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The Maps We Carry
Featuring interviews with leading figures including Amanda Fielding, Michael Pollan and Gabor Maté What if treating misery as a medical problem is making us miserable?
What if our intense distress is not a symptom of illness, but a desperate expression of our need for love and connection?
Someone dies by suicide every 40 seconds. Antidepressant use in the West has more than doubled in the last twenty years. And there is still no biological test which can diagnose any mental health problem.
So where are we going wrong?
In this revolutionary book, Rose Cartwright reveals how the failure of the mental health system to cure her OCD led her to radical action. While she explored her trauma through a series of mind-bending psychedelic trips, she began to interrogate our dominant medical paradigm.
Part radical manifesto, part revealing memoir, The Maps We Carry provides a new path to understanding and re-evaluating our approaches to mental health. This is a book is for everyone who has questioned why they are the way they are.
What if our intense distress is not a symptom of illness, but a desperate expression of our need for love and connection?
Someone dies by suicide every 40 seconds. Antidepressant use in the West has more than doubled in the last twenty years. And there is still no biological test which can diagnose any mental health problem.
So where are we going wrong?
In this revolutionary book, Rose Cartwright reveals how the failure of the mental health system to cure her OCD led her to radical action. While she explored her trauma through a series of mind-bending psychedelic trips, she began to interrogate our dominant medical paradigm.
Part radical manifesto, part revealing memoir, The Maps We Carry provides a new path to understanding and re-evaluating our approaches to mental health. This is a book is for everyone who has questioned why they are the way they are.
374 pages, Kindle Edition
Published April 11, 2024
37 people are currently reading
561 people want to read
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Displaying 1 - 15 of 15 reviews
December 15, 2024
The Maps We Carry: A radical new book on mental health from the acclaimed author of PURE (which isn't the subtitle on the hardback's cover) is the best book about mental illness that I've read in 2024 so far and likely to remain so. I saw it on the library new acquisitions shelf and was arrested by the blurb, as that same week I'd been thinking about how to articulate a narrative of your life which helps you recover from chronic mental distress. I haven't read Cartwright's first book, Pure, although I'd heard of it. In many ways The Maps We Carry seems intended as a response to and refutation of that book. Pure, which was popular enough to be made into a TV series, talked about getting diagnosed with OCD and recovering with the help of CBT. The book turned Cartwright into a well-known mental health advocate, who talked about her illness publically and sought to spread awareness of OCD.
The narrative of Cartwright's life in that first book seems to have been: suffering from symptoms -> mental illness diagnosis -> NHS treatment -> recovery -> advocacy. In The Maps We Carry, she explains that this neat narrative didn't prove realistic or helpful. While her first book was being adapted for TV, she was still suffering from the same awful symptoms and searching for ways to recover. It's fascinating to find a mental health advocate explaining so thoughtfully how she came to realise that her diagnosis and the whole conventional medical model of mental illness didn't actually alleviate her suffering beyond the very short term. She describes in detail how her whole view evolved, here regarding the claim that 1 in 4 people in the world have a mental illness:
Cartwright then notes that after she'd become a mental health influencer, she got various offers from brands to endorse products like app-based therapy. Profit is definitely not a consideration that is absent from the sphere of mental illness.
