Strangers to Ourselves: Unsettled Minds and the Stores that Make Us by Rachel Aviv

Some time ago, I read a review in the NYT of a memoir written by a woman who went off all her psychiatric medications, and she'd been on a lot of them for a very long time so this was significant. I couldn't remember the author's name, the book's title, nor could I re-find the review after searching in the app. I bought "Strangers to Ourselves" hoping it might be the book I read about in the review and while it wasn't, it does feature the story of Laura Delano (author of the book I was trying to find) and is an insightful, moving book I'm grateful to have bought (sort of) by mistake.

"Strangers to Ourselves" includes stories of the author and five others who faced life-altering mental health diagnoses. Some recovered, some did not. Some sought care in traditional psychiatric facilities and leaned on evidenced-based modalities and some did not. "Strangers to Ourselves" demonstrates that a diagnosis is really just a story, perhaps even just one side to the story. And there is never just one story nor one side. 

Mental health diagnoses often carry a heavy stigma and medicalizing them does reduce some of that. Society does not treat a cancer patient as if something is intrinsically wrong them; we understand their cancer as a disruptor, something to treat and mitigate, and the patient as someone bravely enduring the whole ordeal. Treating depression, schizophrenia, disordered eating, and other psychiatric diagnoses through a medical model may facilitate some of that separation and "Strangers to Ourselves" traces how psychiatric treatment has evolved within the medical model. But "Strangers to Ourselves" also highlights the limitations of the medicalization of mental health and left me wondering more about the unmeasurable, invisible, spiritual connections between our bodies, minds, histories, and environments. Maybe the author's eating disorder was cured when she completed an in-patient program or maybe it was cured when her life became more stable and predictable. Maybe the man whose depression derailed his life would have had a different experience had social expectations of him been different. 

"Strangers to Ourselves" explores the power of identity in shaping destiny, and the risks that come when identity and diagnosis are conflated. It doesn't lean woo-wooey, doesn't make a claim about certain care being right or wrong, and doesn't discredit the good intentions of providers, researchers, or the patients themselves who may or may not find provider-recommended treatment helpful. It does tell human stories in complex, interconnected, multi-layered ways and creates space for many truths to co-exist. This book made me think about the impact of traditional healing practices, social traditions long-lost, and the limitations of replicable science. It left me considering the nuances of the stories that make up my own life and the power held by the identities we claim. 

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