Book Ends: The Center Cannot Hold by Elyn R. Saks

Book Ends: The Center Cannot Hold by Elyn R. Saks

Reviewed by Columnist Kurt Sass

A “broken brain” that accomplished a great deal

In the very last chapter of Professor Elyn Saks’ book The Center Cannot Hold: My Journey Through Madness, she states that the reason she writes and speaks out is: “to bring hope to those who suffer from schizophrenia, and understanding to those to those who do not.” I just have one message for her: Mission accomplished! After reading about all the trials and tribulations that Ms. Saks has endured and survived, I believe anyone who is fighting the daily battles with schizophrenia, or any other psychiatric disability, will come out of the experience with a renewed spirit. Also, I believe anyone who has never experienced schizophrenia will find reading this book an extremely educational, eye-opening experience.

One very strong point about Ms. Saks’ writing is her honesty and candidness, especially when it comes to her struggles with remaining on her medication. Ms. Saks points to many instances when she is doing fairly well, but then decides to lower or stop taking her medication altogether and then almost immediately relapses into psychosis. Many writers would not write anything at all that might shine a negative light on themselves, but Ms. Saks explains the reasons why she (and many others) make these decisions about stopping medications.

It took Ms. Saks many years to come to terms with the fact that the medication does help keep the psychotic thoughts away and that she must continue to take it, even when feeling well. She discovered the reason she would stop taking medication was that she would feel that each time she put a pill in her mouth it was a reminder that her brain was profoundly broken and defective, and that by taking pills she wasn’t being her authentic self.

In addition, Ms. Saks said she had to come to terms and accept that she had a mental illness. She tells the story of an analogy a friend told her about a riptide, that your first instinct is to fight it, and you use all your energy fighting it. Ms. Saks was using all her energy fighting her diagnosis of mental illness by stopping her medication. Once she accepted the diagnosis and allowed the medication to do its job, things continued to get better.

Ms. Saks also goes into great detail about the importance of talk therapy as well as medication in her recovery. There were many examples in the book when she was completely off medication and feeling psychotic and either reached out to others (friends, therapists, etc) or they reached out to her.

Perhaps the most powerful part of the book is the amazing disparity of treatment she received while going through her various psychotic episodes. Many times it simply came down to a matter of who noticed the behavior or which hospital she was admitted to. The most blatant example of this was when she was admitted to one hospital (she was talking incoherently, but not behaving violently at all) and put in four-point restraints for days. Just a short time later, exhibiting the same exact behavior, a different hospital nearby felt that no restraints were necessary at all. And it turns out they weren’t needed.

Professor Saks is a Graduate of Oxford University and is a Professor at the University of Southern California Gould School of Law. She was able to achieve all this while having numerous psychotic episodes throughout the years.

The Center Cannot Hold: My Journey Through Madness has won numerous book awards and was on the Time magazine top ten best-sellers list for Non-Fiction books.

Pullout: “...each time she put a pill in her mouth it was a reminder that her brain was profoundly broken and defective, and that by taking pills she wasn’t being her authentic self.”