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The Center Cannot Hold: My Journey Through Madness Paperback – August 12, 2008
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From Publishers Weekly
In this engrossing memoir, Saks, a professor of law and psychiatry at the University of Southern California, demonstrates a novelist's skill of creating character, dialogue and suspense. From her extraordinary perspective as both expert and sufferer (diagnosis: Chronic paranoid schizophrenia with acute exacerbation; prognosis: Grave), Saks carries the reader from the early little quirks to the full blown falling apart, flying apart, exploding psychosis. Schizophrenia rolls in like a slow fog, as Saks shows, becoming imperceptibly thicker as time goes on.- Along the way to stability (treatment, not cure), Saks is treated with a pharmacopeia of drugs and by a chorus of therapists. In her jargon-free style, she describes the workings of the drugs (getting med-free, a constant motif) and the ideas of the therapists and physicians (psychologist, psychiatrist, psychoanalyst, cardiologist, endocrinologist). Her personal experience of a world in which she is both frightened and frightening is graphically drawn and leads directly to her advocacy of mental patients' civil rights as they confront compulsory medication, civil commitment, the abuse of restraints and the absurdities of the mental care system. She is a strong proponent of talk therapy (While medication had kept me alive, it had been psychoanalysis that helped me find a life worth living). This is heavy reading, but Saks's account will certainly stand out in its field.
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At eight years old, Saks began suffering hallucinations and obsessive fears of being attacked. An adolescent experimentation with drugs provoked her parents to enroll her in a drug treatment program. But Saks' incredible self-control masked the fact that she was suffering from a debilitating mental illness. By the time she entered graduate school at Oxford University, her symptoms were so severe—including full-blown psychotic episodes and suicidal fantasies—that she was hospitalized. Through Oxford, law school at Yale, and a move to Los Angeles to work in the law school of the University of California, Saks struggled mightily to balance her ambitions with her illness, which was eventually diagnosed as schizophrenia. Never wanting to concede to her mental illness, Saks founds calm and comfort in a rigorous work routine. An analyst characterized her as having three lives: as Elyn, as Professor Saks, and as the Lady of the Charts mental patient. As Saks battled to get off medication and leave behind the Lady of the Charts, she fought for the rights of mental patients, and came to terms with her own limitations. Bush, Vanessa
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Top customer reviews
It renewed the sense that I chose the right field -- of course I would be a mental health concentration! This resonated with me in so many different ways, and I have never had a moment of psychosis. It changed my lens I saw my grandmother in so many years ago (even though I was just a child- it helped me to understand behaviors that I could never had made sense of). It exposed me to new modalities I knew nothing about, and has made a big impact on the type of clinician I will become.
Elyn is one of the most resilient individuals I have ever heard about. There were parts of the book I literally sat to myself and said -- no way that happened and been in awe of her true story.
Elyn, if you are reading this (which you are probably not), but you are an inspiration and truly admirable for the struggles you have overcome - and I know you say you are an exception to the rule, but your book alone has expanded my world and lens I can see people from. It makes me proud that you ended up at USC because that is where I am studying for an MSW -- FIGHT ON! That slogan seems to be so fitting for your life philosophy. I am glad you put yourself out there and used your name - you are a major force in changing mental health stigma. For that, I thank you. I work with children and their families who have mental health issues and will surely be recommending this book to many parents who lack empathy for their children with psychotic symptoms.
I did feel it could've been a lot shorter and still keep the same impact. I admire her perseverance, it truly is an inspirational story for doctors and patients alike to see someone be able to withstand the devastating effects of ongoing progressive psychotic illness and be able to succeed in the manner in which she did. It creates an interesting contrast to compare her story to that of someone without the same generous resources as Ms. Saks had at her disposal (financial conditions to allow psychoanalysis, for instance). Within the premise of the book it was the patient's exposure to Kleinian analysis that I found the most fascinating; I think that for someone with less familiarity with what this entails it may have seemed like many random weird statements made by the therapist, and the author may have benefited from elaborating a little further on what the logic is behind the Kleinian interventions (deep primitive interpretations done at an early stage to evoke the transference neurosis), which without context can literally seem like "verbal rape." This was ultimately a very nice read, and I can only hope that advances in neurobiology and psychopharmacology will allow for the schizophrenic population at large to be able to progress to a place where a functional niche is not just a fantasy.