The Power Threat Meaning Framework

A conceptual alternative to psychiatric diagnosis.

[James Barnes MSc., MA @psychgeist52]

In my latest @PsychToday post, I examine @AwaisAftab's attempt to rescue psychiatry on pragmatic grounds after conceding longstanding critiques of its foundations.

I argue the defence fails—and it leads not to reforming the psychiatric paradigm, but to moving beyond it.

https://t.co/7NdhEoeR0W

[Mad In The UK @MITUKteam]

Calling Out the Root Causes of Loneliness
By Jordan Reyne

https://t.co/8yPbnCVSGh

#Loneliness #MentalHealth #LateStageCapitalism #SystemicChange

[Mark Horowitz @markhoro.bsky.social @markhoro]

I wrote a blog on "Why Doctors Don’t See Withdrawal:
Severe antidepressant withdrawal is often hidden in plain sight. Here's why most clinicians don't recognise it – and why I wouldn't have either until it happened to me." Link below. Please re-tweet.

[Mad In The UK @MITUKteam]

Calling Out the Root Causes of Loneliness
By Jordan Reyne

https://t.co/8yPbnCVSGh

#Loneliness #MentalHealth #LateStageCapitalism #SystemicChange

[Mad In The UK @MITUKteam]

Check out the blogs we published in May 🧡

https://t.co/fd5yxZR3Oi

[Sam Hall @samhall404]

1/ Thanks to @MikhailaFuller for allowing me to share my story. 🧵

My experience sits in the uncomfortable space between what patients are routinely told about antidepressants and what can, in many cases, actually unfold over time. It is not simply a story of adverse effects, it is a story about the consequences of incomplete information, overconfidence in simplified narratives and a medical culture that too often defaults to explanation rather than investigation when things go wrong.

I was prescribed the antidepressant Sertraline for situational panic attacks following a house fire when I was younger and remained on it for approximately 13 years. During that time, I was never meaningfully informed about the possibility of physiological dependence, nor about the potential difficulty of stopping the drug after long term use. The phrase “safe and effective” was presented as if it were a stable, universal truth, rather than a context dependent conclusion drawn from limited and biased data.

There was no discussion of what happens when the brain adapts to a drug over more than a decade. No acknowledgement that removing that drug might not be a neutral act. No mention of protracted withdrawal or that stopping could result in a severe and prolonged destabilisation of the nervous system. Informed consent, in any meaningful sense, was absent.
When I eventually came off the SSRI, it was done through a rapid doctor led taper that bore no relation to the duration of my use. What followed was not a return of my original symptoms, but the onset of something far more severe, complex, disabling and life changing.

Almost immediately, I began to experience intense and persistent surges of physiological anxiety and panic. These were not thoughts or worries in the conventional sense. They were full body events; overwhelming waves of adrenaline that arose without psychological trigger, accompanied by a profound sense of internal threat. They were not responsive to reasoning, reassurance or standard psychological strategies because they were not primarily psychological in origin.

Alongside this, I developed widespread neurological and sensory disturbances. I experienced constant “electric” sensations throughout my body, moving unpredictably through my arms, legs, hands and across my head and face. These were often painful, presenting as burning, tingling or sharp nerve like sensations. My muscles began to twitch involuntarily, with fasciculations and spasms becoming a daily occurrence. At times, my facial muscles would contract and twitch without warning.

One of the most severe and distressing symptoms I experienced was akathisia. It is often described clinically as restlessness, but that description is profoundly inadequate. What I experienced was an intense, unrelenting inner agitation combined with a powerful urge to escape my own body, alongside a compulsion to move that made stillness feel intolerable. At its worst, it generated intense suicidal urges, not from hopelessness, but from a desperate need to escape the sensation itself. It was not psychological distress in any conventional sense, it was a physical state that overrode any attempt at control. It is difficult to overstate how severe and destabilising this symptom has been for three years.

Sleep became almost impossible at times. I went through prolonged periods of insomnia, sometimes sleeping only three hours across several days. When I did manage to fall asleep, I was frequently jolted awake by hypnic jerks; sudden, violent awakenings accompanied by adrenaline surges. The cumulative effect of this sleep deprivation was profound, amplifying every other symptom and eroding my ability to cope.

