Elyn R. Saks

I finished this book in tears of joy. I don't know if I can do justice to how much this book moved me as a person with schizoaffective disorder. I've read many books by people who have bipolar disorder and some by parents of people with schizophrenia but this was my first book written by someone who has schizophrenia. That sentence is a mess but I think you can gather the gist.

The fact that Elyn is hospitalized and so greatly affected by her schizophrenia, yet goes on to lead a richly show more successful and fulfilling life is inspiring. I am picking up the pieces of my life after it was shattered last summer. My goal is to put them back together again and Elyn gives me hope that it can happen. So far, being well enough to work eludes me. But I am determined that my years of getting a graduate degree and working in challenging positions will not go to waste. I am taking classes and volunteering as a start, and while it may be years before I work again full-time, I am not giving in, not giving up on my brain.

Thank you, Ms. Saks (if you ever read this), for putting yourself out there when stigma and shame are very real and threatening. You are an inspiration. show less

I thoroughly enjoyed this book. Elyn's recitation of her life and struggle is both pragmatic and incredulous. I found it to be a very straight forward read and one night, when I finally had time to really sit down and dig in I poured through over a hundred pages in what felt like minutes.

Portions of her story are significantly disturbing, including her parents' overreaction to her "drug abuse" and her subsequent "treatment" which sets her up for medication failure in the future, the blase show more way her concerns are at times brushed aside as just another sign of mental illness, and her treatment at the hands of several hospitals. These experiences should make us all take a deep, grim look at what we think is "right" for those who suffer from mental disorders.

Despite how disturbing it was, I also found it very refreshing. Elyn has found great success in her life in comparison to anyone, not just your average schizophrenic. She has a huge support web which really helps her through many tough times and stresses the importance of such people in everyone's lives. It's also notable that not once does she discuss the cost of these treatments, but for most people her good fortune wouldn't be possible due to the huge financial constraints your average middle class American now faces. She repeatedly thanks her own intelligence and hard work for getting her through but also credits her doctors who she often sees on a daily basis, without once seeming to worry about the cost.

That said, I do think there is a take away from Elyn's life, beyond "be able to afford excellent medical care." Elyn battles her disease, her prognosis, and her medication for a large portion of the book. She goes off her drugs multiple times. This isn't some internal flaw specific to her - getting your patients to stay on long term medication is difficult at best, and even harder when it carries a stigma in the form of admitting they have a mental illness. Elyn's epiphany that her medication is not a sign of failure, but rather more like insulin for diabetes or a crutch for a weak ankle, is a pivotal turning point and hopefully something more people will find helpful. Our disgust with mental illness and the treatment of mental illness has turned it into a damned if you will or damned if you won't affair, but the relief Elyn feels after accepting her disorder and her medication is great to see and hopefully will persuade others that they too are just fine taking the medications and accepting the therapy that they need.

All in all a great book which helps present what is actually going on in a schizophrenic's head and hopefully will convince more people to ignore negative stereotypes and help those in need wherever they can. show less

Elyn Saks is a distinguished law professor at USC, where she holds an endowed chair; she is a published author who has studied psychoanalysis; she is someone with a husband and many dear friends; and she is a schizophrenic. “The Center Cannot Hold,” her 2007 autobiography, traces her fall into madness, and her slow climb out. Just as Temple Grandin’s “Emergence” made it possible to begin to understand what it is really like to be autistic, and William Stryon’s “Darkness show more Visible” did the same for serious depression, “The Center Cannot Hold” provides a remarkable account of what it is like to experience psychosis—and what it is like to have the resilience to nonetheless create a successful, productive, happy life.

Even as a child, Saks had experiences that may have presaged her later illness, most notably when she came to believe that the houses she passed on her walk to school were sending her messages. However, she made her way through high school, graduated from college, and then moved to Oxford with a Marshall Scholarship before experiencing her first psychotic break. Over the next two decades, she struggled to control her illness. She obtained significant help from psychoanalysis, despite the common belief that the talking cure does little for schizophrenia. She also benefitting enormously from antipsychotic medicine, although she repeatedly tried to wean herself from drugs, both because she was afraid of their side effects and because they clearly represented the diagnosis she did not want to accept. Each time, her illness returned with a vengeance, and she had to return to the drugs, which she finally realized were saving her life.

Saks’ book takes its title from a quotation from Yeats: “Things fall apart, the centre cannot hold; mere anarchy is loosed upon the world.” It’s a fitting description of Saks’ psychotic breaks, which are essentially, periods of mental anarchy. As she describes it: “Place yourself in the middle of the room. Turn on the stereo, the television, the beeping video game, and then invite into the room several small children with ice cream cones. Crank up the volume on each piece of electrical equipment, then take away the children’s ice cream.

Even more harrowing than Saks’ psychoses, however, are the ways in which she’s treated during her psychotic episodes. In contrast to the humane, dignity-preserving treatment she receives at a British hospital while she’s at Oxford, what happens to her when she goes to the E.R. while at Yale Law School is horrifying. She’s immediately put into restraints, which make her even more agitated and scared, and is force-fed medicine without her consent. It’s the first of several such experiences, and it illustrates a particularly poignant problem for psychiatric patients: “The conundrum: Say what’s on your mind and there’ll be [negative] consequences; struggle to keep the delusions to yourself, and it’s likely you won’t get the help you need.”

Saks is determined to have a life despite her illness, and, she succeeds, against the odds. (She reports that only 20% of people with schizophrenia can be expected to live independently and to hold a job. ) As is probably always the case in any remarkable life, she is helped by remarkable people, including her beloved “Mrs. Jones,” her first psychoanalyst, with whom she develops an intense relationship, treating her almost as a mother figure; Steve Behnke, an extraordinarily close friend whom she meets in law school and on whom she relies on in many ways—she notes that to the current day, they speak almost daily; and her husband Will, who completes her journey to a full life when he accepts her for who she is and marries her.

Reading this book is both profoundly painful, and deeply uplifting. show less

I never thought I'd read a book where a Freudian psychoanalyst is a hero. This book just blew me away - at every turn a frank and open story of mental illness from the person who experienced it. I did the audiobook equivalent of "couldn't put it down".