Strangers to Ourselves: Unsettled Minds and the Stories That Make Us

by Rachel Aviv

Bruch, a psychoanalyst known as “Lady Anorexia,” began writing about anorexia in the sixties, when the illness was obscure. She hypothesized that novelty was essential to the disease, which she described as a “blind search for a sense of identity and selfhood.” She predicted (inaccurately) that, once a critical mass of girls became anorexic, the incidence of the illness might decrease, because it would no longer feel special. “The illness used to be the accomplishment of an isolated girl who felt she had found her own way to salvation,” she wrote. “Each one was, in a way, an original inventor of this misguided road to independence.”

I wouldn’t say “eight,” because the number sounds like “ate.” I was upset when one of the nurses, frustrated by my stubbornness, told me that I was a “tough cookie.” My mother was more sensitive to my concerns, and when I asked about the condition of my hospital roommate, a girl with diabetes, my mom avoided the word “sugar.” She explained, “It’s like the opposite of what you have.”

When Hava and Carrie let me watch them play Go Fish, I wanted to know (but was ashamed to ask) what sort of fish they were referring to: Fish in the ocean? Or cooked on a plate? I didn’t understand that fish in the ocean became the type cooked on the plate, and, if they meant the latter kind, I didn’t want anything to do with the game.

anorexia as being rooted in “the desire not to be a saint but to be regarded as one.” He writes, “There is great irony in the fact that the modern process of stamping out religion produces countless caricatures of it.”

Mental illnesses are often seen as chronic and intractable forces that take over our lives, but I wonder how much the stories we tell about them, especially in the beginning, can shape their course. People can feel freed by these stories, but they can also get stuck in them.

In the starkest terms, insight measures the degree to which a patient agrees with his or her doctor’s interpretation.

Studies show that people who see mental illness as biological or genetic are less likely to blame mental conditions on weak character or to respond in punitive ways, but they are more likely to see a person’s illness as out of her control, alienating, and dangerous.

There are stories that save us, and stories that trap us, and in the midst of an illness it can be very hard to know which is which.

Our illnesses are not just contained in our skull but are also made and sustained by our relationships and communities.

In an essay called “The Hidden Self,” William James writes that “the ideal of every science is that of a closed and completed system of truth.”

The divide between the psychic hinterlands and a setting we might call normal is permeable, a fact that I find both haunting and promising. It’s startling to realize how narrowly we avoid, or miss, living radically different lives.

The psychologist Abraham Maslow said, “The world will be saved by psychologists—in the very broadest sense—or else it will not be saved at all.”