Strangers to Ourselves: Stories of Unsettled Minds
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- Create Date：2022-10-27 06:52:58
- Update Date：2025-09-07
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- Author：Rachel Aviv
- ISBN：1787301699
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Summary
In Strangers to Ourselves， a powerful and gripping debut， Rachel Aviv raises 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about how we understand ourselves in periods of crisis and distress。 Drawing on deep， original reporting as well as unpublished journals and memoirs， Aviv writes about people who have come up against the limits of psychiatric explanations for who they are。 She follows an Indian woman， celebrated as a saint， who lives in healing temples in Kerala; an incarcerated mother vying for her children’s forgiveness after recovering from psychosis; a man who devotes his life to seeking revenge upon his psychoanalysts; and an affluent young woman who， after a decade of defining herself through her diagnosis， decides to go off her meds because she doesn’t know who she is without them。 Animated by a profound sense of empathy， Aviv’s exploration is refracted through her own account of living in a hospital ward at the age of six and meeting a fellow patient with whom her life runs parallel―until it no longer does。
Aviv asks how the stories we tell about mental disorders shape their course in our lives。 Challenging the way we understand and talk about illness， her account is a testament to the porousness and resilience of the mind。
Aviv asks how the stories we tell about mental disorders shape their course in our lives。 Challenging the way we understand and talk about illness， her account is a testament to the porousness and resilience of the mind。
Reviews
Robyn
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This is a tough read， might be triggering for some。 If you’re interested in learning or reading about mental illness this book is a really good examination of a wide breadth of the subject。
Sue
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Liked it。 Case studies showing how finding your sense of self can become an extra burden when not only having to deal with mental illness itself， you find you may have to fight against the diagnosis received from a psychiatrist/psychologist becoming your 'sense of self' or your identity。 Liked it。 Case studies showing how finding your sense of self can become an extra burden when not only having to deal with mental illness itself， you find you may have to fight against the diagnosis received from a psychiatrist/psychologist becoming your 'sense of self' or your identity。 。。。more
Lisa
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I am so impressed with how Ms。 Aviv used personal stories to illuminate and explain mental health issues， along with so many other layers and contexts。 Highly recommended。
Debbie
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I have two words for you: BOR-ING！ A nonfiction book about four people with mental illness—should be fascinating， right？ The writing is fine， it’s just that I was expecting a little jazz and instead I got scale exercises。 Was I reading someone’s Ph。D。 thesis？ I’d be reading along， getting absorbed in the stories when suddenly I’d be interrupted by dull sentences。 Things like “Studies show…，” “the famous doctor so and so wrote about this a lot of years ago…” and blah blah blah。 I know I’m risking I have two words for you: BOR-ING！ A nonfiction book about four people with mental illness—should be fascinating， right？ The writing is fine， it’s just that I was expecting a little jazz and instead I got scale exercises。 Was I reading someone’s Ph。D。 thesis？ I’d be reading along， getting absorbed in the stories when suddenly I’d be interrupted by dull sentences。 Things like “Studies show…，” “the famous doctor so and so wrote about this a lot of years ago…” and blah blah blah。 I know I’m risking sounding like an airhead， but I just wasn’t in the mood for grad school， and I wasn’t expecting it。 I swear you can do nonfiction without footnotes。 Because， yes， apparently there were footnotes。 Lots of them。 I realized this when I finished a chapter at 75% of my ebook， only to turn the page and see the beginning of the huge bibliography and footnote list。 I had finished the book and hadn’t even known it; the list took up the entire last quarter of the book。 The extra bad part is， there were no footnote numbers in the text， which I hope hope hope was fixed by publication。 （I had an advance copy。） So the list was useless， in my ebook copy at least。 It wasn’t just all the references that bugged me。 I don’t know， there was something about the way she told the stories that bored me。 She put a spotlight on stuff I didn’t care about， while skimming over the good parts。 I wanted her to focus on different things。 She talked about medication a lot and the perception of mental illness， which was interesting， but I wanted to hear more about the psychology behind the illnesses。 