Although mental health professionals traditionally have been viewed as sole experts and decision-makers, there is increasing awareness that the experiential knowledge of former patients can make an important contribution to mental health practices. I argue that current patients likewise possess a kind of expertise, and that including them as active participants in diagnosis and treatment can strengthen their autonomy and allow them to build up important habits and skills. To make sense of these agential benefits and describe how patients might act as co-regulators of a therapeutic encounter, I look to the enactivist notion of “participatory sensemaking”.