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		<title>Neurology - UnHerd</title>
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		<description>think again</description>
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					<title>The animals trapped in human bodies</title>
					<link>https://unherd.com/2023/05/the-animals-trapped-in-human-bodies/?edition=us</link>
											<comments>https://unherd.com/2023/05/the-animals-trapped-in-human-bodies/?edition=us#comments</comments>
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					<dc:creator>
						<![CDATA[Michael Bond]]>
					</dc:creator>
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							<![CDATA[Shapeshifting. (Credit: John Jerome E. Ganzon/Pacific Press/ Getty)]]>
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						<unherd:twitter_bio>
							<![CDATA[<p><strong>Michael Bond</strong> is a writer specialising in human behaviour. He is a former editor and reporter at <em>New Scientist</em>. His latest book is <em><a href="https://www.waterstones.com/book/animate/michael-bond/9781035021246">Animate: How Animals Shape the Human Mind</a>.</em></p>
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						</unherd:twitter_bio>
						<unherd:twitter_handle>michaelshawbond</unherd:twitter_handle>
															<unherd:author_bio>
						<![CDATA[ is a writer specialising in human behaviour. He is a former editor and reporter at <em>New Scientist</em>. His latest book is <em><a href="https://www.waterstones.com/book/animate/michael-bond/9781035021246">Animate: How Animals Shape the Human Mind</a>.</em>]]>
					</unherd:author_bio>
										<pubDate>Sat, 13 May 2023 00:00:00 +0000</pubDate>
					<updated>Tue, 16 May 2023 11:51:53 +0000</updated>
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		<category><![CDATA[Animals]]></category>
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		<category><![CDATA[Dysphoria]]></category>
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		<category><![CDATA[Therians]]></category>
		<category><![CDATA[Therianthropy]]></category>
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								<![CDATA[Therians are neurological outliers]]>
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								<![CDATA[<p>Not long ago, I had a conversation with a man who feels in his bones that he is a bear. He is a therian: someone who believes from a young age that they are an animal trapped inside a human body. The dysphoria is so far from regular human experience that therians struggle to describe it. Ask them what it is like to be an animal and they will ask you, quite reasonably, if you can describe what it is like to be a human.</p>
<p>I first learned about therianthropy while talking to Kathy Gerbasi, a social psychologist who specialises in relationships between humans and animals. She has an interest in furries, a fandom that dresses up as anthropomorphic animals. Gerbasi conducted a survey at a furry convention that included the following two questions: “Do you consider yourself to be less than 100% human?”, and “If you could be 0% human, would you be?” Furries feel an affinity with animals, but that’s generally as far as it goes. So, when a few of her respondents answered yes to both questions, she realised that she was dealing with people who were fundamentally atypical.</p>
<p>Since then, Gerbasi has held several discussion groups with therians, who she describes as “very sincere”. “They look like people,” she says. “They mostly behave like people… But if you really talk to them, they’ll tell you that deep inside they are not a person.” My friend the bear, who goes by the sobriquet BearX, lives an improbably normal life. He is married. He has two children. His career in engineering has afforded him a nice house and a comfortable middle-class life. As he says: “If you didn’t know something was up, you wouldn’t know anything was up.”</p>
<p>When psychologists investigate an unusual pattern of behaviour, they look for common attributes that may help explain it, such as age, gender, class or geography. So far, Gerbasi and the handful of other psychologists who have studied therians have failed to find any. While researching my new book, I talked to therians in their teens and in their seventies, of female, male and undetermined gender. The only thing that can be said about almost all therians is that they realise at a young age that they are different in body and spirit from those around them. They feel “off”, separated from humanity, and this estrangement defines the rest of their lives.</p>
<p>“I had an internal sense as a kid that I was supposed to be bigger, heavier,” says BearX. “Later, I worked out that bears fit everything that I felt. It led me to think that maybe I was supposed to have been born a bear and there was some kind of cataclysmic failure in the universe’s sorting system.” Caesar, a communications technician in his mid-thirties who identifies as a coyote, remembers feeling “very animal” as a child. “Maybe the best way to put it is that humans think with their emotions or on a higher level of cognition, but the way I responded to a situation was more instinctual, not calculating.”</p>
