Tuesday, February 8, 2011

The Center Cannot Hold by Elyn R. Saks

The Center Cannot Hold by Elyn R Saks
352 pages
Published October 2007 by Hyperion
Source: a book club friend

When Elyn Saks was eight years old, she began having night terrors and developed obsessive compulsions.  That alone would have been a frightening development.  Then one day she was walking home from school and thought that the houses were sending her messages.  Even so, this was nothing compared to what would eventually happen.  After completing her Bachelor's degree at Vanderbilt, Saks went to Oxford to study.  It was there that things went from very bad to absolutely terrifying.  She began hearing voices in her head and having suicidal thoughts.  She was hospitalized and spent years in therapy, including an extra year after she was done at Oxford just because she was unable/unready to leave therapy.

After all of that, Saks did not really think she was ill.  She sincerely believed that everyone had these voices in their heads, these thoughts, but that they were better able to control them.  And with the right therapy, she believed that she, too, should be able to control the thoughts.  Even after she had another psychotic break while attending Yale Law School, one that initiated her into the horrifying world of inpatient "care" for psychiatric patients in the United States, Saks continued to believe that she should be able to fight these thoughts.
"To be weak is to fail; to let down your guard is to surrender; and to give up is to dismiss the power of your own will."
Saks battled taking medication for her symptoms, sometimes with disastrous consequences, for years.  Given the side effects and long-term effects, it's hard not to understand why she would be so adamant.  But the result was that she frequently found herself on a roller coaster of psychosis and often at odds with her doctors.  Further, Saks had been in therapy for years before she finally received the diagnosis that she had been fighting--schizophrenia.
"Schizophrenia rolls in like a slow fog, becoming imperceptibly thicker as time goes on.  At first, the day is bright enough, the sky is clear; the sunlight warms your shoulders.  But soon, you notice a haze beginning to gather around you, and the air feels not quite so warm.  After a while, the sun is a dim lightbulb behind a heavy cloth. The horizon has vanished into a gray mist, and you feel a thick dampness in your lungs as you stand, cold and wet, in the afternoon dark."
Despite this enormous obstacle, the numerous setbacks, the therapy, the medication, Saks managed to earn numerous degrees, become a tenured professor and finally find the love of her life.  What Saks has been able to accomplish is impressive, particularly in light of her diagnosis.

If you follow me on Twitter, you got pretty used to reading tweets from me saying how much this book was scaring me.  Of all of the things that worry a mother, I long ago added the fear that one day one of my kids would develop schizophrenia.  It was my boys I was most worried about; statistically, schizophrenia is more common in males. So for all of these years, I've been sure that I could finally relax about this concern once Mini-me made it through his early twenties (most males develop schizophrenia in their late teens/early twenties).  When I was handed this book, the idea that a woman had suffered so profoundly made me rethink my worries.  Clearly I was going to need to add my daughter to my concern about this disorder.

Then I discovered that Saks had begun having unusual symptoms as a young child.  Well, good then, none of my children suffered from any thing like this.  They're safe, right?  Wrong.  Saks, in addition to suffering from this disorder, has studied it extensively and shares what she's learned.  One of those things is that symptoms we may overlook, particularly in teens, may actually be early warning signs--bouts of depression, inability to focus.  Also, for females, the onset of full-blown schizophrenia might not manifest until the late twenties.  So now I find that I have another 15 years to worry.

Reading about what Saks has been through is heartbreaking, frightening and, eventually uplifting.  She is incredibly detailed in describing her episodes, treatment and inner thoughts which is insightful but I must admit that at a certain point, I began to feel like it might have been too much detail.  As bad as her episodes were, they began to blend in my mind and started to lose some of their emotional punch.  Saks does a lot of writing but her writing is primarily articles for law magazines and books about the mental disorders and diseases. It leaves the book lacking emotional depth, particularly later in the book.  I learned a great deal but readers should know going in that this is every bit as much a lesson about the disorder and treatment as it is a story of Saks' own battle.


  1. This one sounds fascinating! One of my brothers has schizoaffective disorder. It'll probably hit close to home. Thanks for this wonderful review.

  2. this sounds like a truly horrifying read--but one that offers hope and education. a boy i went to high school with--an honor roll student with a full academic scholarship--developed schizophrenia as a freshman and ended up leaving school. i'm not sure this book is for me, but your review is really well written and descriptive.

  3. That sounds like a heartbreaking book. I think it's sad that we've progressed so little in the mental health care department.

  4. Wow..this sounds like a powerful story and I can totally relate to your fears in regards to your children. My boys are 19 and 16...I'm not out of the woods yet!!!

  5. This one sounds amazing! Scary, yes, but powerful still. I agree - I would be creeped out when reading this. There's nothing that scares me more than a mind getting out of control. I may still give this one a try!