The Center Cannot Hold: My Journey Through Madness

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The Center Cannot Hold: My Journey Through Madness

4.14 of 5 stars 4.14 · rating details · 3,000 ratings · 467 reviews

Elyn Saks is a success by any measure: she's an endowed professor at the prestigious University of Southern California Gould School of Law. She has managed to achieve this in spite of being diagnosed as schizophrenic and given a "grave" prognosis -- and suffering the effects of her illness throughout her life.

Saks was only eight, and living an otherwise idyllic childhood

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Hardcover, 352 pages

Published August 14th 2007 by Hyperion (first published January 1st 2007)

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Dec 01, 2008 Osho rated it 5 of 5 stars

Shelves: 2008, psychology

In the tradition of Kay Redfield Jamison, Elyn Saks, a person with a major psychiatric disorder, presents her own history from childhood to her present status as a successful professional specializing in that disorder. In Saks's case, that disorder is schizophrenia, a diagnosis with a much poorer prognosis for a successful adulthood than many others.

Saks's account is both readable and meticulous, with only a few editing problems. She is careful neither to overdramatize nor underplay her psychoti...more In the tradition of Kay Redfield Jamison, Elyn Saks, a person with a major psychiatric disorder, presents her own history from childhood to her present status as a successful professional specializing in that disorder. In Saks's case, that disorder is schizophrenia, a diagnosis with a much poorer prognosis for a successful adulthood than many others.

Saks's account is both readable and meticulous, with only a few editing problems. She is careful neither to overdramatize nor underplay her psychotic episodes or her progress and great accomplishments. Anyone who has been forcibly put into mechanical restraints in the last couple of decades and been evaluated frequently for a lower level intervention (or has successfully pursued a grievance if they were not) has Saks to thank for her legal advocacy.

I would have liked to know more about the quality and character of her relationships with family and friends, but recognize that memoirists may choose to protect aspect of their own and others' privacy. I also would have liked to have a better sense of her psychosis. This is an area where Saks tells more than she shows.

Saks suggests, and I agree, that there may be many causes of schizophrenic spectrum disorders; this in turn implies that different people will have different constellations of disordered thinking, some more pernicious, some more dangerous, and some more treatable. When she is psychotic, Saks experiences what seems to be poor judgment, low insight, disorganization, and a relatively consistent set of paranoid delusions. At the same time, she seems to have good or very good responses to several medications, to recompensate quickly, to return to her high level of baseline functioning, to maintain meaningful and complex relationships, and to have a good emotional range. Since she also describes a variety of other physical problems, it would not surprise me if her schizophrenia were related to a greater underlying physical problem.

As a side note, I enjoyed reading about Saks's long friendship with her law school friend Steven Behnke. I'd be interested to know how he would tell the story of his friendship with Saks, as Ann Patchett did with Lucy Grealy in Truth and Beauty.

I am not sure why Saks's diagnosis is schizophrenia rather than schizoaffective disorder. The big difference between these schizophrenic spectrum diagnoses is the presence of a mood disorder simultaneous with an episode of the thought disorder, and Saks is often diagnosed as depressed while she apparently is also psychotic. Since she works in psychiatry, I assume that she is accurate and that the evidence for this differential diagnosis is not reported in her memoir. (less)

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Aug 03, 2010 Robert rated it 5 of 5 stars

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...more

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Jul 20, 2008 Rebecca rated it 3 of 5 stars

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...more 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.
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Sep 18, 2007 Terry rated it 4 of 5 stars

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 mental...more

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Aug 09, 2007 Jasmine rated it 3 of 5 stars

While this book is pretty rough reading, at the same time, I found it kind of cool. Not only does the author really lay her life out there for everyone to see, including all her thoughts about killing people, but she ends up a totally successful person. Probably more so than I will ever be. At the end, when Saks is trying to sum up what she wants this book to be and why she wrote it, it gets kind of weird: inspiration to other schizophrenics, even though she admits many people with her disorder...more

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Oct 28, 2007 Modern Hermeneut rated it 4 of 5 stars

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...more

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Aug 11, 2012 Cindy Knoke rated it 5 of 5 stars

Elyn Saks is a remarkable and impressive person. She is a law professor At USC who has schizophrenia and is an advocate for the rights of involuntarily hospitalized psychiatric patients. She is an expert in mental health law and has a special interest in limiting the use of involuntary physical restraint on psychiatric patients which she is interested in due to her own terrifying experiences being involuntarily hospitalized and restrained. She is also an adjunct Professor of Psychiatry at UCSD a...more

