Roxane Gay’s memoir, Hunger: A Memoir of (My) Body is exquisitely emotionally raw. If my closest friend poured her deepest, darkest secrets out to me, it couldn’t begin to be this vulnerable. It hurt my heart to read chapter after chapter of Gay’s lifetime of emotional and physical pain. And yet, I have conflicting feelings about this book.

For me, as a lifelong person of average to thin weight, Hunger was eye-opening. Since I’m a massage therapist, I regularly treat larger-bodied people on my massage table. What I see is only the outside, the muscles that are hurting. What I learned from Gay is the emotional pain that can correspond to the physical pain. I know this intellectually, but Hunger’s words and feelings punched me in the gut. I have a more complete perspective now.

Anyone who thinks that 12-year-olds are naturally resilient and don’t need professional help after experiencing the trauma of rape must read this book. (Not a spoiler, as Gay tells her story very early on and has written about this event before.) I also hope psychology and healthcare professionals read this book.

That said, I certainly hope Gay has gotten herself into therapy. She doesn’t discuss it at all, even peripherally, in this book and that concerns me. Clearly, she’s a highly educated woman. She knows therapy exists and can help immensely. Sure, it’s a painful process but so is writing this book. And writing as therapy will only get you so far.

I can’t help but compare this book to Shrill by Lindy West, who basically says f-you to everyone who criticizes her size. In Hunger, Gay tells of reacting the opposite way to her critics, by crying and feeling hurt. Because of this, the book slides along the edges of the body-positive movement. Gay isn’t proud of her status as a fat woman. Like all of us, she’s says she’s a work in progress. Fundamentally, it doesn’t seem that Gay feels positive about her body. She alternately struggles to change it or accept it. She lives through prejudicial experiences, as all people of size do. But I’d never say Hunger is about presenting the positives of her body.

After finishing the book, I searched out Gay’s recent interview on The Daily Show with Trevor Noah. I wanted to hear the tone in her voice as she told her story. I heard only honesty and candor, not a bit of whining, and that’s the same tone Gay imparts in her book. I think that assuming she is whining isn’t how she intended the words to be conveyed.

When I’m sorting through a problem, I’ll often wake in the night and scribble down a paragraph or two of half-asleep, yet uncommonly insightful and eloquent, words. Roxane Gay’s chapters are just that short—only a few paragraphs. Some of them are haphazard enough to have started out as midnight scribbles. The chapters in Hunger were repetitive, in that so many of her experiences engender the same response from Gay. The things she goes through happen in every aspect of her life, past and present. Telling them again and again is the point.

I have to say that after a while, it felt like Gay was allowing herself to be in an emotional rut. I wish the editor had done more to shape the repetition or encourage the writer to expand some chapters.

Hunger is both courageous and poignant, but also troubling. I’m absolutely glad I read it, and Gay is uniquely able to allow us to slide under her skin and feel what she feels. My biggest concern isn’t for me as a reader, but for Gay. I do hope she’s getting some somatic (body-connected) therapy to deal with her feelings.