I really admire Cartwright's ability to bring concepts into dialogue with each other that other books treat more reductively as separate, or at least do not engage with the nuances of. Her consideration of trauma is a good example. She reminds readers that no DNA markers have been found that reliably and strongly predict any mental illness, despite decades of research seeking a biological basis for mental illness. The factor that has consistently been found most likely to increase the odds of it is adverse childhood experience:
She builds on this in a subsequent chapter, making a point that I found genuinely profound:
The Maps We Carry explains in detail what actually made a lasting difference to Cartwright's mental health: understanding that her illness was rooted in childhood trauma and processing that over a number of years via talk therapy and use of psychedelics. Her description of psychedelic therapy is the most in-depth I've read and considers its strengths and weaknesses thoughtfully. For her it was a vital part of healing, as it gave her new pathways when she was stuck, but it wasn't sufficient in itself. She cautions that adding psychedelics to the medical treatments for mental illness removes them from the original context that is key to their effectiveness:
I think this makes The Maps We Carry another on the list of books that offer a powerful critique of capitalism without actually using the word. The health industry shapes public understanding of mental illness and the structure of this industry creates path dependency:
Cartwright uses her experience as a frame within which to have a nuanced discussion about the theoretical models with which we understand mental illness: biomedical, psychoanalytical, social, cultural, etc. The Maps We Carry builds very well on other recent books such as How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, Strangers to Ourselves: Unsettled Minds and the Stories That Make Us, and Coward: Why We Get Anxious & What We Can Do About It. Cartwright is insightful and analytical when considering both her own experiences and their broader significance for mental health in the Western world.
It took me a while to review The Maps We Carry as I feel the need to slowly and carefully digest what it says, particularly the last few chapters. Ultimately it is a lot easier to read about the efforts other people have put into healing from mental illness than to put the work in for yourself. I have a lifelong habit of reading about things rather than doing them; if I could read myself well then surely I'd feel better by now. Nonetheless, this book felt mind-expanding, rigorous, and constructive in a way that very little mental health writing manages. I highly recommend it.
The narrative of Cartwright's life in that first book seems to have been: suffering from symptoms -> mental illness diagnosis -> NHS treatment -> recovery -> advocacy. In The Maps We Carry, she explains that this neat narrative didn't prove realistic or helpful. While her first book was being adapted for TV, she was still suffering from the same awful symptoms and searching for ways to recover. It's fascinating to find a mental health advocate explaining so thoughtfully how she came to realise that her diagnosis and the whole conventional medical model of mental illness didn't actually alleviate her suffering beyond the very short term. She describes in detail how her whole view evolved, here regarding the claim that 1 in 4 people in the world have a mental illness:
My puzzle about the forces that'd led me to view mental health in medicalised terms had spilled out of academia and onto my turf: marketing. I had presumed that '1:4' was a factual communication of the reality of our mental health landscape, and that spreading awareness of this was comparable to sharing other useful public health messages, like excessive alcohol increasing the risk of liver disease. But though it had been presented as fact, '1:4' seemed to be more like a strapline that served to steer audiences towards a subjective medicalised worldview. [...]
Who gets to decide when the public is ready to hear how mysterious and little understood mental health is? Do charities get to decide? Policy makers? Doctors? To me there was something troubling about questioning our readiness at all. I'd seen paternalism at work in advertising. There, the intention had been profit, while here, the intention was fighting stigma, but the methodology was similar. Both ran on the assumption that the public were not ready for complex ideas.
Cartwright then notes that after she'd become a mental health influencer, she got various offers from brands to endorse products like app-based therapy. Profit is definitely not a consideration that is absent from the sphere of mental illness.
I really admire Cartwright's ability to bring concepts into dialogue with each other that other books treat more reductively as separate, or at least do not engage with the nuances of. Her consideration of trauma is a good example. She reminds readers that no DNA markers have been found that reliably and strongly predict any mental illness, despite decades of research seeking a biological basis for mental illness. The factor that has consistently been found most likely to increase the odds of it is adverse childhood experience:
Whether through the presence of bad or the absence of good, if a child's environment is chronically stressful, they can start to feel alone in emotions that they do not understand and cannot express. Perhaps because expressing themselves would inflame their environmental stressors further. Anger cannot be discharged through shouts and tantrums if you risk provoking someone. Fear cannot be discharged through sprinting legs if you're never been outside on your own before. Longing cannot be articulated if that's all you know. Since a child's life is dependent on the stability of its environment and primary caregivers, anything that threatens that stability can feel like a threat to life. If a child can't change the stressors in their environment (when can they ever?), they're likely to believe that the problem lies in them (I'm unloveable, I'm worthless, I deserve this). The alternative is understanding that the problem is 'out there' in the world, and because this idea is synonymous with not being safe, it is too terrible to contemplate. [...]