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Jan 29, 2008 Melissa Fonseca rated it 4 of 5 stars

This is a great book. Occasionally, it was difficult to read the author continuously making the same mistakes in her recovery process. Though at the same time it was comforting, because it was a clear representation of the human character. The attempt to abolish the reality of the situation to the point of bringing on your own delusions. Whether that be trying to deny your illness or to think you can change a cheating and abusive boyfriend. I reflected on the mistakes I make time and time again...more

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Nov 25, 2007 Tracy rated it 4 of 5 stars Recommends it for: those interested in a personal account of schizophrenia

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...more

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Dec 19, 2007 Melissa rated it 4 of 5 stars Recommends it for: anyone interested in mental health issues

The author, Elyn Saks, is an academic (Yale Law School, Oxford scholar, etc.) who has struggled with schizophrenia all her life. It's very well written and easy to read. As an MD, I was interested about the mental health issues raised in the book and what schizophrenic persons are really experiencing when they talk about "delusions" and "hallucinations". As a Christian, I wondered about the spiritual aspect of schizophrenia. For instance, I noticed that the author was incredibly self-absorbed an...more

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Sep 12, 2007 Jenny rated it 5 of 5 stars

A fascinating and enlightening memoir about a life lived to its fullest despite suffering from schizophrenia. I learned so much about the inner life of a person with this particular mental illness, and found my heart stirring over and over with compassion for anyone so afflicted. The book is filled with keen metaphors and rich descriptions of psychotic episodes, so intense and so well-described that even though I have never experienced anything similar, I was easily able to imagine such terrifyi...more

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Jan 16, 2009 Kathleen Hagen added it

Shelves: 2007-audio-books, 2007-nonfiction

The Center Cannot Hold: My Journey Through Madness, by Elyn R. Saks, produced by Recorded Books, narrated by Alma Cuervo.

This is the unflinching look at a history of schizophrenia, undiagnosed and misdiagnosed for a long time. Elyn Saks, now a tenured professor of law, who has garnered many awards, teaches and writes at University of Southern California. This is her own story. She gives us very detailed glimpses of what happens to her when she has a psychotic break. She talks about how long it t...more

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Jan 11, 2009 Elevate Difference rated it 4 of 5 stars

We rarely have the opportunity to hear from people diagnosed with schizophrenia. As a result, the disease remains misunderstood and maligned, confused with multiple personality disorder, and the butt of several jokes. In writing The Center Cannot Hold, Elyn Saks has, in part, set out to remedy this, and she has acquitted herself most admirably.

Saks’s life is an interesting one. Raised in Miami, Florida, she exhibited, as she can recall, a few early signs of the disorder in high school and in col...more We rarely have the opportunity to hear from people diagnosed with schizophrenia. As a result, the disease remains misunderstood and maligned, confused with multiple personality disorder, and the butt of several jokes. In writing The Center Cannot Hold, Elyn Saks has, in part, set out to remedy this, and she has acquitted herself most admirably.

Saks’s life is an interesting one. Raised in Miami, Florida, she exhibited, as she can recall, a few early signs of the disorder in high school and in college, but her first serious break arrived while she was getting her Master’s degree at Oxford University. That year, Saks experienced both a stay in a mental hospital and her first relationship with a talk therapist. (The latter is a treatment she strongly advocates, although it is relatively rare to see it used to treat schizophrenia.) The stark detail in which Saks limns her schizophrenic breaks brings the reader immediately into her mind, yet the tone of the writing is so matter-of-fact that Saks’s mind, the mind of a woman both brilliant and deeply mentally ill, does not seem at all unusual. This is her gift as a writer: emotions, mental disorders, therapeutic relationships, and love are all treated as facts, not as things to fight or justify, but simply as the truths of a life. Saks makes schizophrenia real to her readers, as it has always been to her.

The pillars, and the beauty, of Saks’ story are the relationships she has created in her life and shows to her readers: relationships with therapists are portrayed as clearly, and with as much significance, as those with her close friends, her family, and later her husband. Love, Saks demonstrates, is a powerful stabilizing force, even in the face of the inevitable devastation that mental illness brings. In addition, Saks has used her academic work and interests to center herself since her youth, and as readers watch, Saks become what she is today: a professor of legal philosophy tremendously respected in her field, specializing in the legal rights of the mentally ill. We see that her work, the academic niche she has created for herself over time, has come to a graceful symbiosis with her acceptance of her illness. As she advocates, as a passionate writer and thinker, for others like her who have fewer resources, she comes to accept the role that her schizophrenia has played, and will always play, in her life, and also clarifies for herself that it is not the only defining factor.

