This is a great book - it looks at mental health from a socio cultural lens, looking at the stories we tell about ourselves and others, and wondering how those stories define what mental health and mental illness are. Rachel Aviv is a beautiful writer - she discusses complex issues in an accessible and engaging manner.

Unputdownable. This was an absorbing piece of non-fiction focusing on a number of different individuals and their experiences where professional medical intervention did not necessarily work for them in helping to treat their illness (which were often incorrectly diagnosed). The author frames this narrative around her own story - being hospitalised aged six for what doctors considered to be anorexia - and that of a young woman she met on the ward when she was in hospital as a child.

Naomi Gaines and Laura Delano's stories were the most compelling to me personally, but there is something to take away from all of the case studies Aviv digs into here. Recommended for readers of Patrick Radden Keefe and Andrea Elliott.

Reading New Yorker staff writer Rachel Aviv’s debut, Strangers to Ourselves: Unsettled Minds and the Stories That Make Us (September 13, 2022, Farrar, Straus and Giroux), I realized I had an unintentional trend this year of reading about selfhood in some form. It started with the first book I read in the year, Will Storr’s Selfie: How We Became So Self-Obsessed and What It’s Doing to Us (more on it later).

Aviv’s book is a set of profiles/case studies on various forms of mental illness connected to questions around self and identity, but which also don’t respond to conventional therapies, whether pharmaceutical or otherwise.

At least, that’s my take on it — as much as I enjoyed reading this, I found myself unclear on what the overarching, uniting thesis of it was supposed to be. Not that everything needs to have a thesis: I’m a firm believer in just enjoying the informational journey, as it were. But this gave the distinct impression of lacking something cohesive, or maybe — and I don’t mean to be self-deprecating, just honest — whatever it was went over my head. The synopsis says that Aviv “raises fundamental questions about how we understand ourselves in periods of crisis and distress,” and that’s very true, and maybe that’s enough for what it is.

Aviv herself was the youngest person in the US to be diagnosed as anorexic, at age six. But as she herself explains it, it was an atypical kind of anorexia, and I wonder if that’s even what it actually was, especially as she doesn’t seem to have continued to suffer eating disorders or the obsessive fascination with them that characterizes long-term suffering. But her early diagnosis sets the stage for the case studies to come, as none of the people profiled conform to easy, DSM-style categorizations of mental illness.

During her inpatient treatment, Aviv idolized the older girls there, and after opening the book with her own story, she closes it by looping back to one of them, Hava. I liked this bookending mechanism and it was powerful here, if ultimately a bit self-centric, but I guess that’s the point: how our identities are shaped by others or by group identity when we’re told we’re the same – there are a lot of ideas tossed around here.

In other chapters, she explores the lives and disorders of Dr. Ray Osheroff, a physician whose experience shows the shift towards treatment of mental illness with medication despite its obvious limitations; Bapu, a Hindi woman who may have had schizophrenia; Naomi Gaines, a Black single mother whose untreated mental illness, connected with her experiences with race and poverty, led her to throw her baby sons off a bridge; and Laura, whose overmedication changed her entire sense of self and complicated her conditions even further.

There were so many interesting ideas explored, and a lot of empathy that is necessary to understand others’ experiences and why mental illness is so tricky to treat. The common thread, as far as I can tell, is that these cases that don’t respond to conventional therapies are maybe more the norm than the exception.

Naomi’s story was the one that affected me the most, and that I think speaks to imperative issues in America at the moment. Non-white people are undertreated for mental illness (for any illness, actually) while suffering under systematic oppression and discrimination that compound it. I didn’t expect to feel empathy for Naomi after learning she’d killed one of her children, but her experience and the context of it were so well told and emphasized circumstances that we can’t ignore.

I think a lot about these stories, lives, and experiences will stick with me, even if I’m unsure what to make of the collection as a whole.

This is one of those books that stay with you after reading. As if your still digesting. It starts out with the author's own story of being diagnosed at six with anorexia. That could have been a good book. Aviv builds on this by introducing the reader to other patients of psychiatry for different reasons. The mother who jumped from a bridge with her children really got to me. They are all interesting and emotional stories. Highly recommend this one.

Copy provided by the publisher and NetGalley

Timely and important, this is a recommended purchase for all nonfic collections, particularly where mental health titles are popular.

