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

Well, I think this book is maybe the best book that I read in my whole life. Besides tell us the story of her life, Elyn Saks tell us what a person suffering from schizophrenia thinks and feels during her crisis. Off course that each person is different, but to "healthy" people, know about this is a invaluable knowledge. I was very surprised when she describes that she was shamed because while she was tied during a crisis, in the hospital, the door was open and all people that passed in front that door can see her. Usually we think that mental patients do not completely realize the reactions of the others, so, probably a lot of us don't bother in completely hide our discomfort when in presence of their crisis, probably hurting them still more. This book can teach all of us to be more sensible and solidary to mental ill people, but it is a distressful reading, because we suffer together with the author, chapter after chapter. I did a bad choice to decide reading all book in the bus, because in the last chapter I had to use a lot of self control to avoid to cry.One reviewer seem a little uncomfortable because the author repeatedly cites her intellectual merits, but I think that is absolutely necessary, because the healthy people usually think of mentally ill people like mentally lame, and probably it is not easy to break this misconception, so, her emphasis is welcome and is not a sign of poor writing, but of good writing abilities. She knows what is important to reiterate to her message can be understood. You don't break prejudices only explaining fact after fact, prejudices are hypnotic standards of thought, so you need treat them according and hit the same key again and again and again...Well, I am not that kind of reviewer that put a summary of each chapter, if you want this, try the "Look inside" feature. I think that is much more useful to tell what a person think and feels about the book, because these human reactions are what we share in commom and says more about the books than a summary.Now, I want to say some few things about this sickness, and if you are a materialistic person or a Christian person ( the type of person that think that the bible has all answers), stop to read here, to avoid waste your time.Elyn Saks describes some situations about her "delusions" that seems clearly psychic attacks and this hypothesis should be checked too, together with the schizophrenia hypothesis. In our materialistic society any time when a person see, hears or feels anything that is not physically present, this is interpreted like madness. It is so with astral projection, with see/hear spirits, auras, elementals, or pre/retrocognition. The materialistic point of view is very ignorant about this matters, so, its conclusions has completely no value in this subject. The fact the medicines were able to control or stop the delusions only shows the the medicines can block the perceptions of the person. Off course, a good part of the psychic attack is nothing more than spiritual bullying, so, if you can prevent the victim of perceive the bullying, you can block the negatives effects of the psychic attack, WHILE YOU TAKE YOUR MEDICINES. However, like the most in the medicine, you are only treating the symptoms, not the cause, that MAY be spiritual.A lot of things that Elyn Saks saw or thought during her crisis ( and a lot of mental diseases, but not all of them) , mainly her thoughts about she worth nothing, are the usual technique in psychic attacks, and if she had knew some reliable psychic ( the reliable never will charge any money for this) maybe she can find another answers to her situation, and another solutions.I know that this maybe sounds a little strange in the American culture, but if you can tolerates learn about spiritualism, you can discover that there are more facts than beliefs about this situations. However, IF situations the Elyn tells us about were, in fact, psychic attack, not schizophrenia, even so they are very hard to solve, because there are strong reasons to this kind of problem, usually a person never faces hard problems without strong reasons to them, and in this kind of situation, I mean, psychic attack, usually the offenders were, usually, victims in past incarnations, and the actual victim is, usually (but not always), the tormentor. Silt the actual victim with medicines can help her, but will not solve the problem, IF THE PROBLEMS WERE NOT MENTAL. Anyway, only a psychic can say if there were any real entities attacking the victim or if all was only delusion, a materialistic doctor is not able to conclude nothing about this. In a ideal world, the psychiatrist should be a psychic too.To those people that has any curiosity about the several problems and nuances of psychic attacks and methods of solutions that SOME GROUPS of spiritualists uses, this book has a lot of study cases:Spirit and Matter: New Horizons for MedicineI think that people suffering with mental disorders lose a lot to confine themselves to materialistic point of view, but anyone has the right to only accept the solutions that are according with their beliefs, even if this only treat the symptoms, not the cause.

Terrific engagement and sharing in the life of a courageous woman.A beautifully worded story of her life and one of the most readable booksI have ever encountered.

