Experts – Part 1

In a flyer advertising my book Creating Confidence: How to Do Social Work Without Destroying People’s Souls, I stated that my expertise consists of knowing that I’m not really an expert in anything other than myself.  A friend responded by saying that, in her opinion, I was an expert in a great many more things than “myself”.  But I didn’t make that statement to be modest.  I wanted to make a point about experts and expertise.

A professor of social work e-mailed me that the subtitle was “disquieting”.   After some dialogue we found that we agreed on “the inadequacy of the broad social services network”.   I believe she thought that this situation would improve if all the various social service practitioners had formal training in social work – i.e. became social work professionals.

While I agree wholeheartedly that training is essential – I’m not sure that turning these people into professionals – or certified experts – is the answer.

One of the major “soul destroying” aspects of social work is the widely embraced assumption that those in charge of handing out services are somehow endowed with the ability to know what is best for the people receiving those services.  This assumption is almost always false.  (Even children and mentally disabled individuals understand a great deal more about what they need than we give them credit for.)

The most important skill for anyone in the business of providing social services is listening.  Active, engaged, curious, nonjudgmental listening.  Some people do it naturally.  Some people (like me) have to learn it.

When “experts” believe they already know best, this creates a major barrier to genuine listening.

I remember one remarkable occasion when a woman asked me to accompany her to a mental health intake appointment.  The therapist was a very nice, obviously well-meaning man.  A trained and certified professional.

In the course of the interview he asked her several times if she was depressed.  Each time she said no.  She tried to explain what was going on in her life – a great deal of stress over child custody issues, poverty, on the edge of homelessness, child behavior issues at school, a sister who had major health problems.  He’d listen for a few sentences and then interrupt with questions about how she was eating, sleeping, feeling.  She said she was worried about the various situations and had some trouble sleeping (mostly because she shared a bed with two of her children).  She admitted to sometimes feeling overwhelmed.   (Who wouldn’t?)

At the end of the session, he told her again that she was depressed and made an appointment with the meds nurse so she could start medication.

Now this woman is one of the least depressed people I know.  She is optimistic, determined and resilient.   She is sad sometimes and worries about very specific situations that are sad and worrisome situations.  But she never stays there for long.

She doesn’t need pills to lift her spirits.  She needs someone to talk to about specific situations and problems and help her come up with practical solutions and workable resources.  And mostly she just needs someone to listen to her while she talks her way through her issues.

She was at this intake appointment because her ADD-diagnosed child needed counseling, and parental counseling was part of the package.

I know from experience that listening to this particular woman is not easy.  She tends to jump around from one topic to the next.  She uses pronouns loosely, so that you often aren’t sure whether the word “he” is meant to refer to her son, the teacher or her ex.  It takes time to sort out her nonlinear logic and untangle the twisted threads of her conversation.

Listening to her, in other words, is hard work.

But this professional was an expert.  He listened for less than five minutes before he tagged her as depressed.  And he ignored her repeated assurances that she was not.  I sat silently watching and listening, frankly appalled.

When she left, she turned to me in bewilderment.  “He says I’m depressed.”

“What do you think?” I asked. “You’re the expert.”

Anna Willman, board member of Focusing International, former director of the Confidence Clinic, and author of Creating Confidence: How to Do Social Work Without Destroying People’s Souls