<p>As they grow up, therians move from having a general sense of feeling not quite human to a more concrete awareness of the kind of animal they are: their “theriotype”. The most common theriotypes are predator species such as wolves and large cats. As with furries, culture plays a role here: jaguars are more common in South America, and foxes in Japan, whose folklore contains many stories of people being possessed by a fox. Mythical or fantasy creatures are no less valid, though their owners are differentiated in the community as “otherkin”. While researching, I spoke to a couple of dragons.</p>
<div class="ref-ar"><a href="https://unherd.com/2020/06/why-i-told-my-toddler-a-fox-ate-her-pets/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2020/06/why-i-told-my-toddler-a-fox-ate-her-pets/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2020/06/GettyImages-660158256.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2020/06/why-i-told-my-toddler-a-fox-ate-her-pets/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2020/06/why-i-told-my-toddler-a-fox-ate-her-pets/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>The bloody truth about animals</h5></a><p class="author"><a href="https://unherd.com/2020/06/why-i-told-my-toddler-a-fox-ate-her-pets/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Mary Harrington</a></p></div></a></div>
<p>Finding your theriotype can be a struggle. Most therians make their decision only after a great deal of research and thought. The community encourages its members to be scientifically rigorous: outlandish claims that would give ammunition to sceptics, such as the idea that it’s possible to physically transform into an animal, are dismissed as “fluff”. On therian forums, moderators frequently rebuke contributors for promoting theories that would break the laws of physics, and they are quick to correct errors in morphological or behavioural descriptions of species, such as the suggestion that wolves have red eyes, or that all canines hunt in packs.</p>
<p>A peculiar and often alarming characteristic of being a therian is the feeling that you have phantom body parts. Blayz, a wolf-dog hybrid, lives with the permanent sensation of a tail that wags or droops on command. “Going around corners, I will alter the movement of my frame to keep my tail from getting caught in doors or swiping cups off the table,” he says. Caesar, the coyote, is often convinced he has outsized ears that he can manipulate like antennae. I spoke with a snow leopard — an American woman in her early twenties — who has been saddled with the full range of phantom phenomena. “Even as a kid, I remember feeling like I had a tail and telling people it was invisible,” she explained. “It’s as much a part of me as my arms and legs, really. I also have constant phantom paws and a muzzle, which can make eating and drinking funny sometimes. I’m likely to miss my mouth if I’m not thinking about it.’</p>
<p>To feel body parts where none exist is not as biologically improbable as it sounds. Studies of people born with missing arms and legs have shown that limbs that have always been absent can still be represented in the sensory and motor regions of the brain. The psychologist Ronald Melzack, an expert on phantom pain, proposed that the brain continuously generates a pattern of impulses that indicate that the body is intact and “unequivocally one’s own”, even if it isn’t. This pattern, which Melzack called a “neurosignature”, is genetically determined and characteristic of each individual. It is not inconceivable that someone born with an atypical neurosignature might experience a body that is out of kilter with the one they possess. So far, no one has systematically examined the brains of therians to see if their neural patterns reflect what they feel.</p>
<p>Therians who are acclimatised to their animal side often find their phantom experiences reassuring, since they confirm an identity they have been trying hard to accept. But it can be a let-down when they recognise they don’t have the superpowers they thought they did. When Caesar realises yet again that he cannot direct his ears to hone in on a distant sound, he has the sobering thought that what he is trying to do is “in direct conflict with my own biology”. Kathy Gerbasi, in one of her studies, asked a therian who felt they had “wings” what it felt like when those wings were fully out; they told her it made them frustrated because they knew they couldn’t fly. Many therians avoid looking in mirrors because it reminds them that they are not what they think they are.</p>
<div class="ref-ar"><a href="https://unherd.com/2022/05/you-cant-be-born-in-the-wrong-body/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2022/05/you-cant-be-born-in-the-wrong-body/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2022/05/2GettyImages-1176873806-scaled-e1651689211516.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2022/05/you-cant-be-born-in-the-wrong-body/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2022/05/you-cant-be-born-in-the-wrong-body/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>You can&#039;t be born in the wrong body</h5></a><p class="author"><a href="https://unherd.com/2022/05/you-cant-be-born-in-the-wrong-body/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Ellen Pasternack</a></p></div></a></div>
<p>Some psychologists believe that the distress suffered by therians is similar to the distress suffered by people whose sex at birth does not match the way they feel. The comparison is often made by therians themselves, a minority of whom are transgender as well as “trans-species”, as they sometimes put it. (Not all transgender people are comfortable with this analogy, fearing that it complicates the public discourse and undermines their movement’s drive for recognition.) The obvious difference is that while you can change your gender, you cannot do anything about your species.</p>
