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The Center Cannot Hold: My Journey Through Madness Paperback – August 12, 2008

4.7 4.7 out of 5 stars 3,991 ratings

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A much-praised memoir of living and surviving mental illness as well as "a stereotype-shattering look at a tenacious woman whose brain is her best friend and her worst enemy" (Time).

Elyn R. Saks is an esteemed professor, lawyer, and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry, and the Behavioral Sciences at the University of Southern California Law School, yet she has suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness.

The Center Cannot Hold is the eloquent, moving story of Elyn's life, from the first time that she heard voices speaking to her as a young teenager, to attempted suicides in college, through learning to live on her own as an adult in an often terrifying world. Saks discusses frankly the paranoia, the inability to tell imaginary fears from real ones, the voices in her head telling her to kill herself (and to harm others), as well as the incredibly difficult obstacles she overcame to become a highly respected professional. This beautifully written memoir is destined to become a classic in its genre.
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Editorial Reviews

Review

"Elyn Saks has been to hell and back . . . chilling."--San Francisco Chronicle

"Her descriptions of her descents into psychosis are riveting."--
Entertainment Weekly (Grade: A-)

About the Author

Elyn R. Saks is Associate Dean and Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences at the University of Southern California Gould Law School, an expert in mental health law and a Mac¬Arthur Foundation Fellowship winner. She graduated from Oxford as a Marshall Scholar and received her J.D. from Yale Law School. She has published three books and more than two dozen articles, and serves on the board of several mental health foundations. She lives in Los Angeles with her husband, Will Vinet.

Product details

  • ASIN ‏ : ‎ 1401309445
  • Publisher ‏ : ‎ Hachette Books; Reprint edition (August 12, 2008)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 368 pages
  • ISBN-10 ‏ : ‎ 9781401309442
  • ISBN-13 ‏ : ‎ 978-1401309442
  • Reading age ‏ : ‎ 18 years and up
  • Item Weight ‏ : ‎ 11.2 ounces
  • Dimensions ‏ : ‎ 5.5 x 1 x 8.5 inches
  • Customer Reviews:
    4.7 4.7 out of 5 stars 3,991 ratings

About the author

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Elyn R. Saks
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Elyn R. Saks is the Orrin B. Evans Professor of Law and Psychiatry and the Behavioral Sciences at the University of Southern California Law School and a research clinical associate at the Los Angeles Psychiatric Society and Institute. She is the author of Jekyll on Trial: Multiple Personality Disorder and Criminal Law and Interpreting Interpretation: The Limits of Hermeneutic Psychoanalysis.

