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The Centre Cannot Hold: A Memoir of My Schizophrenia

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Elyn R. Saks is an esteemed professor, lawyer and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry and the Behavioral Sciences at the University of Southern California Law School, yet she's suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness. The Center Cannot Hold is the eloquent, moving stor Elyn R. Saks is an esteemed professor, lawyer and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry and the Behavioral Sciences at the University of Southern California Law School, yet she's suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness. The Center Cannot Hold is the eloquent, moving story of Elyn's life, from the first time that she heard voices speaking to her as a young teenager, to attempted suicides in college, through learning to live on her own as an adult in an often terrifying world. Saks discusses frankly the paranoia, the inability to tell imaginary fears from real ones, the voices in her head telling her to kill herself (and to harm others); as well the incredibly difficult obstacles she overcame to become a highly respected professional. This beautifully written memoir is destined to become a classic in its genre. The title is a line from "The Second Coming," a poem by William Butler Yeats, which is alluded to in the book.


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Elyn R. Saks is an esteemed professor, lawyer and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry and the Behavioral Sciences at the University of Southern California Law School, yet she's suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness. The Center Cannot Hold is the eloquent, moving stor Elyn R. Saks is an esteemed professor, lawyer and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry and the Behavioral Sciences at the University of Southern California Law School, yet she's suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness. The Center Cannot Hold is the eloquent, moving story of Elyn's life, from the first time that she heard voices speaking to her as a young teenager, to attempted suicides in college, through learning to live on her own as an adult in an often terrifying world. Saks discusses frankly the paranoia, the inability to tell imaginary fears from real ones, the voices in her head telling her to kill herself (and to harm others); as well the incredibly difficult obstacles she overcame to become a highly respected professional. This beautifully written memoir is destined to become a classic in its genre. The title is a line from "The Second Coming," a poem by William Butler Yeats, which is alluded to in the book.

30 review for The Centre Cannot Hold: A Memoir of My Schizophrenia

  1. 4 out of 5

    Robert

    It's a little sad and frustrating when people read this and say things like "whenever she's off her meds, she has an episode, she should just stay on them!". The most difficult thing in treating mentally ill people is getting them to take and stay on their meds for reasons she details in her book. First, there are usually pretty severe side effects such as permanent nerve damage that causes you to twitch and spasm constantly, have trouble thinking clearly, have no energy and put on a lot of weigh It's a little sad and frustrating when people read this and say things like "whenever she's off her meds, she has an episode, she should just stay on them!". The most difficult thing in treating mentally ill people is getting them to take and stay on their meds for reasons she details in her book. First, there are usually pretty severe side effects such as permanent nerve damage that causes you to twitch and spasm constantly, have trouble thinking clearly, have no energy and put on a lot of weight. Second, when you're feeling fine for a long period of time it can be hard to believe that you're actually still sick. Third, there's such a strong stigma against mental illness and people who are medicated for mental illness it leads you to feel worthless or inferior when you need meds to control your situation. She has had far more positive impact with her life with this debilitating, incurable illness than most people will have without such an obstacle. If you have no empathy this book will frustrate you. That would also make you an asshole.

  2. 5 out of 5

    Always Pouting

    This is a memoir by a lawyer who has severe schizophrenia and talks about struggling to deal with it while getting through school and then using her unique insight into it to help others with mental illness. If anyone likes TED talks I know the author has one where she discusses it also. I enjoyed the TED talk more than the actual memoir mostly because TED talks force you to cut down to the most important events or ideas but the memoir seemed to drag in a lot of places. It's interesting but at t This is a memoir by a lawyer who has severe schizophrenia and talks about struggling to deal with it while getting through school and then using her unique insight into it to help others with mental illness. If anyone likes TED talks I know the author has one where she discusses it also. I enjoyed the TED talk more than the actual memoir mostly because TED talks force you to cut down to the most important events or ideas but the memoir seemed to drag in a lot of places. It's interesting but at the same time a lot of it felt like it didn't need to be there to help the reader understand Saks and her struggle any better. It's on the higher side of 3 stars or lower side of four stars for me, the writing was really good but again a lot of the book just didn't feel like it imparted much insight. I would suggest checking out her TED talk and if you still want to learn more then reading the memoir as well.

  3. 5 out of 5

    William2

    I have this fascination for mental health memoirs. I’ve read about a dozen or so, among them: Zen and the Art of Motorcycle Maintenance, which is brilliant, one of the essential books of my life; Memoirs of My Nervous Illness by Daniel Paul Schreiber; Awakenings by Oliver Sacks, this more of a multi-persona biography than a memoir; William Styron’s Darkness Visible; Kay Redfield Jamison’s An Unquiet Mind; Andrew Solomon’s The Noonday Demon; Frigyes Karinthy’s A Journey Round My Skull; and The Co I have this fascination for mental health memoirs. I’ve read about a dozen or so, among them: Zen and the Art of Motorcycle Maintenance, which is brilliant, one of the essential books of my life; Memoirs of My Nervous Illness by Daniel Paul Schreiber; Awakenings by Oliver Sacks, this more of a multi-persona biography than a memoir; William Styron’s Darkness Visible; Kay Redfield Jamison’s An Unquiet Mind; Andrew Solomon’s The Noonday Demon; Frigyes Karinthy’s A Journey Round My Skull; and The Collected Schizophrenias by Esmé Weijun Wang. The last here is a recent publication and completely enthralling. Wang led me to Elyn R. Saks. Interesting so far is the early collapse of Elyn’s social world. The early adulthood onset of schizophrenia is so brutal. She’s barely 19 and attending Oxford on a Marshal scholarship when she turns resolutely inward, meaning silent. She’s a philosophy major. Saks has a rich emotional memory. She remember strings of dialogue, but also the succession of her emotional states. I have that skill, too. Every humiliation is so readily recalled. Her first experience of any sort of mental health care was in England, where she was never restrained. In England she found affordable psychoanalysis from a talented woman. It saved her. She graduated Oxford with honors, finished her treatment with Mrs. Jones, the analyst, and returned to the U.S. as she was about to undergo a severe intensification of her illness. At that time, 1981, psychoanalysis, though it was the only treatment she responded to, was out of favor, and the next generation of antipsychotics had yet to come along. (Oliver Sacks, who blurbs this book enthusiastically, wrote Awakenings which discusses the dreaded side effects of some of the first-generation antipsychotics like L-DOPA.) Author Elyn Saks was finally diagnosed with “chronic paranoid schizophrenia with acute exacerbation.” Her prognosis was termed “grave.” She was now attending Yale law school and spending much time in its mental health facilities. It was Yale-New Haven Hospital that Saks was brutally restrained for the first time. She argues convincingly that such restraints were for the convenience of the staff, not for her own well-being. She suffered inordinately. (Ironically, it was also in a Yale-operated psychiatric hospital that Esmé Weijun Wang, author of The Collected Schizophrenias, would be ruthlessly manhandled more than a generation later.) It’s when Saks begins to help mentally ill people like herself, that the story becomes doubly interesting. Today she is a professor at USC’s Gould School of Law. Please look for her TED Talk. Astonishing is her achievement when you consider that many with schizophrenia spend their adult lives playing with their feces or babbling or screaming much of the time. An early lesson. Working with a fellow student, she advocates for a young man to be released from some back ward somewhere who then goes on to burn his mother, father and sibling to death in their trailer. So she has herself gone from powerlessness to being the possessor of formidable legal tools that can be used for good, certainty that’s her goal, but which may have an unknowable downside, too. The prose here is very flat, direct, without subtext. Everything is on the surface. The primary objective is communication. One tires of her up and down struggle with her medication, of her refusal to believe she is mentally ill despite the Mt. Everest of evidence. Yet the medication has the possible side effect of Tardive Dyskinesia, a wretched jerking and plodding manner of walking and bodily movement that is irreversible. She rightly fears it because of this. So she keeps going off her meds whereupon she has a psychotic break. It’s a dreary repetitive cycle that lasts for years. In the meantime—I love this—she completes all the publications necessary to be awarded tenure at USC. But her psychiatrist is dismayed at her stubbornness. Finally, he threatens to end treatment with her if she goes off again. She has an epiphany about her “maladaptive stubbornness.” Thankfully the new generation of anti-psychotics appears. It has its downside, too, but it’s minimal compared to the old drug. She subsequently suffers breast and ovarian cancer in two separate episodes. This woman’s will despite madness and grave illness is astonishing. This is the first story about high-functioning schizophrenics I have ever read. It’s a remarkable document that changes one’s thinking entirely.

