A tale of mental illness from the inside Elyn Saks

so I’m a woman with chronic

schizophrenia I’ve spent hundreds of

days in psychiatric hospitals

I might have ended up spending most of

my life on the back ward of a hospital

but that isn’t how my life turned out in

fact I’ve managed to stay clear of

hospitals for almost three decades

perhaps my proudest accomplishment

that’s not to say that I’ve remained

clear of all psychiatric struggles after

I graduated from the Yale Law School and

got my first law job my New Haven

analyst dr. white announced to me that

he was in a closes practice in three

months several years before I had

planned to leave New Haven white had

been enormous ly helpful to me and the

thought of his leaving shattered me

my best friend Steve sensing that

something was terribly wrong flew out to

New Haven to be with me now I’m gonna

quote from some of my writings I opened

the door to my studio apartment

Steve would later tell me that for all

the times he had seen me psychotic

nothing could have prepared him for what

he saw that day for a week or more I had

barely eaten I was gaunt I walked as

though my legs were wooden my face

looked and felt like a mask I closed all

the curtains in the apartment so in the

middle of the day the apartment was in

near total darkness

the air was fetid the room of shambles

Steve both a lawyer and a psychologist

has treated many patients with severe

mental illness and to this day he’ll say

I was bad as bad as any he had ever seen

hi I said and then I returned to the

couch where i sat in silence for several

moments thank you for coming Steve

crumbling world word voice tell the

clocks to stop time is time has come

white is leaving Steve said sombrely I’m

being pushed into a grave the situation

is grave I moan gravity is pulling me

down I’m scared tell them to get away as

a young woman I was in a psychiatric

hospital on three different occasions

for lengthy periods my doctors diagnosed

me with chronic schizophrenia and gave

me a prognosis of quote grave that is at

best I was expected to live in a board

and care and work at menial jobs

fortunately I did not actually

that grave prognosis instead I’m a

chaired professor of law psychology and

psychiatry at the USC Gould School of

Law

I have many close friends and I have a

beloved husband will who’s here with us

today he’s definitely the star of my

show I’d like to share with you how that

happened and also describe my experience

of being psychotic I hasten to add that

it’s my experience because everyone

becomes psychotic in his or her own way

let’s start with the definition of

schizophrenia schizophrenia is a brain

disease it’s defining future as

psychosis or being out of touch with

reality delusions and hallucinations are

hallmarks of the illness delusions are

fixed and false beliefs that aren’t

responsive to evidence and

hallucinations are false sensory

experiences for example when I’m the

psychotic I often have the delusion that

I’ve killed hundreds of thousands of

people with my thoughts I sometimes have

the idea that nuclear explosions are

about to be set off in my brain

occasionally I have hallucinations like

one time I turned around and saw a man

with a raised knife imagine having a

nightmare while you’re awake

often speech and thinking become

disorganized to the point of incoherence

loose associations involves putting

together words that may sound a lot

alike but don’t make sense and if the

words get jumbled up enough it’s called

word salad contrary to what many people

think schizophrenia is not the same as

multiple personality disorder or split

personality the schizophrenic mind is

not split but shattered everyone has

seen a street person unkempt probably

ill-fed standing outside of an office

building muttering to himself or

shouting this person is likely to have

some form of schizophrenia but

schizophrenia presents itself across a

wide array of socioeconomic status and

there are people with the illness who

are full-time professionals with major

responsibilities several years ago I

decided to write down my experiences and

my personal journey and I want to share

some more of that story with you today

to convey the inside view so the

following episode happened the seventh

week of my first semester of my first

year at Yale Law School

according from my writing

my two classmates rebel and Val and I

had made the date to work to meet in the

Law School Library on Friday night to

work on our memo assignment together but

we didn’t get far before I was talking

in ways that made no sense memos or

visitations I informed them they make

certain points the point is on your head