<p>For therians, “finding yourself” — that nebulous ideal promoted by the self-help industry — is obligatory. Although discovery may bring relief, it does not help with the bigger question: <em>why</em> am I this way? Science doesn’t provide many answers, so they can only speculate. Therianthropy may be a developmental response to early trauma or a childhood fixation on animals, or it may be a result of abnormal brain wiring. People of a spiritual inclination might think of it in terms of reincarnation or a “misplaced soul”.</p>
<p>In psychiatry, therianthropy is often erroneously considered to be synonymous with clinical lycanthropy — a condition related to schizophrenia, where delusions and hallucinations convince a patient that they have transformed into an animal. In her book <em>Unthinkable</em>, Helen Thomson describes meeting a lycanthrope who periodically believes he has turned into a tiger; her interview with him was cut short when he suddenly started growling and threatening to attack her, a relapse his doctors blamed on his failure to take his anti-psychotic medication.</p>
<p>But therians are not delusional or psychotic. Their animalistic feelings are a perpetual feature of their lives and are not alleviated by medication. They are aware, often to their profound disappointment, that they can never transform into animals. The medical profession’s impulse to diagnose them as lycanthropes has less to do with clinical evidence than the age-old tendency to pathologise behaviours and conditions that challenge social norms. The most we can say about the medical status of therians is that they are neurological outliers — hardly a signal of illness.</p>
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<p>In 2019 Helen Clegg, a psychologist at the University of Buckingham, led the first comprehensive investigation into the well-being and mental health of therians. She recruited 112 across a broad range of ages, genders, ethnicities and species. Among them were wolves, foxes, dragons, birds, a snake, a shark and a couple of dinosaurs. Clegg’s team found that a disproportionate number of them had been diagnosed with autism (7.69%, compared with 1.5% in the general US population), though it is not clear how the two conditions could be linked. They also found that, compared with a control group, many therians struggle with relationships and social skills. This could be due to cognitive factors, or it could be because social taboos around therianthropy make it difficult to talk about. When you are forced to hide your true nature, communicating with others can be a challenge.</p>
<p>Their study also noted that many of the therians displayed “schizotypal” personality traits, such as a tendency to have unusual perceptual experiences. But these therians mostly found their experiences enriching rather than distressing. Clegg suggests that this is because they have found a way to integrate their fantastical thoughts into a coherent narrative that allows them to make sense of the way they feel. The therians in Clegg’s study scored just as highly as non-therians on several standard measures of psychological well-being, including personal growth, purpose in life and self-acceptance. The researchers concluded: “The findings suggest that therians are functioning well.”</p>
<p>Azi, a Mexican wolf living in Tennessee, experiences altered states of consciousness around 30 times a day. Therian friends of his told me that his experience is more extreme than anyone they know — for much of the time, he is more wolf than human. When we initially corresponded, he was apprehensive, fearing negative publicity; when we finally spoke via video call, he was open, eloquent and precise. His perceptual changes arrive suddenly and can pass just as quickly. When they happen, he says, “the human part of me is turned off. Mentally, I’m gone. The wolf mindset is running this body… It’s very dissociative.” He often finds himself growling, snarling, down on all fours, walking on his toes or, if the opportunity presents itself, chasing deer. It can be physically exhausting. Towards the end of our video call, my cat Cecil jumped up onto my laptop and started nuzzling the screen. Azi looked away and appeared to disengage for a moment. When I asked him about this, he admitted that as a wolf, few things are more inflammatory than being stared at by a cat. He has to contend with provocations like this whenever he goes out in public — a loud noise, a fleeing animal, a bothersome human. He must always be on his guard to stop himself shifting to wolf.</p>
<div class="ref-ar"><a href="https://unherd.com/2021/04/the-empty-promise-of-pop-psychology/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2021/04/the-empty-promise-of-pop-psychology/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2021/04/GettyImages-3248886-e1618856233966.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2021/04/the-empty-promise-of-pop-psychology/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2021/04/the-empty-promise-of-pop-psychology/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>The empty promise of pop psychology</h5></a><p class="author"><a href="https://unherd.com/2021/04/the-empty-promise-of-pop-psychology/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Sarah Ditum</a></p></div></a></div>