I really enjoyed reading this memoir. It gave a real and candid glimpse into the condition of Schizophrenia and detailed how the author overcame the obstacles of this condition and offered hope to those suffering with the condition as well. I appreciate how the author did not hold back, and painted how intense and frightening psychosis can be, and how even more frightening and frustrating it can be to seek help for this serious condition. My only negative criticism I have is the book did become repetitive at times, especially towards the end when the author kept detailing how she kept going off medication, had a rebound in psychosis, and would then go back on medication. There were also some loose ends in the book that I really wished the author tied up, like what happened with the Tardive Dyskinesia? Lastly, I found that the overall flow of the writing was limited at times. However, despite it’s shortcomings, I found this memoir to be wonderful and would definitely recommend it to anyone who is interested in knowing more about Schizophrenia.

Rossa Forbes is a contributor to Goddess Shift: Women Leading for a ChangeIn schizophrenia memoirs I am always looking to see what things that I can emulate in order to help my son get through his own particular version of schizophrenia. This kind of guidance is virtually non-existent unless you read about it from people who have been there themselves.It is easy to dismiss Elyn Saks as an over-achieving drama queen. Many people think that hers must be a mild case of schizophrenia since she is such a high achiever. I am amazed that she racked up all the credentials that she has while clearly psychotic much of the time. However, by doing this she has also demonstrated the elasticity of this diagnosis, and she has anecdotally pointed out some valuable insights for the rest of us. Her story will be disappointing for people who see getting off medications as a pathway to recovery because she finally admitted to herself, after years of refusing to take them, that she needed the medication to function. It just goes to show that there is no one size fits all solution.When I read these first person narratives, I always ask what information is available now that wasn't available then or what did the person not do that might have helped? None of this guarantees, of course, that the outcome would have been any different. Elyn Saks did not explore vitamin therapy. Vitamins in large doses such as vitamin B3 (niacin) act like drugs and there are no negative side effects. Energy medicine, which has also helped my son, was not widely known back then, and so there is no mention in this book of therapies that could correct an energy imbalanceI have learned enough through my own investigations to see that certain factors were in her favor outside of just being female. One is that her family let her do her thing. It is sometimes said that the family has to be involved but not over-involved. This is what is called Expressed Emotion (EE). Patients with families exhibiting low EE are found to have better outcomes when it comes to schizophrenia. When I first was trying to find out some useful information about what to do for my son, I was intrigued to read that many doctors feel that people do best whose families don't seem to notice that their relative is ill. Elyn Sak's parents win top prize in that category, though it probably wasn't a deliberate strategy on their part. Once I caught on to this simple but elegant idea, I began practicing it with my son. It seems to work because it thrusts a certain responsibility on the person while they remain clueless about how really worried you are. They are less anxious this way. You will eventually be less anxious, too, by practicing low EE.People who get labelled schizophrenic are often overly attached to their family. They can be the dutiful, thoughtful, "good as gold", achieving child. This almost guarantees that their passage into adulthood will be troublesome in really weird ways. Becoming an adult and leaving the framework of the family frightens them. Rather than get angry and openly rebel (a time-honored method of achieving independence), many go psychotic. Highly sensitive to begin with, they simply freak when it becomes apparent that soon they will soon be venturing further into the world or that the world is putting more demands on them. They are, of course, way too "considerate" of their parents. German theologian and counsellor Bert Hellinger says that individuals with schizophrenia are particularly sensitive to (though consciously unaware of) family trauma often originating four generations in the past. They "self-sacrifice" for a parent as a way of atoning for past family trauma. In this case, Elyn Saks is no exception. Early on, she told a therapist that she no longer wanted to see her (Karen) because her parents were upset that the therapist hadn't figured this out and come up with a plan, and that it cost them too much money to continue to see her. "It never occurred to me back then (and if it occurred to Karen, she didn't say so) that I was taking better care of my parents than I was of myself."The drug rehab program that she was forced into in high school by her parents left her no time to think for herself beyond the confines of what she was told to do and how to act. This may have worked to her