a critical reading of the evidence base for existing diagnostic systems and on extensive research supporting alternative understandings of what has traditionally been understood as mental illness. For Norwegian psychologists, PTMF can help enrich evidence-based clinical practice by promoting an understanding of mental illness as meaningful responses to complex life situations. This can be integrated into practice through methodologies such as case formulation, trauma-informed approaches, and network-based working methods that facilitate the exploration of people’s personal narratives and their social context. The article argues that incorporating PTMF as a legitimate conceptual framework in Norwegian health and welfare services could conceivably contribute to a more holistic health service by integrating mental health work with practical help and support from family, friends, and community resources in ways that are more appropriate than the way services work today. PTMF invites psychologists in Norway to challenge traditional models and contribute to more inclusive and contextualised mental health care. With this article, we hope to inspire reflection on new approaches to mental health and debate about the implications of integrating PTMF in clinical work.