This was not an easy book to read, but it was fascinating all the same. It took me some time to read this short book because I would read a long chapter about a patient and then have to let it sit for a time before going to the next chapter. I have read some of Rachel Aviv's articles in the past, but I didn't really know her. Although this story focuses on different individuals suffering from mental illness, this book is also part memoir as Rachel recounts her own experiences as the youngest child to be diagnosed with Anorexia. She did a phenomenal job researching each of these patients and sharing their stories and calls us to question what we think we know about mental illnesses and those suffering from them. It also helps us to think about how we treat mental illnesses in this country (as well as in other countries) and the stigma that is associated with them.

Throughout she shows us that treating mental illness needs to be much more individualized than it has become and that patients themselves should have some say in how they are treated, whether it be medication, talk therapy, etc. I learned a lot about the history of psychiatric treatment in this country and while I knew a lot about the history, I still couldn't help but feel ashamed of how our country treats mentally ill patients.

I also found the discussion Rachel had about her own experiences with Lexapro to be very thought-provoking. She was prescribed Lexapro at a time when it was "popular" and it seemed that every white woman was taking it. While she would probably not be prescribed it now with the symptoms she had back then, she talks about her experience with it vs. another woman's experiences with it and the choice her friend made to get off of the medication (with all the withdrawal symptoms that came with it), while she thought about it but decided she wanted to continue because it enhanced her life in a way she didn't have when she didn't take it.

Overall, this book gave a lot of food for thought, and while nonfiction books are not the norm for book clubs, this is a book that could feed a lot of discussions.

I voluntarily read and reviewed an advanced copy of this book from NetGalley. All thoughts and opinions are my own.

I am not sure what to make of this book -
A 6 year old girl is diagnosed with anorexia.
A woman stops taking her meds because she can't remember what she is like without them.
A successful doctor disintegrates into depression and spends the next 30 years writing a memoir without any apparent insight into what he was writing about.
A woman is obsessed with her religion and her writing is considered divinely inspired. She eventually abandons her family and tries to go to a Hindu monastery. She is later diagnosed as schizophrenic and lives a tortuous life.
A psychiatric hospital failed to successfully treat patients, because the author says the personal doctor/patient relationship turned into a corporate provider/consumer relationship.
There is another heartbreaking story about a woman with anorexia.
The only common thread is that it seems conventional practices & medicine do not work for certain people.

This book is a great book about how we see ourselves in times of crisis. Full of stories of people who have faced a crisis in their lives and have come out the other side. They have come up against the limits of psychiatric explanations for who they are. This is a book about how we should reframe the "Story" of a person who has mental illness.

Not my usual regular reading but I’m so glad I read this book!
Do you know how you react (or would react) in times of crisis, trauma or emergency? Do you already struggle day to day with (diagnosed or not) mental issues?
Unique and interesting stories that make you think!

As an educator and mental health professional, this book was so comprehensive and thoughtful. The choice of candidates for analysis of mental health issues was brilliant. Not one socioeconomic community was identified but several. I developed empathy for each person.
How timely is this subject in the violent world we live in. It seems we retreat to the earlier days of one’s mental health issues to determine one’s path in the future.
Kudos to exploring the psycho pharmaceutical world and managed care world we live in.
Great read. Will recommend to all.

It's hard to describe this book too much without giving away the power of the true stories Aviv shares. Aviv herself has experience with the main theme of the book, and this shows with the way she handles the stories of others. Looking at others' experiences with psychiatry, societal labels, psychoanalysis and self-identity, as well as her own, Aviv truly lays bare the concept of "unsettled minds" and how every one has a story to share.

This is like Dopesick and Hidden Valley Road coming together in a sad, frustrating memoir with other people's stories mixed in. This book is at times relatable, frustrating, hopeful and matter of fact. It uncovers uncommon details about the history and the irresponsibility of the mental health industry.

A very thoughtful and empathetic book about 6 different people's mental health as told by Rachel Aviv, who is a well-known journalist for The New Yorker. I like how each person had a different background and different struggles, as well as different treatments/tools to help them. I also appreciate the bravery it must have taken to share their stories to the world.

I feel that anyone can relate to the stories shared in this book about mental health. It is ok to ask for professional help so you are not alone. I have learned a lot about my own struggles as well. Do not suffer alone!

Highly recommended book for everyone!

Thanks to NetGalley, Rachel Aviv and Farrar, Straud and Giroux for an ARC in exchange for an honest review.

Available: 9/13/22

I really don't know how to classify this book, nor do I feel like it has a definite message, other than exploring the ways in which people's depression and addictive behaviors manifest themselves; the struggle to find one's self perhaps. Several people's stories stand out: Ray's and his history of antidepressants is a story of how we view ourselves. One chapter gives insight into intersections with other countries. Naomi's story describes racial oppression through mental disability (which I found the most interesting).

