The Center Cannot Hold

I just finished reading Elyn Saks memoir The Center Cannot Hold about her struggles with schizophrenia and her determination to succeed in her studies, in her professional life and in her personal life. Though she still suffers from the effects of schizophrenia, she managed to experience all three of those successes. How did she do it? Her scholarly intelligence and sheer stubbornness along with a series of very good psychoanalysts, many good friends and ultimately anti-psychotic medicines all made for a good combination. They not only helped to pull her through the worst of her illness, they allowed her some great achievements like becoming a law professor, an author and a very happily married woman. She writes with clarity and sensitivity and I read the book quickly. I found it very interesting that her experience with psychoanalysis or what she sometimes refers to as “talk therapy” helped to steady her many, many times and this before she committed to taking the anti-psychotic meds faithfully. I found that this is true for me as well. I went to my therapist for three years before I steadfastly began taking the anti-psychotic medicines and during that time I also talked aloud to my voices when I was alone. Both had a deeply therapeutic effect on me and made me feel actively involved in the recovery process. I was literally and figuratively working through my psychosis by talking to someone grounded in reality and to the source of my illness: the voices themselves. It helped to counter a pervasive sense of helplessness. I had a voice and I could use it if only just with my therapist and with myself/the voices.

(Next day)
Towards the end of the book Elyn Saks asks herself “Who was I, at my core? Was I primarily a schizophrenic? Did that illness define me? Or was it an ‘accident’ of being--and only peripheral to me rather than the ‘essence’ of me?”(p.255) Once I accepted the diagnosis of schizophrenia, life got somewhat easier for me and I did think of myself as a schizophrenic almost with pride for having survived the worst of the illness. But still, then as now, I lived in isolation away from other people who were suffering under the illness. No support group. I think this isolation is part of why I still let the illness define me. The essence of me is so intertwined with the ongoing experience of schizophrenia that I have trouble defining myself outside my diagnosis. Some of the so called positive symptoms of my illness, the delusions and paranoia, have nearly gone but I still hear the voices and still believe in their reality. The negative symptoms, social withdrawal and a certain lack of emotion, are with me every day along with the voices. And so, I am not recovered. But compared to the torment of before I know that I am in recovery nonetheless.

We all have our limitations, schizophrenia just puts more emphasis on those limitations. I still hope that someday I will be well enough to find meaningful work, friendships and a healthy love relationship just as Ms. Saks has done. But I must admit that I am afraid of the responsibility that that would entail. Right now, I live one day at a time and continue to feel grateful for all that I have if only just in small ways. The truth is, though, that I need more support. On some level I keep believing that I have to do it all on my own and when I believe that, I lose confidence in my abilities. A big difference between me and Elyn Saks is that she opened herself up to friendships and that is part of why she accomplished so much. She valued people and they valued her. I haven’t been in a close friendship with anyone since my first boyfriend and that relationship ended about twenty years ago. And before that my two best friends from high school gradually pulled away from me (and I them). Since I graduated from Barnard College in 1985 I went from a shame filled isolation (because I didn’t get a job and move out of my parents house) to an abusive relationship with an alcoholic to severe mental illness to now. When I first became psychotic it was my voices who pushed and tormented me to be “of service to my community”. They said I must not isolate myself, that I had to go to the hospital, get a diagnosis, find a therapist, go to any support group even if it didn’t address severe mental illness. They pushed me into helping the women I met in my support groups (Al-Anon and a domestic violence support group). I made phone calls, I visited, I helped with their children, I took notes, I gave gifts, I offered my home as shelter, I helped to get a woman’s children back (children who were being sexually abused), I talked to school principles, I testified in court. I was very psychotic and yet I did all these things, in part because it felt good to help and in part because I felt overwhelmed by the voices punishing insistence that I somehow prove that I was not, indeed, evil. The people I encountered were good people and they helped me but I couldn’t really connect with them. Most of them didn’t know I suffered from schizophrenia. To tell them would be to lose credibility and at that point any credibility I could find I thought was precious. The psychosis was too intense and grueling and I felt powerless to make a bridge to other people on a deeper heart/mind level.

I still feel this inability to connect deeply with others. The online community has been a Godsend to me because at least I can break out of my shell to a certain extent with all the good people out there but offline I mainly keep to myself. Several of the women I knew and supported have repeatedly tried to make contact with me but I won’t answer the phone. I’m afraid to talk about myself person to person. I don’t have a husband and family, I don’t have a job and I don’t have friends. That is no one’s fault or responsibility but my own and I know it. I keep saying to myself “Later when I’ve lost the weight, when I’ve cleaned the house, when I’ve learned how to play the guitar, when I’ve gotten a job, then I’ll make friends and end this isolation.” But so far later hasn’t come and valuable time is passing by. But even if I wanted to, I can’t rush myself. I have to go one step at a time. I returned to therapy and I got a volunteer job within the last six months. I still want to start a support group for people with mental illness and next Spring, with the help of VESID (Vocational and Educational Services for Individuals with Disabilities) I may even get a part time job. At least now I am seriously considering these things whereas before I just wouldn’t have had the motivation to do that. The changes may not come as fast as I want them to but I believe they will come as long as I never give up. I don’t think I will. I do value my life and the lives of others and I do want to continue to try.