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Mental Health Expertise: Engendered Expertise in the face of Rising Hobbyism

Mental Health Profession is in a state of perpetual crisis. In an era of media, misinformation continues to attack the legitimacy of specialties of Psychiatry and Psychology. But, of course, such threats are nothing new. The rise of diverse social media accompanied by a decline of public trust in mental health experts has led to a unique set of threats posed by misled expertise, i.e., the rapid spread of quacks and untrained professionals, with or without an intent to deceive.

People have no choice but to trust experts like doctors (non-psychiatric) or accountants. However, it's different when it comes to mental health issues. In those cases, people are more reluctant to recognize expertise, opting instead to call it "opinion." It is because people detest ambiguity, which is inevitable in complex issues. For instance, when people hear that there's a scientific consensus on climate change, they expect this to mean that every single scientist agrees on the subject of climate change. But when they find out that's not the case, they unfairly label it as a matter of opinion, not recognizing that science, by its nature, can't come to unchangeable conclusions. This idea was perfectly demonstrated in the movie Don't Look Up, the most accurate portrayal of society's terrifying non-response to scientific reasoning as shared by a climate scientist.

What differentiates an Expert from a hobbyist?

Mental health has become this buzzword. Everyone is an expert. Although, there is a term for a person interested in a subject or an activity as a pastime- Hobbyist. If it's common sense, what makes an expert exceptional? Why does one go through such rigorous training and experience if so? Suppose symptoms as mere emotional experiences precipitated by the presence of specific triggers. Why do we have unique words for these experiences that warrant no additional insight?

During the initial years of training, I often heard comments in social gatherings, "so, you are a shrink, go on, analyze me!" I later reflected upon how these comments (offensive as they may sound) came from the place of fear. Fear that these heavy psychologically steered terms invoked. I learned to differentiate between two possible intents, i.e., analyze or label. The use and the intent of using words vs. concepts is one area that can determine an expert from a non-expert who claims to know it all, also known as ultracrepidarians. The origin of this term has a background story that beautifully ends with a saying: "Sutor, ne ultra crepidam," meaning "shoemaker, not above the sandal." A reminder for myself to speak for what I know of.

Using technical terms as labels elevates one’s credibility to be known or associated with a magical fraternity of those who know the unknown, those who read the minds, mental health experts. This exclusive membership to a group of experts elevates one’s status. The simplest way of doing this is to use words. But, this strategy is short-lived without real expertise despite indicating proficiency. These concepts are not these intellectual commodities tossed over to random conversations. Instead, it is used as a form of intellectual dominance. It is like a teacher who reads through the slides versus someone who understands the concept dynamically. Therefore, it’s essential to differentiate between using words and understanding their concepts. At the same time, excessive and compulsive reliance on technical terms when not necessarily suggest a weak understanding of concepts. An expert can convey their meaning without referring to the concept. One can spot the thinking in the absence of terminology, from hypothesis to the idea to the capacity of integrating it into the thought process.

The use of psychological terminology and psychiatric symptomology in the cafeteria, dinner tables, meetings, and corridor conversations is more marked and prevalent now. I wonder if these terms are applied and translated after undergoing a training experience. On the contrary, these concepts were not clinically indicated but used as a social crunch on such occasions. Labels become weapons if used against people you don’t like. In that case, it gives a sadistic and perverse pleasure that these labels provide by diminishing a person’s status due to a lack of understanding. Furthermore, preconceived notions and negative connotations associated with these labels are tied to the person one can’t beat in an argument, making it a power struggle.

What makes a mental health professional an expert is not only knowing the theories, guidelines, recent developments in their fields. Instead, an expert understands the importance of timely interventions, not rushing the process, painting a rosy picture by giving false hopes, knowing when not to intervene, and being aware of one’s limitations. For example, an expert would know how eager patients are to hear a mystic interpretation that reinforces their beliefs despite the limited empirical evidence. Knowing this, an expert would resist the omnipotent temptation to be the only savior that runs to respond to it. However, if not careful, these early interventions often result in externalizing responsibility. To achieve that nuanced understanding, self-analysis, training, and ongoing reflective learning become an integral part of the process. It takes one beyond the simplistic use of jargon towards developing habits of mind; a designed thinking approach.

One more common trend is to use interpretations as coffee table conversations. Interpretations like seeking validation, being anal, oedipal fantasy are common phrases. This understanding is achieved by therapy, a deeply reflective process through which one develops the capacity to bring the unknown to the known mind that needs to be receptive to experiencing the emotional response. This also warrants psychological readiness. If interpretation is given out of therapeutic or clinical connection, it has a detrimental impact.

When I started my psychiatry training, I witnessed how little knowledge could be dangerous. My academic teachings and supervision introduced me to a new worldview. As a result, I began exploring how to translate the knowledge from teaching sessions into clinical encounters. I must say that it was fascinating and disorienting using these concepts outside of clinical realms. Thanks to David P Levine, who wrote this incredible book called Psychoanalysis, Society and Inner world.

The death of expertise is not just a rejection of existing knowledge. It is fundamentally a rejection of science and rationality, which are the foundations of modern civilization. Moreover, it is a sign of mistrust & skepticism of authority. We have come full circle from a premodern age. Folk wisdom-filled unavoidable gaps in human knowledge through a period of rapid development based heavily on specialization and expertise. We have a postindustrial, information-oriented world where all citizens believe themselves to be experts on everything.

Perhaps the endagered expertise is a sign of progress. Who knows?

First of all, experts, no longer have a dominant hold on knowledge. The mysteries of existence are not unknown anymore. The scripture does not only being to grant libraries of the with intimidating halls accessible to the fairly limited people who can visit them. Given such a setting, the emphasis was less between the relational aspect of experts and the general population. Hence, only peer experts challenge experts.

Second of all, in the past, there were few public venues to challenge the expertise before the era of mass communications. Yet the resulting paradox has led an irrational conviction among people that everyone is as intelligent as everyone else instead of respect for knowledge

Third of all, the discord is contrary to education, that aims to make people (irrespective of how smart or accomplished they are), students or beginners with an intellectual quest for am ongoing learning.

Instead, we now live in a society where acquiring title learning is the endpoint of education rather than the beginning.

This is a risky forte.



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Dr. Aisha Sanober Chachar

Consultant Child & Adolescent Psychiatrist; Co-founder & Director @synapsepk Mental Health Entrepreneur. Recycled Stardust.Balint Group.Psychoanalysis.Grit 🇵🇰