Again, it's hard to get at the sense of the overall goal of the book. I would've liked more analysis to tie all of these essays together- they seemed rather disjointed. However, they do show a personal struggle that many readers may recognize in themselves and their loved ones.

Rachel Aviv's STRANGERS TO OURSELVES is that most rare of books, casting a whole new light and prism through which to view our assumptions and presumptions about those who suffer from mental illness. Aviv's exquisite talent for respecting the stories of others and illuminating the experiences of those in the throes and those attempting to be their own truest selves without labels, medicine, and checkbox expectations informed and moved me throughout this important, timely, and marvelous book. I received an early copy of this book and these thoughts are my own, unbiased opinions.

Rachel Aviv’s Strangers to Ourselves: Unsettled Minds and the Stories That Make Us is a rare gem: a non-fiction book I couldn’t put down. Aviv is a staff writer at The New Yorker, and the book reads like a really long New Yorker article. It is intelligent and well-researched yet accessible and compassionate. Tellingly, it is non-prescriptive: readers should not look for pat answers here. Aviv simply tells the stories of half a dozen individuals, mostly women and including herself, for whom modern psychiatry does not suffice and often hurts as much as it helps. Aviv puts special emphasis on the narratives that arise out of diagnoses, and what it means to have mental illness become a main element of one’s story. Highly recommended for anyone interested in mental health.

Recommended: 4 Star

I read this book as a pre-release e-book obtained through NetGalley, provided by the publisher.

An unusual, and fascinating book, made up of six independent stories of people from various races, genders, countries, and socioeconomic classes with one thing in common – all have been diagnosed as having a mental illness. They each have different experiences involving their mental health care and their society’s point of view of that, and what sorts of help are available. Some people get too much of the wrong kind of care which they do not want, while others get very little help with care, treatment, or in living their lives, and cannot obtain it other than through drastic measures.

The book shows how far we have come, in its descriptions of things which happened decades ago, in institutions which are older still, while showing us how much farther we have to go. One thing that’s clear is that what we’re doing is not the answer.

Amazon would not permit me to post a review at this time. I put a review on Goodreads, as linked.

I did not finish this book due to formatting difficulties with NetGalley Shelf (which have nothing to do with the book except for the fact that it was very difficult, technically, to read). Nonetheless, kudos to Rachel Aviv for shedding insight on the effects of serious mental illness on individuals, family, and society, and for providing a broad and intriguing overview of the evolution of modern psychiatric treatment and practice. Her insights into the long hospitalization that were the norm not that long ago to the plethora of medications we have today to help people cope and be productive members of society without having to be locked up in a dismal institution.

The individual true stories, including that of her own hospitalization for anorexia at the age of six (!), reveal the breadth and depth of psychiatric disorders, including how cultural differences come into play in treatment. In one chapter, she discusses the case of Bapu, a woman from India, who believes she is the bride of Krishna, and frequently disappears on holy pilgrimages, only to be retrieved by her family and put into psychiatric care based on Western medicine. She is diagnosed as suffering from schizophrenia, a disorder very difficult to treat in Western culture, takes medication on and off and returns to her “normal” self until she feels gripped yet again by her firm belief that her house is cursed, which sets off her delusional wandering yet again. Clearly, her behavior is erratic in terms of consensual reality. But is it really erratic? Or is she a person so deeply entrenched in the mystic elements of her culture that in those circles her behavior is accepted?

I think about our definitions of normal and reality (that is, the consensual reality a majority of the population accept as normal) and wonder if adhering only to that definition is the only way to look at human behavior. One only has to talk to a person with schizophrenia using that person’s vocabulary to realize that norms are narrow and that broadening one’s horizons to courageously understand differences can only enhance relationships.

Was that the point of the book? Probably not. Actually, at times I wondered what the point was, until I stepped back and understood it as a psychosocial overview of psychiatric disorders and treatments, which, overall, was fascinating.

I received this book as an ARC from the publisher and NetGalley.

i really loved the author's exploration of various people involved in the mental health field, from their diagnoses, treatment, and experiences in facilities. I also appreciated her discussing her own journey.

Wow. Rachel Aviv gives a fascinating insight into mental illness and it’s treatment over the years. While each case study was fascinating, diving deep into different types of treatment over the decades and around the globe, I found Rachel’s own struggle with anorexia as well as her relationship with Hava to be incredibly enthralling. If you’ve ever wondered what goes on within the walls of a mental health facility, this book takes an in-depth look at several people, their struggles in getting not only a diagnosis, but proper treatment and care.