Does Expertise Help or Hurt Community?
Exploring the mental health industry’s influence on connecting with oneself and others
Dear City Person,
After interviewing Alhanoof in last week’s newsletter about her work with insightful.ae that you can read by clicking here, I wanted to share my observations of how people interact with anyone positioned as a mental health expert like myself. Based on those observations, I will share thoughts about what negative and positive impacts might this have on connecting with ourselves and on building social support. I will conclude with ways to navigate the potentially negative impacts while strengthening the positive ones.
Since this is a topic I am ongoingly learning about, I would appreciate reading your observations, even if you are not working in the mental health field. Hopefully we can all learn from each other even if we don’t agree on everything as long as we do not impose our observation as the “capital T” truth that may not apply to everyone in all contexts.
Some house keeping before I dive in…
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When is “Expertise” Harmful
Whenever I tell people that I work as a psychotherapist, I am often asked questions that assume that I will give them a simple answer that will cure whatever is afflicting them without me needing to understand their unique context. Examples of these that I have run into are “how do I stop worrying?” or “how can I let go of the past?”
One assumption that is behind such questions is the notion that there is such a thing as an “expert solution” to subjective human experiences. Purely relying on the idea that there are “expert solutions” to subjective experiences hampers our ability to develop our inner resources that suite our specific contexts. It could also come in the way of reaching out for community supports as we may come to believe that one person or idea out there possesses all that is useful to us.
When some people seek my psychotherapy services with the expectation of receiving “expert solutions” from me, I feel worried about them becoming exclusively dependent on me at the expense of their inner wisdom or community’s wisdom. I rather see my role being more about one or more of the following below depending on the person I am seeing:
empowering them to reconnect with their inner and outer resources, values, and meaningful relationships that can often get pushed aside in the daily grind
having a space where they can freely express themselves
helping them feel less alone in their experience through the quality of my presence. This presence may then become a possible model (among others they can choose from) for how they can have a relationship with themselves as I have written in a past post here.
exploring their preferred response to societal or personal narratives they have found helpful or unhelpful.
collaboratively customizing tools to suite their circumstances (if tools are what they are looking for which is not always the case)
As I hope this list shows, I am not against “solutions.” Rather I prefer to offer them as options among others that a person can consider experimenting with before customizing it to fit their circumstances. I also don’t assume that a person is always looking for solutions or that every problem will have a solution. Sometimes what we need is a way to live with life’s uncertainties or to simply feel fully heard and witnessed without judgement or without trying to be “fixed.”
I further find that solutions offered in self-help books and within mental health outreach assume that individual solutions are enough and that mental health or life coaching services are all that we need. Rarely do I see invitations to have people consider tools that can help them create mutually supportive relationships which are essential to our wellbeing. You can read two of my past posts for more on the importance of social support by clicking here and here.
Some mental health providers and laypeople assume that seeking unlicensed help will always harm and that licensed ones will always help. But I have heard stories of those who were helped and harmed by both licensed mental health providers and unlicensed people whether they be life coaches, spiritual healers, family members, or friends.
While there are different reasons that contributed to the harm, a common denominator is their assumption that they alone are the experts on the person’s subjective experiences and assumed what the person needed instead of collaborating with the person. The latter requires allowing room for curiosity and not assuming that one knows everything no matter their expertise.
When is “Expertise” Useful
Don’t get me wrong: I am not dissing all kinds of “expertise.” A collaborative approach to helping someone is a learned skill, whether this is done within or outside the context of professional mental health services.
One thing I tell those who are seeking out my psychotherapy services for the first time is that while I have something to offer through my studies and experience, I am not an “expert” in their own lives as they know themselves more than I do. I also acknowledge that they likely had life experiences that got them as far as they could go and I am curious about that. So we are both “experts” collaborating with each other and we both continue to learn from each other and from our journey together.
I just wish that these collaborative tools are more widely available so that people can know how to support one another without positioning themselves as “experts over” the other person’s life and can honor what both sides bring to the relationship. I wish for this especially if a person is not able to access professional mental health services or needs additional support outside of therapy.
