What I’m Reading: November 2022

Books! Lots of books! As always, said books are mostly narrative nonfiction about mental health, psychiatry, and trauma.

Photo of the cover of Emily Maloney's book "Cost of Living: Essays"

Cost of Living: Essays by Emily Maloney.

[Content warnings for this book: medical trauma, substance abuse, suicidality, suicide attempt]

A collection of essays from a fellow neurodivergent (ND) person (yay!) that offers a (narrow and fairly privileged) look at our fucked-up healthcare system from the perspective of a woman who interacts with it in a bunch of different roles (ER tech, EMT, bioethics student assigned to shadow med students, medical publications manager) after a suicide attempt lands her in the hospital with a shit-ton of medical debt that she needs to pay off. We get insight from her experiences as a patient (both medical and mental health) and debtor, too.

This book is very much a collection of personal essays that explores the author’s experiences as both patient and caregiver, which was informative and engaging enough to keep me reading. It’s not a deeply nuanced critique of the American healthcare system, though. So if you’re looking for that, look elsewhere.

Also, as an autistic person, I found her descriptions of her internal world to be so, so relatable—she does a good job defying the standard stereotypes and capturing what it feels like to be autistic (I clocked her as ND, probably autistic, literally three paragraphs in). If you read this book and find yourself relating to her internal world, gratz on the autism and welcome to the club. (The author does eventually reveal her diagnosis. It is not, much to my genuine shock, autism. To absolutely no shock, her diagnosis is one that many autistic people feel is a more palatable and ableist way of saying “autism,” in much the same way that “Highly Sensitive Person” is actually just autism. Let me put it this way: The Venn diagram of the author’s descriptions of her internal world and The Autistic Experience™ is a circle.)

Photo of the book cover for Kelly Sundberg's "Goodbye, Sweet Girl: A Story of Domestic Violence and Survival"

Goodbye, Sweet Girl: A Story of Domestic Violence and Survival by Kelly Sundberg.

[Content warnings for this book: domestic violence, substance abuse]

In her essay “In Defense of Navel Gazing,” Melissa Febos writes about writing about trauma:

“Listen to me: It is not gauche to write about trauma. It is subversive. The stigma of victimhood is a timeworn tool of oppressive powers to gaslight the people they subjugate into believing that by naming their disempowerment they are being dramatic, whining, attention-grabbing, or beating a dead horse. Believe me, I wish this horse were dead…But we shouldn’t write about it because people are fatigued by stories about trauma? No. We have been discouraged from writing about it because it makes people uncomfortable. Because a patriarchal society wants its victims to be silent. Because shame is an effective method of silencing.”

I don’t know if the author of Goodbye, Sweet Girl ever questioned the importance or value of sharing her story. As a person who has experienced similar trauma, my guess is that she did. I know how hard it is to write about your trauma (or at least, how uncomfortable and inconvenient it can be), especially when it’s perpetrated against you in your own home, by a person (or the people) you count on to protect you and to be a safe space for you.

This book is so well-written, and it does a great job of illustrating how abuse can happen slowly and subtly, and then suddenly and all-consumingly; about how difficult it can be to see it; and about how difficult it can be to walk away from once you do see it.

A related read: In the Dream House, a lyric memoir by Carmen Maria Machado about, as Roxane Gay says in her Goodreads review of the book, “the complexities of abuse in queer relationships.”

Photo of the book cover for Roxane Gay's "Hunger: A Memoir of (My) Body"

Hunger: A Memoir of (My) Body by Roxane Gay.

[Content warnings for this book: disordered eating, fatphobia, racism, rape]

Immediately yes. Read it. Right now. Especially if you’re not, and have never been, fat. Evocative, uncomfortable, necessary. This book is going to stay with me for a long, long time.

I think Hunger is an incredibly important book that has a lot to teach a lot of people. You’ll get the most out of this one if you approach it with an open mind and the willingness and ability to confront uncomfortable parts of yourself, and to ask yourself—and explore your answers to—uncomfortable questions.

(I have a lot more to say about this book. Enough to write a separate, entire post about it.)

Photo of the cover of Rachel Aviv's "Strangers to Ourselves: Unsettled Minds and the Stories That Make Us"

Strangers to Ourselves: Unsettled Minds and the Stories That Makes Us by Rachel Aviv.

