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Strangers to Ourselves

Unsettled Minds and the Stories That Make Us

Rachel Aviv

Farrar, Straus and Giroux

Strangers to Ourselves Download image

ISBN10: 0374600848
ISBN13: 9780374600846


288 Pages


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In Strangers to Ourselves, a powerful and gripping debut, Rachel Aviv raises fundamental questions about how we understand ourselves in periods of crisis and distress. Drawing on deep, original reporting as well as unpublished journals and memoirs, Aviv writes about people who have come up against the limits of psychiatric explanations for who they are. She follows an Indian woman, celebrated as a saint, who lives in healing temples in Kerala; an incarcerated mother vying for her children’s forgiveness after recovering from psychosis; a man who devotes his life to seeking revenge upon his psychoanalysts; and an affluent young woman who, after a decade of defining herself through her diagnosis, decides to go off her meds because she doesn’t know who she is without them. Animated by a profound sense of empathy, Aviv’s exploration is refracted through her own account of living in a hospital ward at the age of six and meeting a fellow patient with whom her life runs parallel—until it no longer does.

Aviv asks how the stories we tell about mental disorders shape their course in our lives. Challenging the way we understand and talk about illness, her account is a testament to the porousness and resilience of the mind.


Praise for Strangers to Ourselves

"Intimate and revelatory . . . attuned to subtlety and complexity . . . This isn't an anti-psychiatry book— Aviv is too aware of the specifics of any situation to succumb to anything so sweeping and polemical . . . a book-length demonstration of Aviv’s extraordinary ability to hold space for the 'uncertainty, mysteries and doubts' of others."—Jennifer Szalai, The New York Times

"One of the pleasures of this book is its resistance to a clear and comforting verdict, its desire to dwell in unknowing. At every step, Aviv is nuanced and perceptive, probing cultural differences and alert to ambiguity, always filling in the fine-grain details. Extracting a remarkable amount of information from archival material as well as living interview subjects, she brings all of these people to life, even the two whom she never met."—Jordan Kisner, The Atlantic

"The strength of Strangers to Ourselves is in its engrossing case studies, which contribute vivid anecdotes to this ongoing conversation about the complex and perplexing nature of the mind . . . as typically excellent as Aviv's magazine journalism, viscerally rendered and thoughtful portraits that slide into meditations on the mind."—Kate Knibbs, Wired

"A work of fierce moral intelligence. In withholding judgment and letting her subjects speak for themselves, Aviv grants them the dignity that society has often denied."—Rhoda Feng, Vulture

"Known for bringing empathy and an uncanny depth of perception to her reporting on those who exist in the margins, Aviv shines a light on stories of abuse, neglect, mental disorders, and social injustice. She helps readers understand the complex humanity of people who may otherwise be dismissed, seeing past labels and preconceptions so we can connect on a deeper level."Shondaland

"The potential meanings of psychiatric diagnosis refract out and away from one another like light from a prism—a benchmark to guide treatment, a numeric code on a health insurance document, a pretense to enact violence on the vulnerable—but for Aviv, they are stories, first and foremost, sizzling with equal potential to heal or to harm."Astra Magazine

"Written with an astonishing amount of attention and care . . . Aviv’s triumphs in relating these journeys are many: her unerring narrative instinct, the breadth of context brought to each story, her meticulous reporting. Chief among these is her empathy, which never gives way to pity or sentimentality . . . Though deeply curious about each subject, Aviv doesn’t treat them as anomalous or strange . . . She is not an interpreter or a judge. She is an equal, and so readers become peers, too."—Charlotte Shane, Bookforum

"A sharp, compassionate and necessary investigation, not to be missed."BookPage

"In examining the way we tell stories about disorders of the mind, Aviv questions the very core of what is normal and what is reality. An incredibly researched, empathetic, and moving book."—Emily Firetog, Lit Hub