  4. 4 out of 5

    jv poore

    I recently visited a few high school English classes to introduce Nic Sheff's first novel, Schizo. In Schizo, the main character, a 16-year old boy, tries to learn how to live with Schizophrenia. After I explained that I felt that it was very important for us to work together to reduce the stigmas often associated with mental health disorders, one of the students enthusiastically recommended Ms. Saks' book. I have never been disappointed with a book that a student recommends. I recently visited a few high school English classes to introduce Nic Sheff's first novel, Schizo. In Schizo, the main character, a 16-year old boy, tries to learn how to live with Schizophrenia. After I explained that I felt that it was very important for us to work together to reduce the stigmas often associated with mental health disorders, one of the students enthusiastically recommended Ms. Saks' book. I have never been disappointed with a book that a student recommends.

  5. 4 out of 5

    Moira Russell

    Hmmm, this was....interesting. Rather poorly written: emotionally flat all through, often repetitive and very 'cerebral' - the outer sensuous world almost entirely lacking. The middle part, where she describes a full-scale breakdown resulting in restraints and involuntary medication, is harrowing, and should be required reading for medical students, legal students, and indeed psychiatric caregivers. However, her insistence on always having been the best at everything, ever ("I was valedictorian. Hmmm, this was....interesting. Rather poorly written: emotionally flat all through, often repetitive and very 'cerebral' - the outer sensuous world almost entirely lacking. The middle part, where she describes a full-scale breakdown resulting in restraints and involuntary medication, is harrowing, and should be required reading for medical students, legal students, and indeed psychiatric caregivers. However, her insistence on always having been the best at everything, ever ("I was valedictorian....I wrote the finest exam at Oxford....he said my memo could be a paper...I was in the 99% of the bar exam results...I won tenure" &c &c) becomes annoying after a while. Her decades-long resistance to medication finally ends and it's quite clear she is able to do what she does only while on medication, but she still places all her emphasis on talk therapy (not surprising -- she went on for psychoanalytic training). Given the extreme stigmatization of schizophrenics (think any episode of 'Law and Order,' practically), the writing-off of the mentally ill and the continental shift from therapy to medication, her experiences and viewpoint are important. But it may be a revelation of my venal nature, or just a side effect of over twenty years with bipolar disorder and no insurance, but I was left wondering how she paid for - or who paid for - apparently nearly two decades of intensive, top-drawer, near-daily intensive psychotherapy. This is never hinted at in the book. Given how severely mental illness disables people, and how much of her work was originally with the very poor, very mentally ill, this seems a sizable omission, especially in such an honest and thorough recollection. She makes it clear that she had a large and devoted support network of coworkers, dear friends, doctors, and family members, and makes it equally clear she wouldn't have been able to survive let alone flourish without them, so that makes the invisible money supply even more odd. - In fine I guess I feel a little bit about this the way I feel about the old Helen Keller question. When you asked people what kind of a loving God would send people into the world blind, deaf, &c (in itself a question that would probably not be asked now, heh) they used to point to Helen Keller. Look at everything she accomplished! and so on, and while she did accomplish amazing things, that doesn't somehow erase the existence of everyone disabled who was not Helen Keller. A friend of mine calls this "the SuperCrip phenomenon" -- like those people who think the legless runner with carbon steel prostheses has an "unfair advantage" over the competition. No, because he doesn't have feet. Obviously, because schizophrenia is severely disabling, because it is so stigmatized and the treatment for it so poor, and the people it attacks are often isolated, broke, and often warehoused or shoved out into the street, it takes someone like Elyn Saks -- someone with extreme intelligence, determination that could probably change planetary orbits, insurance and/or enough money to find and keep good treatment, and all her other advantages -- to write this book, and she knows it. The main thrust of her book is to tell people who are not mentally ill, "Schizophrenic people aren't monsters - I'm just like you." But we should also remember all the others not like her -- the ones not blessed with her gifts, the ones not able to earn her considerable achievements: the ones teetering on the edge, or dead, or so silenced they might as well be dead. Despite her lengthy training and considerable talent at advocacy, Saks can't speak for them; nobody can. Even for 'he that hath ears to hear,' their stories are silent. (also this book has just a terrible terrible title. Yeats yes yes - still worthy, if terribly overused - but the book makes it clear this isn't a journey through madness (("madness"? WTF?)) - that she has schizophrenia, and she'll always have it. You don't get "through" that.)

  6. 4 out of 5

    Terry

    This book is written by a friend/mentor of mine at USC. It was extremely bizarre to read something so intimate by & about someone I know, so my experience of reading it will be different from the experience of others. That said, I think it's quite powerful. What Elyn is able to pull off is describing, from her currently "sane" place, what it feels like to be severely schizophrenic. Her bridge-building into that experience is rare and worthwhile, and can move a reader's empathy for the mentally i This book is written by a friend/mentor of mine at USC. It was extremely bizarre to read something so intimate by & about someone I know, so my experience of reading it will be different from the experience of others. That said, I think it's quite powerful. What Elyn is able to pull off is describing, from her currently "sane" place, what it feels like to be severely schizophrenic. Her bridge-building into that experience is rare and worthwhile, and can move a reader's empathy for the mentally ill to a new level (at least it did that for me). It's inspiring to see someone struggle with extreme illness and still somehow create a happy, successful, full life for herself. For me the main downside was reading it before bed was stressing me out and giving me bad dreams, especially the parts about forced hospitalizations and being in four-point restraints. Maybe don't read it in bed.

