The Center Cannot Hold

Starred review from May 14, 2007
I
n this engrossing memoir, Saks, a professor of psychiatry at U.C.–San Diego, demonstrates a novelist's skill of creating character, dialogue and suspense. From her extraordinary perspective as both expert and sufferer (diagnosis: “Chronic paranoid schizophrenia with acute exacerbation”; prognosis: “Grave”), Saks carries the reader from the early “little quirks” to the full blown “falling apart, flying apart, exploding” psychosis. “Schizophrenia rolls in like a slow fog,” as Saks shows, “becoming imperceptibly thicker as time goes on.” Along the way to stability (treatment, not cure), Saks is treated with a pharmacopeia of drugs and by a chorus of therapists. In her jargon-free style, she describes the workings of the drugs (“getting med-free,” a constant motif) and the ideas of the therapists and physicians (psychologist, psychiatrist, psychoanalyst, cardiologist, endocrinologist). Her personal experience of a world in which she is both frightened and frightening is graphically drawn and leads directly to her advocacy of mental patients' civil rights as they confront compulsory medication, civil commitment, the abuse of restraints and “the absurdities of the mental care system.” She is a strong proponent of talk therapy (”While medication had kept me alive, it had been psychoanalysis that helped me find a life worth living”). This is heavy reading, but Saks's account will certainly stand out in its field.

June 1, 2007
Schizophrenia reportedly affects one out of every 100 people, and the future of its victims tends to be bleak. In this engaging memoir, Saks (psychiatry, Univ. of California, San Diego; "Refusing Care: Forced Treatment and the Rights of the Mentally Ill") reveals how she beat the odds in a spectacular way. Organized in a traditional fashion, her book cites childhood foreshadowings of her disease but focuses on life after her condition became fully apparent while attending Oxford University as a Marshall scholar. Over time, she bounced between stunning accomplishments in academia and painful relapses into mental illness. Her journey illuminates critical dilemmas faced by the mentally ill, such as the ramifications of refusing treatment and medication, dealing with social stigma, and finding competent and humane psychiatric care. Except for anecdotal references to family dynamics, issues of causation are not explored. Saks's narrative is dramatic, detailed, honest, and extremely readable. The message is inspiring and hopeful, but schizophrenics without her considerable economic and educational resources are unlikely to thrive so well. Strongly recommended for public libraries and consumer mental health collections.Antoinette Brinkman, MLS, Evansville, IN

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