[Content warnings for this book: ableism, disordered eating, filicide, suicidality, suicide attempts]

An exploration of how we understand ourselves, especially in moments of crisis and distress; of how a mental illness diagnosis can shape our understanding of ourselves, our experiences, and the world; and of how mental illness diagnoses can influence how others and the world interact with and experience us.

The book is structured into six chapters, each a case study of a different person and their mental health history, beginning with the author’s own experience of being admitted to an in-patient treatment program for anorexia when she was just six years old, and drawn from the history of psychiatry, philosophy, interviews with the subject of each chapter and their family members and doctors, and primary source documents, like unpublished memoirs. (Technically, the first and last chapters aren’t really chapters, they’re the prologue and the epilogue, but they’re important to the premise of the book, so I’m lumping them in with the chapters.) It’s well-researched, well-reported, and well-written—and I’m not quite sure what to make of it.

I had a lot of trouble getting into a rhythm with this book, and it took me a very long time to read—it just could not keep my attention. I don’t think the book is bad. I think I went into it wanting it to be something it’s not (I really wanted it to do what Pathological: The True Story of Six Misdiagnoses set out, and, in my opinion, failed to do), and I think that influenced my experience of it. That being said, I think the book does exactly what it sets out to do (re-read the first graf, above), and I think it does it very well.

Photo of book cover for "Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror" by Judith Herman.

Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror by Judith Herman

[Content warnings for this book: basically everything associated with all sources of trauma—accidents, domestic violence, kidnapping, natural disaster, sexual violence, war, etc.]

Of the Big Three trauma books—and the ones about complex trauma specifically—I liked this one the best. It’s also the first of the Big Three that was written (the other two are Pete Walker’s Complex PTSD: From Surviving to Thriving and Bessel van Der Kolk’s The Body Keeps the Score), and it’s the book that first introduced the concept of complex trauma and proposed it as a distinct diagnosis.

(Since 1992, the author of the book has advocated for the inclusion of Complex PTSD, or C-PTSD, as a distinct diagnosis in the DSM. To date, those efforts have been unsuccessful—C-PTSD is not an actual diagnosis in the United States because it’s not included in the DSM and therefore doesn’t have an associated billing code and therefore insurance won’t cover it (everything is about money). In countries that diagnose using the ICD instead of the DSM, C-PTSD is an actual diagnosis.)

Honestly, I don’t know how I hadn’t read—or even heard of—this book before this year??? Especially considering my entire-ass college degree is in psychology??? I digress.

This book covers a lot, and it does so in a way that feels cohesive and accessible and digestible. I appreciate that the author walks the reader through the evolution of the study and science of trauma, from the early days of hysteria to our current understanding of trauma as an unconscious and physiological response and process. I appreciate that she cites so much research, and that she presents it using plain language. And I appreciate that she talks about the therapist/patient (client) relationship (this is something that I think deserves more attention, in general, than it gets—especially when the patient/client is autistic and the therapist is not).

Personally, I found the discussion about trauma reenactment and the mechanisms that drive it to be the most helpful part of this book. If, like me, you find yourself wondering why you constantly, or consistently, end up repeating patterns that mirror trauma that you’ve experienced, or why a person doesn’t “just leave” an abuser or abusive situation, this book might be particularly helpful/relevant to you. And if you don’t find yourself asking such questions? This book is still worth a read. Big recommend for everyone.

Two critiques:

One: This book is 30 years old (which is weird because the 90s were only a few years ago), and as such, the way it talks about gender and gender roles is outdated and stereotyped. There’s a lot of good information in this book specifically re: domestic violence—in the context of cishet relationships. If you’re looking for a nuanced take on the dynamics of abuse in queer relationships, you won’t find it in this book.

Two: There’s zero mention, let alone discussion, of the intersection of (non-acquired) neurodivergence (e.g. autism) and trauma, to include approaches to therapy, trauma processing, and healing that are better suited for us. I mean. I didn’t go into this book expecting it to include such a take, but as I read it, it was incredibly obvious that such a take was missing—and is still very much needed in contemporary works on trauma and mental health.

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