<p>The reality of therianthropy can be hard to live with. Elizabeth Fein, a clinical psychologist who has worked closely with Kathy Gerbasi, observed that acceptance of therianthropy often brings sadness or a sense of estrangement. “It’s like, ‘I’m always going to be different, I’m always going to be kind of separate from humanity. I’m never going to have the right body.’” The scale of the challenge that therians I interviewed face in trying to reconcile their human bodies with their animal minds may be partly a function of the culture in which they live. In the West, for much of the past two millennia, we have considered ourselves distinct from the rest of the animal kingdom, elevated by cognition, intelligence, language, morality and culture. The Christian God granted humans “dominion over the fish of the sea, over the birds of the air, and over every living thing that moves on the earth”, and philosophers from Aristotle to Kant have emphasised our superiority over nature.</p>
<p>But over the tens of thousands of years of human existence, the line separating us and other has not always been so well-defined. Many cultures recognise animals as ancestors. A popular Tibetan creation myth maintains that people are descended from a meditating monkey, while in Turkic mythology people originated from a she-wolf named Asena. Meanwhile, stories about people who “shape-shift” between human and animal form have persisted throughout recorded history.</p>
<p>A world in which animals were treated as human and humans were treated as animals would be a lot easier for therians to live in. Their experience and their psychology are so different to most people’s that they often feel profoundly isolated. “Our lives would be immeasurably improved if people accepted it, if it wasn’t considered strange,” BearX told me. Thankfully, therians have each other. The community’s origins lie in the Nineties message boards of an online werewolf fan group called alt.horror.werewolves, and it has since evolved into a vibrant network of discussion forums and advice boards, with thousands of active participants.</p>
<p>Therians do disagree — about the causes of therianthropy, the distinction between therians and otherkin, and whether it is appropriate to discuss the sexual feelings some therians have towards animals. Nevertheless, Caesar the coyote told me that his introduction to the community was “unquestionably one of the happiest moments of my life: finding out that you’re not alone”. Blayz, who spent years trying to figure out his strange canine sensations, came close to dismissing them as “the delusions of a madman, nothing more than a side-effect of mental illness”. When he discovered that he wasn’t the only one who felt this way, it was revelatory. “So many of my own experiences and conclusions were echoed by this group of real people out there in the world.”</p>
<p>“Therians are really weird,” one of the coyotes says to me in a moment of exasperation. But in certain cultures, and in certain eras, they have been regarded as less weird — and among other therians, their behaviour is absolutely normal. Most therians want to be accepted by the wider world. In the meantime, it’s reassuring for them to always be accepted by their own. Life looks different when you’re part of a pack — whether you’re a bear, a coyote, a leopard, a dinosaur or a dragon.</p>
<p>&nbsp;</p>
<p><em>This is an edited extract from </em><a href="https://www.waterstones.com/book/fans/michael-bond/9781529052473" target="_blank" rel="noopener">Fans: A Journey Into the Psychology of Belonging</a><em>, out 11th May.</em></p>
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					<title>The grubby truth about mental health memoirs</title>
					<link>https://unherd.com/2022/10/the-grubby-truth-about-mental-health-memoirs/?edition=us</link>
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					<dc:creator>
						<![CDATA[Freddie deBoer]]>
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							<![CDATA[The temptation to sensationalise stories of mental health is strong. Credit: Girl, Interrupted via IMDB]]>
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							<![CDATA[<p><strong>Freddie deBoer</strong> is a writer and academic. His newsletter can be found at <a href="https://freddiedeboer.substack.com/" target="_blank" rel="noopener">freddiedeboer.substack.com</a>.</p>
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						<unherd:twitter_handle></unherd:twitter_handle>
															<unherd:author_bio>
						<![CDATA[ is a writer and academic. His newsletter can be found at <a href="https://freddiedeboer.substack.com/" target="_blank" rel="noopener">freddiedeboer.substack.com</a>.]]>
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										<pubDate>Fri, 21 Oct 2022 23:15:00 +0000</pubDate>
					<updated>Sat, 22 Oct 2022 14:57:04 +0000</updated>
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															<unherd:app_notification_title>The grubby truth about mental health memoirs</unherd:app_notification_title>
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								<![CDATA[I envy people who remember their illness]]>
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								<![CDATA[<p>I don’t quite know what to do with mental illness memoirs. I’m naturally interested in their subject, as I suffer from bipolar disorder myself. And they fulfil an important social function: despite the rise of innumerable online voices yelling about mental health and ableism, the reality of psychiatric illness remains unknown to most people. Personal narratives tell us things that medical literature doesn’t. The more stories we tell, the more we might expand our moral imagination for the sick.</p>
