Strangers to Ourselves

April 1, 2022

In a debut, New Yorker staffer Aviv considers how we cope with profound mental crises and then make stories of these experiences as we come up against the limits of psychiatry. Among individuals she portrays: a woman who goes off her meds to learn who she is and a man intent on delivering revenge upon his psychoanalysts. With a 100,000-copy first printing

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July 4, 2022
New Yorker staff writer Aviv debuts with a collection of thought-provoking journalistic profiles of people with mental illness. From a depressed self-aggrandizing physician to a mother who murders one of her twins during a mental health episode to a Harvard-educated debutante with bipolar disorder, Aviv details how six individuals have navigated the boundaries of scientific understandings of mental illness and developed self-understanding through psychiatric treatment. The author includes her own story: She was diagnosed with anorexia at age six and committed to a hospital, where she encountered the power of diagnoses to shape one’s self-conception: “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.” Aviv uses interviews, subjects’ journals, and the writings of such figures as Sigmund Freud and psychiatrist Roland Kuhn to study how illness affects how one sees oneself. For example, the journals of Aviv’s subject Bapu, an Indian woman with schizophrenia, pay little heed to her diagnosis and treat her connection with the Hindu god Krishna as real. Aviv’s considerable storytelling abilities are on full display here as she renders compassionate and nuanced portraits of individuals wrestling to gain a coherent sense of identity from the limited lexicon of psychiatry. This eye-opening examination makes for a valuable addition to modern discourse around mental illness.

Starred review from June 15, 2022
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. When she was 6, in the wake of her parents' divorce, Aviv was diagnosed with anorexia despite her abiding sense that that label was inaccurate. Later, the author writes about taking Lexapro. "To some degree, Lexapro had been a social drug, a collective experience," she writes. "After a sense of uncanny flourishing for several months, my friends and I began wondering if we should quit." Aviv applies her signature conscientiousness and probing intellect to every section of this eye-opening book. Her profiles are memorable and empathetic: a once-successful American physician who sued the psychiatric hospital where he was treated; Bapu, an Indian woman whose intense devotion to a mystical branch of Hinduism was classified against her will as mental illness; Naomi, a young Black mother whose sense of personal and political oppression cannot be disentangled from her psychosis; and Laura, a privileged Harvard graduate and model patient whose diagnosis shifted over the years from bipolar disorder to borderline personality disorder. Aviv treats her subjects with both scholarly interest and genuine compassion, particularly in the case of Naomi, who was incarcerated for killing one of her twin sons. In the epilogue, the author revisits her childhood hospitalization for anorexia and chronicles the friendship she cultivated with a girl named Hava. They shared some biographical similarities, and the author recalls how she wanted to be just like Hava. However, for Aviv, her childhood disorder was merely a blip; for Hava, her illness became a lifelong "career." A moving, meticulously researched, elegantly constructed work of nonfiction.

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August 1, 2022

New Yorker staff writer Aviv explores the effects of medication and therapy on treatment of mental illness. She argues that psychiatry's current emphasis on biochemical explanations of mental illness may be detrimental to some patients. Rather, she advocates for a therapeutic approach that seeks to understand the patients' experiences and understandings of their own illness, which aligns with an older psychiatric practice. In this way, patients may understand their illness as something which they can recover from, rather than an incurable condition that needs to be constantly managed. The author describes four case studies in which patients developed mental health issues and sought treatment with medication. Using the patients' own experiences, she describes the nature of their mental illness and explores how medication helped or hindered their treatment. Additionally, she explores external factors such as cultural differences in perceptions of mental health, racial disparities in health-care treatment, economic conditions, and gaps in medical literature regarding long-term use of medication. Finally, Aviv also relates her own experiences with anorexia as a child and her recovery process. VERDICT An interesting look into treatment of mental illness.--Rebekah Kati

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