The Center Cannot Hold is a bold, disturbing, compelling, original book. Elyn Saks is telling a story rarely heard, and she does so with uncommon skill and style.

Review by Gemma Cooper-Novack(less)

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Dec 22, 2008 Chris rated it 5 of 5 stars · review of another edition

Amazing memoir about her lifelong battle with schizophrenia and how she managed to battle, cope and come out on top with a law degree and tenor at USC. Her diagnosis took a long time and she suffered deeply. But she was a highly driven person who would not give in to her madness and wouldn't let it define her or be her. Like many who struggle with thought disorders, she fought taking medicine, in fact she fought her illness and for her life every step of the way. Yet it was her school and her wo...more

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Mar 30, 2013 Mary Whisner rated it 5 of 5 stars

Shelves: law-not-criminal, memoirs, mental-health-narratives

Elyn Saks opens her memoir, The Center Cannot Hold, with a scene every law student can identify with: three students working in the law library on a weekend night, trying to get a moot court brief done. But the action moves to something most students don't experience, hallucinations that lead her onto the law school's roof and, eventually, to the state mental hospital, where anti-psychotic medications are forced on her.

The memoir offers a gripping inside look at mental illness and its treatment....more

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Feb 17, 2013 Catherine rated it 4 of 5 stars

Shelves: 2013, mainstream-us, medicine, mental-illness

Elyn Saks is a schizophrenic - a reality she couldn't bring herself to admit until she was almost forty - and a professor of law and a licensed clinician and a wife and a daughter and a person with good, good friends. The Center Cannot Hold is the absorbing story of her self and her illness, two things that ran, if she was lucky, on two different tracks in her mind. When she wasn't lucky, or off her medication, or triggered by massive change, the two converged and her mind shattered.

Throughout h...more Elyn Saks is a schizophrenic - a reality she couldn't bring herself to admit until she was almost forty - and a professor of law and a licensed clinician and a wife and a daughter and a person with good, good friends. The Center Cannot Hold is the absorbing story of her self and her illness, two things that ran, if she was lucky, on two different tracks in her mind. When she wasn't lucky, or off her medication, or triggered by massive change, the two converged and her mind shattered.

Throughout her life, Saks conflated illness with failure, believing that if only she had enough willpower she could fight back the demons and monsters and aliens and frightening men who wanted to do her harm. But schizophrenia, just like other mental illnesses, is not a matter of willpower - it's a matter of biology and culture, and requires all the support a person can get. Saks took herself off her medication multiple times, hating that she was dependent on pills to live something like a normal life, but every time she was reduced to psychosis. The descriptions of those episodes are painstakingly drawn and unsettling - a glimpse of what it is to be untethered - but so is the narrative that traces her way back to life.

There's much in this book to chew on - the difference between the psychiatric treatment Saks received in England and America for example, given choices in the former, and strapped down and forced to take an anti-psychotic in the latter. There's the support she found in talk therapy, which so many professionals believe is unhelpful for people with schizophrenia. There are the court cases she studied, looking at the intersection of law and mental health, raising questions such as - if someone with multiple personalities commits a crime, and only one personality is cognizant of having done so, should the whole person be put on trial?

I really enjoyed this book, and found Saks' meta-narrative about the stigma that surrounds mental illness absorbing. Very much recommended.

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Jan 04, 2013 Dysmonia Kuiper rated it 4 of 5 stars

Shelves: the-352

I went into this book knowing that the author was hugely successful professionally, and I was interested to learn from the outset what it was that allowed her to become so accomplished while she was also so mentally ill. At the end of the book, she cites three reasons: "parents with resources, access to trained and talented professionals, and a frequently unattractive stubborn streak that's worked in my favor as much as it has against me."

I don't think I have any of these things (certainly not...more

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Nov 01, 2012 Diana Connor rated it 5 of 5 stars

This book presented the story of one person's battle with mental illness, but I found that I could connect with the author on so many levels. The author really moved me.

