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

(Farrar, Straus and Giroux)

Review by Walter Cummins

Like Rachel Aviv, the people whose mental issues she explores in Strangers to Ourselves are driven to write, some with works that have been published, all with journals in which they attempt to tell the stories of their distress. Aviv had access to these documents and quotes from them as she explores what her subjects attempted to explain to themselves. Aviv differs in that she is an acknowledged professional, achieving awards for her articles in The New Yorker. Yet she also reveals that she shares mental issues with the others. Hers emerged at the age of six when she was hospitalized for refusing to eat and later in adulthood as a wife, mother, daughter, and sister relying on antidepressants to function within the range of normality. One of the underlying questions that runs through the book is why she succeeded and the others didn’t.

According to her implicit analysis, stories may lie at the heart of an answer. All five of the people she writes about are products of their life stories, circumstances over which they had little control. In their writing they hope to examine those stories and, in effect, gain control, write themselves back to mental health. They want to escape the trap of their old origin tales and create new ones in which their lives are not foreign to them. They want to be someone different, discovering who that someone really is and then finding the means to remake their lives. Aviv explains her approach to describing them:

This book is about people whose struggles with mental illness exist outside of this “closed and completed system of truth.” Their lives unfold in different eras and cultures, but they also share a setting: the psychic hinterlands, the outer edges of human experience, where language tends to fail. I have chosen subjects who have tried to overcome a feeling of incommunicability through writing; the book draws not only from conversations with them but from their diaries, letters, unpublished memoirs, poems, and prayers. They have come up against the limits of psychiatric ways of understanding themselves and are searching for the right scale of explanation—chemical, existential, cultural, economic, political—to understand a self in the world. But these different explanations are not mutually exclusive; sometimes all of them can be true.

Aviv considers herself an escapee, who from age six could have ended up in a lifetime of mental illness, unable to function in what is considered an ordinary life. In a second- grade diary, barely able to compose sentences, she tried to find words for her condition of not eating: “I had some thing that was a siknis its cald anexorea.” She explains that she had “anexorea” because she wanted to be someone better.

The adult Aviv is aware that she lived at an edge of making that definition permanent: “It’s startling to realize how narrowly we avoid, or miss, living radically different lives.” While for some, writing about the forces that dominate their lives can serve as a means of liberation, those stories also can further entrap them in their illness.

In not eating the child Aviv was trying to make a statement about her upset over the tension of her parents’ divorce and her role as a pawn in their custody battle. Refusing to eat became a weapon, an attempt to assert some form of control over her condition. When she returns to regular eating, one psychologist concluded, her previous refusal was a “coping style in dealing with the pressures that she has felt.” It’s very likely that Aviv was not a true anorexic because the promise of the reward of having her parents visit if she ate quickly leads her to consume real meals.

Yet she does have a tendency toward depression and relies on Lexapro: “… I also feel closer to that space of flexibility when I take Lexapro; it seems to relieve the cognitive rigidity that often accompanies anxiety and depression—the sense that one’s story can unfold only one way.”

Unlike the people she writes about, Aviv is fortunate to have found a medication that works for her. In the book she discusses the debate between treatment with drugs and psychoanalytical methods. Neither approach solves the dilemmas of the others. Is Aviv lucky or just facing a condition less severe than those of the others?

When describing her confinement as a six-year-old, where she is by far the youngest, she notes being drawn to a girl named Hava, “twelve and beautiful,” whose journal provided the title for this book, “strangers to ourselves.” Aviv intentionally delays revealing Hava’s fate till the last section of the book. Hava was a true anorexic, who later also became bulimic.

Aviv reports Hava’s life and the writing in her journal, her inability to escape the obsession with weight and food. Yet at age forty-one Hava seems on the verge of adapting, living with a man named Tim; but one night, her esophagus distorted from bulimia, she asphyxiates on her own vomit.

Aware of her connection the Hava, even told she could have been Hava’s younger sister, Aviv speculates that she could have led a parallel life, that if she had been older when she stopped eating or faced different social pressures, she could have gone on to an anorexic “career.” That possibility overwhelms her.

Yet, although the challenge of this book for Aviv and for those whose journals she cites is putting mental illness into words, language may be inadequate for the goal. Avid quotes a young woman who told her how difficult it is to explain the symptoms of psychosis: “It’s like trying to explain what a bark sounds like to someone who’s never heard of a dog.” Can these stories really be communicated?