<p>And yet I worry, too. I worry because selling a book, especially for any kind of decent advance, is a tricky business, and the temptation to be prurient and sensationalist must be considerable. I am a <a href="https://unherd.com/2022/04/mental-illness-doesnt-make-you-special/" target="_blank" rel="noopener">committed enemy of romanticising mental illness</a>, which contributes to the impression that the mentally ill are somehow living deeper, more “intense” lives, rather than more painful ones. I want mental health memoirists to understand their profound responsibility to tell the grubby, sad truth about this life.</p>
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<p>But mostly, I envy people who write mental illness memoirs. I envy their memories. They can recall the details of their psychiatric histories; I often can’t. Years have passed, faster and faster, since the major incidents in the history of my condition. For important portions of that history, I was brutally depressed, or grindingly manic, or actively psychotic, conditions not conducive to the formation of lasting memories. I have spent 15 years on and off (though mostly off) memory-destroying medications, and have now been on them for five years straight. And for most of that time I was actively in denial, about all of it, to the point of believing at points that it wasn’t real. I did not tell my siblings, those I was always closest to, for more than a decade after my first diagnosis. Sometimes I’d assert that I was finally on the straight and narrow, finally cured — an assertion that always, always preceded the next ruinous crash.</p>
<p>Some things I remember like they were yesterday. Some I don’t remember at all. When I write about my own mental health history, I write in ellipses and at a Dutch angle — for aesthetics, yes, to satisfy my own standards as a writer, but also because to tell it otherwise would make me feel like a liar. I just don’t trust my memory of some details.</p>
<div class="ref-ar"><a href="https://unherd.com/2022/04/mental-illness-doesnt-make-you-special/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2022/04/mental-illness-doesnt-make-you-special/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2022/04/21273022-e1651160775670.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2022/04/mental-illness-doesnt-make-you-special/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">More from this author</span></a><a href="https://unherd.com/2022/04/mental-illness-doesnt-make-you-special/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Mental illness doesn&#039;t make you special</h5></a><p class="author"><a href="https://unherd.com/2022/04/mental-illness-doesnt-make-you-special/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Freddie deBoer</a></p></div></a></div>
<p>I have spotted a similar instinct in other mental health memoirs. <em>Girl, Interrupted</em> is imagistic and ruminative, much less a recounting of the day-by-day events of Susanna Kaysen’s commitment to McLean Hospital, and much more a series of pleasantly meandering meditations on the concept of sanity and the self. Kaysen also includes original forms and files from her hospital stay; George Scialabba&#8217;s brilliant and haunting <em>How to be Depressed </em>consists of little else.</p>
<p>And then there’s <em>Strangers to Ourselves</em>. It’s not a straightforward memoir but rather a collection of brief vignettes, or case studies, about mental illness, written by Rachel Aviv. Her own story opens the volume. She became anorexic as a six-year-old, barely literate, and mostly unable to define what was happening to her. Aviv leaves unsettled the question of whether she was “really” anorexic — her age and stated motives for not eating complicate the question — and instead contrasts her own condition with those of the older patients around her. By reproducing her own experience of mental illness, Aviv brings a little skin to the game in a text that’s mostly about telling other people’s stories for them.</p>
<p>More important, her personal history segues into Aviv setting the boundaries of her project. The book is about people whose “lives unfold in different eras and cultures, but they also share a setting: the psychic hinterlands, the outer edges of human experience, where language tends to fail”. She explains her holistic approach:</p>
<p style="padding-left: 40px;">&#8220;the book draws not only from conversations with them but from their diaries, letters, unpublished memoirs, poems, and prayers… It’s impossible to go back in time and uncover what baseline feelings existed before a story was told — when a person’s angst and loneliness and disorientation had yet to be given a name and a vessel — but I find myself searching for the gap between people’s experiences and the stories that organise their suffering, sometimes defining the course of their lives.&#8221;</p>
