Outgoing APA President Dilip Jeste, M.D., talks with Elyn Saks, Ph.D., J.D., about her experiences as a successful professional who has had severe mental illness and her insights about psychiatric care.
“My therapist used to say I was three people—Professor Saks, the lady with the thick medical history, and Elyn,” recounted Elyn Saks, Ph.D., J.D., to outgoing APA President Dilip Jeste, M.D., about her struggle with and continuing recovery from schizophrenia. “And he thought Elyn was the most neglected. Eventually, through psychotherapeutic work, coming to terms with the narcissistic injury of having a serious mental illness, it began to define me less. It became accident rather than essence. Today Elyn and Professor Saks are at the forefront, and the lady with the thick chart is trailing in third.”
Saks’s remarks were part of a wide-ranging conversation with Jeste at the Opening Session of APA’s 2013 annual meeting in San Francisco, where they talked about her living with a serious mental illness while also pursuing a successful career as a writer, ethicist, and lawyer. Saks is the Orrin B. Evans Professor of Law, Psychology, and Psychiatry and Behavioral Sciences at the University of Southern California and a MacArthur Foundation Fellowship winner. She is also the author of an award-winning best-seller, The Center Cannot Hold: My Journey Through Madness, an autobiographical account of her long struggle with schizophrenia.
It is not the first time Saks has spoken to APA members. At last year’s Institute on Psychiatric Services in New York, she recalled her early ominous symptoms in childhood and adolescence, her first hospitalization while studying at Oxford University in England, her long resistance to and denial of mental illness, and her eventual acceptance of the efficacy of antipsychotic medication in combination with psychotherapy in her treatment and recovery.
“I was given a very poor and grave prognosis,” Saks said then. “In other words, I was expected to be unable to live independently, let alone to work. And yet it hasn’t turned out that way. My central goals in writing my story are to give hope to people with schizophrenia and understanding to those who don’t have the illness.”
Hers is a remarkable story of resilience in the face of adversity. Saks is a cancer survivor in addition to having schizophrenia. And she emphasized in her conversation that illness of any kind need not define an individual, while remarking on the different ways that mental and physical illnesses are regarded.
“For the most part, I think about my academic role and my life with my husband and my friends,” she said. “The mental illness is in the background, but it doesn’t really occupy a lot of my mental time any more. That’s changed. For a long time it was totally preoccupying.
“The cancer diagnosis came as a huge blow,” Saks said. “It’s very threatening and very scary. But if you have a good prognosis after the treatment, you don’t think about it. It’s not a part of me. The mental illness seems like more of a global characteristic. I like to say ‘I am not mentally ill; I have a mental illness,’ just as we say ‘I am not cancer, I have cancer.’
“But a lot of us [with a mental illness] still feel that kind of internal stigma,” she said. “That’s a difference. The other difference is that people tend to think less of someone with a mental illness. I saw a slogan once that said ‘Imagine being blamed for having cancer.’ ”
Yet people tend to blame an individual for mental illness, Saks said. She recounted that when she was in the hospital for cancer treatment, her room was filled with cards and flowers, and she wondered why the same isn’t done when people are hospitalized for serious mental illness. She shared this thought with an audience not long after, and a local mental health advocacy organization began the practice of sending cards and letters to people hospitalized in the local psychiatric hospital.
Saks also recalled the painful—as well as joyful and humorous—aspects of her journey and concluded with a note of gratitude to the field of psychiatry. “In many ways, psychiatry has been the star of my show,” Saks said. “I’m incredibly grateful for what you do. And on behalf of my fellow patients, thank you very much.” ■