That’s what gets me going。 My favorite part was when the author talked about herself。 She had anorexia at age 6 （！） and was hospitalized。 Some bizarro behaviors。 Some anorexics would cut their nails short in the hope of shaving a few milligrams off their weight。 Others wouldn’t pick their noses before weigh-in， in the hope they’d appear a little heavier， making their doctors happy。 （How much can snot weigh， I wanna know。） The author didn’t like hearing the number “eight” because it made her think she “ate” something。 If anyone called her a “smart cookie，” she didn’t like it because it made her think she had eaten a cookie。 Fascinating stuff。 The structure of the book is a bit strange， like it’s having an identity crisis。 We have the well-researched case studies in the middle， with less dry memoir sections as bookends。 Before I got sick of the ivory tower， I highlighted this text， which seemed cool in its formal way:“The divide between the psychic hinterlands and a setting we might call normal is permeable， a fact that I find both haunting and promising。 It’s startling to realize how narrowly we avoid， or miss， living radically different lives。”Most readers loved this book， so please read other reviews。 The author writes for The New Yorker and is good at putting sentences together。 Just not my style。 The book， with its zillion footnotes， seemed to be written for students in a college psych course， not for the general public。One last thing—I hate the cover。 The book title is just about unreadable。 I think the marketers were going for drama， but it only made me dramatically recoil。 I can’t stand these blurry and shaky and scribbly words！ Come on， give me words that are clean and clear and nice to look at。 It’s ugly， it’s just plain ugly。Thanks to Edelweiss for the advance copy。 。。。more
Mike Hartnett
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A very interesting perspective on mental illness， told through individual stories。 To me， this would have hit home more if it went a little deeper on each story， but still worth the read。
Michael Smith
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This book is special， vital， the most empathetic book on the topic I’ve ever read。I come from a family of mental illness， have battled anxiety in the past， and was recently （finally， perhaps） diagnosed with ADHD。 I think a lot about how we treat mental illness， the way it’s demonized and shrugged off， how dependent treatment is upon socioeconomic and demographic status。 I often wonder why there is such an absence of empathy and conversation， particularly at a time when depression， anxiety， and s This book is special， vital， the most empathetic book on the topic I’ve ever read。I come from a family of mental illness， have battled anxiety in the past， and was recently （finally， perhaps） diagnosed with ADHD。 I think a lot about how we treat mental illness， the way it’s demonized and shrugged off， how dependent treatment is upon socioeconomic and demographic status。 I often wonder why there is such an absence of empathy and conversation， particularly at a time when depression， anxiety， and self-image challenges are epidemic。 Perhaps the first step is to spend more time being vulnerable， more time talking about it。 I’m certainly ready for that。 “People get caught in self-fulfilling stories about illness。” 。。。more
sylvie brekke
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this is a book i think everyone should read at least once in their life， whether they struggle with mental illness or not。 it shows the hard and painful truth many people are forced to live with， and does it all with empathy and respect。 the epilogue was my favorite part by far and so impactful to read。
Nafisa
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This is a moving study of how the Western model of mental illness diagnoses and treatment process is deeply flawed， shown through case studies that come from diverse perspectives。 My favorite of these chapters was， by and far， Bapu's。 How does one culture's devout spirituality become the schizophrenia of another？ What is the difference really between saints and madmen？ I will be thinking about this for a while。 This is a moving study of how the Western model of mental illness diagnoses and treatment process is deeply flawed， shown through case studies that come from diverse perspectives。 My favorite of these chapters was， by and far， Bapu's。 How does one culture's devout spirituality become the schizophrenia of another？ What is the difference really between saints and madmen？ I will be thinking about this for a while。 。。。more
Marquise Campbell
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This book just absolutely blew me away and connected with me in ways that I can begin to describe。 Happy I stumbled upon this book on libby， loved every second it。
Patty
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An admirable book in many ways， but a tedious read。
Mary-Ann Kourko
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A compelling and informative read。
