Review of The Center Cannot Hold, by Elyn R. Saks

The Center Cannot Hold is an autobiography, recounting the struggles and triumphs of Elyn R. Saks, a woman battling her demons, namely, schizophrenia.  This inspiring story follows Elyn from childhood through college at Vanderbilt, grad school at Oxford, law school at Yale, career and marriage, to present day.  She gives us an in depth look at her experience as her symptoms begin to unfold, usually at the worst possible time.  Despite struggling with arguably the most difficult and debilitating mental illness known to man, Elyn manages to achieve academic and professional accomplishments that most (non-mentally ill) people never even aspire to.

Elyn Saks embodies strength and courage.  Despite the constant struggle to keep her symptoms at bay, she is determined and perseveres through her endeavors.  She has a few good friends that help her out along the way, demonstrating the great importance of support systems.  She also takes us through her experience with various psychiatrists, hospitals, and psycho-analysts.  At one point she recounts the terrifying experience of being hospitalized against her will, forced into restraints and medicated while in the throws of psychosis.  If you have ever wondered what its like to experience psychosis, this book will give you a glimpse into that world.

Elyn’s story shows us that just because someone suffers from a severe mental illness, does not mean they have to give up on their dreams.  With the right combination of support, treatment, and perseverance, anything is possible.  However, what one person is capable of, and what those dreams may be will vary greatly from person to person.

My only criticism of this book is that it may erroneously raise expectations of what a person struggling with mental illness should be able to accomplish, especially if they are not receiving the appropriate care they need.  Elyn is one of the lucky ones who responds very well to medications.  Many are not so fortunate.  I am not anti-medication because they are extremely important for many people (like Elyn).  However, a large percentage of patients I see come to me because the medications they have tried did not work or had side effects that were unbearable.  This book may give the impression that if someone “just took their meds” they would be fine and able to function well in the world. While this is true for some, unfortunately, it is not the case for many people suffering from mental illness.  Everyone is different and Elyn is a very talented, intelligent, driven person who tolerates medication well.

Elyn does reiterate that while the meds help “keep her demons at bay,” the only true healing she experiences comes through her psycho-analysis.  I only wish that I could have the opportunity to treat Elyn so that she might be able to reduce or eliminate her medication as she has always wanted to do.

I would recommend this book to anyone who is struggling with a diagnosis of mental illness, healthcare providers for the mentally ill, family members of mentally ill persons or anyone interested in learning more about the experience of schizophrenia.

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