Whose Mental Health? Stories We Tell about Ourselves and Others: A Review of The Best Minds and Strangers to Ourselves
Introduction
I call the subjects of these two non-fiction books “protagonists” because their experiences with mental illness are challenging, exceptional, and understandable all at the same time, just like those of characters in the best fiction.
Jonathan Rosen, a Pulitzer Prize nominee for The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions (Penguin Press, New York: 2023) is also a novelist and children’s book author, while Rachel Aviv is a staff writer for the New Yorker, celebrated for its literary style. At least one chapter of Strangers to Ourselves: Unsettled Minds and the Stories that Make Us (Farrar, Strauss and Giroux, New York: 2022) first appeared there.
Having lived with a diagnosis of bipolar disorder II for more than 50 years, and, as a peer specialist since 2002, who has supported several thousand peers also psychiatrically labeled in various ways, I recognize that so-called “mental illness” exists on a spectrum from unusual to usual behavior, which the latest Diagnostic Statistical Manual of more than 500 classifications recognizes infrequently.
Both authors share their mental health struggles that, to some extent, are the basis of their inquiries into the lives of Michael Laudor, Jonathan Rosen’s best childhood buddy, and “Ray” Osheroff, Bapu Bhargavi, Hava Ornstein, Laura Delano, and Naomi Gaines, all of whom Rachel Aviv “befriends” journalistically as a result of post-mortem research and interviews with their survivors or the “characters” themselves.
Given the sensationalism concerning murders by a few or some of our peers—the numbers and percentages compared to the general population are hotly contested—those by Michael Laudor of his fiancée and by Naomi Gaines of one of her twin sons, are the most extravagant tips of the “madness” icebergs described here.
Rachel Aviv’s Testaments
Ray Osheroff, a medical doctor, successfully sued Chestnut Lodge for malpractice, the hospital famously fictionalized in Joanne Greenberg’s I Never Promised You a Rose Garden, where he was treated for depression. Although this supposedly signaled the death knell of non-pharmacological psychoanalysis, Osheroff relapsed after medication initially helped him and died in obscurity.
Why Aviv tracked Bapu Bhargavi to Chenai, in south India, and had her writings in Tamil translated after her even more obscure death is never explained. Perhaps the “mystical madness,” that gained her celebrity and condemnation as she traveled from ashram to ashram, echoed all the way to the New Yorker’s office.
Hava Ornstein, who Aviv first met when they were both treated for anorexia as youngsters in a Detroit hospital, only begins to recover in middle-age when she chokes to death on her vomit while asleep, an outcome Aviv attributes to the bulimia that was the corollary to self-starvation.
Recently, Laura Delano has made a name for herself as an online content creator, who coaches peers on how to withdraw from psychotropic medication after doing so herself agonizingly over many years. Again, it is unclear whether Aviv “discovered” Delano or just added to her notoriety by writing about her.
While the other characters benefit to a certain extent, like Aviv, from their privileged backgrounds, Naomi Gaines garners deservedly the longest “treatment” (57 pages compared to the others, averaging 40) because she emerges rehabilitated after 20 years in prison, having grown up African American in Chicago’s public housing.
Why do these biographers devote so much attention to people who may have been famous for 15 minutes, so to speak, but are not now household names? Because every biographer believes that their subject is the exception that proves a rule, namely that individual lives express universal truths. And here we have six people who went to extremes to fulfill their destinies, whether consciously or not, for better and worse.
Jonathan Rosen’s Confessions
Michael Laudor is a separate “case,” not just because he is committed to a forensic psychiatric hospital for life, but also because Rosen devotes 524 pages to recount Michael’s ups and downs, twists and turns in such minute detail that writing a “blockbuster” was clearly Rosen’s intention. It’s almost as if the best thing that ever happened to him as an author was having Michael as his childhood BFF but then growing enough apart from him so that the necessary objectivity was possible, if problematic.
Laudor and Rosen grew up in the Jewish, middle-class, and intellectual enclave of New Rochelle, in Westchester County, NY. (Aviv and Ornstein are also Jewish, as am I. Is it an epidemiological truth or an anti-Semitic trope that Jews are prone to mental illness?) That they both entered Yale University in the early 1980s demonstrates the extent to which their lives were still intertwined. However, Michael’s graduation in three years demonstrated his genius.
