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