The Center Cannot Hold

I’ve just finished reading Elyn R. Saks’ memoir, The Center Cannot Hold, a moving narrative of her journey from her first commitment as a mental patient in Oxford, England, to a professor at the University of Southern California Gould School of Law and an adjunct professor of psychiatry at the University of California, San Diego. I found Saks’ story both compelling and horrifying. The writing draws you in, then holds you firm, even as you struggle to pull away from the more frightening passages.

When a young adult, Saks was diagnosed as a schizophrenic and sentenced to life-long medication and therapy. What is particularly horrifying about her story is that Saks delineates a clear trajectory from the obsessions and night traumas that she experienced when she was 8 years old, to her disintegration into full-blown schizophrenia when she was a student at Oxford. A lot happened in those intervening years, a lot of signs and symptoms were evident, but not understood.

Saks describes schizophrenia as rolling “in like a slow fog, becoming imperceptibly thicker as time goes on.” Her narrative reads much the same way, slowing covering the reader with a soft fog of strange thoughts and behavior, which gets thicker with Saks’ increasingly erratic and violent behavior. Although she assures the reader that she is not the only “success” story, it is hard to imagine anyone surviving the hospitalizations and forced medications that she had to endure, much less the heartbreaking realization that you are not in control of your own mind.

In spite of her illness, Saks managed to develop a very tight network of friends who seemed to be almost preternatural in their support of her. She comes from a middle-class family and learned early on to be stubborn, to “never surrender.” She is brilliant and has enjoyed academic success from her undergraduate days forward; although, much of this success occurred despite her illness and often to her astonishment. She acknowledges “the ticket [she] drew in the lottery: parents with resources, access to trained and talented professionals, and frequently unattractive stubborn streak . . ..” The purpose of her book is not to say that anyone with a mental illness can be as successful as she has been. There are too many externalities, too many other parameters the mentally ill person has no control over.

Saks wrote this book because she knows what it’s like to be psychotic, and she knows painfully well how the law treats mental patients: what it feels like to be put in restraints, to be forced to take medication, to be threatened with institutionalization. It’s become her life’s work to advocate for the right to self-determination for people with mental illness.

Saks notes that writing this book was not entirely her own effort: “In terms of the actual writing of the book, two people have played central roles.” The Center Cannot Hold is a true testament to one individual’s fight against the odds, but the four-page Acknowledgments at the end are also a testament to that individual’s need for love and support in order to survive.

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