First, I no longer look at people the same. This book drove home for me how difficult mental illness is. Living in San Francisco, most days I see someone walking down the street talking to themselves, someone who very well may have schizophrenia and most likely has some form of mental illness. This book has really enabled me to s...more

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Jul 13, 2012 Varsha rated it 4 of 5 stars

This review has been hidden because it contains spoilers. To view it, click here. As a student of law, one is accustomed to read fat digests, comentaries and case laws that, more often than not, prove to be extremely soporific. The farthest one could go away from this rigidly defined reading bucket list is to immerse oneself in the life story of a renowned lawyer, a rainmaker, one who qualifies to be a role model in the starry eyes of law students, one who qualifies as a sufficient motivational factor for a youngster to opt for law school. While trudging through such general...more As a student of law, one is accustomed to read fat digests, comentaries and case laws that, more often than not, prove to be extremely soporific. The farthest one could go away from this rigidly defined reading bucket list is to immerse oneself in the life story of a renowned lawyer, a rainmaker, one who qualifies to be a role model in the starry eyes of law students, one who qualifies as a sufficient motivational factor for a youngster to opt for law school. While trudging through such general monotony, a book like the Center Cannot Hold: My Journey Through Madness written by Elyn R.Saks does give you a breather, if not leave you in awe and, I confess, certain amount of disbelief.

For one thing, this book is not about the great lawyer who had her victorious day in court; it's not about cleverly worded arguments, orgasmic interpretations, slyly brilliant cross examinations or closing arguments filled with verbal and intellectual grandiose. This book is a stand out- it is a first person account of a lawyer who happened to have schizophrenia (not necessarily in the same order).

I could have very well said a "Schizophreniac lawyer" or "lawyer with schizophrenia", but to say that would mean a sort of insult to everything that this woman has managed to do with her life, despite such a major impediment. Having stepped into the quicksand of schizophrenia at the age of eight, Saks has managed to keep the from swallowing her and has, surprisingly, kept more than just her neck above the mark. Her sinkings into psychosis leave you unnerved; sometimes you'll find yourself simply laughing out loud despite the seriousness- that is how beautifully she connects with her readers.

For someone with the burdensome baggage of a "mental illness" for a shadow, Saks has won the best of both worlds- she has been rational in choosing her ambitions and has, with what is most certainly dogged perseverance and emotional attachment towards her goals that stem from her own personal experiences, managed to make a difference, while not letting her illness permanently cloud her life. Like she says, for an unlucky person, she has indeed been extremely lucky.

The Center Cannot Hold provides an informative insight into the mysterious anomalies of schizphrenia- it disproves common myth and provides you with a lot of medical knowledge about the illness. It is a bold, outspoken and courageous endeavour, for writing a book about your unbalanced mental condition when you're in the prime of a professional career calls for great guts.

And if Elyn R. Saks is not a woman with pluck, I dont know who is.
This book gets a 4/5 from me!(less)

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Nov 19, 2011 Patrick rated it 5 of 5 stars

Amazon review:
Elyn Saks is a success by any measure: she’s an endowed professor at the prestigious University of Southern California Gould School of Law. She has managed to achieve this in spite of being diagnosed as schizophrenic and given a "grave" prognosis -- and suffering the effects of her illness throughout her life.
Saks was only eight, and living an otherwise idyllic childhood in sunny 1960s Miami, when her first symptoms appeared in the form of obsessions and night terrors. But it was n...more

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Aug 22, 2010 Sarah rated it 5 of 5 stars · review of another edition

Shelves: autobiography

In reading this book I am amazed at how vivid and true it is. Not many people have endured psychosis, depression, delusions or paranoia yet are able to communicate the experience in a way others can understand. This book is marvelous. The truth behind so many of her simple statements is what really got my attention.

Saks should be applauded for opening up her mind to others in a way that hopefully will work dispell the stigma associated with those who have a "severe mental illness".

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Oct 24, 2009 Michelle rated it 5 of 5 stars

Who says someone with schizophrenia can't win a MacArthur (genius) award? Or, for that matter, a Nobel Prize? In this amazing book, Elyn Saks details her own experience of schizophrenia, rife with psychotic breaks and an adversarial relationship with the medications that helped to prevent that as she graduates summa cum laude from Vanderbilt, gets an MA in Ancient Philosophy (highest honors) from Oxford, becomes a tenured professor at USC Law School and Med School while training as a psychoanaly...more

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Dec 27, 2012 Theresa rated it 4 of 5 stars

(truncated from my original thoughts)

