M arianne Apostolides is the award-winning author of eight books, four of which have been translated and published internationally. She is a two-time recipient of the Chalmers Arts Fellowship and winner of the K.M. Hunter Award for Literature. Her books include I Can’t Get You Out of My Mind , Deep Salt Water , Voluptuous Pleasure: The Truth about the Writing Life , and Swim . Moving across fiction, memoir, and literary nonfiction, her work often returns to the body, desire, memory, and the stories we tell about ourselves.
Her latest book is Go/No-Go: A Journey Into the Research and Treatment of Mental Health Disorders , which has been called “required reading for anyone with a stake in mental health care.”
In the book, Marianne brings her skills as a writer to contemporary psychiatry and neuroscience. She reads the research closely, following new approaches to treatment that include neuromodulation, digital therapeutics, pharmaceuticals, and psychedelics. She also traces the institutional pressures and conflicts of interest shaping the field.
Throughout the book, she pays particular attention to language. She listens for the metaphors that organize the research and considers the assumptions they carry, often without being examined, about the mind, mental distress, and what researchers are able to see.
Marianne has described the book as beginning in 2022, during a period of creative and emotional crisis, when she encountered a research article that changed how she understood the human mind. In the prologue, she writes that we have “reached a dead end” in our current approach to mental health disorders. The book traces how we arrived there and where we might turn instead.
The transcript below has been edited for length and clarity. Listen to the audio of the interview here.
The short answer is that COVID happened, and my eating disorder got really bad. My eating disorder is something I’ve grappled with for decades. My first book is actually about struggling through it. I wrote that book in my twenties, when it was all still fresh.
At the time, I was supposed to be writing a science fiction novel. I had received a fellowship to work on science fiction, but I could not settle enough to drop down to the place where I could conceive of an imaginative world. I was so inside my anxiety, following the news in three-minute increments for developments with COVID, that I just could not settle enough to write fiction.
The eating disorder was bad, so I did what I usually do with my writing. I used it as a way to engage with what was happening in my world. At that moment, what was happening was the eating disorder and this sense of being out of control.
I thought I was going to write a series of articles about new treatments for eating disorders. It was going to be very straightforward: This is where the field is now . Pretty rapidly, I realized that I wanted to broaden the project to new treatments for mental health disorders in general, in part because of the transdiagnostic approach, which we can talk about later.
But what is more salient at this point is that, over the course of six to nine months, as I was writing journalistically and very straightforwardly about these new treatments, I started to have this creeping sense that something was really not right.
That happened as I did more research and read the studies quite deeply in order to interview neuroscientists. I would read their research, and then read the research they referenced, and keep digging deeper. I began to see how the research was actually conducted, what the findings actually were, and how that differed from the way the findings were portrayed.
I became quite disturbed. I realized that this was the story I had to tell: the research practices underlying these new treatments, and the assumptions within that research about who we are and why we struggle.
Apostolides: That came up in an interview with Helen Mayberg , who’s a brilliant woman. Her work focuses on deep brain stimulation for mental health disorders, mainly depression . She told me that many of her patients—everybody, she said—have a metaphor, a pet metaphor, for their disorder.
I realized that, yes, I definitely have a metaphor for my eating disorder. I imagine it as this beast, this panther-like, feline thing. To extend the metaphor, I need to learn how to ride it—not kill it, cage it, or tame it, but ride it—or else I’ll get mauled.
Whatever force drives me at times to binge, and …