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.