A transcultural approach to the paradigm shift in mental health

This week I listened to a BRILLIANT interview with Dr Diana Kopua, Maori Psychiatrist on Mad in America radio; it was like music to my ears. Dr Kopua said;

I might have the same world view as you, or I might not, but all I care about is whether you get a good outcome.

One day all Psychiatrists will think like this; we have to hold that hope.

But what can we do in the mean time?

The Power Threat Meaning Framework, published by the British Psychological Society in 2018, predicts and allows for the existence of widely varying cultural experiences and expressions of distress without positioning them as bizarre, primitive, less valid, or as exotic variations of the dominant diagnostic or other Western paradigms. . . . Viewed as a metaframework that is based on universal evolved human capabilities and threat responses, the basic principles of the PTM Framework apply across time and across cultures. Within this, open‐ended lists of threat responses and functions . . . allow for an indefinite number of locally and historically specific expressions of distress, all shaped by prevailing cultural meanings. (Johnstone et al., 2018a, p. 22) …

Dr Lucy Johnstone asks;

“Is the Western diagnostic paradigm simply another form of colonialism, perhaps more subtle than earlier versions, but equally damaging in its impacts?”

I think so.

The evolved perspective of the spiritual emergence framework speaks to a 4 quadrant explanation of the roots of mental distress as such;


According to Dr Kopua, New Zealand is in the middle of a major government inquiry into mental health and addiction services, which are seen as failing the population as a whole; suicide rates are high, as are addictions. A long period of consultation has resulted in 40 recommendations, which are currently being considered.

In the article in Mad in America’s blog, Lucy reports;

The summary document reads well—some extracts are given below (He Ara Oranga, 2018): We recognised from the start that this Inquiry represented a “once in a generation” opportunity for change. All over the country, people told us they wanted this report to lead to real and enduring change—a “paradigm shift.” (p. 7) People said that unless New Zealand tackles the social and economic determinants of health, we will never stem the tide of mental health and addiction problems. . . . A call for wellbeing and community solutions— for help through the storms of life, to be seen as a whole person, not a diagnosis, and to be encouraged and supported to heal and restore one’s sense of self. (p. 9) For Māori health and wellbeing, recognition of the impact of cultural alienation and generational deprivation, affirmation of indigeneity, and the importance of cultural as well as clinical approaches, emphasising ties to whānau, hapū and Iwi. (p. 9) For Pacific peoples, the adoption of “Pacific ways” to enable Pacific health and wellbeing—a holistic approach incorporating Pacific languages, identity, connectedness, spirituality, nutrition, physical activity and healthy relationships. (p. 9) We can’t medicate or treat our way out of the epidemic of mental distress and addiction affecting all layers of our society. (p. 10)

This all rings true not just for Maori culture, but for those in the West and other indigenous cultures who are waking up to the pain of our ancestral trauma. Our connection with this pain is necessary for healing our future generations.

I am hosting a unique event in London in Jan 2020 to look at the patterns of these experiences of ancestral remembrance, in order to create bridges by discovering the patterns of commonalities of humanity that connect us all in our shared pain, whatever our heritage – and there are many. Spirituality is ultimately about connection.


We will explore the question together;

“How does the Power Threat Meaning Framework relate to those who perceive their experience in transcendent/ transformative, spiritual or spiritual emergency terms, and how could it be used to support this?”

My aim:

– To trust in the collective wisdom of those who gather, and to let inspiration emerge naturally

– To use the outcomes from the day to inform the possibility of expanding the Power Threat Meaning Framework, if this is deemed appropriate, and/ or to develop ideas for its practical application in this area.

  • To begin to build vital bridges… 


AND THEN – my intention is to take this event out to other countries in order to collect transcultural research outcomes to present back to the Authors of the Power Threat Meaning Framework so that spiritual practice recommendations can be incorporated…

More on that later.

Think this is important? 


A new paradigm is coming…. can’t wait to see you there,

Katie ❤

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