  7. 4 out of 5

    Swaroop

    The Center Cannot Hold: My Journey Through Madness by Elyn R. Saks This is a remarkable memoir by Elyn R. Saks. An inside peek of the experiences she had while going through mental illness. Elyn R. Saks has recounted many years of her life, in detail. Instead of falling apart and giving in, Elyn fought back and this helped her to continue to live a fulfilling life. "The HUMAN BRAIN comprises about 2 percent of a person's total body weight, but it consumes upward of 20 percent of that body's oxyg The Center Cannot Hold: My Journey Through Madness by Elyn R. Saks This is a remarkable memoir by Elyn R. Saks. An inside peek of the experiences she had while going through mental illness. Elyn R. Saks has recounted many years of her life, in detail. Instead of falling apart and giving in, Elyn fought back and this helped her to continue to live a fulfilling life. "The HUMAN BRAIN comprises about 2 percent of a person's total body weight, but it consumes upward of 20 percent of that body's oxygen intake, and it controls 100 percent of that body`s actions." This book is recommended for everyone - as we all know of a person, a family member or a friend, who is either going through this suffering or experiencing all these symptoms. As Elyn R. Saks states multiple times throughout the book, people with mental illness situations are often plagued with stigma and also discrimination. Hence, it is encouraged to go through this memoir to get an understanding and it will help everyone to become more compassionate and most importantly, will stop judging. My only concern was if, in the title, the word "Madness"could be replaced with another word - because, for sure, you are not mad! Thank you, Elyn R. Saks! "Don't take my devils away because my angels may flee too."

  8. 4 out of 5

    Eliza

    Wow. This was wonderful and terrifying. But mainly it was incredibly eye-opening.

  9. 4 out of 5

    Sarah Lumos

    “There’s days I feel guilty for feeling so good” Damn, this book left me speechless. If you or someone you know copes with a mental illness, then read this book. Heck, even if mental illness has played no role in your life, read this book. To me, Elyn R. Saks embodies the epitome of resilience - the ability to bounce back and keep going when things get difficult. She is a TED speaker, ivy league graduate, renowned academic at the University of Southern California Gould Law School, plus a tota “There’s days I feel guilty for feeling so good” Damn, this book left me speechless. If you or someone you know copes with a mental illness, then read this book. Heck, even if mental illness has played no role in your life, read this book. To me, Elyn R. Saks embodies the epitome of resilience - the ability to bounce back and keep going when things get difficult. She is a TED speaker, ivy league graduate, renowned academic at the University of Southern California Gould Law School, plus a total bad-ass. And she accomplished all this while coping with schizophrenia, a thought disorder characterized by delusions, hallucinations, and disorganized speech. Throughout the book, though Saks is uncertain about her future, she has a passion for legal studies, philosophy, and as an undergraduate, admires the rigorous and prestigious life of her professors. Her experience with mental illness also enables her to deconstruct problems with a creative and compassionate lens - a skill that will play a critical role in her future career. While not being the best indicator of healthy self-esteem, school work gives her a tangible way to gauge her self-worth and in some ways, academia becomes her saviour. Given its strong emphasis on academics, impostor syndrome, and mental illness, this book is valuable for students. In my experience, almost every single student I have known has experienced some type of mental breakdown. Academia is rewarding, but it is also competitive, strenuous, and like the Hunger Games IRL - just as gruesome, but less bloody. Yes, Saks is a renowned academic, but her journey did not follow a linear progression. There were even periods she had to take breaks from her academic studies to enter treatment facilities. Despite her chronic psychotic episodes, she denies having a mental illness for years. Sometimes for people with mental disorders, admitting you need longterm help is just as difficult as the actual illness itself. Without acknowledging a problem exists, nothing remains to be solved, and mental illness go untreated. We want to see ourselves as fighters for coping with these inner demons, and we are, but we cannot fail to acknowledge them as illnesses that need medical attention. As Saks mentions in this book, taking medication is not cheating. If you broke a leg and needed a crutch, would you refuse to take it? I don't think so. In this book, Saks is nothing but her raw, talented, and honest self. She never sugar coats the debilitating nature of her mental illness. Yes, she has extraordinary grit and access to mental health treatment, but if somebody offered her a magical pill that could get rid of her schizophrenia, she would do it in a heart beat. This passage hit me hard: Writer Tennessee Williams affirmed, “If I got rid of my demons, I'd lose my angels.” But Saks believes her demons are so bad that they make her angels fly away too. I suspect many will see themselves in Saks. She is awkward, struggles to focus on her work, has trouble forming meaningful friendships, and despite achieving success, continues to doubt herself. It made me feel like I was not alone in my awkwardness. Sometimes when I read books, the popularity and social skills of the people astounds me. Like how can people be so cool? And I'm here struggling to form coherent sentences. I hope everybody gets the chance to read this book. It helped me come to terms with my own struggles, and how I can continue fighting and moving forward despite them. For me, reading The Center Cannot Hold: My Journey Through Madness was inspiring. As cliché as it sounds, Saks helped me confirm that even in the most dismal circumstances, there can be light and something worth fighting for.

  10. 5 out of 5

    Rebecca

    The Center Cannot Hold offers a rare peek into the raging mind of a schizophrenic. While the author is anything but a case study (she is brilliant and accomplished even by mentally intact standards, whereas schizophrenia is usually accompanied by low IQ and functional impairment) her uncommon mental clarity enables her to shed light on an otherwise inscrutable disorder. Of the several memoirs of mental illness I've read, this book offers the most convincing dialogue of psychotic and depressed cha The Center Cannot Hold offers a rare peek into the raging mind of a schizophrenic. While the author is anything but a case study (she is brilliant and accomplished even by mentally intact standards, whereas schizophrenia is usually accompanied by low IQ and functional impairment) her uncommon mental clarity enables her to shed light on an otherwise inscrutable disorder. Of the several memoirs of mental illness I've read, this book offers the most convincing dialogue of psychotic and depressed characters. It also offers an unflinching and disturbing view of the Freudian psychoanalytic tactics used to treat the mentally ill. From a conversation with the author's psychoanalyst, Mrs. Jones: The author: I am in control. I control the world. The world is at my whim. I control the world and everything in it. Mrs. Jones: You want to feel in control because in fact you feel so helpless. The author: I had a dream. I was making golf balls out of fetuses. Mrs. Jones: You want to kill babies, you see, and then make a game out of it. You are jealous of the other babies. Jealous of your brothers, jealous of other patients. You want to kill them. And then you want to turn them into little balls so you can smack them again. ... "Are you trying to kill me?" I hissed. "I know about the bombs. I can make a bomb, too. You are the devil. You are trying to kill me. I am evil. I've killed you three times today. I can do it again." The author’s compassionate treatment of the mentally ill does a great service to readers. She assumes the role of educator and advocate. She convincingly makes a case against the American mental health system, which too often confiscates the autonomy and dignity of its charges, and argues passionately against the use of physical restraints among even violent mental patients. Her push for broader emotional therapies for the mentally ill in tandem with pharmacological treatment (as opposed to the solely pharmacological approach found too often in the US) is powerful and, with luck, will change the minds of medical professionals. As a book, however, the memoir is imperfect. The author arranges events in strict chronology, and gives every event the same narrative weight: her high school experimentation with mescaline, her major psychotic episodes, her first day at law school, the occasions on which she meets minor characters. She probably intends to imbue each incident with the same emotional value, to showcase her normality along with her abnormality. Unfortunately, it has the effect of diluting the plot (even a memoir must be propelled along some trajectory). Even more unfortunate, however, is the author’s tendency to reveal her own impoverished capacity for sympathy and insight. Resentment clouds her portrayal of her long-time psychoanalyst. ("He'd rejected me, he'd betrayed me.") She also describes her parents' growing remoteness with the kind of thoughtless confessionalism one might expect from a reality show contestant. It is clear that the author has omitted her role in the deterioration of those relationships, and fails to understand the damage her indiscretion will cause to the people in her life. Worse, neither of these accounts are relevant to the development of the characters or to the progression of the memoir--rather than meaningful revelation, they smack of careless slander. Ultimately, the book reads not as a cohesive memoir but as a diary, circumscribed by the author's own very limited perspective, occasionally muddled, but extraordinary nonetheless.

