The key ideas

The Center Cannot Hold: My Journey Through Madness

Elyn R. Saks, 2007

Doctors gave her a “grave” prognosis: at best, supervised residential care and simple work. She became a professor of law and psychiatry, married, and wrote an honest book about her schizophrenia. This is an inside account of how psychosis feels, what helped her hold on, and why telling the truth about illness is so difficult.

Who it is for

For anyone who wants to understand mental illness from within, for people close to someone with a mental disorder, and for everyone tired of frightening stereotypes and labels.

My good fortune is not that I have recovered from mental illness. I have not recovered, and I never will. My good fortune is that I have found my life.

What the book is about

Doctors told a young woman her prognosis was “grave.” At best, life in supervised residential care and simple work. Many years later, she became a professor of law, psychology, and psychiatry at the University of Southern California, married, and wrote this book.

Elyn Saks lives with schizophrenia. Her memoir describes from within how psychosis feels, what helped in her case, and why she concealed the illness for so long. This is one person’s story rather than a textbook: the book helps you understand but does not diagnose you or your loved ones.

Idea 1. A sandcastle

Elyn is about eight. One day, she suddenly feels she is falling apart like a crumbling sandcastle. She is frightened and cannot explain it to anyone.

As a teenager, she begins feeling that houses on the street send her messages. Saks writes that schizophrenia rolls in like a slow fog that thickens almost imperceptibly.

This is her path rather than a general pattern. Many people experience similar strange moments, which prove nothing on their own.

In her case, the illness began quietly over a prolonged period. It can therefore be hard for someone to understand where strangeness ends and trouble begins.

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About the author

Elyn Saks is an American lawyer, professor of law, psychology, and psychiatry at the University of Southern California, and a researcher in mental health law. She received a MacArthur Fellowship in 2009.

All books by this author: Elyn R. Saks

Terms from the book

  • psychoanalysis
  • Schizophrenia
  • Psychosis
  • Paranoid schizophrenia: The diagnosis Saks received in the early 1980s. After the book appeared, modern classifications, DSM-5 in 2013 and later ICD-11, abandoned these schizophrenia subtypes.
  • Stigma: Prejudice and a mark society places on someone because of illness or another characteristic. It may prevent people discussing a problem and seeking help.

All terms

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