Key takeaways
A diagnosis compresses a life into a word. A story holds what happened, what it meant, how you survived and where you might go next.
The idea is close to psychological formulation, which is already part of good clinical practice.
A new story isn’t a cure, but it can change your relationship to hardship. Medication and therapy remain valuable.
We began this series with a single question: what if, instead of asking “What’s wrong with you?”, we asked “What has happened to you?” Over five posts, we’ve followed that question through the Power Threat Meaning Framework (PTMF) — power, threat, meaning, survival, and strength — each one a different lens on the same life.
The final, integrating question the PTMF asks is disarmingly simple: “What is your story?”
Why stories, and not diagnoses
A diagnosis compresses a life into a single word — “depression,” “anxiety,” “bipolar disorder” — chosen from a fixed list, largely the same for everyone who receives it. A story does the opposite: it holds the particular, irreplaceable shape of one person’s life. It can say, in effect: here is what happened to me, here is how it threatened me, here is the sense I made of it, here is what I had to do to survive, and here is what has carried me through — and, crucially, here is where I might go next.
This isn’t a new invention. Something close to it, called a psychological formulation, is already used quite widely in good clinical practice: a clinician and a patient working together to build a shared, evolving understanding of a person’s difficulties, rather than the clinician handing down an expert verdict. The PTMF extends this idea further, and insists it belongs to everyone, not only people who have been formally diagnosed — because all of us, at some point, are trying to make sense of our own difficult chapters.
It’s also worth saying that stories don’t have to be spoken or written in tidy paragraphs. The authors of the PTMF are careful to note that art, music, poetry, movement, and communal rituals can all be forms of story-making — sometimes reaching what words alone cannot.
A story is not a cure, and that’s honest
It would be tidy, but untrue, to say that finding a new story simply dissolves distress. The PTMF is careful here, and so are we: some things that have happened cannot be undone, and some present circumstances — poverty, illness, an unsafe situation — genuinely limit what is possible right now. A new narrative doesn’t erase those constraints.
What it can do is change your relationship to them. It can move you from passive object of an illness to active author of a life that includes hardship — someone who is, in the framework’s own words, both shaped by their circumstances and still capable of shaping what comes next. That shift, modest as it might sound, is often where real change becomes possible: in how you treat yourself, what you allow yourself to hope for, and what kind of support you’re willing to ask for.
Where this leaves us
This series hasn’t been written to argue against psychiatric care — medication, therapy, and good clinical support remain genuinely valuable for many people — but to add something diagnosis alone often leaves out: curiosity about the whole of a life, and respect for the story only you can tell about it.
If any part of this series resonated with your own experience, or that of someone you love, consider starting, gently, with the same questions we’ve walked through here. And if you’d like support putting that story into words, help is available in many forms — a trauma-informed therapist or counsellor, a psychiatrist, a support group, or simply a trusted person willing to listen. Reaching out for that support is itself an act of strength, not a last resort.
This concludes our six-part series on the Power Threat Meaning Framework. Thank you for reading.
This series draws throughout on Mary Boyle and Lucy Johnstone’s A Straight Talking Introduction to the Power Threat Meaning Framework (PCCS Books, 2020) and the Power Threat Meaning Framework (British Psychological Society, 2018), available free at bps.org.uk/power-threat-meaning-framework.