Pat used to say that have you killed

anyone rebel and Val looked at me as if

they arrived and splashed in the face

with cold water what are you talking

about Ellen oh you know the usual who’s

what what’s who heaven and hell let’s go

ahead on the roof it’s a flat surface

it’s safe rebel and Val followed and

they asked what had gotten into me this

is the real me I announced waving my

arms above my head and then late on a

Friday night on the roof of the Yale Law

School I began to sing and not quietly

either come to the Florida sunshine bush

do you want to dance are you on drugs

won’t answer you hi Jaime no way no

drugs come to the Florida sunshine bush

where there are lemons where they make

demons you’re frightening me one of them

said and rebel and Val headed back into

the library I shrugged and followed them

back inside I asked my classmates if

they were having the same experience of

words jumping around our cases as I was

I think someone’s infiltrated my copies

of the cases I’ve said we’ve got a case

two joined I don’t believe in joints but

they do hold your body together it’s an

example of loose associations eventually

I made my way back to my dorm room and

once they are I couldn’t settle down my

head was too full of noise too full of

orange trees and law memos I could not

write and mass murders I knew I would be

responsible for sitting on my bed I

rocked back and forth moaning and fear

in isolation this episode led to my

first hospitalization in America I had

to earlier in England continuing with

the writings the next morning I went to

my professors office to ask for an

extension on the memo assignment and I

began gibbering unintelligibly as I had

the night before and he eventually

brought me to the emergency room once

there someone I’ll just call the doctor

and his whole team of goons swooped down

lifted me high into the air and slammed

me down on a metal bed with such force

that I saw stars then they strapped by

and arms to the metal bed with thick

leather straps account sound came out of

my math that I’d never heard before half

grown half scream barely human and pure

terror

then the sound came again forced from

somewhere deep inside my belly and

scraping my throat raw this incident

resulted in my involuntary

hospitalization one of the reasons the

doctors gave her fine for hospitalizing

me against my will was that I was quote

gravely disabled to support this view

they wrote in my chart that I was unable

to do my gay law school homework I

wondered what that meant about much of

the rest of New Haven

during the next year I would spend five

months in a psychiatric hospital

at times I spent up to twenty hours and

mechanical restraints arms tied arms and

legs tied down arms and legs tied down

with a net tied tightly across my chair

tress I never struck anyone I never

harmed anyone I never made any direct

threats if you’ve never been restrained

yourself you may have a benign image of

the experience

there’s nothing benign about it every

week in the United States has been

estimated that one to three people died

in restraints they strangle they

aspirate their vomit they suffocate they

have a heart attack it’s unclear whether

using mechanical restraints is actually

saving lives or costing lives while I

was preparing to write my student note

for the Yale Law Journal on mechanical

restraints I consulted an eminent law

professor who was also a psychiatrist

and said surely he would agree that

restraints must be degrading painful and

frightening he looked at me in a knowing

way and said Ellen you don’t really

understand these people are psychotic

they’re different from me and you they

wouldn’t experience restraints as we

would I didn’t have the cars to tell him

in that moment that no we were not that

different from him we don’t like to be

strapped down to a bed and left to

suffer for hours anymore that he would

in fact until very recently and I’m sure

some people still hold it as a view that

restraints help psychiatric patients

feel safe I’ve never met a psychiatric

patient who agreed with that view today

I like to say I’m very Pro psychiatry

but very anti force

I don’t think forces effective as

treatment and I think using force is at

Arab

thing to do to another person with a

terrible illness eventually I came to

Los Angeles to teach at the University

of Southern California law school for

years I had resisted medication making

many many efforts to get off I felt that

if I could manage without medication I

could prove that after all I wasn’t

really mentally ill it was some terrible

mistake my motto was the less medicine

the less effective my LE analyst dr.

