The Center Cannot Hold: My Journey Through Madness by Elyn Saks

Center Cannot Hold

Summary
  1. Elyn Saks details her own journey through life with serious schizophrenia. She describes how she dealt with her delusions, therapy, progress and medication while trying to live and overcome this illness
Key Takeaways
  1. Schizophrenia is a brain disease. Not a split or multiple personality disorder as it is often perceived but shattered personality with disorganized thinking, hallucinations and delusions. Saks describes some of her experiences as “nightmares while awake.”
  2. “This experience is much harder to, and weirder, to describe than extreme fear or terror. Most people know what it is like to be seriously afraid. If they haven’t felt it themselves, they’ve at least seen a movie, or read a book or talked to a frightened friend – they can at least imagine it. But explaining what I’ve come to call “disorganization” is a different challenge altogether. Consciousness gradually loses its coherence. One’s center gives way. The center cannot hold. The “me” becomes a haze, and the solid center from which one experience reality breaks up like a bad radio signal. There is no longer a sturdy vantage point from which to look out, take things in, assess what’s happening. No core holds things together, providing the lens through which to see the world, to make judgments and comprehend risk. Random moments of time follow one another. Sights, sounds, thoughts and feelings don’t go together. No organizing principle takes successive moments in time and puts them together in a coherent way from which sense can be made. And it’s all taking place in slow motion.”
  3. “…not everything can be conquered with willpower. There are forces of nature and circumstances that are beyond our control, let alone our understanding, and to insist on victory in the face of this, to accept nothing less, is just asking for a soul-pummeling. The simple truth is, not every fight can be won
  4. At her worst, she would hardly speak and go days without eating – convinced she was an evil person and did not deserve to eat. “I’m not sick. I’m bad.” She thought beings in the sky were controlling her thoughts and that she has killed hundreds of thousands of people with her thoughts
  5. I found the depressing and self-deprecating talk difficult to read. I can’t even imagine living through it
  6. Describes what living with schizophrenia is like – “Now consider this: The regulator that funnels certain information to you and filters out other information suddenly shuts off. Immediately every sight, every sound, every smell coming at you carries equal weight; every thought, feeling, memory, and idea presents itself to you with an equally strong and demanding intensity. You’re receiving a dozen different messages in a dozen different media – phone, email, TV, CD player, friend knocking at the door, ideas inside your head – and you’re unable to choose which ones come to the front and are relegated to “later.” It’s the crowd at the Super Bowl, and they’re all yelling directly at you.”
  7. “My brain was the instrument of my success and my pride, but it also carried all the tools of my destruction.”
  8. Crazy people don’t make the news for living their lives successfully, you only hear about the horrible events. Be very mindful of how you react and deal with somebody who is brave enough to open themselves up and tell you about their issues
  9. She gives a good overview of the book in this great TED talk
What I got out of it
  1. I am so fortunate and so grateful that I don’t have to deal with a situation like Elyn Saks does – continuous and terrible thoughts/episodes that touch everyone around her and can derail lives. Humbling for sure and it makes you more mindful of taking a second to stop and think before doing/saying anything rash to anyone as you never know what somebody is experiencing or has gone through in the past.

  • At a very young age, Elyn already has a strange experience where she feels that her “center gives way.”
  • Early on she was sent to a rehab clinic due to her parent’s overreaction to minor drug use. Here they taught that any form of medication was bad and this would hurt her for years to come as she would avoid taking medication that could drastically help ease her thoughts and episodes
  • “…not everything can be conquered with willpower. There are forces of nature and circumstances that are beyond our control, let alone our understanding, and to insist on victory in the face of this, to accept nothing less, is just asking for a soul-pummeling. The simple truth is, not every fight can be won
  • She started having her first truly scary schizophrenic episodes in college but still managed to do very well at Oxford
  • She found that having a predictable and structured routine, as is often found in academia, greatly helped
  • At her worst, she would hardly speak and go days without eating – convinced she was an evil person and did not deserve to eat. “I’m not sick. I’m bad.” She thought beings in the sky were controlling her thoughts and that she has killed hundreds of thousands of people with her thoughts
  • Finally convinced to take medication and while it helped, it also had bad side-effects – grogginess, lack of clear thought, irritation, etc.
  • I found the depressing and self-deprecating talk difficult to read. I can’t even imagine living through it
  • “When you’re really crazy, respect is like a life-line somebody’s throwing you.”
  • Started therapy with Mrs. Jones who demanded absolute honesty. “To her, my thoughts and feelings were not right or wrong, good or bad; they just were.”
  • After Oxford, got into Yale Law and while she was doing well in all her classes, she was still suffering through her episodes. Amazing that she had pretty much perfect grades and was always one of the best students in her class while dealing with all this
  • Recounted how awfully she had been treated at some of the mental hospitals – often being strapped down to a table for hours on end, not being able to move a single muscle
  • Started volunteering as a lawyer for mentally ill patients – had the unique perspective of both sides
  • Discovered that her psychosis helped protect her from painful thoughts and feelings
  • Describes what living with schizophrenia is like – “Now consider this: The regulator that funnels certain information to you and filters out other information suddenly shuts off. Immediately every sight, every sound, every smell coming at you carries equal weight; every thought, feeling, memory, and idea presents itself to you with an equally strong and demanding intensity. You’re receiving a dozen different messages in a dozen different media – phone, email, TV, CD player, friend knocking at the door, ideas inside your head – and you’re unable to choose which ones come to the front and are relegated to “later.” It’s the crowd at the Super Bowl, and they’re all yelling directly at you.”
  • After practicing law for a bit, she accept a tenure track position at USC
  • “My brain was the instrument of my success and my pride, but it also carried all the tools of my destruction.”
  • Has been on medication pretty consistently at this point and decides she wants to reduce them due to the side-effects. After 20 years of living with schizophrenia, she still has trouble admitting to herself that she’s not weak, she’s sick
  • Crazy people don’t make the news for living their lives successfully, you only hear about the horrible events. Be very mindful of how you react and deal with somebody who is brave enough to open themselves up and tell you about their issues
  • Achieved tenure at USC and found a very nice man who soon became her husband. She was finally on a medicine that worked for her and almost immediately her delusional thoughts and episodes retreated.
  • Received another devastating blow, as she was making wedding preparations, she found out she had breast cancer

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