Cognitively, I experienced significant impairment. I developed …

https://t.co/TYB7skwY3t

[Mad In The UK @MITUKteam]

What the Shadow Holds: Turning Survival Skills Into Superpowers – Part two
By Matt Benson

https://t.co/la2JLfEZJM

#trauma #mentalhealth #shadowwork #healing #traumarecovery #psychology

[Dr Joanna Moncrieff @joannamoncrieff]

Fascinating report on the recent American Psychiatric Assn conference. Among the defensive positioning, it is good to see some psychiatrists acknowledging 'meds are not the answer' and severe harms like protracted withdrawal. @EllenBarryNYT https://t.co/72z8BH1AE4

[Mad In The UK @MITUKteam]

What the Shadow Holds: Turning Survival Skills Into Superpowers – Part one
By Matt Benson

https://t.co/1uFCIo1TQ3

#trauma #mentalhealth #shadowwork #healing #traumarecovery #psychology

[ad4e @dropthedisorder]

Tomorrow! (28 May)
The ‘Mental Health Crisis’
Should we continue with soaring numbers of drug prescriptions, and calls for more services and research? Or do we need to ask more fundamental questions about our rising levels of unhappiness and despair?
 https://t.co/0di8bZqbXY

[Dr John Read @ReadReadj]

“What happens when psychiatry claims depression is an illness?”
https://t.co/SpF4sfdtU5

[Mad In The UK @MITUKteam]

What the Shadow Holds: Turning Survival Skills Into Superpowers – Part one
By Matt Benson

https://t.co/1uFCIo1TQ3

#trauma #mentalhealth #shadowwork #healing #traumarecovery #psychology

[The Power Threat Meaning Framework @PTMFramework]

Many Selves, One Soul https://t.co/0fwy1jN7YT via @MITUKTeam A moving poem by Catherine Heseltine

[ad4e @dropthedisorder]

Kicking off in the #adisorder4everyone zoom room in 2 hours! (6pm, 21st May)

Highly recommended to everyone who offers therapeutic and/or supportive spaces for people.

Join us!

The recording is included with every ticket.

https://t.co/9ZyB2OQmgG

[Mad In America @Mad_In_America]

Psychiatry’s Attack Dog Is at It Again
By Robert Whitaker

Awais Aftab's latest post lumps critics as varied as journalists, psychiatrists, and those with lived experience together, inaccurately smearing them by invoking MAHA and Szasz.

https://t.co/Dy6FVUDoSs

[Mad In The UK @MITUKteam]

Rearranging deck chairs while the Titanic goes down �� The American Society of Clinical Psychopharmacology Issues Deprescribing Recommendations
By Carrie Clark and Mark Horowitz

https://t.co/KzPY6601HH

#Deprescribing #PsychiatricDrugs #InformedConsent #MentalHealthReform

[The Power Threat Meaning Framework @PTMFramework]

Free webinar on June 5th 12.00 - 1.30 with #PTMFramework authors Lucy Johnstone and Peter Kinderman, joint winners of @UKDCP Lifetime Achievement Award. Sign up here:

https://t.co/6bpbNXKkKR

[Dr Joanna Moncrieff @joannamoncrieff]

I can understand this is a difficult time for my psychiatry colleagues. I am sure they all have good intentions, but it turns out that the most widely used psychiatric treatment, antidepressants, causes significant iatrogenic effects (e.g. severe withdrawal reactions, PSSD), is not very effective (at best) and does not target an underlying biological abnormality after all. Although many people still seek a psychiatric diagnosis and a medical approach, increasing numbers highlight how misleading and disabling this approach can be. Their voices are starting to be heard, and we need to work with them to provide help for people who have been harmed by psychiatric treatment, and to prevent more harm being done. Trying to shoot the messenger doesn’t help anyone.

[The Power Threat Meaning Framework @PTMFramework]

@vauntedrevelrie Some people have been opposed to it even before it was published. It’s fine to disagree with it. Unlike diagnosis, it is an optional perspective. But most X criticisms are not based on what it actually says.

[The Power Threat Meaning Framework @PTMFramework]

@mattBernius These are all very good questions. They don’t have simple answers- but a PTMF narrative is designed to show how structural issues impact upon the individual (in PTMF terms, linking threat responses with threats.) This can at least offer a starting point for different ways forward