Strangers to Ourselves: Unsettled Minds and the Stories That Make Us
January 12, 2023 4:05 PM - Subscribe
"Strangers to Ourselves poses fundamental questions about how we understand ourselves in periods of crisis and distress. Drawing on deep, original reporting as well as unpublished journals and memoirs, Rachel Aviv writes about people who have come up against the limits of psychiatric explanations for who they are" (Macmillan).
"A perceptive and intelligent work about mental illness from the New Yorker staff writer. In her debut, Aviv illuminates the shortcomings of modern psychiatry through four profiles of people whose states of being are ill-defined by current medical practice—particularly by those diagnoses laid out in the Diagnostic and Statistical Manual of Mental Disorders. Throughout, the author interweaves these vivid profiles with her own experiences" (Kirkus).
NPR interview with the author: "I think [my early-childhood experience with psychiatric hospitalization] always created a question in my mind, sort of this mismatch between our own experiences of mental distress and the ways that they get classified. And I think a larger question for me was, you know, how do the ways that our mental distress get classified - how do those classifications themselves kind of act on us? Like, how do they change the course of our lives or our expectations for ourselves?"
"A perceptive and intelligent work about mental illness from the New Yorker staff writer. In her debut, Aviv illuminates the shortcomings of modern psychiatry through four profiles of people whose states of being are ill-defined by current medical practice—particularly by those diagnoses laid out in the Diagnostic and Statistical Manual of Mental Disorders. Throughout, the author interweaves these vivid profiles with her own experiences" (Kirkus).
NPR interview with the author: "I think [my early-childhood experience with psychiatric hospitalization] always created a question in my mind, sort of this mismatch between our own experiences of mental distress and the ways that they get classified. And I think a larger question for me was, you know, how do the ways that our mental distress get classified - how do those classifications themselves kind of act on us? Like, how do they change the course of our lives or our expectations for ourselves?"
I liked and appreciated this book for exploring a question rather than offering answers, and respected Aviv's choice to ground her reporting in empathy, compassion, and her own experience. So much context, and such a good attempt at accounting for angles of time, evolving approaches to psychiatric treatment, gender, nationality, religious belief, economic status, race, and individual interiority. And well-written, too.
"Psychiatrists know remarkably little about why some people with mental illness recover and others with the same diagnosis go on to have an illness 'career.' Answering the question, I think, requires paying more attention to the distance between the psychiatric models that explain illness and the stories through which people find meaning themselves….These stories alter people's lives, sometimes in unpredictable ways, and bear heavily on a person's sense of self--and the desire to be treated at all." I found this fascinating, the dive into that chasm. Bapu's story, especially: escape after escape so she could construct her own way of living with her mind. And then Laura, so deeply sunk into her identity as a patient. And Naomi--God, Naomi--and her response to a cruel world/mental distress. The instances in which human connection made a difference (and really, I would like Aviv to explore that separately, the therapeutic nature of connectedness in tension with outsiders' difficulties in accepting extreme stories that form meaning. I'm thinking about the prison librarian's words, "This is scary for me. I'm trying to understand you right now, but I don't fully recognize you."). And Ray, the most self-documented patient but (sorry, Ray) somehow the least interesting--though his story sets up a great deal of history in terms of changing treatment.
I think what I appreciated most is that this isn't a book of answers, but wrestles with this subtle, nuanced, varied experience of the dynamic between diagnosis and self-definition. And I felt like bookending it with her own experience helped her stay curious and out of judgment; neutrality wouldn't have served as well as the wish to understand something she has a stake in. I'm not sure that I will be re-reading this one soon, but I am so grateful that I encountered Aviv's work and recommend it to anyone who wants to think more about the influence and limits of psychiatric diagnoses, and the drive to make meaning out of mental distress.
posted by MonkeyToes at 8:22 AM on January 28, 2023 [1 favorite]
"Psychiatrists know remarkably little about why some people with mental illness recover and others with the same diagnosis go on to have an illness 'career.' Answering the question, I think, requires paying more attention to the distance between the psychiatric models that explain illness and the stories through which people find meaning themselves….These stories alter people's lives, sometimes in unpredictable ways, and bear heavily on a person's sense of self--and the desire to be treated at all." I found this fascinating, the dive into that chasm. Bapu's story, especially: escape after escape so she could construct her own way of living with her mind. And then Laura, so deeply sunk into her identity as a patient. And Naomi--God, Naomi--and her response to a cruel world/mental distress. The instances in which human connection made a difference (and really, I would like Aviv to explore that separately, the therapeutic nature of connectedness in tension with outsiders' difficulties in accepting extreme stories that form meaning. I'm thinking about the prison librarian's words, "This is scary for me. I'm trying to understand you right now, but I don't fully recognize you."). And Ray, the most self-documented patient but (sorry, Ray) somehow the least interesting--though his story sets up a great deal of history in terms of changing treatment.
I think what I appreciated most is that this isn't a book of answers, but wrestles with this subtle, nuanced, varied experience of the dynamic between diagnosis and self-definition. And I felt like bookending it with her own experience helped her stay curious and out of judgment; neutrality wouldn't have served as well as the wish to understand something she has a stake in. I'm not sure that I will be re-reading this one soon, but I am so grateful that I encountered Aviv's work and recommend it to anyone who wants to think more about the influence and limits of psychiatric diagnoses, and the drive to make meaning out of mental distress.
posted by MonkeyToes at 8:22 AM on January 28, 2023 [1 favorite]
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I'm doing a little project this year of reading about mental illness and would be curious to hear other recommendations from folks who appreciated this book.
posted by latkes at 2:22 PM on January 15, 2023 [1 favorite]