In "The Second Coming," Yeats writes: "Things fall apart, the centre cannot hold; mere anarchy is loosed upon the world." From this evocative poem comes the title of this searing "journey through madness," by the brilliant and courageous Elyn Saks. The author had an idyllic childhood in a loving and prosperous Miami home. However, when she was eight, she began to experience intense compulsions, night terrors, and most frightening of all, a feeling that her mind "was like a sand castle with all the sand sliding away." "Sights, sounds, thoughts, and feelings [didn't] go together." When she was twelve, she stopped eating properly and lost an alarming amount of weight. Elyn feared that something was terribly wrong with her, and she did her utmost to hide her condition from her friends and family.
When she was a teenager, Saks experimented briefly with drugs, and this brought on more unpleasant symptoms. Things deteriorated further when she entered Vanderbilt University, where "schizophrenia [rolled] in like a slow fog," and she began to neglect her personal hygiene, forgetting to bathe and change her clothes. As a college freshman, she miraculously earned top grades while she struggled to keep her hallucinations at bay. Her "illness was beginning to poke through the shell" that helped her separate fantasy from reality. As long as the shell was intact, she could fool the world. When the shell broke down, so did she.
In "The Center Cannot Hold," Saks describes a see-saw existence in which she excelled at her studies while trying to keep her mental illness from disabling her. Over the years, she saw various therapists (some of whom were insensitive and even cruel, others warm and protective), was institutionalized and physically restrained repeatedly, and reluctantly tried different psychotropic medications, some of which had debilitating side effects. If her life were a bar graph, it would look like a series of peaks followed by precipitous drops. Any stress or sudden change would send her into a severe tailspin, and for a long time, she believed that her delusional behavior resulted from her weakness and worthlessness.
Saks is an eloquent writer who allows the reader to share her most personal and painful secrets; how difficult it must have been to reveal so much of herself after years of presenting a façade of normalcy to the world. This is an engrossing and poignant account of psychotic breaks, hospitalizations, and regressions, as well as of social, academic, and professional achievements. A less determined individual might have avoided challenging herself, but Saks was a serious scholar who studied philosophy, psychology, and law in such prestigious schools as Oxford and Yale. She also formed and maintained close friendships and sought a man who could love and accept her. Slowly, she climbed her rock-strewn path, suffering many distressing setbacks, but ultimately prevailing.
The author insists that the mentally ill are not inherently different from any of us. Schizophrenia favors no intellectual or social class; it can strike anyone. Saks has worked for years advocating for men and women with psychological illnesses, and she wrote this brutally honest book partly to make a public statement that no one suffering from any disorder, mental or physical, should be stigmatized. Saks sheds light on the ways in which schizophrenia afflicts young men and women, robbing them of everything that they need to take their place in society: an education, normal relationships, and a profession. Unfortunately, most schizophrenics do not have Elyn Saks's intellectual, emotional, and financial resources, nor do they have her strong support system. However, with ongoing research and more effective drug treatments being devised every year, there is hope that this heartening success story will someday be the norm, not the exception.