Customer reviews

4.7 out of 5 stars
4.7 out of 5
3,991 global ratings
Brain seizure, broken brain, head attack, biological dysfunction
5 Stars
Brain seizure, broken brain, head attack, biological dysfunction
The center that I cannot find is known to my unconscious mind. W H AudenOther informative biographies: Temple Grandin Emmy Best Actress Claire Danes biopic. Dr Grandin has autism, her commentary in Special Features attributes her continuing growth in her 60s to 30 years of antidepressants (with no alcohol nicotine caffeine), My Stroke of Insight: A Brain Scientist's Personal Journey 37yo anatomy instructor in medical school experiences stroke as mental illness, dementia. An Unquiet Mind: A Memoir of Moods and Madness Kay Redfield Jamison professor of psychiatry Johns Hopkins Medical School, world expert on BD bipolar disorder, manic-depressive illness, suffers from BD. Fictional portrayal of alcohol precipitated psychosis: Black Swan.One can never consent to creep when one feels an impulse to soar.Helen KellerThrough excerpts from diaries she has kept since childhood, Elyn Saks narrates recurrent brain attacks, like heart attacks, during which her mind is controlled not by her, thoughts feel imposed, she feels overwhelming guilt for being responsible for killing everyone and anyone. Instead of a seizure in the motor control centers of her brain which leads to muscular flailing, she has seizures in the thinking portion of her brain, which then flails about rhyming non-random words to express terror of frightening change, perceived failure or rejection. Her riveting accounts of her brain's attempts to regain a foothold on reality, and preserve dignity while suffering a biological-biochemical disconnect reflect the organic nature of the illness: repetitive thought scrambles each time the brain filter deteriorates.Her courage in stubbornly fighting for aspirations despite crippling delusions hallucinations and depression must be obvious meeting her in person, as she attracts loyal and supportive friends throughout her life in spite of her frightening psychotic seizures. Her nickname "lunch Mother" for gathering all around her to share good food and fellowship reflects the warmth with which she is held.I have no special gift. I am only passionately curious. The most beauty or experience we can have is the mysterious. . . . It is the fundamental emotion which stands at the cradle of true art and true science.Albert EinsteinRevelation of her broken brain through this book must have come at great cost, since her strength and pride reside in that same organ. But she chooses to share her life suffering publicly in advocacy for humane treatment of those who are unable to speak out for themselves. Her frightened painful restraint by leather straps and body wrap in a US psychiatric hospital which compressed her chest and prevented adequate breathing is terrifying. The contrast with the dignified respectful approach in the UK where a physician sits down and explains clearly what is not acceptable, and offers medication or an opportunity for self-calming is enlightening.Given her brain's dependence on solitude, ritual, routine, regularity, predictability for function and productivity, what is most admirable was her meeting the challenge of cancer not once, but twice, and finding herself able to sustain clarity through treatment. The most informative aspect of her healing appears not solely in talk therapy, medication or abstention from alcohol nicotine caffeine, but in befriending: finding and drawing close a group of confidants who know and accept you just as you are, human and broken and caring and proud and stubborn, and to whom you offer friendship in return.See also Nell with Jodi Foster's commentary.Without deep reflection one knows from daily life that one exists for other people. Albert EinsteinProfessor Saks' lucid account of psychosis allows one to feel the pain of her confusion, fear, sadness as her brain which serves her so nobly in her work as a law professor, betrays her repeatedly. Her advocacy for humane and dignified treatment of the mentally ill is fortified by her courageous memoir, and allows one to see the advantages of Aikido Communication: aligning, agreeing, redirecting, resolving while sharing common ground. Reading this book allows one to enter the realm of fear experienced by the mentally ill and compassionately empathize with the desire to protect oneself from frightening unknowns.Some reviewers comment on the self-absorbed wooden writing style. Professor Saks has a thinking disorder. She controls her life by controlling her thinking. Her field is mental health law, an intellectual pursuit, characterized by writing, editing, revision and re-revision to provide clarity and argue persuasively. She is not bipolar which is the brain seizure suffered by artistic creatives, so her writing does not carry the theatrical dramatic flavor of poets, playwrights, lyricists. Hers is a thought disorder, keeping her thoughts in order is a priority. Saks uses both direct grammar and vocabulary to maintain accessibility for patients and families.Some reviews note the distance sustained by Saks' parents when she was in distress. According to current thought, high expressed emotion, dramarama, theatrical displays of passion and emotionality are associated with relapse, decompensation, aggravation of functional instability. Maintenance of a neutral, low tone atmosphere in relationship devoid of drama is less likely to precipitate the painful decline in brain function called psychosis. Family intrusiveness, invasiveness, conflict, crying screaming high drama is associated with deterioration. Neutral friends and therapists were able to maintain the caring but encouraging environment she needed to acquiesce with treatment advice after 20 years of recurrent psychotic episodes from medication refusal.Temple Grandin acknowledges in her DVD commentary that her mother never felt comfortable with her squeeze machine. The neutral objectivity and distance of her aunt Ann allowed Temple to invent this calming chute, a coping skill which allowed her hours of productive function each day. The protectiveness of her mother cried out against the device. DVD Dhamma Brothers documentary of 10 day meditation training and 10 year follow up. CD Zen Garden, DVD Departures Oscar Best Foreign Film Japanese with English subtitles score CD Okuribito (Departures) gentle music for meditation or Tai Chi.Recovery is creating a "new normal." There is no current cure for schizophrenia, but Professor Saks shows there can be healing.Mental illness is a moment which changes, mental health is a moment which changes. Recovery is not returning to the way you were in the past, it is a collaboration between meeting the demands of illness while continuing to pursue meaningful work, family, friendships, marriage. Her memoir is a gift of sharing from a very private, painfully shy person, a story of suffering and ultimately resilience and hope DVD Happy [HD] documentary interviews with happy people worldwide.If you see yourself in others, then whom can you harm? Buddha5* stars
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Top reviews from the United States

