Recently, I completed the coursework for Mental Health First Aid from the National Council for Mental Wellbeing, and I’ll be honest, it challenged more of my thinking than I expected.
Not just about when to lean in or how to support others in moments of crisis (something that doesn’t come naturally to me), but about the language we use. The common phrases that can unintentionally reinforce stigma. The assumptions we carry that can block deeper connections. And the support systems available to us—often underutilized or misunderstood—when things feel difficult.
In my own studies, one model that closely parallels this training is the Power Threat Meaning Framework (PTMF), developed by Lucy Johnstone and Mary Boyle in 2018.
It offers a different way of understanding mental and emotional distress, one that feels especially relevant for anyone navigating prolonged stress, mental health challenges, identity shifts shaped by diagnoses (or the absence of them), the pressure to conform or mask, or significant periods of change.
Let’s take a closer look at what the PTMF is and how it might actually help in real life, especially during times of adversity.
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What Is the PTMF?
The Power Threat Meaning Framework shifts the question from: “What’s wrong with you?” to: “What happened to you, and how did you make sense of it?”
Instead of focusing on diagnosis first, it explores four key areas:
- Power: What has happened in your life? (relationships, systems, environments)
- Threat: How did those experiences impact you?
- Meaning: What meaning did you make of those experiences?
- Response: How did you learn to cope or survive?
This isn’t about dismissing or devaluing diagnoses. It’s about adding context. When we understand why something developed, we often unlock more compassionate and effective ways to move forward.
A Coaching Lens: Why This Matters
From a coaching perspective, this framework aligns closely with how sustainable change actually happens.
People don’t just need strategies. They need understanding, agency, and alignment.
PTMF supports this by helping people:
- Reduce shame (“This makes sense given what I’ve been through.”)
- Increase self-awareness (“Oh, that’s why I respond this way.”)
- Create more purposeful action (“What would I like to do differently now?”)
It creates space for something I come back to often: Why does this matter?
Because awareness, without judgment, leads to more useful action.
And when that action is rooted in intentional choice, it doesn’t just create short-term change. It supports more stable mental and emotional health, stronger relationships and communities, and a greater sense of empowerment in how you think, respond, and engage with the world.
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Supporting Vulnerable Populations
For many individuals, especially those in high-pressure environments or navigating ongoing mental health challenges, experiences of power and threat are not isolated. They are layered, cumulative, and often ongoing.
This can include:
- Military members navigating hierarchical systems, high-stakes decisions, and transitions back to civilian life
- Individuals living with persistent and sometimes complex or difficult-to-control symptoms
- Anyone adapting to environments that require masking, heightened control, or hypervigilance
Over time, these experiences can shape not just behavior, but identity.
It’s easy for internal narratives to form:
- “Why can’t I just adjust?”
- “This is just how I am.”
- “Something must be wrong with me.”
The Power Threat Meaning Framework offers a different entry point. It gently asks, “Given what I’ve experienced, how have my responses helped me survive? And are they still serving me now?”
This shift is subtle, but powerful. It allows us to:
- Honor adaptive responses (hypervigilance, emotional shutdown, control, avoidance) as intelligent survival strategies
- Explore whether those strategies are still useful in current contexts
- Rebuild a sense of personal agency, especially when moving beyond environments that once required those responses
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For individuals navigating diagnoses, this can be especially meaningful. A diagnosis can provide clarity, but it can also shape identity in limiting ways. The PTMF gently reframes symptoms not as random or broken, but as understandable responses to lived experience.
This doesn’t replace treatment. It enhances it by adding context, compassion, and curiosity.
From a coaching perspective—and something you can tenderly explore on your own—this creates space for a more collaborative relationship with yourself:
- What patterns show up most often, and when did they begin?
- What helped you get through those experiences?
- What parts of those responses are still useful, and what might you want to adjust now?
- What feels at risk when this reaction shows up, and is there a small way to support that differently?
- How might this response be helping you, even if imperfectly?
- If this isn’t the ideal response, what might be a more manageable option right now?
You might find yourself landing somewhere honest and surprisingly compassionate: “This may not be the best option, but it’s the best I can do right now.”
And from there, change becomes a little more possible.
Before moving forward, I want to note that this kind of self-exploration can bring up more than you might expect.
If at any point it begins to feel overwhelming or difficult to hold on your own, reaching out to a qualified mental health professional can provide meaningful support. You don’t have to carry it by yourself.
Applying This to Everyday Challenges
You don’t need a formal diagnosis or a major life event for this to be useful. The Power Threat Meaning Framework can support how you approach everyday moments that feel uncomfortable, stuck, or out of alignment. For example:
- Avoidance (“I keep putting this off…”)
- Overthinking
- Emotional reactions
- Burnout
- Relationship patterns
When something feels off, you can slow down and get curious with this simple 4-step self-check:
- Power – What’s happening in my environment or situation?
- Threat – What feels at risk here? (rejection, failure, loss, uncertainty)
- Meaning – What story am I telling myself about this?
- Response – What am I currently doing—and how is it helping?
This process doesn’t force immediate change. It is designed to build awareness, clarity, and choice.
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Now, if you’re supporting someone else, this framework can be just as helpful. Instead of jumping straight to solutions (or placing blame), it creates space to slow down and ask more thoughtful questions.
While it’s natural to want to tell someone what to do, remember that this approach focuses on evoking their own insight and motivation. Here are a few simple ways to apply this in conversation:
1. Ask, Don’t Assume
- Example: “What feels most important to you about this right now?“
2. Reflect Without Judgment
- Example: “It sounds like part of you wants change, and another part feels unsure.“
3. Support Autonomy
- Example: “What feels like a realistic next step for you?“
4. Build on Strengths
- Example: “You’ve handled a lot already. What has helped you get through before?“
This approach doesn’t require you to have the “right” answers. It simply helps create a space where understanding comes first and change can follow more naturally.
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Frameworks like the Power Threat Meaning Framework remind us that:
- People are not problems to solve.
- Symptoms are not random failures.
- Responses often make sense in context.
And when we understand that context, we create space for something more useful than judgment: Choice.
Choice in how we understand ourselves.
Choice in how we respond.
And, over time, choice in how we move forward.
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