Turkey Hash
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Incredible - review to come （possibly）
Carl
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Excellent ！ A series of related case studies including the author。 Aviv uses these studies to cast light on psychotherapy and psychopharmacology as practiced in the United States from talk therapy and insight to here is your prescription。。。
Hana
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4。5 stars， incredibly thought provoking。
Emily Carlin
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Stunning， as expected。 Having a feeling where I’m like， “I love this so much and _because_ I love it so much I also think it could have been better” …。 like compared to all books， this is a great one。 But zooming in on the internal world of this book as well as Rachel Aviv as a writer， I think this could have gone a lot harder。 eg I wish it was 5x longer。 The first few chapters were heaven to me， like fullbody chills “this is the point of life this is the point of reading” vibes。Anyway…。now I’m Stunning， as expected。 Having a feeling where I’m like， “I love this so much and _because_ I love it so much I also think it could have been better” …。 like compared to all books， this is a great one。 But zooming in on the internal world of this book as well as Rachel Aviv as a writer， I think this could have gone a lot harder。 eg I wish it was 5x longer。 The first few chapters were heaven to me， like fullbody chills “this is the point of life this is the point of reading” vibes。Anyway…。now I’m jonesing for a big ass doorstop comprehensive and also readable history of psychology…。。off to google…。。also wouldn’t mind reading an essay about the state of psychoanalysis in 2022。 Also whatever company makes lexapro should pay her for the part where she’s like “yeah， lexapro， it makes me and all my friends better versions of ourselves…。anyway enough about me…。。” actual quote: “My first six months on Lexapro were probably the best half year of my life。 I was what psychiatrists call ‘a good responder。’ My brain suddenly felt like a sun， fresh place to be。 ‘Today: nothing I’m feeling shame for，’ I wrote in my journal。 I began writing jokey emails to people for no other reason than that I was brimming with warmth for them…。When [my boyfriend and I] took a trip to Portugal， I felt as if I finally understood vacations—why it is that people cherish and enjoy them…。。Even if I had never been clinically depressed…。perhaps there was some misalignment between my mind and the rhythms of contemporary life。 The bioethicist Carl Elliot writes that for some people anti-depressants do not address an inner psychic state so much as ‘an incongruity between the self and external structures of meaning—a lack of fit between the way you are and the way you are expected to be。’ Elliot wonders if ‘at least part of the nagging worry about Prozac and it’s ilk is for all the good they do， the ills that they treat are part and parcel of the lonely， forgetful， unbearably sad place where we live。’…The psychoanalyst Adam Phillips has said that ‘everybody is dealing with how much of their own aliveness they can bear。’ It was as if Lexapro directly acted on this capacity。 Without the drug， I lacked the courage to try something new。 In Roland Kuhn’s terms， I had lost ‘the power to experience。’ Okay now for my final remark…。。there’s a sign hanging on the fence of a school down the street for me that says “LOVE TRANSFORMS” …。 and I gotta say， folks， it’s true。 Aviv didn’t really specifically note this but I was struck by the ways in which change was catalyzed （or at least supported） by love …。 Ray and his hospital gf， Bapu’s daughter in law， Laura and her bf， Hava and her bf…。I love love…+ Need to read （or read about） Roland Kuhn / the phenomenological psychiatry。 Also essay The Walmarting of American Psychiatry。 My little fragments for later:“The philosopher Ian Hacking uses the term ‘looping effect’ to describe the way that people get caught in self-fulfilling stories about illness。 A new diagnosis can change ‘the space of possibilities for personhood，” he writes。 ‘We make ourselves in our own scientific image of the kinds of people it’s possible to be。’”“Psychoanalysis was once a lifelong process。 Now， nearly two decades after the closure of Chestnut Lodge， psychopharmacology has entered a similarly chronic mode。 Today， antidepressants are taken by one in eight people in America， and a quarter of them have been doing so for more than a decade。 Nathan Kline warned of this problem as early as 1964。 ‘It is relatively simple to determine when to start treatment，’ he wrote， ‘but much more difficult to know when to stop。’ Once the chemical imbalance theory become popular， mental health became synonymous with an absence of symptoms， rather than a return to a person’s baseline， her mood or personality between periods of crisis。 