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The Center Cannot Hold by Elyn R. Saks

The Center Cannot Hold: My Journey Through Madness - Elyn R. Saks

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 a chronological 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 the schizophrenia really sets in. 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.