Kaplan was urging me just to stay on

medication and get on with my life but I

decided I wanted to make one last

college trying to get off quoting from

the texts I started the reduction of my

beds and within a short time I began

feeling the effects after returning from

a trip to Oxford I marched into Kaplan’s

office headed straight for the corner

crouched down covered my face and began

shaking all around me I sensed evil

beings poised with daggers they’d sliced

me up in thin slices or make me swallow

hot coals Kaplan would later describe me

as quote writhing in agony even in this

state what he accurately described as

acutely and floridly psychotic I refused

to take more medication the mission is

not yet complete immediately after the

appointment with Kaplan I went to see

dr. martyr as schizophrenia expert who

was following me for medication side

effects he was under the impression that

I had a mild psychotic illness once in

his office I sat on his couch folded

over and began muttering head explosions

and people trying to kill is it okay if

I totally trash your office you need to

leave if you think you’re gonna do that

said martyr okay small fire our night

tell them not to kill me tell them not

to kill me what have I done wrong

hundreds of thousands with thoughts

interdiction Ellen do you feel like

you’re dangerous to yourself or others I

think you need to be that in the

hospital I could get you admitted right

away and the whole thing could be very

discreet hahaha you’re offering to put

me in hospitals hospitals are bad

they’re mad they’re sad one must stay

away I’m God or I used to be at that

point in the text where I said I’m God

are used to be my husband made a

marginal note he said did you quit or

were you fired

I give I give life and I take it away

forgive me for I know not what I do

eventually I broke down in front of

friends and everybody convinced me to

take more medication I could no longer

deny the truth and I could not change it

the wall that kept me Ellen professor

Sachs separate from that insane woman

hospitalized year pass years passed like

smashed in and ruins everything about

this illness says I shouldn’t be here

but I am and I am I think for three

reasons first I’ve had excellent

treatment for two five-day-a-week

psychoanalytic psychotherapy for decades

and continuing and excellence

psychopharmacology second i have many

close family members and friends who

know me and know my illness these

relationships have given my life a

meaning and a depth and they also help

me navigate my life and fate in the face

of symptoms third I work at an enormous

ly supportive workplace at USC Law

School it this is a place that not only

accommodates my needs but actually

embraces them it’s also a very

intellectually stimulating place and

occupying my mind with complex problems

has been my best and most powerful and

most reliable defense against my mental

illness even with all that excellent

treatment wonderful family and friends

supported work environment I did not

make my illness public until relatively

late in life and that’s because the

stigma against mental illness is so

powerful that I didn’t feel safe with

people knowing if you hear nothing else

today please hear this there are not

schizophrenic

there are people with schizophrenia and

these people may be your spouse they may

be your child they may be your neighbor

they may be your friend they may be your

co-worker so let me share some final

thoughts we need to invest more

resources into research and treatment of

mental illness the better we understand

these illnesses the better the

treatments we can provide and the better

the treatments we can provide the more

we can offer people care and not have to

use force also we must stop

criminalizing mental illness it’s a

national tragedy and scandal that the LA

County Jail is a big a psychiatric

facility in the United States American

prisons and jails are filled with people

who suffer from severe mental illness

and many of them are there because they

never received adequate treatment I

could have easily ended up there

or on the streets myself a message to

the entertainment industry into the

press on the whole you’ve done a

wonderful job fighting stigma and

Prejudice of many kinds please continue

to let us see characters in your movies

your plays your columns who suffer with

severe mental illness portray them

sympathetically and portray them in all

the richness and depth of their

experience as people and not as

diagnosis recently a friend posed a

question if there were a pill I could

take that would instantly cure me would

I take it the poet Rainer Maria Rilke he

was offered psychoanalysis he declined

saying don’t take my Devils away because

my angels may flee to my psychosis on

the other hand is a waking nightmare in

which my Devils are so terrifying that

all my angels have already fled so would

I take the medicate the pill in an

instant that said I don’t wish to be

seen as regretting the life I could have

had if I’d not been mentally ill nor am

I asking anyone for their pity what I

rather wish to say is that the humanity

we all share is more important than the

mental illness we may not but those of

us who suffer with mental illness want

is what everybody wants in the words of

Sigmund Freud to work until love thank

you