If I ever needed a surgery, I sure as hell would not trust someone who does not know the technical details of conducting one. But the science of mental health is not the same as that of surgery or many branches of medicine/healthcare for the matter.
There are objective measurable facts about when and how to do surgery that have been refined over generations and continue to be built upon the more human knowledge evolves. In contrast, mental health is a relatively new field and the measurements that are often used to diagnose, assess, and treat often rely on the person’s self-report of what they are going through. A brain scan can only tell you if there are structural issues with the brain but not how it is functioning in the world outside the scanner or how the person is experiencing it. A provider’s observation can also yield helpful data but providers are human beings with biases they may not always be aware of that can impact how they are interpreting what they are observing.
I am not dissing seeking out mental health providers. They are essential when:
a person’s social supports reach the limit in what they can do to help with a given problem
the person wants the perspective of someone outside of their social circles. These social circles may have solidified their views of a person based on their history with that person. While I have mentioned peer-to-peer support groups with non-friends/non-family members in a past post here, not everyone has access to them or feels comfortable in them and they may not always replace a person’s need for professional help.
the person does not have access to said supports and needs help in the process
when depression stops a person from reaching out even when they say that they need to do so.
the person has internalized narratives that stop them from seeking out social support. Examples of such narratives I heard are:
“I don’t want to come off as needy/weak.”
“I don’t want to be a burden.”
“I am not deserving of receiving help.”
“I worry I will get judged.”
“ I don’t know what help do I need to ask for.”
“I should be able to figure it all out on my own.”
“I was always the person helping others and never the person being helped.” I use the word “narratives” rather than “ideas/thoughts” because there tends to be stories that contributed to them.
Psychotherapy can be helpful in exploring these narratives, their impacts, when were these narratives useful versus not useful to the person, and how the person wants to respond to them.
Before I conclude, I have a few questions for readers…
Are there other examples of narratives or ideas that you have seen stop a person from reaching out for support from others?
What are your thoughts about the notion that one can exclusively rely on “expert solutions” on mental health?
Have you ever found yourself dismissing or minimizing the value of social supports because of prioritizing “expert knowledge” in mental health?
What are examples of “collaborative expertise” or “collaborative curiosity” that you have seen whether within or outside mental health institutions?
Conclusion and plan for next week’s newsletter
How can we lessen the negative impacts of relying on mental health expertise and increase its positive impacts? I am still reflecting on this myself but one place I find myself landing on is the idea of “collaborative expertise/curiosity.”
This means to me being open to the fact that both we and others have expertise to offer, admitting where our knowledge falls short, and being open to curiosity about where the journey is taking us. It also means customizing the therapy based on each unique person’s needs and listening to them instead of assuming what those needs are. These are in contrast to positioning one side as the “expert over” the other person’s subjective life. I highlight “subjective” as I recognize that there are hard facts in science that don’t have room for subjectivity (such as the fact that the earth is round) or that require highly technical knowledge based on said hard facts (like being an engineer or a surgeon).
I also wish that more mental health approaches emphasize helping the person to build socially supportive networks so that they have something to fall back on whether in between sessions, as part of safety planning with mental health crises, and after ending services. In this way, the person does not become purely dependent on the services or on the limitations of their own self care as one can only help themselves so much.
I myself get stuck on ways to do this with some of the people who see me but I have been gradually incorporating more of these conversations into my work. One way I have been doing so is through what is called “collective documents” in Narrative Therapy. I will discuss this as part of my monthly series on belonging practices in my post next week.
Before I wrap up…
I am ending each of my posts with a randomly drawn conversational card that you can consider using to deepen your conversations with people this week. So here’s today’s card drawn from a deck called Scenario Cards:
“What if you could be the president of your country for one year? What is the one thing that you would change?”
Let me know if you end up using this question in any of your conversations and how it goes!
Click the link here to learn more about Scenario Cards. I currently earn an affiliate fee for every purchase from this link. This is so far the first affiliate partnership I have and I only plan to do so with products I genuinely benefited from. I had previously written a post about conversational cards in general prior to being invited to Scenario Cards’ affiliate program. Click here for the link to the post.