Dorian Deshauer， a psychiatrist and historian at the University of Toronto， told me， ‘Once you abandon the idea of a personal baseline， it becomes possible to think of emotional suffering as a relapse—instead of something to be expected from an individual’s way of being in the world。’ There’s also the possibility that mental health is determined not only by symptoms but by aspirations， like， say， experiencing the ‘oceanic sentiment，’ or other forms of belonging。 For adolescents who go on medications when they are still learning what it means to be their best self， they may never know if they have a baseline， or what it is。 ‘It’s not so much a question of， ‘Does the technology deliver？’ Deshauer said。 It’s a question of， ‘What are we asking of it？’“ Winnicott: “It is a joy to be hidden but disaster not to be found。” “In an essay on the nature of recovery， the psychologist Pat Deegan， who was diagnosed with schizophrenia when she was seventeen， criticized the messaging of a popular advertising campaign for antidepressants。 In an ad that circulated in the late nineties， a smiling girl faces up the stairs to greet her mother。 ‘I got mommy back，’ reads a note in crayon。 Deegan challenges the idea that， after the disruption of mental illness， people can slip back into their former identities。 ‘For those of us who have struggled for years， the restitution storyline does not hold true，’ she writes。 In another essay， comparing herself to a friend who was paralyzed from the neck down， Deegan writes， ‘Recovery does not refer to an end product or result。 It does not mean that the paralyzed man and I were ‘cured。’ In fact， our recovery is marked by an ever-deepening acceptance of our limitations。’ She proposes that ‘transformation rather than restoration becomes our path。’…’All of the polemic and technology of psychiatry， psychology， social work， and science cannot account for this phenomenon of hope，’ she writes， ‘But those of us who have recovered know that this grace is real。 We lived it。 It is our shared secret。’” 。。。more
David Montano
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A deeply personal book with insightful material about psychology but was unfortunately too short for its own good and a little confusing in how each chapter were supposed to relate to each other。 Rachel Aviv definitely writes the shit out of each chapter though， and since Aviv has written other stories in the New Yorker I cannot wait to read these as well。 Aviv has a talent in making these different life stories teem with vibrancy， making the reader unable to put down the book as the different f A deeply personal book with insightful material about psychology but was unfortunately too short for its own good and a little confusing in how each chapter were supposed to relate to each other。 Rachel Aviv definitely writes the shit out of each chapter though， and since Aviv has written other stories in the New Yorker I cannot wait to read these as well。 Aviv has a talent in making these different life stories teem with vibrancy， making the reader unable to put down the book as the different facets from each subject's story is fleshed out expertly。 This is especially true with the chapter on "Naomi" and her Epilogue on "Hava"， which was especially heart-breaking。 The central thesis of "Strangers to Ourselves" involves how people can cope with mental illness through writing and story-telling。 It also displays how important these artifacts of self-reflection （through journals， memoirs and lyrics） are to loved ones。Rating : 3。5/5 。。。more
Harrison Malkin
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Really powerful and moving stories about “mental health，” mythology， and life itself。 Reading her prose is both destabilizing and healing， which is what Aviv probably does best。
D
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3。5⭐️ for being well written and well researched。 When I first read a preview of this book in Buzz books fall/winter 2022 sampler， I was hooked。 However after reading it not so much。 I got bored and confused about the thesis of the book。 A detailed review to come。
Benjamin Priest
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An amazing book。 Aviv profiles four people from the U。S。 and India， using their individual mental health struggles to explore the complicated ways in which psychiatric diagnoses and treatment methods interact with larger social and cultural forces。 Highly recommended。
Sarah
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Haunting and hopeful， this book questions everything—language， diagnosis， treatment—that has long gone unquestioned on the topic mental illness。 A return to the "case study" and the promise （scientific and literary） that the form once held。 I wish it was longer。 I will return to many of its passages。 Aviv is a master。 Haunting and hopeful， this book questions everything—language， diagnosis， treatment—that has long gone unquestioned on the topic mental illness。 A return to the "case study" and the promise （scientific and literary） that the form once held。 I wish it was longer。 I will return to many of its passages。 Aviv is a master。 。。。more
Daniel Schulof
