"An outline of the PTM Framework This broad PTM Framework is derived from a wide range of theory and research, across disciplines and research methods. It comprises four interrelated aspects: 1. The operation of POWER (biological/embodied; coercive; legal; economic/material; ideological; social/cultural; and interpersonal). 2. The THREAT that the negative operation of power may pose to the person, the group and the community, with particular reference to emotional distress, and the ways in which this is mediated by our biology. 3. The central role of MEANING (as produced within social and cultural discourses, and primed by evolved and acquired bodily responses) in shaping the operation, experience and expression of power, threat, and our responses to threat. 4. As a reaction to all the above, the learned and evolved THREAT RESPONSES that a person, or family, group or community, may need to draw upon in order to ensure emotional, physical, relational and social survival. These range from largely automatic physiological reactions to linguistically-based or consciously selected actions and responses. Unlike the more traditional biopsychosocial model of mental distress, there is no assumption of pathology and the ‘biological’ aspects are not privileged, but constitute one level of explanation, inextricably linked to all the others. Equally important, although a tripartite model is a convenient heuristic, the four elements of Power, Threat, Meaning and Threat Response are not independent, but evolve out of each other. 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. Within this, ‘meaning’ is intrinsic to the expression and experience of all forms of emotional distress, giving unique shape to the individual’s personal responses. In summary, this PTM 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?) Translated into practice with an individual, family or group, two additional questions need to be asked: ● ‘What are your strengths?’ (What access to Power resources do you have?) ● ...and to integrate all the above: ‘What is your story?''