Fifty pages into her debut memoir, Men Have Called Her Crazy, multidisciplinary artist Anna Marie Tendler describes a recurring dream. In a small, low-lit room that “resembles a detective’s office from a 1940s noir film,” Tendler and a faceless man argue over whether or not she’s crazy. They go back and forth—he says yes, she says no—before he laughs and vanishes. Then, the door disappears, leaving her trapped inside. Tendler wakes in a psychiatric hospital where, a day earlier, she checked herself in for suicidal ideation, self-harm, and disordered eating. But when she recounts the dream, she describes it to the reader—not a therapist. The dream itself needs no interpretation. As Freud might say, all its latent content—the unconscious urges the dream stutters to express—is right there on the surface.
Tendler wants you to know that she is deeply distrustful of men. She retains a litany of ways “men have asserted their power over [her]” and the ways she has “fought to be equal or conversely sublimated [herself] to keep peace.” At the hospital, she requests the female-only residence because she doesn’t want to even look at men. When the only other person in a hospital yoga class is a man, she is “furious.” Tendler is an amiable narrator, nervy and bright, who eventually cuts her unrelenting stance with a moment of self-reflexivity: “Perhaps I shouldn’t be so quick to pathologize everything men do as merely a failing of being male,” she says, wary of doing the very thing she so detests in them—“though men do make it difficult not to.”
The conviction that men cannot be trusted gives the book an engine and a frame. Its chapters mostly toggle between Tendler’s hospital stay and a catalogue of past romantic relationships. (The most visible entry—Tendler’s ex-husband, comedian John Mulaney—is largely absent.) Men are not positioned as the reason she wound up hospitalized, exactly. Other parts of her past loom large: an emotionally volatile mother, her parents’ unravelling marriage, anxiety and depression. But when the opening gambit establishes both crisis and diagnosis—the first scene is Tendler checking herself in—the rest of the narrative is shunted into a responsive position: and this is how I got here.
Much has been made of the incursion of therapy speak off the couch and into conversation. Tendler is conversant in that vernacular—she sublimates herself to men. When an intense event happens, she resolves to process it in her next session. An insulted man has an ego wound. But there’s a deeper therapeutic move taking place in the segment of the iceberg below the surface—a zone one might call the book’s unconscious. Not therapy language, but therapy logic. It is a marked symptom of contemporary memoir: the tendency to impose a diagnostic structure. Such books are usually about mental health. They exhibit the propensity to attribute the author’s suffering to a single cause—the patriarchy, say, or familial dysfunction. Every anecdote the writer offers thereafter becomes a symptom of the diagnosis.
Such a tight weave between writing and therapy is understandable. The two share core similarities. Both are catalyzed by storytelling, require deep psychic work, and reach for insight; mental health is a fertile subject for memoir, and the prose can suffer if events are narrativized before they’ve been processed. But therapy and writing are also fundamentally different projects. Transposing the aims of one onto the other can feel defensive, even litigious. An elbow jammed between the ribs, a hissed see? The author presides, smacks a gavel. Each scene feels not like the bloom of self-discovery but evidence that snaps toward a verdict. As if to inflict any other interpretation might be a form of—therapy speak again—trauma.
This is not to denigrate the therapeutic element of writing or, indeed, the value of therapy itself, tool of many a memoirist. The former notion—that any literary work that entails processing trauma is a lesser art—has long been used to trivialize work by people of marginalized genders and backgrounds. In her non-fiction craft book, Body Work, memoirist Melissa Febos pushes back against this belief, common even among writers: “I am done agreeing when my peers spit on the idea of writing as transformation, as catharsis, as—dare I say it—therapy.” Such ideas have nothing to do with quality, she argues, but instead reflect ingrained biases. When a man writes about his life, he’s a genius; when a woman does, she’s a narcissist. In certain bodies, to write about yourself at all is already to be pathologized. But there’s a difference between creative work conferring self-knowledge on a par with psychiatric insight and structuring that work to shore up the psychiatric diagnosis or breakthrough.
Like Men Have Called Her Crazy, Jennifer Romolini’s Ambition Monster opens in a moment of crisis. Romolini is on stage, giving a presentation, when she suddenly loses her voice. She pushes through the pain, but the countdown has begun. The book is an account of workaholism, an addiction nurtured by capitalism and patriarchy but, above all, Romolini reveals in the prologue, by her family. (The therapist steeples his fingers, light glinting off his glasses.) “Those with a predisposition to overwork often grow up in chaotic homes,” she explains, 200 pages later, after many chapters evidencing the same. This workaholic “unconsciously, repeatedly seek[s] out chaotic workplaces in order to maintain a high level of stress that’s familiar from childhood.”