But we should also be cautious about broadening the definition of trauma. Professor Nick Haslam coined the phrase 'concept creep' in reference to the 'semantic inflation' that happens when definitions of harm are gradually expanded. [...] While it's been positive in shedding light on previously overlooked forms of harm, it has also diffused our warranted focus on some of the worst forms of it.
I share his ambivalence, especially now that social media and alternative healing, and the saccharine place where those two things meet, has become saturated with trauma language. [...]
Attempts to control the words that others use to express their inner life are almost always part of a divisive, possessive narrative, itself a product of pain: 'You don't know what it's like to be me.' The traumatised and the not-traumatised, the diagnosed and the undiagnosed, the ill and the well. There are no clear demarcations between us. We are not at odds with each other.
She builds on this in a subsequent chapter, making a point that I found genuinely profound:
I ran my quandary past Dr. Kinderman. Have my mental health problems been the result of my circumstances or the result of the way I think about my circumstances? He introduced me to the idea of 'the social determinants of perception', meaning that perception itself is partially determined by environment. On reflection this sounds obvious, but it hadn't been to me. I was so used to thinking in binary terms about the world inside my head and the world outside of it; of my thinking as product of the machinery of my brain, quite separate from the environment.
"It's a powerful psychological finding that we do have agency," Dr. Kinderman said. "But the way we discharge our agency is shaped by how we were brought up, how we've been treated, and the things that have happened to us." [...]
[This idea] introduced a more skilful flexibility into my self-therapy that stopped me clinging too tightly to any one way of seeing my story. A sort of 'yes, also' approach. Yes, bad things happened that led to my suffering. Also, I have an active role in the perpetuation of that suffering. This means I get to keep all of the compassion and causal common sense of the trauma model, and keep all the agency of the stoic one. Viewing myself as a victim of negative circumstances helped me move towards my pain, while viewing myself as a source of negative patterns helped me not get stuck there. Eventually I found I could lightly hold both views at once, since both were true.
The Maps We Carry explains in detail what actually made a lasting difference to Cartwright's mental health: understanding that her illness was rooted in childhood trauma and processing that over a number of years via talk therapy and use of psychedelics. Her description of psychedelic therapy is the most in-depth I've read and considers its strengths and weaknesses thoughtfully. For her it was a vital part of healing, as it gave her new pathways when she was stuck, but it wasn't sufficient in itself. She cautions that adding psychedelics to the medical treatments for mental illness removes them from the original context that is key to their effectiveness:
This is what Western mental health care seems to have forgotten. I'm afraid that the trauma-informed model and medicalised psychedelics, by treating individuals with individual disorders, often forgets it too. Without these conditions of community, so much of the Western conversation about mental health seems like well-meaning busywork that obscures and overcomplicates what has always made us happy. Worse, under the banner of progress, we seem to have written off so much traditional wisdom as primitive superstition.
'If the modern world lets the indigenous world die,' wrote Somé prophetically in 1994, 'it will probably mean a long hard trip into the future in search of the values of the past.'
On this lone hard trip is where we find so much research into mental health faltering: caught in an absurd topsy-turvy attempt to justify with science what we already know in our bones. Every week studies are published 'proving' that things like nature, singing, dance, exercise, and community make us happier, framing these things as prescriptions for ills rather than cornerstone characteristics of healthy lifestyles that prevent those ills.
