... like so many of the stories in this intimate and revelatory book, the truth of it is real but incomplete ... Aside from her candid reflections in the prologue and the epilogue, Aviv mostly hangs back, even though her own experience primes us — as maybe it primed her — to be alert to how stories can clarify as well as distort the mental distress that a person is going through ... Aviv’s narrative is so attuned to subtlety and complexity that any summary risks making it sound like she’s doing something she’s not. This isn’t an anti-psychiatry book — Aviv is too aware of the specifics of any situation to succumb to anything so sweeping and polemical. What she does is recognize the multiplicity of stories that attach to her subjects’ experiences, exploring a variety of interpretations instead of jumping at the impulse to explain them away ... delicately balances two truths that prove remarkably difficult to hold in tandem. We all have our own minds, our own experiences, our own suffering; we are also social creatures who live among others, and social forces have at least some bearing on how we understand who we are ... a book-length demonstration of Aviv’s extraordinary ability to hold space for the 'uncertainty, mysteries and doubts' of others.
... written with an astonishing amount of attention and care ... Aviv’s triumphs in relating these journeys are many: her unerring narrative instinct, the breadth of context brought to each story, her meticulous reporting. Chief among these is her empathy, which never gives way to pity or sentimentality. She respects her subjects, and so centers their dignity without indulging in the geeky, condescending tone of fascination that can characterize psychologists’ accounts of their patients’ troubles. Though deeply curious about each subject, Aviv doesn’t treat them as anomalous or strange ... Aviv’s daunted respect for uncertainty is what makes Strangers to Ourselves distinctive. She is hyperaware of just how sensitive the scale of the self can be.
Stands out by virtue of how successful she is in the attempt. In fact at moments it feels quite far from the fray, perhaps because...her pieces, even her sentences, tend to conclude ambivalently, and are driven throughout by a curiosity that resists its own moral and rhetorical instincts, forging narrative ones instead ... Texts that appear in Strangers are rich ground for layered readings: poetic, humorous, impassioned, or else curiously vacant ... In trying to articulate what makes Aviv’s writing so generative and particular I keep gravitating to her style, unusual for a reporter or essayist exploring the 'psychic hinterlands,' as Aviv puts it, 'where language tends to fail' ... I am impressed by Aviv’s deft manipulation of studies, academic treatises, doctor’s notes, and interviews, but I am moved by her commitment to weaving uncertainty, mystery, and devotion into these narratives as well. It’s writing that aspires to spare nobody the anguish of its ambivalence, and yet helping to illuminate a subject’s particular suffering or ecstasy can be a gift. At its best the words wield this dimensionality like a threshold, which I envision not as a window onto a subject’s soul, but like a door that stays open for anyone wishing to be welcomed as a stranger.
One of the pleasures of this book is its resistance to a clear and comforting verdict, its desire to dwell in unknowing. At every step, Aviv is nuanced and perceptive, probing cultural differences and alert to ambiguity, always filling in the fine-grain details. Extracting a remarkable amount of information from archival material as well as living interview subjects, she brings all of these people to life, even the two whom she never met. I zipped through each essay—propelled by curiosity—yet needed to take breaks between them, both to recover from the intensity of the human experience described and to sit with the implications of the argument Aviv is building, which suggests that it may be more harmful than helpful to see yourself the way doctors see you ... Approved insight, the kind that informs 'correct' narratives, exerts real and lasting power, whether damaging (Aviv’s focus) or healing, as is often the case. But Aviv is more preoccupied with insight in the philosophical sense—finding order and meaning in one’s own story—which is anything but straightforward or static ... Aviv reminds us that Who am I now? is less a momentary question than a koan that suffuses every life, an invitation to revisit and revise the conundrum, whoever you are and whether or not you have a diagnosis. All of Aviv’s subjects, herself included, live at the mercy of social and medical constructions, and yet strive to shape and reshape their irreducible, protean selves.
Aviv approaches her critiques obliquely and suggestively, through in-depth reports on individuals based on their letters, diaries, interviews with family members, friends, medical records, doctors, and, when possible, the subjects themselves ... Strangers to Ourselves adds anecdotal and emotional weight to a growing body of evidence that the progressive narrative of mental health is largely fictitious ... Aviv then takes things a step further—and perhaps too far: She suggests that our faults are neither in our stars (our biology) nor ourselves (our minds in response to our environment) but in the stories medical professionals tell about those faults and how willing we are to accept them ... Aviv would never go so far as to endorse a revival of R.D. Laing’s and Thomas Szasz’s radical anti-psychiatry movement of the 1970s. Nor is she a cheerleader for more recent efforts spearheaded by the journalist Robert Whitaker to combat America’s pill-industrial complex ... Aviv appears to hedge her bets when it comes to the question of whether even florid cases of mental illness are 'real' ... For Aviv, society is therefore to blame, except when it isn’t ... At its most cogent, Strangers to Ourselves appears to be making a case for the equal agency of those with mental health issues to determine their own treatments ... Yet this Jamesian libertarianism, however delightful in theory, remains subject in practice to the strong gravitational pull of other force.
Strangers to Ourselves is doggedly resistant to sounding definitive. Instead, it is insistent on ambivalence ... An of-the-moment book ... The strength of Strangers to Ourselves is in its engrossing case studies, which contribute vivid anecdotes to this ongoing conversation about the complex and perplexing nature of the mind ... Taken individually, each story in Strangers to Ourselves is as typically excellent as Aviv’s magazine journalism, viscerally rendered and thoughtful portraits that slide into meditations on the mind. As a collection, though, they coalesce into an eloquent shrug. I wondered, upon closing the book, whether it might have left a firmer impression had it been published in serialized form—say, in a magazine—rather than gathered into a collection so opposed to clarity ... Better a sincere, beautifully written whimper than a disingenuous bang, of course. Aviv’s hazy but honest irresolution is much preferable to the blunt-force tendency to turn mental health diagnoses into cornerstones of identity.