Even as hallucinations and delusions began to preoccupy him, he convinced Yale Law School to accept him five years later. Though he never practiced law, Michael made it through the coursework with the support of a sympathetic faculty, much like a phalanx of well-wishers who were there for him throughout his life because they were dazzled by his quirky gifts. Among these were a never-finished memoir, which was prematurely optioned as a movie, and the resulting celebrity by the National Alliance on Mental Illness (NAMI), who treated him as a peerless peer.
It’s hard to further summarize the 42 chapters, plus an epilogue, of “The Best Minds.” That Jonathan Rosen often played second fiddle to Michael Laudor makes you wonder if Rosen included himself among those minds, especially because he suffered from a social anxiety that in no small measure was due to hanging out with his overconfident friend. The cruel irony is that the best psychiatric minds couldn’t prevent Michael from believing that Carrie Costello, with whom he was living, had turned into a soulless, and therefore expendable robot.
“To err is human, to forgive is divine” would be a fitting apology for psychiatry if its practitioners admitted their mistakes and its critics weren’t so merciless. Rosen ultimately relies on the expertise of psychiatrist E. Fuller Torrey as a proponent of involuntary hospitalization for potentially dangerous individuals like Michael. (Torrey’s younger sister was diagnosed with and institutionalized for schizophrenia throughout her adult life. His famous dictum about those with the diagnosis was that “a third get better, a third get worse, and a third stay the same” no matter what their treatment.)
Torrey is reviled by certain “psychiatric survivors” and behavioral health peers who have clamored for community-based treatment rather than hospitalization ever since the deinstitutionalization of the 1960s caught them in its dehumanizing grip before and after release from state “asylums.”
Aviv and Rosen Face to Face
There’s a life insurance ad on WINS-1010 Radio in NYC that encourages potential buyers to talk to agent “Big Lou because he’s on meds too.” Both Rosen and Aviv are on medications for their occasional depression and anxiety. This reliance while questioning psychiatry’s effectiveness is a contradiction that seems to escape their attention. Privilege doesn’t guarantee success, but I have benefitted from 65 years of talk therapy and decades of taking mood stabilizers, if only because of their placebo effect. (On the other hand, lithium damaged my thyroid and kidneys, requiring more medication to manage those side effects.)
All of this doesn’t account for the different connections these authors have with their protagonists. Rachel Aviv’s five peers are basically loners. Relying on reams of writings by and about them, as well as interviews with people they knew, is, therefore, necessary to reconstruct their lives. The 36 pages of meticulous footnotes after just 238 pages of equally dense text, nevertheless, make “Strangers to Ourselves” harder to swallow than Jonathan Rosen’s tome, in part, because Aviv is more argumentative.
Not only does Rosen have first-hand knowledge of Michael Laudor and the people surrounding him, making both of them more gregarious than Aviv, who tends to be buried in research about her subjects, but Rosen’s style is also breezier, including an infectious sense of humor, which would seem inappropriate, except it makes his 524 pages a real page-turner. While relying on similar sources as Aviv’s, he opts out of footnotes and appends a brief reading list, realizing that the reader would be exhausted otherwise.
Conclusion
The moral of these stories is that it takes two to tango. Both authors went to extraordinary lengths to bring their partners to the dance floor, dead, alive, or in Michael’s state of limbo. (My sister, who is the secretary of her 1982 class at Yale, told me that “Michael Laudor” doesn’t appear in the alumni directory.)
However, their efforts reinforce the civil rights slogan, “Nothing about us without us.” On my dance card are the following unpublished collections of autobiographical essays: “From Here to Recovery: Confessions of a Peer Counselor,” “Bibliotherapy: How Reading and Writing Restored my Mental Health,” “No Joke: Fishing for Laughs without a Hook,” and “A Quaker’s Guide to the Cosmos, Including the Friendliest Places to Eat.” I was trained in comedy by Stand Up for Mental Health and believe that humor is essential for healing. Email carlblumnthl@gmail.com and I will return the favor with free copies of any of these reflections.
