Wednesday, June 5, 2013

The Center Cannot Hold -- Elyn Saks

Psychiatric Times published an excellent review of the great personal memoir by Elyn Saks, a U.S. law professor and MacArthur "genius" grant fellow who also happens to suffer from chronic schizophrenia. Read the review in its entireity if you like -- it won't spoil the book. Saks' memoir is probably the best first person account of psychosis that I have encountered and I strongly recommend it. (If you are interested in drug-induced psychosis, this is not to be missed.)

From the Psychiatric Times review:

As she brings her story to an end, Elyn is still taking clozapine and is told by her psychopharmacologist that she will most likely have to take some antipsychotic medication for the rest of her life. She credits both psychoanalysis and psychopharmacology for the progress she has made. “While medication had kept me alive,” she acknowledges, “it had been psychoanalysis that had helped me find a life worth living.” For someone so long and so tightly in the grip of a psychotically transformed world as Elyn has been, the challenge of breaking that defensive structure is probably in some ways akin to breaking an addiction to a chemical substance.
Elyn’s descriptions of her psychotic (and normal) experiences are taken here to be primary data, in the way that numbers, and the statistical elaboration of these numbers, are considered data in the empirical approach to studying psychopathology. Hermeneutic analysis of what Elyn tells us about her fall into psychosis and her efforts to have a career and a life—her story—reveals the phenomenon of one of the phenotypes of the heterogeneous illness we call schizophrenia. Her narrative draws us into the interior world of the psychotic person, territory that few clinicians attempt to access or assess.
Here's a link to her TED talk, which is well worth watching (why not learn something during the next 14 minutes?). She does a great job depicting the loose associations that are the hallmark of schizophrenic speech.


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