It’s a memoir about a woman born into a perfectly normal family, who turns out to be very smart, in fact she is probably a genius. Trouble is she is VERY schizophrenic (well, I don’t know that you can be a little schizophrenic, but either way…). She gets these thoughts (not hearing a voice, its her own voice but she knows the thought is not her own)... Then she starts babbling in a sort of nonsensical way... And these thoughts and babbling (and the occasional...more

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Apr 27, 2013 Karyl rated it 4 of 5 stars · review of another edition

Shelves: 2013, biography, memoirs, non-fiction, library-reads

Elyn R. Saks resisted her diagnosis as a schizophrenic for most of her life. Feeling that it would pigeonhole her into the stereotypical role of a raving lunatic out on the streets, she kept looking for less serious diagnoses. She also spent most of her life convincing herself that she only needed her medication to get back on track, and once everything was hunky-dory, she could reduce her medications until she was no longer taking anything. This thinking had catastrophic results each and every...more Elyn R. Saks resisted her diagnosis as a schizophrenic for most of her life. Feeling that it would pigeonhole her into the stereotypical role of a raving lunatic out on the streets, she kept looking for less serious diagnoses. She also spent most of her life convincing herself that she only needed her medication to get back on track, and once everything was hunky-dory, she could reduce her medications until she was no longer taking anything. This thinking had catastrophic results each and every time she tried it. It wasn't until she was nearly 40 that she accepted that she does indeed have schizophrenia, and that she will have to be on medication for the rest of her life to keep, as she puts it, her demons and delusions in the closet where they belong, with the door firmly shut.

This was a very interesting read, as I hadn't ever done any kind of reading or research into this particular type of mental illness. She's very honest in the things that she thinks and says while in the grip of psychosis, and it can make for difficult reading. I do understand how she came to believe that it wasn't that she was mentally ill, it was just that we all have these thoughts and feelings, but she just didn't hide them as well as everyone else. At the same time, her parents' insistence on pulling oneself up by one's bootstraps, to just buckle down and stick in to something until you've accomplished it, may have contributed to her feeling that if she used a crutch such a medication, she was somehow weak and unworthy. Had her parents not been as firm, one wonders if she could have made peace with her illness sooner.

The first half of the book, while made tedious by her constant attempts to wean herself off medication only to result in worsening episodes of psychosis, is quite interesting. As her book goes on, and she goes through the cycle of weaning, psychosis, weaning, psychosis, it gets a bit tiring to read.

I'm amazed at all Saks has managed to accomplish, even with being hospitalized for months at a time and easily spiraling down into psychosis before she found the appropriate medication. She is certainly a woman to be admired for her persistence to get where she wanted to be, regardless of and despite her mental illness.(less)

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Nov 28, 2012 Dorothy rated it 5 of 5 stars

I found this book fascinating, inspiring, and a quick read. The honesty with which Saks tells her story is astounding. She talks frankly of her experiences with her family, her career, her time in mental hospitals, and her sexuality, all with the aim of removing the stigmas surrounding mental illness, and perhaps give hope to others who are mentally ill. She makes it a point to clarify that abilities of those who suffer from schizophrenia vary just as much as do those of the general population,...more

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Aug 09, 2011 James rated it 2 of 5 stars

Shelves: health

I wanted to like this book, the world of the mentally ill is extremely hard for anyone else to fathom.
There are so many people with mental problems, an inside look would be interesting.

But the book is overly long and very repetitive.

About 2/3 of the way through I began to wonder how much of the story is really true.
The author claims the drugs fogged her brain.
When she took an IQ test she scored slightly retarded .

Yet many decades later she has perfect recall of minute details.
Lengthy and de...more

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Mar 22, 2013 Coreen Knowles rated it 5 of 5 stars

"When you're really crazy, respect is like a lifeline someone's throwing you. Catch this and maybe you won't drown."

I simply cannot recommend Elyn Sak's account of living with schizophrenia highly enough. It is engrossing, eye-opening, heart-breaking and beautiful (for just a few adjectives). As a fully independent, successful academic who has experienced debilitating psychosis, sometimes horrifying hospital stays as well as the respite that medication and therapy can provide, her perspective is...more

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Nov 14, 2011 Dorothea rated it 4 of 5 stars

Insofar as I can judge -- knowing very little about schizophrenia, psychology, philosophy, or the particular areas of law that Saks specializes in -- this is an excellent book.

I make that disclaimer because part of the book's excellence is in how much it teaches the reader about these subjects: more of an education than I would have expected from a memoir, but appropriate to Saks' brilliance, knowledge, and life's work as a professor and legal advocate for people with mental illnesses.

