Key takeaways
Many “symptoms”, such as dissociation, hypervigilance, restricting food or numbing, can be understood as strategies for surviving threat.
Society praises some threat responses, like overwork, and diagnoses others. Where that line falls is partly cultural.
Seeing a response as survival rather than sickness eases shame. Some strategies still need professional support to change safely.
If you have ever watched a tree growing on a windswept cliff, you’ll have noticed it doesn’t grow straight. It bends, twists, sometimes grows low and gnarled — not because something is wrong with the tree, but because that is exactly what a tree must do to survive in that wind. Given a sheltered valley instead, the same tree would have grown differently. Neither shape is a malfunction. Both are the tree’s best answer to its circumstances.
The fourth question in the Power Threat Meaning Framework (PTMF) applies this same logic to human distress: “What did you have to do to survive? What kinds of threat response are you using?”
Reframing “symptoms” as responses
Psychiatric language tends to describe reactions like self-harm, disordered eating, hearing distressing voices, dissociating, drinking heavily, or withdrawing from the world as symptoms — signs that something has gone wrong inside a person. The PTMF offers a different, and in many ways more respectful, way of seeing the same behaviours: as threat responses — creative, often ingenious strategies a person’s mind and body found to survive circumstances that were, at the time, genuinely threatening.
Consider:
• Dissociating during overwhelming trauma has sometimes been called “the escape when there is no escape” — when a child cannot physically leave an unsafe situation, the mind finds a way to leave anyway.
• Hypervigilance in someone who grew up around unpredictable danger is a nervous system doing exactly its job: staying alert, because staying alert once kept them safe.
• Restricting food, or over-controlling any part of life, can be — not always, but often — an attempt to find a sense of control in a life where control has otherwise been taken away.
• Numbing with alcohol, drugs, overworking, or constant busyness can all be ways of turning down the volume on feelings that would otherwise be unbearable.
None of this is a moral failing, and none of it means “it’s all in your head, just think differently.” These are real, embodied strategies — some conscious, many not — for coping with real threats.
A spectrum, not a category
The PTMF also points out something worth sitting with: many threat responses that get diagnosed as pathological in one context are praised as admirable in another. The executive who works seventy-hour weeks to outrun old insecurities is rarely called “unwell” — he’s called driven. The person maintaining an exhausting standard of appearance out of deep self-doubt is often admired, not diagnosed. Threat responses exist on a spectrum, and society’s judgment about which end of that spectrum counts as “illness” has as much to do with cultural approval as with the underlying psychology.
This isn’t said to minimise anyone’s suffering — some threat responses cause real, serious harm and absolutely deserve careful clinical attention and support. It’s said to loosen the grip of shame that so often attaches to these behaviours. A person who self-harms or hears frightening voices isn’t broken; they found a way through something very hard, even if it’s a way that now needs to change.
Moving on from strategies that have outlived their usefulness
The PTMF’s message, echoing trauma-informed care more broadly, is something like this: you can be proud of surviving very difficult circumstances in the best way you could, with the resources you had at the time. Some of those strategies may no longer be needed — and with the right support, it is possible to gently leave them behind.
That last part matters. Recognising a threat response for what it is doesn’t automatically make it disappear, and some strategies (like substance use, or certain physical health risks) need careful, professional support to change safely. But naming them as survival, rather than sickness, is often where people find the dignity — and the motivation — to begin that work.
Next in this series: “What Are Your Strengths? Understanding Power Resources.”
This post draws on Mary Boyle and Lucy Johnstone’s A Straight Talking Introduction to the Power Threat Meaning Framework (PCCS Books, 2020). If a threat response you recognise here feels risky or hard to manage alone, please reach out to a mental health professional, a trusted person, or a helpline in your area — you don’t have to work through this by yourself.
