When Strangers to Ourselves was released in 2022, it quickly drew acclaim as one of the most important books of the year. It was named one of The New York Times’ Top Ten Books of 2022, a finalist for the 2022 National Book Critics Circle Award in Autobiography, and landed on best-of lists from The New Yorker, The Washington Post, NPR, and TIME. That kind of recognition is rare for a work that sits at the intersection of narrative nonfiction, memoir, and psychology. But Rachel Aviv’s book stands out because it doesn’t just tell us about mental illness. It challenges the very stories we use to define it.
Why It’s Important
Aviv, a longtime staff writer at The New Yorker, uses her investigative skills and lyrical writing style to examine how we understand and narrate mental illness. The book blends deeply reported case studies with Aviv’s own experience as a child who was briefly hospitalized for anorexia. Instead of reinforcing a single model of diagnosis or treatment, Aviv asks: How do the stories we tell about ourselves…our identities, our illnesses, our recoveries…shape the lives we live?
This is a timely and important question. In an era where mental health language saturates social media and where self-diagnosis has become common, Aviv’s work asks us to pause and reflect on whether our dominant narratives help or harm.
What the Book Does Well
The power of Strangers to Ourselves lies in its storytelling. Aviv profiles individuals from vastly different contexts: a Black mother in the U.S. whose depression is inseparable from systemic racism and poverty; a devout Hindu woman in India whose spiritual beliefs frame her psychosis in ways Western psychiatry often dismisses; a wealthy white man whose bipolar disorder is exacerbated, not soothed, by privilege and self-absorption. Each story is vivid, compassionate, and unsettling in the best way.
Aviv’s prose is elegant but never heavy-handed. She doesn’t sensationalize suffering, nor does she reduce her subjects to diagnoses. Instead, she places them within broader cultural, historical, and social contexts, allowing readers to see how mental illness is not only biological but also narrative, constructed in part by the meanings we attach to it.
For clinicians, this book is a reminder of humility. No single framework (biological psychiatry, psychodynamic theory, cognitive-behavioral therapy, etc.) captures the full truth of a person’s experience. For the general reader, it offers both empathy and perspective: the realization that there are many ways to understand and live with a troubled mind.
What to Question or Be Careful About
At the same time, the very openness that makes Aviv’s book powerful may leave some readers unsatisfied. Those looking for clear answers or practical guidance will not find them here. Aviv resists prescribing solutions; she is more interested in raising questions than resolving them. This can feel frustrating, particularly for readers steeped in the language of self-help or evidence-based treatment.
Another limitation is that Aviv, as a journalist, necessarily shapes these stories through her own lens. While she is transparent about this, it’s worth remembering that what we read are curated narratives. Readers should be cautious about generalizing from individual stories to broader truths about mental illness or treatment.
Finally, Aviv’s skepticism toward diagnostic categories, though refreshing, may be taken too far by some readers. While it’s true that diagnoses can constrain and stigmatize, they can also provide clarity, community, and access to treatment. Striking the balance between critique and utility is delicate, and the book leans heavily toward critique.
Conclusion
Despite these cautions, Strangers to Ourselves more than earns its place on the “best of” lists. It’s beautifully written, meticulously reported, and profoundly humane. Aviv invites us to sit with complexity rather than rushing toward simplistic solutions.
For those of us in mental health fields, the book is a call to listen more deeply, not only to symptoms but to the stories patients tell about themselves. For the wider public, it is a moving exploration of what it means to live with a mind that doesn’t fit neatly into diagnostic categories.
Aviv doesn’t give us answers, but she gives us something perhaps more important: the courage to keep asking better questions. That is what makes Strangers to Ourselves not just one of the best books of 2022, but one that will be read and referenced for years to come.