The Shaking Woman, By Siri Hustvedt

Siri Hustvedt's subtle novels have long manifested a fascination with the mind-body duality. How does the first play and prey on the second? More crucially, for our neuroscientific era, how does the second impact on the first?

In What I Loved, one of Hustvedt's characters is researching a book on Charcot's hysterics, that panoply of women who suffered from fits, anaesthesias and paralyses with no identifiable organic cause. Through some mysterious process Freud would later interrogate, the "mental" had been converted into physical symptoms. In The Sorrows of an American, Hustvedt's psychiatrist hero finds himself involuntarily saying the words "I'm so lonely" over and over again, seldom realising that he has spoken. Brain has somehow by-passed mind and awareness to produce speech. So where in all this can the self be said to reside?

Hustvedt's new book is a journey into this perplexing terrain, using the maps and signposts mind doctors and philosophers have provided both past and present. Her voyage is sparked by the fact that she has become a mystery to herself – a patient against the grain, a suitable case for treatment if only the right one could be found.

It all begins (or begins again) two and a half years after her father's death. She is back in Minnesota at the university campus where her father taught Norwegian literature, poised to give a speech in honour of her father. She is a confident and practised public speaker and has prepared thoroughly for the occasion. But no sooner does she look out on the assembled crowd and utter a first sentence than a violent shudder takes her over from the neck down.

"My arms flapped. My knees knocked. I shook as if I were having a seizure. Weirdly, my voice wasn't affected... Astounded by what was happening to me... I managed to keep my balance and continue, despite the fact that the cards in my hands were flying back and forth in front of me. When the speech ended, the shaking stopped. I looked down at my legs. They had turned a deep red with a bluish cast."

There had been one prior instance long before when she felt "as if some superior power picked me up and tossed me about as if I were a doll". That had lasted only for a few seconds, and afterwards she had felt euphoric, "filled with supernatural joy", only then to develop a violent migraine that lasted for a year, though nobody could quite diagnose what was wrong with her.

Migraines had been Hustvedt's constant companions since childhood. The pain, the dizzy spells, divine highs and black lows, together with a single visual hallucination "of a little pink man and a pink ox on the floor of my bedroom", had made her curious about herself. Researching for The Sorrows of an American, she had thrown herself into the study of neurology, psychiatry and psychoanalysis, and that most recent research which attempts to provide links between them all.

Her own convulsing self may act as the spur to Hustvedt's investigations, but it is the lucidity she brings to these which mark the strength of this new book. She thinks her way through complex subject matter with the effortless clarity of a poised and sceptical outsider who has little time for nonsense or the blithe reductionist certainties of supposed experts.

She moves from Charcot to Freud and Janet, with a side-step into Luria and memory work, sifts and marries this with the latest research in neuropsychiatry and neuropsychoanalysis, while bringing to bear on it all her own experience with patients in a psychiatric ward – as well as her prize test case, herself. The result is a short book with an encyclopaedic breadth, one that recognises the "terrible strangeness" of the inner life.

The Shaking Woman is an invigorating antidote to the emotional squelchiness which too often inhabits misery memoirs and illness narratives. Hustvedt is a calm traveller on the storm-tossed seas of the self. If her odyssey provides no ready answers and immediate cures, it deepens understanding. The self she gives us is capacious and never altogether knowable. It is the self novelists engage with; one that, happily or not, escapes the confines of diagnostic manuals.

Lisa Appignanesi's latest book is 'Mad, Bad and Sad' (Virago). She will be in conversation with Siri Hustvedt at Foyles on 3 February: www.foyles.co.uk