advantage, not because she was abusing drugs (she wasn't) but because it gave her a framework of hard work and structure to her day that she was able to use throughout her psychosis. She always reached out for someone to hang onto, like clinging to a doorframe in a high wind, using that person as a frame of reference for her day. In her Oxford years she allowed time for herself to be clearly psycho within a framework of rigorous Kleinian psychotherapy, and then sobered up somehow during the rest of the day and went back and racked up more academic credentials. It was astonishing to me that the analysis that she underwent on a daily basis for three years in England didn't seem to lift her psychosis. She literally clung to the analyst right up until the day she left to go back to the United States, weeping and being her usual psychotic self. She had unknowingly done what psychiatrist Thomas Szasz advises. She found herself a contractual psychiatrist unconnected to an institution. She paid out of pocket for the privilege and she got what she wanted, rather than having the State force its one size fits all approach on her.The high school drug rehab program also gave her a lifelong aversion to taking any drugs, whether legal or illegal. If you read Robert Whitaker's new book, Anatomy of an Epidemic, you will see that her success, messy as it is, may be in large part because she continually refused to take the antipsychotics that were offered her. Whitaker's book extensively documents that long term use of psychiatric drugs leads to poorer outcomes. Psychiatrist Daniel Carlat says: "We often talk about neuro-transmitters like serotonin and noroepharin. But that really ends up being neurobabble. It sounds impressive to patients and it makes them think we know what we're doing when we're prescribing the medications. But we don't really know how these meds work." Side effects, said Carlat, can be serious or in some cases, unknown. "We don't know enough about the side effects to know how many people we're putting at risk."Elyn Sak's very messy psychotic life almost tempts me to say that an antipsychotic introduced earlier would have helped get her life together, and I am someone who is not at all in favour of relying on drugs to solve personal problems in living. Reading this book I am tempted to think "oh, please, just try an antipsychotic," but I am only too aware that psychiatric drugs can put you in a never-ending nightmare. They are major tranquillizers that set most people spinning off into long periods of relapse, weight gain, apathy, and unemployment. Should Elyn Saks have chosen the drug route, my guess is that she would not be where she is today. Sylvia Nascar, the author of A Beautiful Mind, might agree that Saks got where she did because she refused to take the drugs. Nascar writes: "Nash's refusal take the antipsychotic drugs after 1970, and indeed during most of the periods when he wasn't in the hospital in the 1960s, may have been fortuitous. Taken regularly, such drugs, in a high percentage of cases, produce horrible, persistent, symptom like tardive dyskinesia. . . and a mental fog, all of which would have made his gentle reentry into the world of mathematics a near impossibility."Another affirmation I got from this book is, if someone tells you that a certain therapy worked for them, then don't wait for the latest "scientific" evidence or psychiatrists to give it their blessing as a therapy in order to try it for yourself. Everybody "knows" apparently, that psychoanalysis "doesn't work for schizophrenics." Elyn Saks gives Kleinian psychotherapy (think Freud) major credit in helping her cope. Freud has been routinely trashed by modern psychiatry as unhelpful for schizophrenia. However, as her therapist pointed out to her back in the early 1980s, therapists have built on Freud's work as the basis of their work with schizophrenia. This influence doesn't seem to be well recognized today in an age where people think Freud has no relevance. Luckily for Elyn Saks, she didn't know what everybody else knows.One can quibble by saying that since she still suffers from psychosis, then what good did psychotherapy do? I understand that she is now in training to be a psychoanalyst so she must believe in it strongly. People say the same things about cognitive behavioural therapy, which is finally getting a rethink after many years of being dismissed for schizophrenia. Most psychiatrists don't want to get that involved with their psychotic patients. It's easier and more financially rewarding to medicate them than to do the really hard work of getting to know them. I can't believe the number of people who won't try something because "there is no scientific evidence" that it works for schizophrenia. Well, individuals are not statistics, you are the persons most interested in your own recovery and you should do whatever it takes to get there. I have introduced to my son some truly unusual therapies, short of dancing on a toad's grave, but if I thought that might work, I'd be game. I noticed that most of these non-sanctioned therapies moved him forward in some way. The bottom line here is think for yourself. You are you, but you are simply a statistic to the medical profession as it stands today.To make a long story short, I think this is a great book with a lot of insight.

10/10 loves this book!