  11. 5 out of 5

    Joanne

    I'm going to totally and consciously cop out on this review. Yes, the book was maddening to read at times given the "one step forward, five steps back" nature of her journey. And I beat myself up throughout most of it, as my impatience with Saks's actions grew. She takes the meds. She feels better on the meds. She insists on abandoning the meds. She goes "floridly psychotic," gets hospitalized and has a horrific time of it. Multiply that sequence by 20-25 and you get the first 300 pages of the b I'm going to totally and consciously cop out on this review. Yes, the book was maddening to read at times given the "one step forward, five steps back" nature of her journey. And I beat myself up throughout most of it, as my impatience with Saks's actions grew. She takes the meds. She feels better on the meds. She insists on abandoning the meds. She goes "floridly psychotic," gets hospitalized and has a horrific time of it. Multiply that sequence by 20-25 and you get the first 300 pages of the book. As I chafed against the repetition of this vicious cycle, I thought "Could I really be this cold and lacking in empathy? Compassion is what's called for here!" And then I realized: *this* inability to see things as they are is the essence of her disease process, and the crux of all types of insanity: doing the same things over and over again and expecting different results. I can't say I loved this book, but it was an important and revealing look into the mind of a person who is both brilliant and tortured... and very brave.

  12. 4 out of 5

    howl of minerva

    Elyn Saks is an unusual figure to say the least. An academic superstar: Vanderbilt valedictorian, Marshall scholar to Oxford for graduate study in philosophy (Aristotle's metaphysics in the Greek no less), Yale Law School, tenured faculty at U South California, MacArthur "Genius" Fellow. And since her late teens, battling with schizophrenia: disabling and terrifying bouts of delusions and hallucinations. High-functioning people with mood disorders like depression or bipolar disorder are all arou Elyn Saks is an unusual figure to say the least. An academic superstar: Vanderbilt valedictorian, Marshall scholar to Oxford for graduate study in philosophy (Aristotle's metaphysics in the Greek no less), Yale Law School, tenured faculty at U South California, MacArthur "Genius" Fellow. And since her late teens, battling with schizophrenia: disabling and terrifying bouts of delusions and hallucinations. High-functioning people with mood disorders like depression or bipolar disorder are all around; many of them manage to hide their illness very effectively. Perhaps they are even your colleagues, your doctor or your lawyer. High-functioning people with schizophrenia are vanishingly rare. (The only other example that comes to mind is the mathematician John Nash). This is the disease of those people you try to ignore on public transport, who mutter and shout to themselves or apparently at random, who drift down the social ladder to homelessness and addiction, who appear unable to care for themselves or to hold down any kind of employment. Saks' memoirs should remind us that this outcome is not inevitable, that people with psychotic disorders can lead fulfilling lives. Of course she had well-off parents and access to excellent care. Again unusually for psychotic disorders, she has found psychoanalysis greatly beneficial. But the lesson stands. Anti-psychotic medication - for all its flaws, side-effects and problems - has helped her remain functional. She has brought her personal and professional experience to bear on the ethico-legal problems of psychiatry: competence, restraint, right to refuse treatment etc. The most interesting parts of the book are the first-person descriptions of how psychosis disintegrates one's relationship to reality. To describe this is a waking nightmare would be almost literal. Recommended for anyone with an interest in mental illness.

  13. 4 out of 5

    Amanda

    4.5 stars! This is an eye-opening memoir by a fascinating woman. Elyn R. Saks is a highly functioning intelligent woman with multiple higher degrees from places like Oxford and Yale and she just happens to have Schizophrenia. In this memoir she does battle with her demons and for the most part she wins. I found this to be extremely inspiring. It is also a look into the way we treat mental health especially in the US. It's pretty bad. 4.5 stars! This is an eye-opening memoir by a fascinating woman. Elyn R. Saks is a highly functioning intelligent woman with multiple higher degrees from places like Oxford and Yale and she just happens to have Schizophrenia. In this memoir she does battle with her demons and for the most part she wins. I found this to be extremely inspiring. It is also a look into the way we treat mental health especially in the US. It's pretty bad.

  14. 5 out of 5

    Cori

    I will be thinking about Elyn and her book for a long time. For the last nine years, I've worked on an inpatient psychiatric unit, first as a nurse intern, and eventually as a nurse. I dearly love my patients with all of my heart, and believe there is no group that is more discriminated against in most of the world. At least, truly, in America, there is little to no discrimination left culturally- EXCEPT for mental illness. Fight me on this. But no one can unless they've seen it first hand, whic I will be thinking about Elyn and her book for a long time. For the last nine years, I've worked on an inpatient psychiatric unit, first as a nurse intern, and eventually as a nurse. I dearly love my patients with all of my heart, and believe there is no group that is more discriminated against in most of the world. At least, truly, in America, there is little to no discrimination left culturally- EXCEPT for mental illness. Fight me on this. But no one can unless they've seen it first hand, which I have. For nine years. I've had patients tell me they would rather be diagnosed with cancer. At least then people won't tell you to "just go for a walk and you'll feel better." At least then, they buy you flowers. Patients of every color, creed, and religion come together in solidarity in our unit because they know they are the remaining unfortunate few who truly know what discrimination is. Elyn's story is heart-wrenching as the reader watches her wrestle from beginning to end with fear of accepting her mental illness, uncertainty about sharing it with others, and decades of battling over taking her meds because doing so is to acknowledge the illness. My only sticking point with this story is Elyn's relationship with one of her psychoanalytic therapists, Mrs. Jones. I'm pissed at Mrs. Jones. Not only is the Freudian preoccupation bizarre, but she knowingly allowed her client to develop a codependent relationship with her, encouraging her to wallow in her psychosis during their sessions, and never directed her to take much needed medications. Elyn's brain was on fire the entire time they met. I do not like Mrs. Jones. The juxtaposition in Elyn's treatment in the 80s versus the care we give now was horrifying. While some of the inpatient treatment she received was appropriate, there is a REASON we've moved away from some of the old methods of treatment, including extreme requirements for use of restraints. That hurt my heart to read. If you are interested in a mind's eye view of the schizophrenia experience, I highly recommend this book. I'd rate this book an PG-13 for scary situations, adult content, some swearing, some discrete sexual encounters, and mild drug use.

  15. 5 out of 5

    Tracy

    Saks presents an articulate and honest portrayal of her life with schizophrenia, from its early days to the present. She doesn't deny the severity of her symptoms, while also acknowledging that the life she's built for herself is atypical -- she is a married, tenured law professor at USC with degrees from Vanderbilt, Oxford, and Yale. The most devastating part for me was Saks' account of her days in the Yale psychiatric centers, acting out and recognizing that the staff didn't particularly care Saks presents an articulate and honest portrayal of her life with schizophrenia, from its early days to the present. She doesn't deny the severity of her symptoms, while also acknowledging that the life she's built for herself is atypical -- she is a married, tenured law professor at USC with degrees from Vanderbilt, Oxford, and Yale. The most devastating part for me was Saks' account of her days in the Yale psychiatric centers, acting out and recognizing that the staff didn't particularly care if she got better; they just wanted her to behave. This book makes a good case for the necessity of mental health reform in the US, particularly because Saks' first full psychotic break occurred in Great Britain and she spent years in treatment there before being treated in the US. It also nuances the many ways that stigma against mental illness persists, even among those who claim to be healers, and how that can make it difficult for those with illness to admit to themselves that they are ill. And it presents an eloquent case for the power of psychoanalysis as a tool for determining the functions of psychosis and for allowing Saks to eventually focus on all of the aspects of her life, not just the illness or the work that served as her salvation from the illness for so long. What this account does best in many ways is present the power of a fighting spirit, the places where that fight can cause problems, and the power of friendship in the darkest of days.