Saks' schi...more Insofar as I can judge -- knowing very little about schizophrenia, psychology, philosophy, or the particular areas of law that Saks specializes in -- this is an excellent book.

I make that disclaimer because part of the book's excellence is in how much it teaches the reader about these subjects: more of an education than I would have expected from a memoir, but appropriate to Saks' brilliance, knowledge, and life's work as a professor and legal advocate for people with mental illnesses.

Saks' schizophrenia first fully manifested itself when she was at Oxford University studying philosophy. Despite being unable to read, write, or speak effectively when most ill, she managed to finish not only this degree but a law degree at Yale, and to become an accomplished and honored professor at the University of Southern California. This impressive background enabled her to combine scholarly insights on personhood, perception, and agency with her own experiences of all three of these necessary things being taken away, by her illness but sometimes even more by healthcare providers.

Not knowing what this book is like to a person who has schizophrenia, I think it must be a helpful read to anyone who doesn't. I wish I had read it when I was working on a crisis line -- I worried that if I ever took a call from a mentally ill person, I wouldn't know how to react and help them properly. Saks not only explains her personal and theoretical understandings of schizophrenia, but describes many occasions in which she became ill and interacted with other people, who reacted in helpful and unhelpful ways.

I can't find the passage where she says this explicitly, but Saks describes the main emotion she feels when psychotic as fear. She says it's a terrifying thing to experience -- losing control of one's thoughts, becoming incapable of communicating effectively, being bombarded with ideas about danger and violence.

A common experience for Saks (more so in American than British medical care) was for healthcare providers to force her to do things when she was sick: to go to the mental hospital, to take medication, to stay in a room or in bed (to which on a couple of instances she was tied down painfully, for hours at a time). This theft of her agency exacerbated the loss of control she was already experiencing through schizophrenia.

Saks determined that in many situations in which she was restrained, drugged, or otherwise controlled, it was not primarily as treatment for her but as a way for the healthcare practitioners to feel more comfortable in her disturbing presence. (There was never any need to prevent her from harming another person.)

In the situations Saks described in which another person, interacting with her when she was sick, helped instead of harmed her, that person spoke to her with respect, not ordering her to do things or giving her no choice, but requesting and explaining. (E.g. "Please don't run away. I am worried about you and don't think you will be safe on your own. Please come back here so that we can try to help you.") When she said psychotic things, such as "I'm afraid there will be aliens at the reception," helpful people weren't alarmed, but calmly reassured her that this wouldn't happen.

There are a lot of very interesting things in this book -- the evolution of her attitude towards taking medication (first shaped by an abusive drug rehab clinic her parents unnecessarily made her attend in high school), the way she used work as an escape from her illness when possible, her comparisons among different types of treatment for schizophrenia, her legal work on behalf of people with mental illnesses -- but I think that the most important for me was this explanation of how to treat a person who is having a schizophrenic episode with respect and without making things worse for them.(less)

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Apr 15, 2013 Peter Mcloughlin rated it 5 of 5 stars · review of another edition

Shelves: biography, brains-and-behavior

I reread this book for a class presentation. Elyn Saks has suffered from Schizophrenia since her early twenties as a Rhodes Scholar in England. This has not stopped her from getting a Ph.D. in Philosophy, A law degree from Yale and a Job as a tenured Professor at UCLA. She has written books on the law as relates to Mental Health Issues. She did all this while suffering from one of the most debilitating mental illnesses Schizophrenia. She writes of her hospitalizations and being put in restraint...more

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Apr 19, 2013 Tiruba Tuba rated it 5 of 5 stars

Shelves: 2013-read

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 successfu...more

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About Elyn R. Saks

Elyn R. Saks, training to be a psychoanalyst, specializes in mental health law, criminal law, and children and the law. Her recent research focused on ethical dimensions of psychiatric research and forced treatment of the mentally ill. She teaches Mental Health Law, Mental Health Law and the Criminal Justice System, and Advanced Family Law: The Rights and Interests of Children. She also teaches at...more

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Books by Elyn R. Saks

Refusing Care: Forced Treatment and the Rights of the Mentally Ill

Jekyll on Trial: Multiple Personality Disorder and Criminal Law

Informed Consent to Psychoanalysis: The Law, the Theory, and the Data

Interpreting Interpretation: The Limits of Hermeneutic Psychoanalysis

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