The Expert in the Room is Me
Moving beyond the belief that degrees matter more than a life lived.
Author: Katie P.
Before You Read: Seeing Below the Surface
To understand why systems of support often feel like systems of control, we use a tool called the Iceberg Model.
When we experience a difficult interaction—like being dismissed by a professional—we are only seeing the Event (the tip of the iceberg above the water). But beneath that surface lie:
- Patterns: Recurring trends of being ignored or overruled.
- Systemic Structures: The laws and policies that give professionals absolute authority.
- Mental Models: The deep-seated beliefs—like the idea that a degree is more valuable than lived experience—that drive the whole system.
The following story illustrates what happens when we look “beneath the waterline” of a psychiatric diagnosis.
The Expert in the Room is Me
Thirteen years ago, my life changed forever. After experiencing strange symptoms and a feeling like my life was spiralling out of control, I was diagnosed with Bipolar 1. I was told by a psychiatrist that I was having a severe manic episode and that I needed to be admitted to a hospital immediately.
Over the course of my stay and subsequent treatment, the medical staff generally treated me with dignity, care, and respect. However, they also began to define what it meant for me to be “a person with bipolar 1.” It felt as though they knew more about who I was—and what was happening to me—than I did. The doctors informed me that I would need to take psychiatric medication for the rest of my life, and as time went on, they dictated exactly which medications would be required.
| Reflecting on the Iceberg: The Mental Model (The Foundation) The Belief: “Formal Knowledge is Superior” This is the unshakeable assumption that knowledge from formal institutional education is inherently superior to lived experience or self-direction. When this model is in place, the system believes the doctor knows your mind better than you do. |
At first, this felt okay. I felt like the staff were acting with kindness, in what they believed to be my best interests. It felt like they genuinely wanted to help me and that they knew what was best for me. So, I believed everything that they said. Besides, I was scared and it felt like a huge relief to have people who knew my problems and the way to solve them.
Over time, however, I realised it wasn’t going to be that easy. I saw that the doctors didn’t always have the answers, nor did they always know what was best for me. Sometimes, they didn’t even understand what my problems were—at least, not in the way I understood them.
A particular example of this is in relation to prescribing medication. Like many people, my experience with psychiatric medications was not an easy one. While the initial medication in the hospital helped, the different drugs prescribed for my long-term care made me feel worse. I felt my mania escalating and my stability spiralling. When I told my psychiatrist, she insisted it wasn’t possible for the medication to cause those feelings.
| Reflecting on the Iceberg: The Systemic Structure (Deeper) The Cause: “Paternalistic Legal Framework” This interaction is driven by a structure that grants absolute authority to professional titles. In this framework, a mental health challenge is often seen as a loss of capacity, allowing the system to justify making decisions for you rather than with you. |
This was extremely jarring. On this and other occasions, I felt my feedback regarding my personal experiences was dismissed, marginalised by medical staff, or simply not believed.
Embedded in many of these interactions is the pervasive idea that formal knowledge is superior. This made me feel both frustrated and sometimes undermined. If my experience didn’t fit neatly into a textbook description of symptoms or side effects, they didn’t know how to respond. It felt like they didn’t believe me—but why would I be making things up?
| Reflecting on the Iceberg: The Pain Point (Just Below Water) The Consequence: “Systemic Coercion & Incapacity” Because the system assumes we lack the capacity to direct our lives, professionals make the decisions. This pattern of dismissal prevents us from being active partners in our own healthcare and builds a cage of compliance rather than a foundation of support. |
It took years of my own research and the courage to follow my own convictions to find a path to stability. My approach now depends not just on medication, but on lifestyle choices and alternative treatments: flotation therapy, exercise, diet, and meditation.
When I tell doctors about this, they frequently respond with comments like, “that’s interesting,” but I am left with the feeling that they don’t believe that what I’m describing could work, or in really hearing about my experiences in managing my symptoms.
To live a good life, we must be the lead architects of our own recovery. If my doctors had been more receptive—if they hadn’t assumed their formal knowledge was superior—my journey to stability could have been much faster and significantly easier.
Take the Next Step
This story is part of a larger conversation about our rights. If you want to learn more about how to identify and challenge these invisible barriers, we encourage you to read our full resource:
‘Understanding the Barriers to a Good Life’
This guide provides a deeper look at the Iceberg Model and identifies the common mental models that keep us from our rights. By learning to name these barriers, we gain the power to challenge them together.
[Download the full resource here]
Reflection Questions
If the system started with the assumption that you always have the capacity to know your own body and mind, how would your interactions with doctors change tomorrow?
Can you identify a time when a professional’s “textbook knowledge” was used to overrule your lived experience? How did that impact your trust in the system?
In what ways does the current legal or medical framework make it difficult for you to be the leader of your own life?