STRANGERS TO OURSELVES

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.