The best books on how we understand (and misunderstand) mental illness

Before I’d finished the prologue to Rachel Aviv’s book, I’d already begun recommending it to other people. Her incisive and curious approach to questions of what constitutes mental illness, who gets to decide, and the personal impact of diagnostic labels and treatments—ranging from intensive psychoanalysis to medication—is exactly what our culture needs right now.

The book is structured as a series of case studies but reads more like a collection of interlinked short stories, full of vivid prose and fully realized human characters. Aviv is compassionate toward her subjects without ever condescending; she is critical of our mental health and legal systems without resorting to polemics. Her book is beautiful and essential.

There’s a long history of books about mental illness that regard the subject as though it exists in a bubble—something that impacts a single individual, or maybe a family, but is otherwise disconnected from broader social and political realities.

Ben Lerner’s semi-autobiographical novel hit me somewhere deep in my chest because it does precisely the opposite. With a mounting sense of dread, his book explores psychological disturbance and the attempts to treat it as phenomena rooted firmly in our world, and all the messy smaller worlds within: worlds of privilege, misogyny, and xenophobia, to name a few. I still think about the last chapter often.

When a friend first handed me her copy of Esmé Weijun Wang’s book, I imagined it would sit unread on my shelf for a long time. Given how much time I spend in my professional life working with people with severe mental illness, I assumed Wang’s personal account of her struggle to find a diagnosis and effective, compassionate treatment would be redundant for me.

I was so, so, so wrong. I read nearly the entire essay collection in one sitting—it is stunning, somehow scholarly and deeply personal at the same time. The book is required reading for anyone who wants to better understand one of the least understood diagnoses in the history of psychiatry.

Le Guin is one of my all-time favorite writers, and this book is one of her lesser-known gems. It is a weird, kaleidoscopic story about a man whose dreams change reality and a therapist who tries to take advantage of this to create his own idea of utopia.

It’s a story that doesn’t exactly leave a flattering impression of my profession. But I love it, not only for its mind-bending creativity but as a cautionary tale about what can happen when the imbalance of power in therapeutic relationships goes unchecked. Le Guin takes a question about psychotherapy that I think about all the time—who gets to define what it means to be “healthy”?—and follows it to its dizzying extreme: who gets to decide what kind of world we want to live in?

I love this book for a number of reasons, perhaps chiefly because it’s so hard to pin down. What is it? Part memoir, part biography, part meditation on grief, part instructional guide to falconry.

Helen Macdonald interweaves her own story of dealing with her father’s death with a historical account of the tortured life of T. H. White (known best as the author of The Once and Future King). In juxtaposing these stories across time and space, we are able to see the blurred lines between bereavement, madness, and social isolation. I will hold forever in my mind Macdonald’s description of looking into her hawk’s eye and seeing nothing familiar, an alien consciousness—it helped to remind me that for all the complexity and diversity of the human species, our perspective is only one among the countless others with which we cohabitate on this planet.