  16. 5 out of 5

    Crystal

    Apparently on a roll with reading memoirs related to my diagnosis. Can't believe my psychiatrist recommended I read this. This book left me utterly cold. Her experience in the psych ward was moving (I cried) but her pull yourself up by your bootstraps mentality is frustrating, as is the fact that her self-worth revolves around her being the best, the smartest, etc., etc. When the author's psychoanalyst describes her as "a republican" when it comes to the mentally ill they are not kidding. Her lac Apparently on a roll with reading memoirs related to my diagnosis. Can't believe my psychiatrist recommended I read this. This book left me utterly cold. Her experience in the psych ward was moving (I cried) but her pull yourself up by your bootstraps mentality is frustrating, as is the fact that her self-worth revolves around her being the best, the smartest, etc., etc. When the author's psychoanalyst describes her as "a republican" when it comes to the mentally ill they are not kidding. Her lack of generosity towards those who 'give up' by going on disability—to people who don't have parents that can bankroll seeing a psychoanalyst daily and who can basically pop in to said psychoanalyst whenever a crisis happens—is damning. Also, it's John Nash all over again. A genius who has schizophrenia accomplishes major things, people point to them as "what you could do if you tried harder." "Why don't you write a book?"

  17. 4 out of 5

    Cindy

    Elyn R. Sak's The Center Cannot Hold tells the story of the author, a Yale law school graduate from a well-to-do family who deals with her chronic depressive schizophrenia amidst the struggles of school, a career, and her own willpower. The book is set in a number of places, such as Miami, Britain, New Haven, and Los Angeles, in the time period between the 1960s and the 1990s, when the world was just learning about how serious mental illnesses can be. Hoping gain some sense of being normal, Saks Elyn R. Sak's The Center Cannot Hold tells the story of the author, a Yale law school graduate from a well-to-do family who deals with her chronic depressive schizophrenia amidst the struggles of school, a career, and her own willpower. The book is set in a number of places, such as Miami, Britain, New Haven, and Los Angeles, in the time period between the 1960s and the 1990s, when the world was just learning about how serious mental illnesses can be. Hoping gain some sense of being normal, Saks puts herself through Yale law school and a profession while dealing with constant episodes of schizophrenia. Saks uses her intelligence and willpower to overcome the demons in her mind, which prevent her from maintaining steady relationships and reaching her full potential as a student, professor, and friend. The book reveals a vivid account of schizophrenia to show that our way of treating "psychotic" patients is not always based on the needs of the misunderstood victim, but based on our perception of the mental illness, which makes us reconsider who the crazy people really are. The most memorable event in the book is when Saks is locked up in the Yale Psychiatric Institute (YPI). After having a breakdown in the university library, in which she ends up on the roof singing and accepting dares, Saks visits Professor M., the instructor for her criminal law class, for assistance on a memo. He brings her to YPI, where she refuses to take antipsychotic drugs. The stern officials tie her down and treat her in a dehumanizing manner. Saks uses all her strength and will to fight her way out, but there is no avail. Eventually, she realizes that it would be best if she kept her mouth shut and behaved well, fighting the process of releasing the demons in her mind, which, in turn, counteracts any progress she had made. These memorable events add up to a captivating story of the brilliance and betrayal of the mind. I often found myself engrossed with the series of events, and I even felt ashamed for having similar misconceptions of the mentally ill. I was able to share a sense of sympathy and compassion for the author, after realizing that we share more similarities than the differences that our minds create. This book, a first-hand account of the world of a schizophrenic, presents a thought-provoking, unique, and touching story that relies heavily on an open mind, one which is willing to accept that a mental illness is not what defines you, but makes up a small piece of who you are. This first-hand account allowed me to educate myself on related topics, such as psychology and medicine. There are many interesting facts and comments that give the reader a detailed insight on the differences between the way a healthy person and an ill person view schizophrenia, medical care, and their world. I was able to learn about the drugs used to treat schizophrenia, the psychoanalytic techniques used by her therapists, and the requirements for achieving tenure at USC. This book is an amazing summary of the entirety of being mentally ill along with factual information, a little bit of romance and humor, and a story of failure and triumph. It's an eye-opening read that will change the way you think about the mentally ill, the brain, and the human capabilities. Ultimately, the story of Professor Elyn R. Sak's jounrey to finding the life for her with a mental illness is the story of the suffering that comes with the denial of being a schizophrenic; working physically and mentally against her own mind to find a sense of normalcy; and satisfying the needs of "The Lady of the Charts", Professor Saks, and Elyn, all figures that Saks's psychoanalyst Kaplan created to portray her broken mind. It all adds up to a tale of human strength, an example that shows the world that a mental illness does not deprive one from the same will power and motivation as someone who does not share the shattered mind. The Center Cannot Hold tells that story incredibly well, encouraging us to look more deeply into the minds of the mentally ill and helping them find the passion and life that's right for them, rather than setting more limitations on them than their minds already do. Of the many books I've read independently, this book is definitely one that was worth reading. I would, without hesitation, recommend it. It's is an incredible and inspiring tale of a woman who proved the medical world wrong. The book gives a vivid tour of the mind of the schizophrenic, showing that schizophrenics pose a greater threat to themselves than to the rest of the world. It presents everything you need to know about dealing with schizophrenia, wrapped in an awe-inspiring narrative, an unforgettable account of the broken mind.

  18. 5 out of 5

    Mark

    The more I study the issue of schizophrenia, the more I realize what tremendous courage it takes for anyone to talk about living with it -- let alone a professor at a major university. In this gripping, literate memoir, Elyn Saks talks about her lifelong struggle with paranoid schizophrenia, from the time she was a young woman to the present, working as a tenured law professor at the University of Southern California. Growing up in Miami, she was always a talented student. Then, as a teenager, he The more I study the issue of schizophrenia, the more I realize what tremendous courage it takes for anyone to talk about living with it -- let alone a professor at a major university. In this gripping, literate memoir, Elyn Saks talks about her lifelong struggle with paranoid schizophrenia, from the time she was a young woman to the present, working as a tenured law professor at the University of Southern California. Growing up in Miami, she was always a talented student. Then, as a teenager, her parents discovered her with some marijuana and insisted she go into a strict anti-drug facility, where she heard over and over again the mantra that drug dependency could be overcome by willpower and determination and never giving in to any excuses. This intense focus on believing you have control over your behavior would go on to give Elyn enormous problems when she began to experience psychotic breaks. For years, she resisted using any drugs, and even after she relented, she kept trying to scale back on her anti-psychotics, believing they were somehow a crutch or an admission of failure. Despite her sometimes severe symptoms -- and one of the book's best features is its ability to recreate her disordered, paranoid thoughts of having killed people or being able to kill them with her mind -- Elyn made it through Oxford as a classical philosophy scholar, even though it took her twice as long because of stays in mental hospitals. She had a similar struggle getting through Yale Law School, and in America, suffered her first experience of forcible restraints and forced medication. Eventually, against enormous odds, she obtained a teaching position at Southern Cal and got tenure after publishing academic papers on the rights of mentally ill patients to refuse treatment, and whether people with multiple personality disorder should bear responsibility for crimes committed by one of their personalities. The book is also a testament to the friends who stuck by her through all the chaotic years, when so many did not know she had mental illness, and to the man who finally brought love into her life. And she has always had her work -- her safest haven, just as school libraries were the places she always sought out when she felt most fragile. “Occupying my mind with complex problems has been my best and most powerful and most reliable defense against my mental illness,” she has said. This sometimes grim but enormously moving memoir is so literate that it reads like a novel, and like a good novel, it has you rooting throughout for the heroine in spite of her struggles.

