The Center Cannot Hold: My Journey Through Madness

by Elyn R. Saks

Philosophy and psychosis have more in common than many people (philosophers especially) might care to admit. The similarity is not what you might think—that philosophy and psychosis don’t have rules, and you’re tossed around the universe willy-nilly. On the contrary, each is governed by very strict rules. The trick is to discover what those rules are, and in both cases, that inquiry takes place almost solely inside one’s head. And, while the line between creativity and madness can be razor thin (a fact that has been unfortunately romanticized), examining and experiencing the world in a different way can lead to sharp and fruitful insights.

True friends help us chart our course in the world, and in my case—with the earliest mixed signals of schizophrenia beginning to fuzz my ability to think clearly—Kenny was like a guide in a forest. If you are walking on a path thick with brambles and rocks, a path that abruptly twists and turns, it’s easy to get lost, or tired, or discouraged. You might be tempted to give up entirely. But if a kind and patient person comes along and takes your hand, saying, “I see you’re having a hard time—here, follow me, I’ll help you find your way,” the path becomes manageable, the journey less frightening.

I was desperate. I held my own life in my hands, and it was suddenly too heavy to be left there.

Not until that moment had I realized how much rage I felt, directed mostly at myself. It was as though I had been carrying a large sandbag on my back, and now some of the sand—just a little, but some—had been let out. And with my load just a bit lighter, maybe another kind of hard work could begin.

Once, there’d been a time in my life when thoughts were something to be welcomed, and pored over, like pages in a favorite book. Just to idly think about things—the weather, the future, the subject of a paper I needed to write for a class, the friend I was going to meet for a cup of coffee—these things felt so simple, so taken-for-granted. But now thoughts crashed into my mind like a fusillade of rocks someone (or something) was hurtling at me—fierce, angry, jagged around the edges, and uncontrollable. I could not bear them, I did not know how to defend myself against them, and I could not bear to be near anyone when I was experiencing them.

Psychotic people who are paranoid do scary things because they are scared. And when you’re both psychotic and paranoid, it’s like that sweaty midnight moment when you sit bolt upright in your bed from a nightmare that you don’t yet know isn’t real. But this nightmare went on all through the daylight as well.

Think about having a bad flu, on a day when you can’t stay home huddled under the covers. You have business, you have responsibilities. And so, summoning up reserves you didn’t know you had, you somehow make it through the day, sweating, shaking, nodding politely to colleagues while barely controlling the nausea—because you know that if you can just pull it off, then you can go home, where your couch (or your bed, or a hot bath, or whatever you define as comfort and safety) is waiting. You hold it together, and then, once

you’re home, you collapse. For two straight years, I did my work, met my obligations, made it through the day as best I could, and then fled to Mrs. Jones, where I promptly took the chains off my mind and fell apart.

Unscheduled silliness, with no goal except to enjoy the moment and the little girl who was sharing it with me—it felt exactly like the sun coming out after a long, long rainy season.

From time to time, I considered asking the flight attendant whether she would mind if I jumped out the emergency door. Other than that, it was an uneventful flight.

Having a home-cooked meal, having nice people to talk to, to spend time with…perhaps that might prevent my head from exploding and splattering the walls.

So some people went away believing I didn’t want to see them, when nothing could have been further from the truth. That said, having company was sometimes exhausting and even confusing. I’d summon focus and energy to keep the demons away during a visit, and then go to pieces after friends and family were gone.

I would become violent, as the delusions in my head grew more real to me than reality itself.

Sometime later, it occurred to me that at the very moment I was being tied to a bed in a psychiatric ward, screaming bloody murder and afraid for my life, Steve was singing Gregorian chant in a monastery overlooking the ancient city of Rome. And here we were now, come to the same place, from two very different directions. It was past midnight when we said good night, and as I walked back to my room, I had the distinct feeling, in the middle of my usual muddle, that I’d been unexpectedly blessed.

I’d been in an academic program that offered equal parts structure (which I needed) and unstructured time (which I needed to learn to manage). Everybody, on some level, needs a good day-care program: Mine was the Yale Law School.

What you lose in the way of spontaneity, you gain by way of sanity.

Suicide almost always leaves shipwrecked survivors in its wake, feeling as though there were something else they could have done, should have done, to keep the one they loved alive. “If only I’d said this, if only I’d done that…What did we miss, how did we fail?” In those first awful days, there’s nothing anyone can say or do to ease that kind of sorrow, and any suggestion that it was “inevitable” gets pushed away.

My brain was the instrument of my success and my pride, but it also carried all the tools for my destruction. Yes, the pills helped, but each time I put them in my mouth, it was a reminder that some people—smart people I trusted and respected—believed that I was mentally ill, that I was defective; every dose of Navane was a concession to that. More than anything, I wanted to be healthy and whole; I wanted to exist in the world as my authentic self—and I deeply believed that the drugs undermined that. And so I kept backing away from them, tinkering with the dosage, seeing how far I could go before I got burned. And of course, I got burned every time—even in my denial, I knew that. But if the fire that burned me signaled my destruction, it was also the same fire that got me out of bed in the morning and sent me to the library even on the most frightening days.

Packing up your whole life and starting all over again is high on the list of major life stressors—it ranks right up there with divorce, diagnosis of serious illness, being fired from an old job, jumping to a new one, and grieving a death in the family. And then there was the smaller list, the everyday list: Where’s the grocery store? Where’s my bank? Where’s the best place to buy toothpaste, or lightbulbs, or fresh fruit, or to rent a movie on Friday night? When is the telephone guy coming, and where’s all my forwarded mail?

I taught criminal law class four years, and although I became a little better at it each time, I never got comfortable there, and approached the evaluation period each time with the same dread. My reviews got better, but I always disliked teaching first-year students. As I liked to say, the neuroses of first-year students conflicted too much with my own.

Dropping in and out of your own life (for psychotic breaks, or treatment in a hospital) isn’t like getting off a train at one stop and later getting back on at another. Even if you can get back on (and the odds are not in your favor), you’re lonely there. The people you boarded with originally are far, far ahead of you, and now you’re stuck playing catch-up.

“Crazy people” don’t make the evening news for successfully managing their lives; we only hear about them when something horrible happens. The

When you have cancer, people send flowers; when you lose your mind, they don’t.