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Engaging and even-tempered prose。 Some courageous and evocative material from the author’s own experiences with mental illness。 In many ways the NYer styling （less focused on explaining and defending a central thesis， lots of “all sides” personal character/subject details that only loosely relate to a central perspective on the matter at hand） makes for a better examination of this topic。 It’s a squishy subject where much of the accepted framing/discourse is faulty or inadequate。 But it probably Engaging and even-tempered prose。 Some courageous and evocative material from the author’s own experiences with mental illness。 In many ways the NYer styling （less focused on explaining and defending a central thesis， lots of “all sides” personal character/subject details that only loosely relate to a central perspective on the matter at hand） makes for a better examination of this topic。 It’s a squishy subject where much of the accepted framing/discourse is faulty or inadequate。 But it probably also led to making some questionable choices about what material to include — some of the extensive life details about the various characters （and even the characters that were chosen） hurt more than helped me improve my understanding of this challenging and compelling topic。 。。。more
Camelia Rose
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Recently I went to Rachel Aviv’s book talk and immediately decided that I must read the book。 Strangers to Ourselves is one of the two best books about mental illness I’ve read this year （the other is What My Bones Know: A Memoir of Healing from Complex Trauma）。 In the Prologue， Rachel Aviv included her own experience as the youngest patient of anorexia （a label she later doubted） at the age of 6。 There are four case studies， each representing a different angle of treating mental illnesses。 The Recently I went to Rachel Aviv’s book talk and immediately decided that I must read the book。 Strangers to Ourselves is one of the two best books about mental illness I’ve read this year （the other is What My Bones Know: A Memoir of Healing from Complex Trauma）。 In the Prologue， Rachel Aviv included her own experience as the youngest patient of anorexia （a label she later doubted） at the age of 6。 There are four case studies， each representing a different angle of treating mental illnesses。 The first case， Ray， shows the change of mental illness treatment in the United States--from psychoanalysis to psychopharmacology， and to the realization that pills can’t fix everything。 What strikes me is that the distinction between personality and mental illness is not as clear as one might think。 Ray seemed to be an unlikable narcissist。 Is this the cause or consequence of his illness？The third case， Naomi， displays how mental illnesses of underprivileged groups， such as Blacks， are chronically undertreated。 Their trauma is largely caused by social injustice， therefore it can not be solved by medicine alone。 The last case， Laura， who let the medical diagnosis define her， tells what over-medication looks like。 It asks important questions: Does over-medication make an episodic mental disturbance chronic？ And why do some people find it hard to taper off antidepressants？Throughout the book， a recurring theme is this: modern medical science still knows very little about mental illnesses。 Different patients react differently to their diagnosis， even if the diagnosis is accurate。 Some may see it as liberating， others as limiting。 The author keeps mentioning that for some patients， the medical diagnosis becomes a “career” for them， which stops them from recovery。My favorite chapter is the second case study， which tells the life story of Bapu， a Hindu schizophrenia patient。 Since her leg was damaged by polio， Bapu’s rich parents married her to a man who wanted her for money。 The husband and the in-laws abused her。 Bapu sought solace in religion。 She wrote poems to Krishna， a Hindu deity。 She even published poetry collections。 She believed Krishna to be her true husband who would offer unconditional love。 The stronger Bapu's devotion became， the more abuse she received from her family。 Later she abandoned the household duties， became uncommunicative， attempted multiple times to run away， and sometimes succeeded。 She was found living on the street in shabby clothes with other pilgrims and later locked up in a cell in a mental hospital。 Eventually， her family became more tolerant， but she was still shunned until her children grew up and took care of her。I almost didn’t believe Bapu had schizophrenia。 Sure she just didn’t fit the required womanhood？ Even during her self-imposed “exile”， Bapu never could get over the desire of holding her children again。 When Karthik introduced his future bride Nandini to Bapu， Bapu’s face was “baby-like， approachable， easy”。 Nandini said: “She asked me， ‘Do you like me？ Do you want to come and live with us？ Do you like my son？’ I was so moved。” But according to Bhargavi， the daughter， Bapu lacked insight into her mental state and was incoherent in speech and in writing。 At least， her schizophrenia was directly caused by abuse and intolerance under patriarchal rules， as Bhargavi understood after studying feminism。 Would have Bapu been “normal” if she was loved and supported？My second thought is that the line between religious devotion and schizophrenia is very thin。 What is schizophrenia anyway， if not deviation from social norms？Bapu’s story also makes me want to know more about Hinduism。 Study shows the recovery rate of schizophrenia is the highest in India， although this result is subjected to contradicting interpretations。 I am definitely not religious。 Organized religions， especially monotheistic religions， have caused immense human sufferings in history。 And yet， religion can also offer psychological comfort to those who believe them。 It’s complicated， because humans are complicated。 。。。more
Franklin Codel
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Stranger to Ourselves is an insider’s look at the world of diagnosis， treatment， and impacts of mental illness。 My biggest takeaway is that the approaches for working with patients of mental illness have evolved over the years and the book does a nice job sharing some of that history。 I am sure that a generation or two from now， people will look back at what we are doing today and conclude it was not state of the art， but actually primitive and misguided。 I found the most compelling sections to Stranger to Ourselves is an insider’s look at the world of diagnosis， treatment， and impacts of mental illness。 My biggest takeaway is that the approaches for working with patients of mental illness have evolved over the years and the book does a nice job sharing some of that history。 I am sure that a generation or two from now， people will look back at what we are doing today and conclude it was not state of the art， but actually primitive and misguided。 I found the most compelling sections to be the ones about the over-prescribing of medicine and the impact that has on patients。 Some interesting questions were explored， although few were definitively answered。 Overall， I found the book to be a bit of a tweener: not a medical book， not a fully baked memoir， not a history， or a policy study or a “how to cope” book。 It is a hodgepodge of stories told through about a half dozen real examples of people who have suffered from mental illness。 My guess is everyone will take away a little bit from it and be left with the feeling that there is no perfect answer。 Maybe that’s the point。 。。。more
Barb
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Interesting， especially the section about Naomi and the underserved， disenfranchised， and incarcerated。 The population with mental illness， and incarceration as a result are not properly treated。 Mental illness is a treatable illness and must be addressed。 This book opens many avenues for discussion and possible improvement of our current systems。
James D。
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The Lives of Those Who SufferThis book is written from a perspective seldom seen in literature， in everyday language that we can all follow。 Readers will come to a better understanding of the lives of those who suffer。
Rebecca Randall
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"There are stories that save us and stories that trap us， and in the midst of an illness it can be very hard to know which is which。 Psychiatrists know very little about why some people with mental illnesses 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。"I found this book fa "There are stories that save us and stories that trap us， and in the midst of an illness it can be very hard to know which is which。 Psychiatrists know very little about why some people with mental illnesses 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。"I found this book fascinating， inspiring， important。 。。。more
Abby
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Very good！ I would heartily recommend。 The prose， the narration， the nuance， the introspection。 It is very well researched; I can only imagine （and shudder at） the time spent just on single paragraphs。 The main premise here is the power （both constructive and destructive， but mainly destructive） of labels。 A diagnosis can be powerful and confirming， but people often don’t fit cleanly into those prescribed boxes。 What then？
Ran
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Very interesting read of six people’s mental illness stories， including the author herself。 I admire how Aviv was able to collect these people’s own writing， giving the book a super powerful narrative。
Sarah Swong
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Wanted even more of Aviv's voice/analysis on a book-long level， not just at the end， where it is very compelling。 Wanted even more of Aviv's voice/analysis on a book-long level， not just at the end， where it is very compelling。 。。。more
Dan
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