I am not a book reviewer and generally don’t weigh in on +/- of art.
I believe that art is subjective and that all art will have both fans and detractors and those perspectives have nothing to do with the quality of the work or the authentic expression of the maker. As an artist myself, I recognize that it’s a coin toss if someone digs my output or not. This is not about that.
I am writing this book review as a mental health researcher, scholar and advocate.
I have loved Elizabeth Gilbert’s writing ever since reading Eat, Pray, Love. I have read it several times. I have watched the movie several times. I read Committed. I like her general style and approach to interviews (except all the “my darlings” shit that I cannot stand). I often recommend her book about creativity, Big Magic. I enjoyed City of Girls. I read Rayya Elias’ book Harley Loco and quite enjoyed it too.
So, I was excited to read Gilbert’s latest book All the Way to the River, a memoir about relationship, love, loss, and addiction.
Yikes.
Yes, Gilbert has solid storytelling chops. She’s a great writer!
But what really saddens me, disappoints me, surprises and confuses me, is the strong current of stigmatizing language used to tell the stories of addiction and mental illness.
For almost a decade, I have been studying stigma and language and mental health. I thought we were getting somewhere. I still regularly hear stigmatizing language in the media, and social media, and even in clinical settings, but hey, this woman has a massive cultural platform to do good, to do better. To cultivate compassion, understanding, and connection among people experiencing addiction and those who experience it through others. And pretty much all of us have a small degree of separation from addiction, either our own or someone else’s.
So it is harmful, not benign, to use this language. The missed opportunity is enormous. This book could have led to greater understanding of the complexity and multidimensional nuances of mental illness, addiction, and recovery.
The stigmatizing language used repeatedly throughout the book has been proven to cause harm: “junkie,” “addict,” “vampires,” “liars, cheaters, thieves,” “clean” and “addicts are different from everyone else.” Why wouldn’t Gilbert confer with a modern, research-based addiction specialist who could advise her on the non-stigmatizing ways to tell the same story without the bitter aftertaste of judgement, hopelessness, ‘othering’ and disconnection?
One person’s experience is just that—an experience, not a proven scientific theory.
I think she could’ve told the same story in a very impactful way while using more helpful language. Of course, how she chooses to identify is up to her. Many people find comfort in describing themselves in traditional terms, most often found in the rooms of 12-step recovery programs. And I can appreciate that her understanding of addiction is through the lens of an up-close-and-personal experience with someone she loves and admires deeply. Some of Rayya’s opinions and assertions about addiction and mental illness are lauded as the right way. I think we can all relate to blind spots and biases when it comes to people we love – we trust them, we revere them, we hold their opinions in high regard. So if this book was a simple sharing of their experiences with addiction – separately and together – I think it would be another powerful memoir about one of the most common social ailments we humans experience.
However, this book reads like a how-to guide to understanding addiction, and that’s where it is harmful. Gilbert has a powerful platform for social connection and improved collective understanding of the ups and downs of the human experience. Unfortunately, using stigmatizing language in this way will likely deepen the general public’s misconceptions and misunderstandings of addiction and recovery. When we use these terms to label others based on behaviour, we ‘otherize’ them, and that leads to judgy sympathy and tsk-tsk’ing, distancing, and proven social harms.
These days, we know more about how addiction actually develops. Yes, there’s a genetic component—some people carry a predisposition toward substance use disorders, a sort of dormant vulnerability in the wiring. But genes aren’t destiny. It’s the environment that often flips those switches: chronic stress, trauma, stigma, financial instability, unsafe work environments, childhood adversity, lack of support, shame, disconnection.
Addiction is almost always a biopsychosocial storm, not a moral failing or a character flaw. When we reduce it to personal weakness or some inherent “addict identity,” we ignore decades of science that show how profoundly context shapes behaviour. And that matters, because the more we understand the interplay between vulnerability and environment, the closer we get to compassion, prevention, and recovery that actually works. If you’re wondering how else she could’ve described the people and actions in her story, simply replacing ‘junkie’ and ‘addict’ with ‘person with addiction’ or ‘someone with substance use disorder.’
If you’d like to learn more about stigma and language, check out this excellent reference by Dr. John Kelly (Recovery Research Institute). I also recommend this learning tool from the Canadian Centre on Substance Use and Addiction. And you can check out a super short blog I wrote in 2024 about how to talk about addiction.
It was also notable how firmly Gilbert asserts that codependency and addiction are interchangeable, one and the same. They’re not.
Addiction is a diagnosable medical condition with clear criteria—compulsion, impaired control, neurological changes, and real health consequences. Codependency, on the other hand, isn’t a psychiatric disorder at all; it’s a relational pattern rooted in over-caretaking, blurred boundaries, and losing yourself in someone else’s chaos. It often develops around addiction, but it is not addiction. The research is very clear on that. When you collapse the two, you erase the complexity of both the person who is consuming the substances and the person who is trying to survive alongside them. You miss the nuance, the systems, the relational dynamics. You reinforce stigma instead of dismantling it. And for a story with this much emotional weight, that oversimplification felt careless and unnecessary.
I don’t expect perfection from anyone—writers included. But I do expect awareness and responsibility when the subject matter carries this much weight. Addiction and mental illness are complex, deeply human experiences, and the language we use shapes how people are seen, treated, and understood. That’s not a small thing.
Despite everything, I’m still hopeful. Language evolves. People evolve. Our understanding of addiction and mental health evolves. Maybe Gilbert’s book will spark overdue conversations about how we talk about these issues, what we get wrong, and how we can do better.
My hope is that we keep expanding our compassion, our accuracy, and our willingness to learn. That we improve our own mental health literacy and compassionately challenge stigma when we see it. That we stay curious about each other’s experiences, even when they’re uncomfortable or unfamiliar. I’m certainly still learning, and I think most of us are.
If anything, reading this book has reminded me how urgently we need to keep pushing these conversations forward—with more care, more nuance, and more humanity. We can move in that direction if we want to. And I really believe we can and we should.