<p>This is what I needed, from this book, up front: both information about how these individual stories were compiled and an acknowledgment that we all, as patients, construct truths with the raw material of memories that so often refuse to cohere, and therefore use the textual record to confirm and supplement our stories. In the opening section, she quotes her younger self as writing: “I had some thing that was a siknis its cald anexorea.” I was initially sceptical: it sounds like an adult writing the way they think a child would write. But Aviv later explains that she had dug out her childhood diary. I didn’t need her to do so to make her recollection of her illness more real; it just helps to know that the exact wording came from the page and not her memory.</p>
<div class="ref-ar"><a href="https://unherd.com/2022/10/dont-punish-kanye-west/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2022/10/dont-punish-kanye-west/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2022/10/GettyImages-612082132-1.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2022/10/dont-punish-kanye-west/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2022/10/dont-punish-kanye-west/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Don&#039;t punish Kanye West</h5></a><p class="author"><a href="https://unherd.com/2022/10/dont-punish-kanye-west/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Hadley Freeman</a></p></div></a></div>
<p>Sometimes, texts are all there is to go on. Aviv can’t speak to some of her subjects, such as Ray, a depressive who has been dead for years. Instead, she pulls significantly from his unpublished memoir, which follows his decision to sue a psychiatric facility where he was committed. Ray struggled through psychoanalysis at Chestnut Lodge, where he lived in for long months, only to come later to feel that he had been fooled by a broken paradigm that forbade the use of antidepressants. As Aviv tells it, Ray’s psychiatrist seemed to think of such drugs as a shortcut rather than a cure, and therefore avoided their use.</p>
<p>Aviv tells Ray’s story both for its own sake and to consider the fundamental conflict in late 20th-century psychiatry. The Freudian assumption that all psychiatric conditions could be traced to discrete events in childhood, and cured through excavating these memories in psychoanalysis, dominated American psychiatry for decades. It led a lot of patients to endlessly recite early traumas, without much therapeutic gain. That approach was overtaken by an ascendant hope that new drugs could fix chemical imbalances in the brain and turn psychiatry into a medical field like any other. Now, we appear to have swung back the other way: decades of disappointments in psychopharmacology have inspired many to declare that “there’s no such thing as a chemical imbalance”, which has become an inescapable social media bromide.</p>
<p>What frustrates me is that people seem unable to accept that the interaction between the brain and the mind is extremely complex. That the simplistic not-enough-serotonin theory of depression appears to be wrong does not imply that <em>all</em> neurological explanations are off-limits. We don’t have to yaw constantly between “all brain” and “all mind” explanations. Aviv, thankfully, settles on no pat answers to these questions, instead, simply meditating on them via Ray’s strange story.</p>
<p>Likewise, she uses every case study to examine the nuances of some broader social or economic or political issue. There’s Bapu, a Brahmin-class Indian woman whose religious adherence straddles the line between faith and madness; her story considers the conflict between Western medicine and spiritualism. There’s Naomi, a young black mother whose deepening paranoia compels her to attempt to drown herself and her two young children; her story illustrates how entrenched racism complicates psychiatric care for people of colour. There’s Laura, an affluent young woman who starts taking a cocktail of medications at a young age and finds it very hard to stop; her narrative helps explore the thorny questions of how long patients should stay on drugs. It’s never advisable to draw too deeply from individual stories in analysing societal trends, but the connections Aviv draws to such trends give the book teeth, making it more than merely poignant.</p>
<div class="ref-ar"><a href="https://unherd.com/2022/08/can-depression-be-cured/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2022/08/can-depression-be-cured/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2022/08/GettyImages-459964106-scaled.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2022/08/can-depression-be-cured/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2022/08/can-depression-be-cured/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>Can depression be cured?</h5></a><p class="author"><a href="https://unherd.com/2022/08/can-depression-be-cured/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Ann Manov</a></p></div></a></div>
<p>The final section enables us to consider Aviv’s responsibility to her subjects and the difficulties of telling their stories. It focuses on Hava, an anorexic who Aviv encountered at a young age and whose life she sees as something of a road untraveled, given her own early struggles. Hava appeared to be making clear progress in her life, finding a steady boyfriend and planning for her future; sadly, years of making herself sick had damaged her body’s ability to regulate the reflex, and one night she choked on her own vomit in her sleep. She is one the three people profiled who were dead prior to the completion of the book, but Aviv’s deference to their own words makes their stories seem like memoirs all the same.</p>