  19. 5 out of 5

    Jgknobler

    Elyn Saks suffers from schizophrenia and says she wrote this book to demonstrate that people with this illness can lead rich and successful lives. She herself teaches at a top law school, has had psychoanalytic training, has written a number of scholarly articles and is married to a kind and understanding man. As a psychiatrist, I found her infuriating, and I imagine her doctors over the years did, too. She takes forever to realize that she absolutely must take antipsychotic medication and, desp Elyn Saks suffers from schizophrenia and says she wrote this book to demonstrate that people with this illness can lead rich and successful lives. She herself teaches at a top law school, has had psychoanalytic training, has written a number of scholarly articles and is married to a kind and understanding man. As a psychiatrist, I found her infuriating, and I imagine her doctors over the years did, too. She takes forever to realize that she absolutely must take antipsychotic medication and, despite all her own evidence to the contrary she attributes her success in controlling her illness to psychoanalysis, buying into the, to my mind, untestable and fanciful notion that psychosis serves to "protect" her from her strong negative emotions, and that exploring this notion four to five times a week in analysis is in some way helpful. She never says how she manages to finance this treatment. I assume some of it was financed by her parents; she is pretty hard on them. I can only imagine how exhausted they were by her psychosis and refusal to accept medical advice and take medication regularly. I found the writing rather flat-footed for someone so apparently talented (as she repeatedly tells us) and also oddly lacking in introspection. I actually think this memoir may have been ghost written, as in the acknowledgements Saks thanks Larkin Warren who "helped bring the book to light, in a way that will allow me to 'speak' to more people in these pages." I notice that Larkin Warren is the coauthor of several "memoirs" of people with troubled pasts.

  20. 4 out of 5

    Cathy

    Elyn was an amazing individual, with schizophrenia, under the best possible circumstances. She acknowledges that her supportive upbringing, affluence, opportunity for psychoanalysis, extreme intelligence and sheer determination are valid factors contributing towards academic success, not being homeless or institutionalized indefinitely and having the ability to form friendships and meaningful relationships. While a struggle to incorporate the three indwelling entities (her as a doctor, her as th Elyn was an amazing individual, with schizophrenia, under the best possible circumstances. She acknowledges that her supportive upbringing, affluence, opportunity for psychoanalysis, extreme intelligence and sheer determination are valid factors contributing towards academic success, not being homeless or institutionalized indefinitely and having the ability to form friendships and meaningful relationships. While a struggle to incorporate the three indwelling entities (her as a doctor, her as the 'Lady of the Charts', and her as a person) that made up Elyn Saks, she manages her symptoms finally after years of denial, with submission to medication. Through her experience during hospitalization, she rightfully challenges and changes laws such as forcible confinement with use of restraints, and, more confusingly so, fighting for the rights of people with severe mental health issues to refuse being medicated. This book was an eye-opener for those in the helping industry, if one ever wanted to understand better, by reading a frightening and detailed account of the torment someone with schizophrenia goes through while in a psychotic state. You will also learn more about post Freud psychoanalyst Melanie Klein. http://www.melanie-klein-trust.org.uk...

  21. 4 out of 5

    Chrissy

    A truly eye-opening book. I thought I had a basic understanding of what schizophrenia was, but Saks really proved me wrong. She describes her experiences eloquently and expresses both her feelings and delusions well, resulting in a powerful memoir that gives you a short glimpse into what it's like for her living with schizophrenia. Her accomplishments are extraordinary, regardless of her diagnosis. I can only hope to be as successful as she in the academic world one day, as it takes a lot of amb A truly eye-opening book. I thought I had a basic understanding of what schizophrenia was, but Saks really proved me wrong. She describes her experiences eloquently and expresses both her feelings and delusions well, resulting in a powerful memoir that gives you a short glimpse into what it's like for her living with schizophrenia. Her accomplishments are extraordinary, regardless of her diagnosis. I can only hope to be as successful as she in the academic world one day, as it takes a lot of ambition and drive to get to where she is even with a "neurotypical" brain. It is remarkable that she was able to go through her battles with mental illness while still holding on to that essential part of herself, her intellect and her need to keep learning and pushing herself. To say her story is inspiring would be an understatement. I was angry and confused with her throughout a large portion of the book. I was not alive in the 1980s and even though I was aware that mental health treatment has come a long way, I was shocked by how she was treated in the United States. Restraints, tricks, threats, and even doctors denying that what she was experiencing was real at all! I was also disappointed that the first professionals she saw simply diagnosed her with depression and encouraged her to eat more. I know that medical professionals at that time were not evil, and many of them probably had only good intentions, but her experiences were inhumane and appalling. My heart breaks for her and other mentally ill patients who had to go through anything even remotely similar. Psychoanalysis is something I'd learned about in college psych but not something I'd ever given much credit to. It was interesting to see how it works for her, and how central it is to her treatment. I wonder if it is still popular today? I learned so much while reading this book, from her delusions to her traumatic experiences in hospitals and emergency rooms. There were two central things I took away from her writing: one, that people battling with schizophrenia may be acting strangely or violently because they are scared themselves; and two, that mentally ill patients are always being told what they need to do, and that sometimes what they need is to be asked what they want to do. (I wish I could provide the two quotes for these, but I've already returned the book to the library. They were fantastic quotes though.) I highly recommend this to anyone who wants to understand more about schizophrenia or really any severe mental illness.

  22. 4 out of 5

    Lindsay Stoffers

    Unfortunately, schizophrenia as a health condition is often misunderstood. People tend to make assumptions based off of out dated notions of what mental illness is and is not and in turn feed into the stigma of mental health disorders. Elyn Saks tells her story with incredible honesty and vulnerability. In "The Center Cannot Hold" Dr. Saks shares a deeply personal account of her life. As a second year master's student, majoring in Mental Health Counseling, I am so grateful for her courage to sha Unfortunately, schizophrenia as a health condition is often misunderstood. People tend to make assumptions based off of out dated notions of what mental illness is and is not and in turn feed into the stigma of mental health disorders. Elyn Saks tells her story with incredible honesty and vulnerability. In "The Center Cannot Hold" Dr. Saks shares a deeply personal account of her life. As a second year master's student, majoring in Mental Health Counseling, I am so grateful for her courage to share her story. Her unique and personal struggle with schizophrenia allowed for me to really empathize with her as she gave me a glimpse into her world. It is a beautifully told narrative that took me into the mind of a woman struggling to live her life in a meaningful way. This is a book that I would highly recommend to anyone seeking to more fully understand the challenges of living with a mental illness. Dr. Saks discusses the debate over medication as well as the continual struggle to not be defined by the stigma.