I think this makes The Maps We Carry another on the list of books that offer a powerful critique of capitalism without actually using the word. The health industry shapes public understanding of mental illness and the structure of this industry creates path dependency:
I think many psychiatrists tend to subscribe to the biomedical model because that's just the way things are and have been historically, and because they can't see the water they're swimming in. It seems that we have a collective shifting baseline syndrome when it comes to medicalised psychiatry, whereby we think what's happening is normal because the shifts have been incremental and most us can't remember it being any other way. We need only skip backward seventy years (or skip forward seventy years?) to arrive at a time when psychiatry in its current guise did not exist. Right now, the medical model seems impossible to dismantle, having become literally codified and manualised to meet the administrative and financial needs of pharmaceutical and insurance companies, in turn ensuring that doctors are not incentivised to see the water. Altered states of consciousness are very helpful in this regard, since their disruptive nature makes the water unignorable.
Cartwright uses her experience as a frame within which to have a nuanced discussion about the theoretical models with which we understand mental illness: biomedical, psychoanalytical, social, cultural, etc. The Maps We Carry builds very well on other recent books such as How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, Strangers to Ourselves: Unsettled Minds and the Stories That Make Us, and Coward: Why We Get Anxious & What We Can Do About It. Cartwright is insightful and analytical when considering both her own experiences and their broader significance for mental health in the Western world.
It took me a while to review The Maps We Carry as I feel the need to slowly and carefully digest what it says, particularly the last few chapters. Ultimately it is a lot easier to read about the efforts other people have put into healing from mental illness than to put the work in for yourself. I have a lifelong habit of reading about things rather than doing them; if I could read myself well then surely I'd feel better by now. Nonetheless, this book felt mind-expanding, rigorous, and constructive in a way that very little mental health writing manages. I highly recommend it.
April 22, 2024
Fucking phenomenal. Even if you're not into psychedelics (I'm not, really, but did more than my fair share of experimentation in my youth), it's just a banging indictment of our society's approach to mental illness, and how both psychiatry (diagnose, prescribe) or psychotherapy (trace everything back to childhood trauma) fall short. Also a cracking read, and I think she's really brave for coming out with this second memoir that essentially retracts her entire analysis in her first one. Bravo!
September 23, 2025
Brilliant analysis of the current state of our mental health system and the fundamentals which underpin it eg a loss of community and security. It had a nuanced view of the role of psychedelics in mental health and their role within the wider landscape of mental health treatments.
May 18, 2025
The Maps We Carry is a fantastic and eye-opening read, brilliantly revealing how society profoundly impacts our mental health. It offers a crucial new lens for understanding individual struggles within a larger social context. Highly recommended for anyone seeking deeper insights.
January 26, 2025
this book is literally what Moshfegh parodies in 'My Year of Rest and Relaxation,' also misleading title since maps imply a conversation about spatiality which does not occur but wtv. despite rolling my eyes a lot during the reading process, i have a soft spot for pop psychology and Gabor Maté interviews.
February 12, 2025
I think this is the best book I've read about mental health in many years.
It's a deeply personal account of a writer previously diagnosed with OCD and Body Dysmorphic Disorder amongst many other diagnoses moving from being a professional advocate for increasing diagnosis and focus on the medical model, to a rejection of those models and an understanding of herself as a whole person outside of constraining diagnoses and in the context of community, human connection and the social structures we all live within.
It provides a great balance of the benefits and problems of diagnosis, the evidence (or lack thereof) behind the medical model and a psychiatry-focused mental health system, and a personal story of seeing mental health issues through the lenses of illness, trauma and society/culture.
I think it does a good job of not trying to say there's one right answer or that one thing will work for everybody, but still demonstrating the fundamental flaws of our mental health system as it currently stands. While making a clear case for the need for change, it is full of humility and admissions of uncertainty, aspects completely lacking in other books like Johann Hari's.
Basically, I think it's a passionate and persuasive rallying call to a shift towards restoring inter-personal connection and cohesive community as a means to improving the mental wellbeing of the population.
