The Center Cannot Hold: My Journey Through Madness (43 page)

Many people who suffer from manic depression and depression
lead full and rich lives: Journalists Mike Wallace and Jane Pauley, the
writer William Styron, and the psychologist and writer Kay Redfield
Jamison are just a few prominent examples. Famous historical figures
may have suffered from mood disorders as well—Abraham Lincoln,
Vincent Van Gogh, Virginia Woolf, and Samuel Johnson. Go to any
support group of people with mood disorders and, with some
understandable sense of pride, they will name their famous forebears
and their contemporary heroes.

However, people with thought disorders do not keep a list of
famous and successful people who share their problem. They can't,
because there
is
no such list. Comparatively few schizophrenics lead
happy and productive lives; those who do aren't in any hurry to tell the
world about themselves.

That said, some people with a thought disorder accomplish great
things before they become incapacitated by illness. John Nash, for
example, received the Nobel Prize for discoveries he made early in his
career. He then spent much of his ensuing adult life delusional,
wandering the Princeton campus, drifting aimlessly in and out of the
university library. In time, Nash (and his family and his doctors) built
a support system sufficient for him to largely manage his disease and
even "recover" from it, which was movingly captured in
A Beautiful
Mind.

However, a more typical example of the way people with a thought
disorder find their way into the media is the tragic example of Michael
Laudor. Like me, Laudor attended Yale Law School. In 1995, shortly
after his graduation, the
New York Times
ran a story about Laudor,
focusing on how someone with schizoaffective disorder managed to
make it through arguably the finest law school in the country. Yale
Law School, Laudor told the
Times,
was "the most supportive
mental-health-care facility that exists in America." After graduation,
he contracted to write a book about his life, his travails and his
successes.

And then, in 1998, for some reason—no one is quite sure what set
him off—Laudor went off his medication. When his pregnant fiancee
tried to convince him that he needed both the meds and possibly even
hospitalization, he stabbed her to death at their kitchen table.

I had been thinking for a long time about writing a book about my
life when Laudor's story became public. I already had mixed feelings
about putting everything down on paper. The heartbreaking story
happening on the other side of the country only increased my
ambivalence. Maybe coming out about my illness would change the
way friends, colleagues, and students perceived me. Maybe, once they
knew the truth, they'd see me as too fragile or too scary to trust as a
professional colleague or an intimate. Maybe they'd believe that a
tragic, violent breakdown was inevitable.

In the end, though, it was Laudor's story that convinced me to go
ahead. The media frenzy that surrounded it only added to the
mythology that fuels the stigma: that schizophrenics are violent and
threatening. In truth, the large majority of schizophrenics never harm
anyone; in fact, if and when they do, they're far more likely to harm
themselves than anyone else.

Another reason I was compelled to write about my life was to give
people hope: A mental illness diagnosis does not automatically
sentence you to a bleak and painful life, devoid of pleasure or joy or
accomplishment. I also wanted to dispel the myths held by many
mental-health professionals themselves—that people with a
significant thought disorder cannot live independently, cannot work
at challenging jobs, cannot have true friendships, cannot be in
meaningful, sexually satisfying love relationships, cannot lead lives of
intellectual, spiritual, or emotional richness.

Medication has no doubt played a central role in helping me
manage my psychosis, but what has allowed me to see the meaning in
my struggles—to make sense of everything that happened before and
during the course of my illness, and to mobilize what strengths I may
possess into a rich and productive life—is talk therapy. People like me
with a thought disorder are not supposed to benefit much from this
kind of treatment, a talk therapy oriented toward insight and based
upon a relationship. But I have. There may be a substitute for the
human connection—for two people sitting together in a room, one of
them with the freedom to speak her mind, knowing the other is paying
careful and thoughtful attention—but I don't know what that
substitute might be. It is, at the heart of things, a
relationship,
and for
me it has been the key to every other relationship I hold precious.
Often, I'm navigating my life through uncertain, even threatening,
waters—I need the people in my life to tell me what's safe, what's real,
and what's worth holding on to.

I write, then, because I know what it's like to be psychotic. And I
know, better than most, how the law treats mental patients, the
degradation of being tied to a bed against your will and force-fed
medicine you didn't ask for and do not understand. I want to see that
change, and now I actively write and speak out about the crying need
for that change. I want to bring hope to those who suffer from
schizophrenia, and understanding to those who do not.

I now have almost everything in life I could have wished for, but
my illness took an enormous toll. I lost years of my life. I missed
countless relationships—intimate friends, cherished lovers. I never
had children. I never enjoyed the excitement of working in a
high-powered law firm, with challenging cases and extremely
hardworking and bright colleagues. Even now I can't travel the way I'd
like to—spontaneously, for weeks at a time in a strange and new place.
I can speak Spanish, but I can't go to Spain. My comfort limit for
out-of-town trips, even with Will, is about four days. He threatens to
make me a "virtual office" computer program so we can go away and
yet I'll feel like I'm safely in my office at USC. Work is both my solace
and my mirror—when I lose track of who I am, it is there on the page,
to remind me; when I'm away from it, I lose my bearings.

For years, I'd seen my body as the place that I lived, and the real
me was in my mind; the body was just the carrying case, and not a
very dependable one—kind of dirty, animal-like, unreliable. Will has
changed much of that for me, and so has surviving cancer. I'm more
comfortable with my body lately, maybe even more possessive of
it—but I'm wary at the same time. It has, after all, let me down more
than a few times.