  23. 4 out of 5

    Steve

    Fascinating story told by a schizophrenic woman who managed to graduate Yale Law and then become a tenured professor, all the while struggling against delusions and other symptoms. Not a poetic book but it felt very honest and it was a way to get a bit of a clue to what psychosis must feel like.

  24. 5 out of 5

    Carrie Poppy

    A very compelling read, and does much to battle the stigma against thought disorders. The book, written by a brilliant USC law professor with schizophrenia, is a real page turner, as she is locked up in institutions, chained to tables, and ignored when she’s genuinely dying from a brain hemorrhage. The whole story is harrowing til it’s not. Suddenly a bright future emerges and she is powerful and free. I loved following her. I was also impressed with the economy of the text. She never uses three A very compelling read, and does much to battle the stigma against thought disorders. The book, written by a brilliant USC law professor with schizophrenia, is a real page turner, as she is locked up in institutions, chained to tables, and ignored when she’s genuinely dying from a brain hemorrhage. The whole story is harrowing til it’s not. Suddenly a bright future emerges and she is powerful and free. I loved following her. I was also impressed with the economy of the text. She never uses three words when two will do, nor works things out in front of us. The result is a balanced, composed text that lacks floweriness, mostly to its benefit. It’s a bit dated (a lot of her hospitalization stories are from the 70s) and biased toward Freudian psychoanalysis, but she also makes it clear that medication is a necessary part of her ongoing success. I did start to worry that she was essentially guru-hopping between her different analysts, and falling into psychosis whenever one died or moved. But perhaps that’s a pitfall of any human relationship on some level; it sustains you until it doesn’t. I just would have liked to see more reference to behavioral research and less to her analysts’ idiosyncratic theories along the lines of, “you are projecting on me that which your father said about you as a toddler.” I also would have liked more vivid descriptions of her hallucinations and delusions. As a person without a thought disorder, it’s hard for me to get in her head when she vaguely refers to, say, “the evil beings I sensed in the sky.” But I’m sure there are good arguments to be made for not fleshing them out too fully. This won’t give you an overview of schizophrenia, its treatments, or modern theories thereof. But it will give you a peek into the much-lauded barrier between genius and madness.

  25. 4 out of 5

    Emma Deplores Goodreads Censorship

    This seems to be the schizophrenia memoir, and it comes as no surprise that it’s written by a very accomplished, successful person: going public with an account of one’s psychosis and delusions could be career-ending for many people, but when you’re a tenured professor at a prestigious law school, with a stack of degrees and publications, you can basically do what you want. Still, it’s a gutsy thing to publish. This is an account of the author’s life from childhood up to probably her 50s, though This seems to be the schizophrenia memoir, and it comes as no surprise that it’s written by a very accomplished, successful person: going public with an account of one’s psychosis and delusions could be career-ending for many people, but when you’re a tenured professor at a prestigious law school, with a stack of degrees and publications, you can basically do what you want. Still, it’s a gutsy thing to publish. This is an account of the author’s life from childhood up to probably her 50s, though the bulk of it takes place while she’s doing her graduate and law studies, which is when her mental health problems cause the greatest crises. Fortunately for her, she’s in England on a Marshall scholarship when she’s first hospitalized, in an environment where patients’ personhood and wishes are respected – unfortunately, a sharp contrast to her hospitalization during law school back in the States, which is harrowing, as these stories tend to be. She is a tough lady though, and a strong sense of purpose in her studies and her work – as well as a few close friendships and a lot of psychoanalysis – gets her through. I was surprised that Freudian psychoanalysis could actually do somebody with a serious mental illness much good, but it makes sense that having one-on-one time 4-5 times a week with someone who would listen nonjudgmentally to all her bizarre thoughts would help. She does eventually wind up having to be on medication long-term, and her discussion of all the reasons she resists this is really interesting. She doesn’t want to be “dependent on drugs,” the side effects of the antipsychotics available at the time were quite bad (including the risk of permanent, very visible nerve damage for those who took them long-term), but she also doesn’t want to view herself as damaged enough to need this. It doesn’t make logical sense and yet this seems to be a thing with the most stigmatized illnesses, that people often view taking medication for them as a symbolic capitulation, as if acknowledging the disease enough to treat it means turning over control of their lives to it. Overall this is definitely an interesting memoir, though not a particularly artistic one; it’s told in a straightforward, chronological manner, albeit with a lot of dialogue that is probably not exact. Given how much the author has studied mental illness, I would have liked to see her broaden the scope of the book a little more, comment on how her experience of schizophrenia compares to that of others. That said, it works well as is, it’s accessible and engaging, and it’s a great window into a dreaded disease that’s generally discussed as if people who have it are incapable of contributing to the conversation themselves. Saks is living proof that people with schizophrenia are as capable as anyone else of living a full life, under the right circumstances: despite grave prognoses early on, and various crises along the way, she has a great career, is happily married and has a lot of strong friendships. At any rate, this is an eye-opening book and I recommend it.

  26. 4 out of 5

    Modern Hermeneut

    An eye-opening memoir. What it what it lacks in stylistic flare, it more than makes up for in bracing sincerity. The author pulls back the curtains on the subjective experience of schizophrenia. This is an unflinching testament of what it FEELS like -- not just what it LOOKS like from the outside -- to be in the grip of psychosis. It's also an indictment of the draconian methods often used to "treat" psychotic patients. Even readers who are well-versed in the literature of psychopathology will fin An eye-opening memoir. What it what it lacks in stylistic flare, it more than makes up for in bracing sincerity. The author pulls back the curtains on the subjective experience of schizophrenia. This is an unflinching testament of what it FEELS like -- not just what it LOOKS like from the outside -- to be in the grip of psychosis. It's also an indictment of the draconian methods often used to "treat" psychotic patients. Even readers who are well-versed in the literature of psychopathology will find themselves looking at the mentally ill in a new way.

  27. 5 out of 5

    DebsD

    Wow. Okay, let's get the not-so-great over with first. The writing isn't always great; it's sometimes a bit repetitive and the author's high-achieving academic history is mentioned a bit too often. And there was a bit near the end when I got a bit bored - I'm not really that interested in the details of anyone's wedding cake, to be honest. But the good bits? They are fabulous. This is honest, insightful and raw. As someone with secondary personal (i.e. not me but about as close as otherwise possib Wow. Okay, let's get the not-so-great over with first. The writing isn't always great; it's sometimes a bit repetitive and the author's high-achieving academic history is mentioned a bit too often. And there was a bit near the end when I got a bit bored - I'm not really that interested in the details of anyone's wedding cake, to be honest. But the good bits? They are fabulous. This is honest, insightful and raw. As someone with secondary personal (i.e. not me but about as close as otherwise possible) experience of schizoaffective disorder, I was blown away. I could not put this down. I started to read at about 4 a.m. (couldn't sleep - story of my life - reading puts me back to sleep faster than lying there with my brain awhirl), didn't stop reading until I had to do a school-run, then came home and read until I'd finished. There is a fairly heavy emphasis on psychoanalysis which is now widely agreed to be an inadequate, if not ineffective, management tool for schizophrenia. However until relatively recently, we did not have effective pharmaceutical treatments, and the choice was between psychoanalysis, drugs with fairly horrific side-effects, or nothing. Reading this, I found myself frequently reminded of how grateful I am that we now have better medications - not cures, but drugs that give many people their lives back. Saks is hugely impressive in what she has managed to achieve *despite* the lack of availability of appropriate treatment throughout most of her life, and although this book does wander at times, it provides an excellent insight into what living with psychosis (or the threat of psychosis) is actually like. For that reason, I'm calling this at 4.8*.