It's a deeply personal account of a writer previously diagnosed with OCD and Body Dysmorphic Disorder amongst many other diagnoses moving from being a professional advocate for increasing diagnosis and focus on the medical model, to a rejection of those models and an understanding of herself as a whole person outside of constraining diagnoses and in the context of community, human connection and the social structures we all live within.
It provides a great balance of the benefits and problems of diagnosis, the evidence (or lack thereof) behind the medical model and a psychiatry-focused mental health system, and a personal story of seeing mental health issues through the lenses of illness, trauma and society/culture.
I think it does a good job of not trying to say there's one right answer or that one thing will work for everybody, but still demonstrating the fundamental flaws of our mental health system as it currently stands. While making a clear case for the need for change, it is full of humility and admissions of uncertainty, aspects completely lacking in other books like Johann Hari's.
Basically, I think it's a passionate and persuasive rallying call to a shift towards restoring inter-personal connection and cohesive community as a means to improving the mental wellbeing of the population.
May 23, 2024
A very interesting view of the mental "wellness" dynamic in our society and how it, and medicine in general has been reduced to simplistic answers that really don't work that well. For me it was very interesting because of parallel experiences in my childhood and adult life, but I'm not sure if this is more of an explanation from the authors point of view. I found it a worthwhile and very engaging read.
May 14, 2025
This book complements Cracked by James Davies so well. It’s an excellent read, especially because I had my own uncertainties about Cracked. This book is very well written—particularly the introduction. I resonated with the author’s hesitations, as her views could come off as offensive to some readers.
The thing about mental illness is that it’s incredibly complex. As a mere reader, it’s difficult for me to explain that complexity accurately—because it’s easy to say something wrong and unintentionally offend those affected by it. On one hand, mental illness is real—it’s not “wrong” or made up. But on the other hand, there are aspects of it that need to be questioned and re-examined. Since mental health is so complex, the way we treat people who experience mental distress should not be reduced to a one-size-fits-all system. The problem arises when treatment is standardized and rigid, ignoring personal experiences and root causes.
There’s still so much that remains unknown about mental health. And the public deserves to know that. People deserve to understand the complexity of mental health, and the consequences of the current systems we use to explain and treat it. For example, we’re often told that conditions like depression, anxiety, or OCD are caused by a chemical imbalance in the brain—but research shows there’s no definitive proof of this. Strangely, this is a well-known fact within the field, yet it remains hidden from the general public. Most patients live their lives on prescription drugs, believing they have a chemical deficiency in their brain.
This is where epistemic injustice occurs: Who decided the public doesn’t deserve to know the truth? Who decided they shouldn’t understand that mental health is not just biological—it’s emotional, social, and deeply personal?
Sometimes—and I say sometimes because I don’t know the full truth—mental illness isn’t an illness in the traditional sense. Sometimes, it’s our body’s way of protecting us from overwhelming emotional pain. In those cases, prescription drugs (which act mainly as pain blockers) may not be the answer. The real answer might lie in uncovering and healing the source of the pain itself.
“I asked him to define mental illness, but I was only met with a series of ‘uhh’ and ‘uhmm,’ which was strange. They couldn’t even define what it was. For them, mental illness seems to be a metaphor for people who are lacking in some way—perhaps lacking affection or care.”
The thing about mental illness is that it’s incredibly complex. As a mere reader, it’s difficult for me to explain that complexity accurately—because it’s easy to say something wrong and unintentionally offend those affected by it. On one hand, mental illness is real—it’s not “wrong” or made up. But on the other hand, there are aspects of it that need to be questioned and re-examined. Since mental health is so complex, the way we treat people who experience mental distress should not be reduced to a one-size-fits-all system. The problem arises when treatment is standardized and rigid, ignoring personal experiences and root causes.
There’s still so much that remains unknown about mental health. And the public deserves to know that. People deserve to understand the complexity of mental health, and the consequences of the current systems we use to explain and treat it. For example, we’re often told that conditions like depression, anxiety, or OCD are caused by a chemical imbalance in the brain—but research shows there’s no definitive proof of this. Strangely, this is a well-known fact within the field, yet it remains hidden from the general public. Most patients live their lives on prescription drugs, believing they have a chemical deficiency in their brain.
