A new philosophy that positions former mental health patients as important contributors to the field is gaining momentum and attention.
In a compelling new study published in philosophical psychology, Roy Dings and Cherif Tekin explore the philosophical underpinnings of the movement to transform mental health care.
Dings, a postdoctoral researcher at Ruhr-Universität Bochum, and Tekin, an associate professor of philosophy at the University of Texas at San Antonio, discuss the role and recognition of “empirical experts,” or individuals with personal opinions. We are having a delicate discussion about this. Encounters with mental health issues provide unique insights into care practices.
“The origin and nature of what can be grouped under the label of the Expert by Experience (ExpEx) movement is complex because it is not a homogeneous group with clearly defined common goals and direction. Rather, it includes many subgroups that have emerged at different times and in different places, including but not limited to the mad studies movement and the consumer/survivor/former patient/service user movement. and exercise,” Dins and Tekin write.
“But central to the development of the ExpEx movement is a reassessment of the concept of expertise: Who is an expert on what? What special value does Experts-by-Experience (Exp) have for theoretical frameworks on public administration? need to do it.”
Service user involvement in mental health care has been proven to be effective and ethical. In recent years, there has been an increase in the integration of experience-based (exp)-based professionals in mental health care. These experts are people who have personal experience with mental illness and can provide valuable insight beyond academic and biomedical knowledge. Despite their growing popularity, the role and contribution of these professionals in mental health care has remained largely unexplored, both philosophically and practically.
Roy Dings and Cherif Tekin delve into the philosophical arguments underlying the movement to include lived experience in mental health research, aiming to dismantle the conceptual and epistemological barriers that stand in the way . Their analysis, centered on the Dutch mental health system, argues for a framework that acknowledges the subjectivity of patient expertise while promoting its integration into mental health care, policy making, and organizational structures. Through this lens, they reveal the complex dance between personal experience and professional knowledge, challenge the philosophical status quo, and defend models that link human rights and mental health research.
They start with a thought experiment.
“Imagine this hypothetical scenario: Sarah is often referred to as a depression expert. After all, she graduated from medical school and has a PhD in neuroscience. She knows all the theories about depression, whether biological, psychological or social. Therefore, she knows all there is to know about depression: its genetic and neurological basis, its developmental We know all about its origins, its relationship to stress, the role of specific neurotransmitters, and more. Sarah has done a lot of clinical research. She has conducted many in-depth interviews with patients (and their families and friends). Sarah has many years of clinical experience treating patients diagnosed with depression. However, at some point she becomes depressed herself. Sarah talks about depression after becoming depressed herself. Did you learn anything new?”
Thought experiments in philosophy are considered powerful tools to reveal our beliefs and ideas about particular phenomena or experiences. In this context, the author uses a thought experiment to prompt the intuitive realization that Sarah has experienced depression and has knowledge that she did not have before the experience. This insight forms the basis of the article, which delves deep into the unique and valuable understanding Sarah gained from her first-hand encounter with depression.
In the first section of the article, the author first discusses the advantages and challenges of experts based on their experience (rules of thumb).. They initially recognized the role. Experience point Issues in the mental health field are still under debate. However, the specific notable benefits are: Experience point And patients may be able to empower each other. The drawbacks, on the other hand, are more philosophical in nature. In particular, the underlying assumptions below are: Experience point There may be a crack between Experience point Expertise and other expertise.
In the second section of the article, Dings and Tekin extend these assumptions. In the Netherlands, Experience point They argue that this movement assumes that: “Experience is transformed into experiential knowledge, and experiential knowledge is transformed into experiential expertise. What is the difference between experiential knowledge and professional knowledge?”
In their discussion, the authors state that experiential knowledge emphasizes actual, observable outcomes that “work” as subjectively perceived by those experiencing that experience. Expertise, on the other hand, involves evaluating results using a scientific or theoretical framework agreed upon by a community of experts. Experiential knowledge relates to action in the present moment. At the same time, professionals also prioritize action, but in addition to achieving results that help their clients, they frequently care about considerations such as recognition from colleagues and working within established theoretical models. Finally, experiential knowledge is holistic and encompasses the complete phenomenon experienced by the individual.
The third aspect is particularly important because it provides the benefit of personal, lived experience that Dings and Tekin discussed earlier in the article. His third section of the article focuses on the challenges faced by professionals with experience in the mental health system. One of the most important challenges is that to become an experiencer, one must be formally diagnosed in the biomedical setting of the problem that the experiencer is trying to solve.
Dings and Tekin propose an active affordance-based framework to clearly understand the goals of the experience-based expertise movement. This framework aims to overcome current conceptual and epistemological challenges and pave the way for its growth.
The affordance-based framework emphasizes the importance of valuing and trusting each person’s unique contribution, much like a chair sits. Affordances act as a link between the subjective and objective realms and are directly connected to our everyday experiences. In other words, our perception of the world is shaped by the realm of affordances we experience. This is not just a subjective process, but is based on interaction with the social and material world.
Rather than viewing experiential and scientific knowledge as binary oppositions, the Enactive Affordance Model views them as points along a continuum. It acknowledges that all knowledge is based on embodied experience, but that experience can be systematically studied and understood through the scientific method.
By recognizing the validity of both forms of knowledge, the active affordance model enables a dialogue in which experiential knowledge informs scientific inquiry and the scientific method contributes to a deeper understanding of individual experience. I’ll make it. This mutual information allows for more nuanced and effective mental health interventions based on the realities of patients’ lives.
This model encourages a collaborative approach to knowledge creation, where experts and individuals with lived experience work together to co-create an understanding of mental health issues. This co-creation respects and leverages the strengths of both experience and expertise.
The authors provide a compelling case for integrating lived experience into mental health care and argue that these personal insights provide a valuable perspective that cannot be replicated with academic or clinical knowledge alone. doing. They argue that individuals with personal experiences can bring deeper understanding and enrich mental health practice, policy development, and organizational frameworks. This approach is not only consistent with human rights principles, but also enriches the paradigm of mental health research and bridges the gap between empirical wisdom and professional knowledge.
Dins and Tekin present a new framework that reconciles the subjective richness of individual experience with the objectivity required in mental health care. This active affordance-based framework emphasizes the intrinsic value of every individual’s experience. Such affordances connect individual experience with concrete reality and emphasize the interaction between our perceptions and the world around us.
By applying the active affordance model, mental health care can transcend traditional boundaries and create a more integrated approach that respects and actively incorporates the wealth of knowledge from lived experience. This leads to more person-centred and empathetic forms of care that are closely aligned with the complex realities of individuals’ lives.
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Dins, R., Tekin, Ş. (2023). A philosophical exploration of experiential expertise in mental health care. philosophical psychology, 36(7), 1415-1434. (Link)