Reviewed in the United States on May 22, 2013
"I needed to put two critical ideas together: that I could both be mentally ill and lead a rich and satisfying life." ~ (Locations 5056-58)

Elyn R. Saks is a professor who has struggled with schizophrenia for most of her life. As a child she became slightly obsessive compulsive and then anorexic. As she grew older she started to have more symptoms of the disease and suffered for many years without medication.

Throughout the book you will read completely honest revelations of what it is like to be on medication and to be off medication. You will be amazed at how creative a writer Elyn R. Saks is and how she remembers precises details of her life, even down to conversations she had with numerous people. Obviously she has a brilliant mind to remember with such clarity.

At times this book can be shockingly honest but it is never frightening as I thought it might be. Elyn R. Saks always seems to have protections in place so when she falls gravely ill she has a support system and friends to help her.

For some of the book you may feel frustrated that Elyn R. Saks thinks she can function without medication. Each time she is thrown back into a debilitating psychosis. The triggers are interesting and for that reason I think this book can explain a mentally ill person's basic needs for understanding and support.

As we watch Elyn R. Saks struggle with her demons we are invited into a very private world of fears most will never experience. People who are mentally ill will however really relate to the hallucinations and voices and feeling of impending doom.

Overall this book is a captivating and compelling story of one woman's journey to happiness and success. As I finished this book I was so glad I had read it. The ending is profound and when Elyn R. Saks comes to terms with her illness you will feel a great sense of relief.

~The Rebecca Review
8 people found this helpful
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Reviewed in the United States on March 25, 2024
Between reading to this book and listening to it as I moved around my house or was in the car, I have been immersed in Elyn Saks’ story for several days. I was moved by her courage, inspired by her tenacity and brilliance and uplifted by her loving community. Also horrified by her treatment by mental health practioners at the hospital where she was restrained.
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Reviewed in the United States on December 13, 2010
I just finished "The Center Cannot Hold" after it showed up in my Amazon recommended reading. What an amazing book. It's been my experience that sometimes people who aren't writers by trade can tell an engrossing story but not necessarilly tell it WELL...not the case with Elyn Saks. It's an amazing story that's beautifully written. At her darkest times in the book, I felt so much pain and empathy, and only knowing that she came out the other side successful got me through. And boy, did she come out successful. A gripping and inspiring read for anyone interested in mental health.
6 people found this helpful
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Reviewed in the United States on October 22, 2007
This book gets my vote for Book of the Year.

Saks is an acclaimed professor of law and psychiatry. She also struggles with severe symptoms of schizophrenia. She risked her reputation in academia in order to give hope to others like herself, and to counter the negative stereotypes about mental illness held by both the general public and mental health professionals:

"I wanted to dispel the myths ... that people with a significant thought disorder cannot live independently, cannot work at challenging jobs, cannot have true friendships, cannot be in meaningful, sexually satisfying love relationships, cannot lead lives of intellectual, spiritual, or emotional richness."

The topic is inherently compelling, and Saks masterfully describes what it is like to be tormented by inner demons, to be forcibly restrained on a hospital bed, to require medications that alter one's mental state and can cause horrific, irreversible side effects. She articulately describes her years of talk therapy, in which she came to understand the functional underpinnings of her psychotic thoughts, for example in warding off feelings that would have been consciously threatening.