  28. 4 out of 5

    Maggie Heim

    This book added new depth to my ability to think about mental illness. It gave a fullness to my understanding of word salad and psychosis. Getting a firsthand, experiential account of how restraints feel when having a breakdown is invaluable. I now think more critically about what it means to force medicate someone. I have a new humility when considering someone dependent on medication who is struggling with taking it. It's not fair for me to think of it as simple to take the medication and be b This book added new depth to my ability to think about mental illness. It gave a fullness to my understanding of word salad and psychosis. Getting a firsthand, experiential account of how restraints feel when having a breakdown is invaluable. I now think more critically about what it means to force medicate someone. I have a new humility when considering someone dependent on medication who is struggling with taking it. It's not fair for me to think of it as simple to take the medication and be better, when I have never struggled with serious mental illness. At its core, this memoir is about the importance of autonomy and human dignity for everyone. I am so glad I read it and it was so hard to put it down!

  29. 5 out of 5

    Jeanne

    “Oh, they’re nice. Do you like spice? I ate it thrice. They’re all hurting me! They’re hurting me and I’m scared!” (p. 191) Elyn Saks' The Center Cannot Hold: My Journey Through Madness is an unusual mental illness memoir, of which there are many. Saks is clearly bright, capable, and competent – graduating from Vanderbilt, Oxford, and Yale Law School, teaching and working in administration at University of Southern California – and also frequently actively delusional and unable to function. At h “Oh, they’re nice. Do you like spice? I ate it thrice. They’re all hurting me! They’re hurting me and I’m scared!” (p. 191) Elyn Saks' The Center Cannot Hold: My Journey Through Madness is an unusual mental illness memoir, of which there are many. Saks is clearly bright, capable, and competent – graduating from Vanderbilt, Oxford, and Yale Law School, teaching and working in administration at University of Southern California – and also frequently actively delusional and unable to function. At her first hospitalization she said, “People are trying to kill me... They’ve killed me many times today already. Be careful, it might spread to you” (p. 3). It is difficult for many people to see two apparently-conflicting sides of the same story. She was described in another admission as “Thin, tall, chain-smoking, sad, inappropriate laughter at times, seems physically and mentally retarded” (p. 77). During one job interview, she was described as “practically comatose.” Can one be psychotic and brilliant simultaneously? Can one both be unable to function and professionally successful? Saks recognized that she tended to compartmentalize her life: professionally successful as Professor Saks; the "Lady of the Charts" when ill; and Elyn, who she neglected. Sometimes she saw herself as the Lady of the Charts who was an impostor in her professional life – and at other times she denied that she was ill and didn't need medication (she always decompensated when testing this hypothesis). She thought: Either I was mentally ill or I could have a full and satisfying personal and professional life, but both things could not be equally true (p. 263). Most of us have difficulty incorporating our contradictions, although generally with less tragic consequences. There are many reasons to read Cannot Hold. Saks both describes herself as others saw her, but also how she perceived herself, giving us an inside view of the illness. Schizophrenia is often seen as untreatable, especially when symptoms continue and there are multiple relapses. Antipsychotics – and increasingly cognitive behavioral therapy, family therapy, and psychoeducation – are commonly-accepted treatments, but Saks found psychoanalysis extremely helpful and described her work with four analysts over the course of her life. Saks also profited from her times in the hospital (as did we); her work informed her academic publications about mandated treatments, involuntary constraints, and the use of restraints. I have mixed feelings about memoirs like Cannot Hold. Are we suggesting that everyone diagnosed with schizophrenia can and should be as successful as Elyn Saks or John Nash? Nash argued that his schizophrenia was part of what made him successful and who he was: So at the present time I seem to be thinking rationally again in the style that is characteristic of scientists. However this is not entirely a matter of joy as if someone returned from physical disability to good physical health. One aspect of this is that rationality of thought imposes a limit on a person's concept of his relation to the cosmos….[W]ithout his "madness" Zarathustra would necessarily have been only another of the millions or billions of human individuals who have lived and then been forgotten. Saks' response to the same question is different: My psychosis is a waking nightmare, in which my demons are so terrifying that all my angels have already fled. So would I take the pill [to make schizophrenia go away]? In a heartbeat. (p. 336)Still, her voice, Nash's, Pat Deegan's, and others' reminds us that our stereotypes of schizophrenia are more limiting than the real picture. They remind us to see others more fully and clearly.

  30. 5 out of 5

    Klerik

    To be succinct, I think this is a very moving book. Though it's obviously hard for me to say, I felt like The Center Cannot Hold does a great job of conveying what it's like to live with Schizophrenia". That's a very general statement, though, so I figured I would talk a bit about some more specific details of her book which stuck out to me. In particular, I found her descriptions of the onsets of her psychotic episodes very chilling. Going from fully professional to incoherent and free-associati To be succinct, I think this is a very moving book. Though it's obviously hard for me to say, I felt like The Center Cannot Hold does a great job of conveying what it's like to live with Schizophrenia". That's a very general statement, though, so I figured I would talk a bit about some more specific details of her book which stuck out to me. In particular, I found her descriptions of the onsets of her psychotic episodes very chilling. Going from fully professional to incoherent and free-associating in the span of an hour must be terrifying and disorienting, and the way these transitions were often described very briefly (a paragraph at most) meant they kind of "snuck up" on me, kind of yanking me away from thinking about whatever professional issues were being discussed. While I don't mean to imply that these small surprises are comparable to an actual psychotic break, the lack of any longer build-up or foreshadowing gave me some idea of how disruptive a psychotic episode must be. Further, the book gave me an appreciation of why someone with a mental illness might want to get off their medication. I guess the way I felt about this before could be summarized by the comparison Saks makes to physical disease - "if your leg is broken, why wouldn't you use a crutch?" - so whenever I saw someone in a movie or whatever not take their medication, it always felt more like a plot device than something a real person might reasonably do. Saks' constant fighting to lower her dosage with the goal of getting off medication gave me some idea of why it might be different with mental disease, though. Leaving aside the significant side effects of many anti-psychotics, I hadn't really thought about how accepting that you need medication on some level means surrendering to the disease. For Saks, trying to get off medication seems to be a means of resisting her disease - a way of refusing to be defined as merely a crazy person. I was very impressed by her ability to make me appreciate how difficult it must have been to give up her goal of getting off medication, and found her ultimate acceptance of her need for medication very touching. (Just to be clear, I don't mean to romanticize not taking medication or anything. It's just that but before reading The Center Cannot Hold, I hadn't really thought about why you might not feel happy about taking your medication even in the absence of side effects.) One last thing which stuck out to me was just how good a job Elyn Saks the author does of writing Elyn Saks the main character. While I understand that the book is a memoir and so the two are actually the same person, The Center Cannot Hold made me feel like I had spent some time with its author more than most other memoirs I have read. Saks doesn't just recount events, she goes out of her way to make you understand what she was thinking and feeling at the time, and how she feels about it looking back. I just found it really well written, I guess. So in short, I think this is a book well worth reading.

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