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HomeHealthRachel Aviv on how the stories we tell about mental disorders shape...

Rachel Aviv on how the stories we tell about mental disorders shape patients’ lives

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A commentary from New Yorker journalist and author Rachel Aviv, whose new book, “Strangers to Ourselves,” focuses on the challenges faced by those struggling with mental illness:


When I talk to people with mental illness, I’m often struck by how hard it is for them to communicate what it feels like.

Once, a young woman told me that trying to describe her symptoms was like “trying to explain what a bark sounds like to someone who’s never heard of a dog.”

strangers-to-ourselves-jacket-farrar-straus-and-giroux-1500.jpg

Farrar, Straus and Giroux


Another person, who’d just been diagnosed with schizophrenia, told me she’d studied her diagnosis in the DSM, the manual for mental disorders. Her experience of illness felt so hard to pin down that she worried she was inadvertently adjusting her own behavior to fit the way it’d been classified.

For some people, getting a diagnosis – and being told that they have a brain-based disorder – can feel healing and liberating. But we may overlook the role of these explanations in our lives: they can shape our identities and our expectations for the future.

Like the people I’ve written about, I’ve also gone through a period of illness that felt nearly impossible to classify.

When I was six, I stopped eating for three days, and my pediatrician put me in a hospital that treated patients with anorexia who were more than a decade older than me. I became especially close with one of them, whom I saw as a kind of mentor. As an adult, I learned about the path that her life had taken after we were hospitalized, and I was shaken: first, to discover how similar our stories were at the time; and second, to realize how our lives had veered in such different directions. Our outcomes seemed tenuous and perhaps arbitrary – I felt as if she could have lived my life, or I could have lived hers.

Psychiatrists have a limited understanding of why one person’s illness becomes a kind of life sentence and another person with the same diagnosis moves on. Answering this question, I think, requires that we pay more attention to the individual stories through which people find meaning for themselves.

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

    
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Story produced by Aria Shavelson. Editor: George Pozderec. 

     
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