by Martin Seager, Consultant Clinical Psychologist.

Many psychologists question the wisdom of the DSM diagnostic system, and would like to see it replaced or modified to something more ‘human’. The fact that the Power Threat Meaning Framework (PTMF) is an alternative model makes it immediately appealing to some, but closer inspection reveals that the PTMF contains within it a highly questionable view of the male gender.

The PTMF is a vast document of 400 pages with the grand aim of replacing a psychiatric categorisation system for mental health with an equivalent psycho-social system. It is written using a narrow band of evidence by a small clique of clinical psychologists who don’t speak for many others even among our own profession. One problem with the PTMF is that it is emotionally driven by a (perhaps understandable) resentment of psychiatric culture.

However taking an anti-psychiatric stance can too easily become an anti-biology / pro social constructionist stance, therefore becoming naive in relation to the biological and embodied aspects of the human condition. In essence we are splitting mind from body and simply swapping biological determinism for social determinism. Leaving out the “bio” in “bio-psycho-social” is no better than leaving out the “psycho-social”.

In no area of human science is naïve social constructionism more dangerous and misleading than in the field of human sex and gender. Through such a constructionist lens, the evolution of human beings as a mammalian species becomes totally and arrogantly disregarded. Biological sex is presumed to have no direct bearing on psychological gender. Body and mind are naively split.

In the PTMF there are 3 pages devoted to men and masculinity. Nestled in a 400 page document, these 3 pages might be easily overlooked, but they represent a sad indictment of current post-feminist attitudes to the male gender based on untested political theories and prejudices rather than empirical bio-psycho-social science and empathic humanity. For a profession that claims to be rooted in values of science and compassion for human suffering, these unexamined and lazy prejudices towards the male gender represent a complete failure to meet core standards. In essence, the PTMF takes a judgmental and a negative stance towards the male gender. All psychologists, therapists and counsellors should know that being “judgmental” or “negative” is the worst starting point for helping any group of people and can only undermine empathy and scientific understanding.

The primary presumption made by the PTMF is that being of the male gender somehow confers a “dominant” status. This vague notion of male power is simply accepted without proper definition, self-reflection or question. In a framework that is all about “power” and “threat”, the implication here then is clear that men are presumed to be more “powerful and threatening” than women. Nowhere, however, in a supposedly serious scientific document, is the concept of power adequately defined or measured. The idea of female power within certain domains of life (e.g. over children, education and family life) is considered a form of oppression, and the equivalent idea of male vulnerability or disadvantage (e.g. suicide, deaths at work, reduced life expectancy) register little sympathy. Substantial evidence (e.g. relating to dangerous situations in war and peace time) showing that men are generally protective of women and children (to the point of self-sacrifice) is completely ignored. Ignoring male protective behaviour or reframing it as “dominant” represents a failure of science. Equally, ignoring the evidence of high levels of female domestic and interpersonal violence towards males or downplaying it as “defensive” can hardly be considered a serious and objective scientific approach.

The PTMF notes the relationship between male gender and suicide but does not even consider this as possible evidence against its own theory of male dominance. Instead the tragic male suicide statistics are twisted to fit the assumption. According to the PTMF, men must be killing themselves because of their own “hegemonic” masculinity which entails a pathological need for power and control. Rather than re-designing research and therapy to be more male-friendly, therefore, the implication of the PTMF is that men need to change their masculinity to express their emotions differently to fit the gender neutral or perhaps “feminised” therapies that already exist. The PTMF also notes the link between unemployment and male suicide but again the implication is not that we must help men with employment issues (thus showing empathy) but that men must learn to be less dependent on work as part of their masculine identity (thus showing judgmentalism).

All in all, the PTMF is unashamedly biased and a recipe for misunderstanding and negatively judging the male gender. For a document that claims to represent a breakthrough in anti-psychiatric and empathic psychological thinking this is rather ironic. This document offers no proper evidence or balance. It offers nothing practical that will help vulnerable men and boys and a lot that will reinforce or exacerbate their problems through prejudice and bad science.

About the author

Martin is a consultant clinical psychologist and psychotherapist, currently working with “Change, Grow, Live”. He is a lecturer, author, campaigner, and broadcaster. He worked in the NHS for 30 years, becoming head of psychological services in two mental health Trusts. He has advised government and has regularly broadcast with the BBC on mental health issues. He is co-founder of the Male Psychology Network, and was the original proponent of the Male Psychology Section of the BPS. He was branch consultant to the Central London Samaritans for over 10 years and has also been an adviser to the College of Medicine.

[Reference. The material about masculinity is in pages 124-8 of the long version of the Power Threat Meaning Framework ]