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Karen writes, "What would sanity be like? I cannot substitute someone else's thinking for my own. When I am paranoid I can guess what my sister will say: that people can't be bothered to care so much about my personal life. My fears are absurd. But I am unable to feel reassured. Trust isn't something people arrive at, logically. It's a type of faith. I am a chronic disbeliever. No one seems to be telling the truth. I only pretend I am not being persecuted. I only pretend to believe what others say. I play along, as if I believe what others call sane. But I do not really believe the persecution is imaginary. I doubt I am safe with the raw woundedness of someone recently betrayed. I have my own ideas about how my life makes sense."
In this fictionalized memoir Karen struggles to reclaim her own authenticity from a swamp of denial and mental illness. Why & Why Not explores the questions of what is true, what has value, and how one arrives at forgiveness.

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