So I fight the lethargy that comes from being buried in books while
on sedating drugs. Exercise has always provided a challenge—I've
never taken to treadmills, or stationary exercise bikes; they bore me.
And unlike most of California, I was certainly never a runner. So I
roller skate. My parents started skating in Central Park years ago, and
one time they asked me to come along; I thought they were maybe
losing their grip a bit, but I went with them, and loved it, immediately.
So now I roller skate and I take lessons—artistic skating, dancing, plus
the basic steps and forms. For a while, I did it twice a week; now I can
manage to protect the time for only one session a week, with a
professional coach. It's focused, and disciplined, and predictable and
invigorating. And most of the time, it's just plain fun.

Writing this book meant that I needed (and wanted) to start telling
people I hadn't told already the truth about my illness. Some of these
were quite close friends, but friends whom, for some reason or other,
I'd been hesitant to disclose to before. For instance, one of my friends
used to joke around about the mentally ill a lot; I thought he would
look down on me when he heard the truth. Other friends were
professional colleagues of fairly recent vintage, and I didn't want them
to lose faith in my academic abilities.

My experience of revealing my illness to all these people has been
eye-opening. Most people have been very accepting; many said they
had no idea and were shocked. Did this happen long ago and was it
not an issue now? One person, a law professor, revealed in turn that
he struggled with bipolar disorder; with that revelation—together with
our mutual support over the years—we have become close friends.
Another friend, a psychiatrist, urged me to use a nom de plume when
writing this book, but I thought that that would send the wrong
message—that all of this was too awful to say out loud. She then said
something that made me think: "But, Elyn, do you really want to
become known as the schizophrenic with a job?" I was taken aback by
her question. Is that who I am? Is that
only
who I am?

Ultimately, I decided that writing about myself could do more
good than any academic article I'd ever pen. Why do it under a
pseudonym if what I intended was to tell the truth? I don't want to be
marginalized; I've fought against that all my life.

I needed to put two critical ideas together: that I could both be
mentally ill and lead a rich and satisfying life. I needed to make peace
with my demons, so I could stop spending all my energy fighting
them. I needed to learn how to navigate my way through a career and
relationships with a sometimes tenuous hold on what was real. I
needed to understand what lay behind my terrible thoughts and
feelings and how my psychosis served to protect me. Through years of
hard and intense work, Mrs. Jones, White, Kaplan, and Freed had
helped me find my way to a life worth living. My last two
hospitalizations left me with "very poor" and "grave" prognoses. Those
are the prognoses I would have lived out had I not had very skilled,
very dedicated talk therapists—psychoanalysts—by my side.

I believe (at least I have no reason not to believe) that skills and
talents are distributed among the mentally ill more or less as they are
among the general population. Everyone has a niche. Of course,
resources are heavily skewed against the mentally ill, and the majority
never have a chance to realize anywhere near their potential. That
said, I'd feel terrible to learn that anyone had read this book and said
to a family member or friend, "She did it, so can you." I'm
not
saying
that everyone with schizophrenia or a psychotic disorder can become
a successful professional or academic; I'm an exception to a lot of
rules, and I know that. But much of that is about the ticket I drew in
the lottery: parents with resources, access to trained and talented
professionals, and a frequently unattractive stubborn streak that's
worked in my favor as often as it has against me.

My life today is not without its troubles. I have a major mental illness.

I wall never fully recover from schizophrenia. I wall always need to be
on antipsychotic medication and in talk therapy. I wall always have
good days and bad, and I still get sick.

But the treatment I have received has allowed me a life I consider
wonderfully worth living. USC Law School is an ideal place for me to
write and teach. I have smart and generous colleagues there who have
nurtured me through difficult and trying times. I count the school's
dean and associate dean as my good friends, and they have been kind
to me. The school has supported me as I've ventured to work wdth
other disciplines, psychiatry and psychology, and have found grants to
do empirical research relevant to my legal scholarship. In 2004,1 was
awarded USC's Associate's Award for Creativity in Research, given to
two professors each year—the highest honor the university bestows
for scholarship. At the same time, my
Refusing Care
was honored
wdth a USC Phi Kappa Phi Faculty Recognition Award. According to
the administration, no one has ever won these two awards in a single
year.

Recently my work life has gotten even better. Apart from the first
few years teaching criminal law, I have always been a reasonably
popular teacher. But over time (and it should have been going in the
opposite direction), I began to find teaching more and more stressful.
Blessed with a dean who has always tried to be supportive and
accommodating, I was offered a new job: Associate Dean for Research.
Instead of teaching, I now help colleagues obtain research grants. Of
course I love most doing my own research, but given all the
responsibilities one might have on a law faculty, helping my colleagues
find support for their work is an excellent second best.

My studies to be a research psychoanalyst have also taken place in
a rich environment and given me lively and interesting colleagues,
many of whom have become my closest friends. I am actively involved
in committee life at the psychoanalytic Institute. I still talk
often—pretty much every day—with dear Steve, and I enjoy our work
together. I am in love with and married to a kind and funny man who
understands and accepts me and makes me feel like a woman. So—it's
a good life, all in all.

Recently, however, a friend posed a question: If there were a pill
that would instantly cure me, would I take it? The poet Rainer Maria
Rilke was offered psychoanalysis. He declined, saying, "Don't take my
devils away because my angels may flee too." I can understand that.
Mania in manic depression has been described as a sometimes
pleasurable high that brings with it feelings of omnipotence. But that's
not the experience of schizophrenia, at least not for me. My psychosis
is a waking nightmare, in which my demons are so terrifying that all
my angels have already fled. So would I take the pill? In a heartbeat.

That said, I don't wish to be seen as regretting that I missed the life
I could have had if I'd not been ill. Nor am I asking anyone for pity.
What I rather wash to say is that the humanity we all share is more
important than the mental illness we may not. With proper treatment,
someone who is mentally ill can lead a full and rich life. What makes
life wonderful—good friends, a satisfying job, loving relationships—is
just as valuable for those of us who struggle with schizophrenia as for
anyone else.