In the authors’ first nonfiction title, the particulars of Munchausen Syndrome—those diagnosed perpetually feign or provoke symptoms of illness for attention—appear not in the jargon of medical textbooks but in the fraught life of one woman.
Through alternating recollections from Avigal, the patient, and Hall, the therapist, the specifics of Avigal’s episodes are brought into disturbing focus. Abused by her father and unprotected by her mother, Avigal suffered repeated traumatic events. Lacking familial refuge, she continued to harm herself until she was eventually placed in a residential school for children dealing with emotional abuse. Even there, though, she couldn’t escape, falling prey to her caregivers. Avigal didn’t meet Hall until well after she had already married, bore children and lost a son to cancer—a loss which prompted her to attempt suicide again and then reevaluate her well-being. Under Hall’s guidance, Avigal underwent a therapeutic regimen that caused both her and Hall to question many aspects of their own lives. The book’s approach is somewhat unseen in the genre of psychological memoirs: Instead of opting for a singular perspective, the combined frankness of Avigal about her tribulations and Hall about his hurdles in combating them offers enlightening changes of perspective and pace. Despite the book’s often stomach-turning content, it ends on a note of well-earned hope, with Avigal working to address the afflictions of her past. Avigal’s honesty is riveting and bracing, as is Hall’s when he candidly writes of the difficulties of treating Avigal. The book carries a dual meaning in its title: firstly, the secrets of the illness itself and, secondly, the mystery of treating an ailment from which many have not recovered. Avigal and Hall’s collaboration offers readers a coherent timeline while still managing to put forth an arrestingly personal account of redemption. Sensitive, nuanced, ethical and creatively wrought—including reproduced emails between patient and therapist about the treatment process—the book is a major step forward in overcoming the formal restraints of psychiatry to secure dignity, optimism and peace for the mentally ill.
As Hall himself says, “an eye-opening and sobering experience.”