<p>Perhaps it’s a sign of solipsism that this book often provoked me to wonder what Aviv would make of my story. I crave the simplicity of having my life printed out in black and white text; I also dread the inevitably reductive nature of such an exercise, and I’m scared of what someone else’s eyes might see in my narrative. For me personally, mysteries abound. I couldn’t possibly tell you the name of the doctor who diagnosed me as bipolar. At the time, I was not conscious in a conventional sense and everything that happened seemed to happen somewhere outside of me, people puttering around and talking in strange language I didn’t understand. There was an ER, there was a shot of haloperidol, and there was a stretch in a grey and muted psychiatric facility. Someone must have written my diagnosis down on a chart. Who that was is known only to God and, I imagine, to some mouldering file somewhere that I have absolutely no interest in digging up.</p>
<p>There are a lot of things I don’t understand about my own history. Worse, I can’t remember if the weight of years, mental illness and medication has simply obscured that knowledge, or if I never knew. In general, my time in the mental health system has been marked by constant confusion; I would feel like a liar if I said, “and then this month, in 2011, this happened”.</p>
<div class="ref-ar"><a href="https://unherd.com/2022/08/the-curse-of-miserable-older-white-women/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><a href="https://unherd.com/2022/08/the-curse-of-miserable-older-white-women/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><img decoding="async" src="https://unherd.com/wp-content/uploads/2022/08/GettyImages-84959843-scaled.jpg?w=300" /></a><div class="content"><a href="https://unherd.com/2022/08/the-curse-of-miserable-older-white-women/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span class="meta">Suggested reading</span></a><a href="https://unherd.com/2022/08/the-curse-of-miserable-older-white-women/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><h5>The curse of Miserable Older White Women</h5></a><p class="author"><a href="https://unherd.com/2022/08/the-curse-of-miserable-older-white-women/?edition=us&#038;ref=refinnar" class="text-decoration-none border-0"><span>By</span> Phoebe Maltz Bovy</a></p></div></a></div>
<p>Do the subjects in <em>Strangers to Ourselves </em>struggle the same way? What must it feel like, for those who are still living, to read this book? Aviv tends to avoid the overly literal, rescuing the book from questions of simple authenticity and making it, usefully, a record of how foggy our recollections can be. But I can also imagine readers who might be frustrated by the lack of clear lines between certain truth and imperfect memory. All of us long for order in the stories we read. I think that’s why people gravitate towards mental illness narratives, to clarify something that has been obscured by instability. But how do you faithfully translate what is by its nature not translatable?</p>
<p>I honestly don’t think writers tell lies in mental illness memoirs. I wouldn’t even say they bend the truth. I would suggest, perhaps, that they take the fragments of what they know happened, and through them assert a kind of truth, as part of a therapeutic process. That asserted truth might not look exactly like that of a dispassionate observer — say, one of the many doctors who wander into our lives, speak to us condescendingly, make marks on a chart, and shuffle out of our story. But I can’t see much harm done, when patients tell it themselves. The conceit of a memoir is that other people will be entertained by our misfortune; so long as we tell our stories with integrity, those who suffer through the instability and boredom and deprivation of dignity common to serious mental illness are entitled to our own frames. I only hope that both writers and readers know that the attempt to organise the experience is quixotic and we are narrativising the un-narrativisable. I understand the feeling that we must try anyway.</p>
<p>Aviv, like me, is wary of the way that definition can trap and limit us. In our online culture of mental illness, diagnoses are celebrated: young people wield them like talismans for a sense of validation. And I am not entirely a stranger to the seductive power of becoming one’s diagnosis, letting it become the load-bearing element of your personality. But I am also no stranger to the way that, further down the road, that self-definition becomes cramped and uncomfortable, even horrifying, as you start to want to be something else. (To the newly-diagnosed, I urge you, do not become your illness.) For years I resisted writing anything about my mental illness; now I worry constantly that when I do so, I pigeonhole and limit myself.</p>
<p>“People can feel freed by these stories,” Aviv writes, “but they can also get stuck in them… a role that at first seemed freeing, but it began to destroy them.” This is the most recurrent theme in <em>Strangers to Ourselves</em>: the double-edged sword of the stories we tell to make our disorders comprehensible. Aviv’s is the kind of mental illness narrative I trust and value the most: suspicious of narrative itself. It’s perhaps a kind I could even write myself. The bigger kind, the longer kind, the “and then this happened on this date” kind, is both beyond my abilities and against my best interest. As Aviv writes, “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”.</p>
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