I enjoyed her dry humor in highlighting the condescension and absurdities of the mental health system. In one case she reviewed during a legal internship, the patient was restrained because he refused to get out of bed. In another case, a young man was deemed delusional because he continually spoke with "imaginary lawyers" - who turned out to be none other than Saks and her colleague.

For years, in order to excel, Saks had to lead a double life. Swirling around her, constantly threatening, was the stigma of mental illness. While writing an academic paper on restraints, she asked a professor, "Wouldn't you agree that being restrained is incredibly degrading, not to mention painful and frightening?" With a kind and knowing look, the professor responded: "These people are different from you and me. It doesn't affect them the way it would affect us."

This book is especially important reading for mental health professionals in the United States, where medication reigns supreme (it has become practically taboo to recommend psychotherapy for severe psychosis, despite ongoing research establishing its efficacy) and coercion often trumps choice. Saks contrasts her experiences of being hospitalized both in the United States and in England, where restraints have not been in widespread use for more than 200 years. In doing so, she gives us a deeper appreciation of the trauma induced by coercive and sometimes brutal treatment.

"The Little Engine that Could" is what her close friend Steve Behnke calls her, referring to her indomitable spirit even in the face of hospital clinicians' dire predictions about her future.

I highly recommend this courageous and brilliant memoir.
18 people found this helpful
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Reviewed in the United States on January 12, 2024
Excellent read. Before reading this book, I did not understand why people with a mental illness stopped taking medication or that some medications were no longer effective after a patient had successfully taken a drug for years. I did not know that 1 percent of the population has schizophrenia and only one person in five can successfully work at a job. Elyn Sacs has schizophrenia and can explain what it is like to suffer from this disease.

Top reviews from other countries

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Aturo
5.0 out of 5 stars Amazing book
Reviewed in Germany on March 29, 2024
By far the best book. I‘ve ever read. A very touching and relatable story about living with an mental illness. A must read for any schizophrenic out there.
Amazon customer
5.0 out of 5 stars Phenomenal
Reviewed in the United Kingdom on April 18, 2022
Elyn Saks has written a beautiful , moving and astonishing account of living with a mental illness. I was blown away by her immense courage, versatility and spirit. At times, I felt so angry on her behalf about the way she was treated by mental health professionals, especially with regard to the cruel and repressive treatment that was employed during her two admissions to American psychiatric hospitals. I was absolutely appalled by her description. I wasn't very impressed by the treatment she received in the UK system either, but at least it was not brutal. And yet, despite all this, and also three life threatening physical illnesses, Elyn has not just survived, but thrived. Her achievements are phenomenal and I was impressed by the way she has used her intelligence and legal abilities to improve the American mental health system for others. Elyn also describes some of the many friends she has made, and she is clearly a wonderful person who inspires others. I was so glad the book ended with an account of happiness and fulfilment on all levels. I would recommend this book to anyone, and particularly to psychiatrists and therapists. The act of writing this inspiring book was one of enormous courage. Towards the end a psychiatrist asks: Elyn, do you want to become known as the schizophrenic with a job? I would say this is the wrong question. To me, Elyn Saks is an amazing person and law professor who also happens to have a diagnosis of schizophrenia, who has still achieved a phenomenal amount and made the world a better place through her work and through her presence.
Cliente Amazon
5.0 out of 5 stars Livro agudo e impactante
Reviewed in Brazil on January 11, 2019
Modifica a visão do senso comum de doenças mentais.
Suzanne
5.0 out of 5 stars Awesome read
Reviewed in Australia on January 24, 2023
One of the best books i have read on the subjet. Elyn is an exceptional writer and storyteller. I highly reccomemd this book to anyone wanting to better understand mental illness.
K
5.0 out of 5 stars Five Stars
Reviewed in India on July 1, 2017
Insightful look into the mind of a schizophrenic
One person found this helpful
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