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Virginia Journal of Social Policy and the Law





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Professor Elyn Saks is a well-recognized expert in mental health law, and is training to become a psychoanalyst. Her latest book reflects her continued interest in mental health issues, but this book differs from her previous works because it is written in the voice of someone who has a personal stake in the topic.

In The Center Cannot Hold: My Journey Through Madness, Saks recounts her own experience of schizophrenia, the most serious of all mental illnesses. Beginning with some “little quirks” in childhood and progressing to full-fledged psychosis by her first year at Yale Law School, Sak’s illness caused her doctors to predict early on that she would be unable to complete law school and that over the course of her life she would require extended hospitalizations. But not only did Saks finish law school, she has fashioned both a successful academic career and a fulfilling personal life.

In Sak’s book there is a great deal to admire and only a little to regret. The book will undoubtedly change the way that people think about schizophrenia, diminishing the fear and stigma that surround this disorder. Additionally, that psychoanalysis was part of Sak’s story might well contribute to a reevaluation of that particular therapy’s effectiveness in the long-term treatment of schizophrenia.

However, whatever else psychoanalysis might be able to do over the course of many years, it is not an efficient weapon against the acute symptoms of psychosis—the demons, the voices, the fog of confusion and disorganization. Antipsychotic medication is far from a panacea, but to someone who is in the firm grip of schizophrenia’s most terrifying symptoms, it offers the best hope. It would be regrettable if the criticisms Saks makes of forced medication made it harder to provide this therapy to others who are journeying through their own madness.

Recommended Citation

Dora W. Klein, Autonomy and Acute Psychosis: When Choices Collide, 15 Va. J. Soc. Pol’y & L. 355 (2008).

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