Such reasoning is persuasive and self-aware. Its claims and evidence snap together like a set of teeth. If the plausibility of the book’s thesis were put to a vote—workaholic, yea or nay—addiction would unambiguously win. But something gets lost, too, in presenting so neat a key to the psyche. Up until this point, Romolini’s memoir has been uncommonly propulsive. But there are still almost a hundred pages to go. Such stark diagnostic revelation sucks the tension out of later workplace scenes, or any scene at all. Some essential mystery has been diminished. If the case has already been decided—if the remaining facts couldn’t possibly stand for anything else—why stick around? We found the guy who did it: it was the unconscious (again). This approach renders the self as a problem to be solved once every other option has been eliminated. Should this be the aim of memoir? Should it always be the aim of therapy?
In therapy, quips doyenne Mary Karr in The Art of Memoir, “the therapist is the mommy, and you’re the baby. In memoir, you’re the mommy, and the reader’s the baby.” If the writer is meant to be the mommy—that is, the doctor—this positioning would seem to suggest pathology is the goal. The problem arises when the doctor bites down on the diagnosis too hard, leaving the patient no space for insight of their own. This is one way to read Sociopath, the buzzy memoir by Patric Gagne, whose PhD and condition adorn the cover as if she is mommy and baby both. (It’s worth noting, too, that these three highly visible examples of self-diagnostic memoir are all by white women and all published by the same press.) “My name is Patric Gagne and I am a sociopath” is the book’s first line. As a child, Gagne has a penchant for stealing. Lest the reader also want to flex her diagnostic muscles, Gagne promptly curbs that impulse: “To be clear: I wasn’t a kleptomaniac.” Yes, Your Honour. Inevitably, such obsessive dominance can invite rebellion. On Reddit, some readers have questioned both her credentials and her diagnosis.
In Strangers to Ourselves, Rachel Aviv problematizes the very concept of diagnosis. Five case studies of mental illness are preceded by a prologue in which Aviv recounts being hospitalized for anorexia at age six. Though her symptoms match the presentation, she does not pathologize herself in the narration. Her reasoning stops where the evidence ends: she doesn’t recall why she suddenly began fasting—“only the reactions of adults and [her] vague sense of pride.” Her medical records “do not present a coherent picture.” When Aviv was a child, this unruly evidence was made coherent by the disciplining force of diagnosis. But now, examining the data as an adult, Aviv questions whether she had anorexia at all. Narratives of illness, she posits, can influence the way that illness manifests. “People can feel freed by these stories,” she writes, “but they can also get stuck in them.”
This is the memoirist’s task as much as it is the therapist’s—to follow the tells and find a shape without imposing one too harshly. The late Lucy Grealy wrote a memoir called Autobiography of a Face that, when summarized, sounds like a cut-and-dried trauma tale: as a child, she was diagnosed with cancer, had a third of her jaw removed, and underwent chemotherapy and years of reconstructive surgeries. In a later essay, she reflects on writing the memoir. Her aesthetic philosophy, honed as a poet, was that she must render experience as faithfully as possible. Any pre-existing idea of the work’s shape was enough to tank it. Only when she applied this standard to her own childhood did Grealy realize she’d “undergone an extraordinarily difficult set of circumstances,” a fact she’d never been willing to admit. For many people, this admission would have preceded the writing, even been the reason to begin.
Reading Autobiography, this reticence is palpable. The arc of “childhood cancer diagnosis” is littered with justified invitations to victimhood. Grealy refuses them all. The specificity with which she reinhabits the experience—a child, full of pluck, who does not understand that she might die—leads to observations so esoteric and human, they both cut the tension and magnify the stakes. Lying in the ward the night before surgery, she feels “special, singled out.” Facing painful tests, she becomes “a machine for disassembling fear.” What a different, lesser book it would have been had she set out to prove her suffering. After Autobiography was published, Grealy started therapy, where she found herself unable to apply the same standard of truth. She could not shake the hope that if she just made her story conform to the right shape, she’d be cured. Grealy blames Freud, who prized narrative so much, he made it “both diagnostic tool and therapeutic treatment.”
The joy of reading memoir is to watch another mind puzzle through its inner mechanics. Febos, in Body Work, praises this dynamism—“books that evidence this kind of emotional confrontation with the self” such that the reader can “feel on the page how the writer changed.” To have it all sewn up and static before the reader gets there precludes both parties from a transformative experience. The unconscious is a swampy and surprising wellspring, not a cheat code. Why am I like this? is one of the most prismatic, horrifying, liberatory questions a writer can ask, an attempted answer one of the most intimate offerings it’s possible to make to a reader. Why rule out that path before even taking the first step?
