At the age of 6, Rachel Aviv was hospitalized when she stopped eating and was diagnosed with anorexia. At such a young age, the details of such a diagnosis were lost on the young girl. She explained her situation to herself by saying she had it because “I want to be someone better than me.” (15)
The older girls on her hospital ward had a much greater attachment to the diagnosis. One of them, Hava, became particularly close to Rachel, but could not form enough sense of herself to live into another identity. “I suppose I am one of those people that thoroughly understands myself yet am a stranger to myself,” she wrote in a journal. (233)
“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.” (24)–Rachel Aviv
Anybody who has struggled with mental illness, or who has lived with someone who has, knows the dance we perform with diagnoses. They can offer some comfort as an explanation for the unexplainable, but they can’t provide a stable identity. And they remain mysterious, even to professionals.
Rachel Aviv’s beautifully-written new book, Strangers to Ourselves: Unsettled Minds and the Stories That Make Us, takes us through a number of case histories, including her own, to look at how the stories we tell ourselves about what’s going on are lived out. The characters she introduces us to, Ray, the businessman, Bapu, the Hindu devotee, Naomi, the young mother haunted by the nation’s history of racial injustice, and Laura, the privileged New Englander, all have their unique experiences with mental health systems and their cultural attachments. Aviv portrays their stories with empathy and soberness.
In the end Aviv has given us a grand tour through the successes and limits of psychiatric treatments through the last 80 years. Despite the promise of new medications, there are no easy answers. But we admire each of these characters for their own attempts to tell a coherent story of their lives.
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