Rachel Aviv was six years old when she was hospitalized for not eating. She
was so young that she had never encountered the word “
anorexia” before; it
sounded to her like a kind of dinosaur.
اضافة اعلان
Her doctors decided that she should be kept with the
older girls with eating disorders, who taught her how to exercise obsessively
and treated her like an “anorexic-in-training.” But Aviv soon started eating
again and quickly lost interest in depriving herself of the food she had
previously refused even to talk about (pronouncing the words had felt the same
to her as consuming them). A year later, she would confide in her diary, “I had
some thing that was a siknis its cald anexorea.” She explained that she had
anorexia “because I want to be someone better than me”.
It’s a startling passage in the prologue of
“
Strangers to Ourselves,” but like so many of the stories in this intimate and
revelatory book, the truth of it is real but incomplete. As an adult, having
written a number of stories about people in extremis for The New Yorker, Aviv
has come to “question whatever basic feelings existed in me before they were
called anorexia.” Her medical records failed to present a “coherent picture” of
why she stopped eating and drinking, but that did not stop the doctors from
issuing diagnostic proclamations. “The original experience couldn’t be captured
or understood on its own terms,” she writes, “and gradually became something
that wasn’t entirely of our own making.”
By “our” Aviv is referring to the other people in
her book. There’s Ray, who sued an elite psychiatric hospital that prided
itself on its psychoanalytic approach for failing to make him better; Bapu, a
wealthy Brahmin mother of two who repeatedly left her family in Chennai,
India,
to pursue the ascetic life of a mystic; Naomi, who was incarcerated for
second-degree murder after throwing herself and her twin babies into the
Mississippi River; and Laura, a Harvard graduate from a well-to-do family, who
had been prescribed psychiatric medications since she was a teenager and
decided — years later — to see who she was without the drugs.
We learn about these people one by one, with a
chapter for each, so that Aviv can recount their lives in detail and therefore
in full. She interviews doctors, friends, and survivors; she reads her
subjects’ journals in order to get a grasp on how they explained themselves to
themselves. Aside from her candid reflections in the prologue and the epilogue,
Aviv mostly hangs back, even though her own experience primes us — as maybe it
primed her — to be alert to how stories can clarify as well as distort the
mental distress that a person is going through.
Psychiatric explanations can be helpful and harmful,
Aviv says. They pretend to a neutrality that can offer consolation but also
condescension. Persistent colonial assumptions about the irrationality of
Indian religions meant that some of Bapu’s doctors were disdainfully
dismissive. “She was ugly,” one tells Aviv. “She was living like a witch, and
looking like a witch.”
In Naomi’s case, medications helped with her
psychosis, but psychiatric evaluations were also used against her. Naomi, who
is Black, said that she had dropped her babies into the river in order to save
them from a life of “inferiority, indifference, and ridicule” in a racist
society. The psychiatrists who first evaluated Naomi after her arrest decided
that even though she talked about an impending apocalypse and living in another
dimension, her remarks about racism were too astute for her to meet the legal
bar for insanity. But as her release date approached, 13 years later, a
psychiatrist concluded that she had not yet “achieved adequate stability”: “Now
she was deemed unwell enough to be indefinitely detained,” Aviv writes.
Aviv’s narrative is so attuned to subtlety and
complexity that any summary risks making it sound like she is doing something
she is not. This is not an anti-psychiatry book — Aviv is too aware of the
specifics of any situation to succumb to anything so sweeping and polemical.
What she does is recognize the multiplicity of stories that attach to her
subjects’ experiences, exploring a variety of interpretations instead of
jumping at the impulse to explain them away.
“Strangers to Ourselves” delicately balances two
truths that prove remarkably difficult to hold in tandem. Aviv suggests that we
continue to cling to reductive theories about brain chemistry because “the
reality — that mental illness is caused by an interplay between biological, genetic,
psychological, and environmental factors — is more difficult to conceptualize.”
Psychiatrists talk a lot about “insight,” or what
one defined as “the correct attitude to a morbid change in oneself.” Aviv
points out the professional presumption baked into the term, as if insight is
supposed to measure “the degree to which a patient agrees with his or her
doctor’s interpretation.” Aviv, for her part, finds more resonance in Keats’s
notion of “negative capability” — the capacity to experience “uncertainty,
mysteries, and doubts, without any irritable reaching after facts or reason.”
She admits how hard it is for her to sustain such patience for her own
anxieties and preoccupations, but “Strangers to Ourselves” is a book-length
demonstration of Aviv’s extraordinary ability to hold space for the
“uncertainty, mysteries, and doubts” of others.
Looking back on her hospitalization three decades
ago, Aviv remains haunted by what happened to another girl in the ward, named
Hava, who died in her early 40s from complications of bulimia. In her journals,
the 12-year-old Hava showed plenty of insight about her condition, referring
frequently to her “chemical imbalances,” whereas the six-year-old Aviv “had
basically none”.
But perhaps it was this lack of insight that made Aviv’s
diagnosis feel more malleable to her, allowing her to pursue other
possibilities. The divide between her fate and Hava’s was enormous but also
porous. “There are stories that save us, and stories that trap us,” Aviv
writes, “and in the midst of an illness it can be very hard to know which is
which.”
Read more Books
Jordan News
.jpg)
.jpg)