Aviv steps outside of these rigid explanations to paint more complex portraits of interiority ... Aviv does not attempt to replace imperfect wisdom with her own. She is a dogged epistemological lawyer for opposing sides of every argument ... Aviv is especially sharp in the granular — by focusing on the unique composition of each of these individuals’ perceptions, she can show how they change shape as soon as they come into contact with perceptions crafted in the forge of social history ... Mental health narrative frameworks can liberate, and they can bind. We need them, but we have to find a way not to be trapped by them either. Aviv’s writing locates its strength not in abjuring mental health concepts or strategies wholesale, but instead showing that every framework is part of its own zeitgeist. This doesn’t make them wrong or even ineffective necessarily, but it’s important to understand in what ways they are part of a web of ideologies that shift and change over time. We should still take our solutions where we can find them, of course, as long as we don’t become too attached to an idea of their everlasting categorical truth.
The accounts are vivid, wrenching and ambitiously researched and include dispatches from the subjects’ voluminous diaries, blogs and unpublished memoirs ... The book is organized around a profound and plausible hypothesis: that the stories people tell themselves about their mental disorders shape the course of their lives. Yet the case studies in this book cannot prove it, as the author seems to suggest ... showcases her mastery of psychological portraiture. It is these stories and the ones her subjects tell themselves about their mental disorders that fascinate. As for the author’s framing questions, while they are essential to ask, they remain unanswered.
... a subtle and penetrating investigation into how mental illness is diagnosed, and the ways in which the language used – far from neutral – moulds a patient’s innermost self, promising to explain who they are by weaving narratives that free and entrap ... Aviv is an instinctive storyteller and her book’s episodic, immersive format is underpinned by in-depth reporting as she tracks down those closest to her subjects ... Woven throughout is an intimate examination of the roles that injustice and inequality play in mental distress and of the evolution and limitations of modern psychiatric practic ... Her own language is meticulous, empathic, tirelessly inquisitive. Despite – or perhaps because of – her rigour, she also dares to acknowledge facets of identity that elude any theories of the mind currently available to us and to engage with profound mystery in the form of hauntings and religious mysticism ... It’s this glimpse of a path untaken that infuses her approach to mental illness with such humility and kinship and her complex, illuminating book is all the stronger for it.
... profoundly intelligent ... hat she avoids these easy positions is testament to the open, curious nature of her inquiry. If there is an argument she wants to advance, it is that the stories we tell about distress, and unusual, sometimes destructive behaviour, are just that – stories. They can be salvational, oppressive, or something in between; they can work primarily for our benefit, or for others. They can also, in the same person, change or intermingle ... superbly written portraits ... remarkable.
Lucid reporting and memoir ... Aviv’s commitment is to the complexity of narrative above all else, the irreducibility of each case to any single explanation. Her project is to offer a series of questions about the relationship between our experiences and how we categorize and name them. The only hint of a conclusion takes the form of another question.
The honesty and openness with which Aviv, now a New Yorker journalist, describes her childhood experience sets the tone for a book that captures with subtlety and empathy the complicated reality of mental illness ... What makes the book so powerful is that the stories are told in the words of the protagonists. Aviv draws on unpublished journals as well as interviews with family members and experts. The result is a human chronicle that is intimate and unpredictable. Instead of demonising disorders of the mind, Aviv seeks to understand their causes.
... fascinating ... In crafting compassionate, probing portraits of people who have forged their own stories, Rachel Aviv has written an engrossing and important book that shows how managed care and the current state of mental-health treatment is working from a two-dimensional model that reduces patients to diagnoses and — in some cases — dooms them to 'careers' in mental illness that they cannot escape. With Strangers to Ourselves, she reminds us that we are all more complex, more multi-dimensional, more fascinating and mysterious than any single diagnosis, and that the real stories of who we are are worth probing in depth.
... well researched, quietly provocative book ... performs a rhetorical feat that you might call the Reverse Gladwell. Where Malcolm Gladwell infamously — sometimes exasperatingly — uses peer-reviewed sociological and psychiatric literature to essentialize human behavior, extrapolating it into cozy generalities, Aviv does the opposite. Her book complicates mental illness, particularizes it, questions psychiatry’s ability to provide a cure-all, or even a cure-many ... A book that is framed around unsatisfactory answers to the questions of what makes us mentally well and unwell is inevitably going to feel a bit unsatisfactory itself. Aviv’s structure demands she proceed from anecdote; the fact that each of the stories is rich and compelling doesn’t change the fact that they remain stories, individual examples of an outsize challenge. But to the extent that these narratives expose the gap in our understanding — and our wishful thinking that we’ve closed it — Strangers to Ourselves is a valuable book.
... a stunning book, offering sensitive case histories of people whose experiences of mental illness exceed the limits of psychiatric terminology, diagnosis and treatment ... a compassionate and necessary exploration of the complex relationship between how we understand ourselves and how psychiatric diagnoses define us.
... perceptive and intelligent ... Aviv applies her signature conscientiousness and probing intellect to every section of this eye-opening book. Her profiles are memorable and empathetic ... Aviv treats her subjects with both scholarly interest and genuine compassion ... A moving, meticulously researched, elegantly constructed work of nonfiction.
... thought-provoking ... 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.