This is where epistemic injustice occurs: Who decided the public doesn’t deserve to know the truth? Who decided they shouldn’t understand that mental health is not just biological—it’s emotional, social, and deeply personal?
Sometimes—and I say sometimes because I don’t know the full truth—mental illness isn’t an illness in the traditional sense. Sometimes, it’s our body’s way of protecting us from overwhelming emotional pain. In those cases, prescription drugs (which act mainly as pain blockers) may not be the answer. The real answer might lie in uncovering and healing the source of the pain itself.
“I asked him to define mental illness, but I was only met with a series of ‘uhh’ and ‘uhmm,’ which was strange. They couldn’t even define what it was. For them, mental illness seems to be a metaphor for people who are lacking in some way—perhaps lacking affection or care.”
August 14, 2024
I do not understand how this book comes to be claimed as being radical. Radical in what perspective, radical for whom? It's more like one person's journey in coping with/overcoming difficulties in a particular category. There are no novel discoveries. All it has is one person's realization of what has already been known to many.
The author's background in screenwriting and journalism helps make a nice story. On the other hand, just like so many contemporary stories, it lacks depth. It's a mix of diaries and quotes and fragments of interviews. Perhaps better as a magazine story.
Nor do I like the comparison between the West and the traditional societies. It's cliche. Westerners see the merits in Eastern philosophies because they are already well-versed in Western ideas and can recognize what they're missing. The same holds for orientals.
The author's background in screenwriting and journalism helps make a nice story. On the other hand, just like so many contemporary stories, it lacks depth. It's a mix of diaries and quotes and fragments of interviews. Perhaps better as a magazine story.
Nor do I like the comparison between the West and the traditional societies. It's cliche. Westerners see the merits in Eastern philosophies because they are already well-versed in Western ideas and can recognize what they're missing. The same holds for orientals.
September 22, 2024
I loved this book and I love Cartwright. She is a much needed voice in this time. This book helped deshame me and relate more compassionately to my heavy use of MDMA post some serious sexual assualt trauma.
I love how mental illness is seen as a social issue not an individual personal failing.
The ONLY reason I didn't give it five stars was because there was no part about how if we are to take mental health seriously we should be studying and understanding the impacts of women and their cycles on mental health including contraception.
I personally have OCD and know it gets worse when I am pre-menstrual and think things like this are so important to know and track for women.
I love how mental illness is seen as a social issue not an individual personal failing.
The ONLY reason I didn't give it five stars was because there was no part about how if we are to take mental health seriously we should be studying and understanding the impacts of women and their cycles on mental health including contraception.
I personally have OCD and know it gets worse when I am pre-menstrual and think things like this are so important to know and track for women.
November 10, 2025
So true. The book has moved me to tears so many times, thank you so much for bringing new perspectives, painting a bigger picture. And I hope we all can find a brighter world to live in.
I think I’ve grown so much since I opened the first page of this book, because it’s been encouraging me to look into my “real” self, with or without psychedelics.
I think I’ve grown so much since I opened the first page of this book, because it’s been encouraging me to look into my “real” self, with or without psychedelics.
May 18, 2024
The author seems to be having mommy issue
December 27, 2024
Toch wel heel onder de indruk van dit boek. Andere kijk op psychische problemen. Heb er nooit zelf mee te maken gehad, maar mocht het ooit zo ver zijn dan hoop ik dat ik me dit boek herinner.
April 7, 2025
This was really good. Very thoughtful and provocative. Though the path she pursues (taking MDMA at home alone) is not really one you can do if you have kids, lol.
February 19, 2025
Amazing!! Has changed my whole mindset on mental health and the system that's been set up to help us. Honestly brilliant read!
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