"Strangers to Ourselves is relentlessly faithful to complexity, absolutely unsettling in all the best and most important ways. If, as James Baldwin writes, 'the purpose of art is to lay bare the questions hidden by the answers,' then Aviv’s reportage becomes literature; not just because of the nimble pivots in her prose, the way her syntax unseats our expectations as deftly as her stories do, but because of her restless integrity. Louise Gluck describes anorexia as an attempt 'to construct a plausible self,' and Aviv explores her subjects not as diagnoses but as fully dimensional characters—full of yearning, self-questioning, heartache, savvy, and hope—trying to construct plausible selves through and despite their experiences of what we call mental illness, inside social landscapes shaped by injustice and inequality. Aviv is attentive to the nuances and tendrils of their interior lives—the moments where their experiences refuse to conform neatly to the narratives they’ve been described by. What other writers treat as easy conclusions, Aviv treats as doorways—stepping through them into a more rugged wilderness of truth on the other side."—Leslie Jamison, author of Make it Scream, Make it Burn

"In this penetrating, landmark book, Rachel Aviv investigates what she calls the 'psychic hinterlands,' drawing on her customary vivid reporting and her own extraordinary personal story to pose unsettling questions about the ways in which we reckon with mental illness by categorizing it, diagnosing it, giving it a name. Threading together the intimate and emotionally shattering stories of a series of very different people who have struggled to live with and to understand their own psychological afflictions, Aviv has created an arresting work of profound empathy and insight."—Patrick Radden Keefe, author of Say Nothing and Empire of Pain

“Master prose stylist Rachel Aviv quietly explodes our neat narratives as she rescues the radiant meanings of lives formed in extremity, including her own. Breaking away from labels that have the power to create the futures they foretell, her case histories are kaleidoscopic, filled with sudden radiance and uncomfortable discontinuities that in the end, force forward profound questions about what is real. Brilliant.”—George Makari, MD, author of Of Fear and Strangers: A History of Xenophobia, director of the DeWitt Wallace Institute of Psychiatry, Weill Cornell Medical College

“A groundbreaking, paradigm-shifting exploration of the relationship between diagnosis and identity. This is the kind of book that can make your life flash before your eyes, glittering with new insights and a sense of unguessed possibilities.”—Elif Batuman, author of Either/Or and The Idiot

"Writing with uncanny empathy and integrity, Rachel Aviv illuminates the ways that culture shapes our perceptions of mental illness and who is deserving of care. Strangers to Ourselves is a work of landmark reporting that is truly heartbreaking and astonishing.”—Cathy Park Hong, author of Minor Feelings: An Asian American Reckoning

“Aviv writes with an unpredictable mixture of intimacy and distance, exploring how psychiatric language often alters what it names. She has assembled a remarkable archive of unpublished materials—memoirs, poems, journals (including her own)—that offers a visceral counterpoint to the official languages of institutions and expertise. I admire her rigor and eloquence but also her restraint—she makes vivid experiences we can’t explain.”—Ben Lerner, author of The Topeka School

"A heartfelt plea for a return to detailed storytelling as an element in mental health care and, within the stories, attention to context: the factors like culture, class, race, religion, family customs, idiosyncratic experience, and private dreams and ambitions that shape lives and illnesses."—Peter Kramer, author of Listening to Prozac

"Perceptive and intelligent . . . Aviv applies her signature conscientiousness and probing intellect to every section of this eye-opening book. Her profiles are memorable and empathetic . . . Aviv treats her subjects with both scholarly interest and genuine compassion . . . A moving, meticulously researched, elegantly constructed work of nonfiction."Kirkus Reviews (starred review)

"This eye-opening examination makes for a valuable addition to modern discourse around mental illness."Publishers Weekly

Reviews from Goodreads


Read an Excerpt


“Am I really this? Am I not this? What am I?”

In 1979, Raphael “Ray” Osheroff walked eight hours a day. Breathing heavily through pursed lips, he paced the corridors of Chestnut Lodge, one of the most elite hospitals...

About the author

Rachel Aviv

Rachel Aviv is a staff writer at The New Yorker, where she writes about medicine, education, criminal justice, and other subjects. In 2022, she won a National Magazine Award for Profile Writing. A 2019 national fellow at New America, she received a Whiting Creative Nonfiction Grant to support her work on Strangers to Ourselves. She lives in Brooklyn, New York.

Rachel Aviv

Rachel Aviv in The New Yorker