(by Rachel Aviv)
This book, whose subtitle is “Unsettled Minds and the Stories That Make Us,” takes the form of the psychiatric case study and goes somewhere a little different with it. In the book’s six sections, the author explores six different people’s experiences of mental illness, including her own (she stopped eating when she was six and was admitted to the hospital and diagnosed with anorexia nervosa). She talks about each person’s diagnoses and the details of each person’s interactions with psychologists and/or psychiatrists, and part of what she’s interested in is what factors lead to different experiences and different outcomes. Mental illness is so multi-faceted: there are possible chemical factors and possible genetic factors but also cultural and societal factors and factors related to an individual’s life experiences: at one point in the book a psychoanalyst writes to one of his patients about the dangers of “neglecting the context and specificity of why someone is having those particular life problems at that particular time.” And part of Aviv’s point is that the stories we tell ourselves or are told by others about our mental states are significant: as she puts it, “Mental illnesses are often seen as chronic and intractable forces that take over our lives, but I wonder how much the stories we tell about them, especially in the beginning, can shape their course.” And as she also says: “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.”
Woven in with each person’s story we also get some pertinent information about key moments in the history of psychiatry, from when the DSM III came out (this being the point when “mental illnesses were redefined according to what could be seen from the outside, a checklist of behavioral symptoms”) to the introduction and rise of antidepressants (particularly after Joseph Schildkraut’s 1965 introduction of the chemical-imbalance theory of depression). Questions of different experiences of/narratives of mental illness in different countries and different cultures also come up: one of the chapters is about a woman in India who was diagnosed with schizophrenia but who sees herself as part of the Hindu tradition of mysticism; another chapter is about a Black woman whose experience of mental illness has links to racism and to personal and generational trauma.
I found this book really well-written and interesting; it was a book club pick that I happened to already have a copy of, and I’m glad to have finally read it. (I won my copy at a New Yorker trivia event around the time the book came out, so it’d been sitting on my shelf for nearly two years!)
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