The Center Cannot Hold
- How unpleasant and almost medieval(?) restraints seem, and “I later learned that a hundred or so people die each year in the U.S. while being put or kept in restraints”
- The (complicated) reasons why Saks kept most of the details (of her behavior, of the various diagnoses, of all the doctor’s opinions, of therapy sessions) away from her parents: “First, I was ashamed […] Second, I didn’t want to worry them […] Third (and this is the most sensitive of my reasons), I did not want them interfering in my life […] Why increase that burdensome cast of characters if I could possibly help it? Why do that to myself? And besides, what could they do to help?”
- After threatening a nurse… “I don’t know where this came from. I don’t know why I felt about the metal ring and lighter as I did, or why I threatened the nurse. I had no intention of hurting her or anyone else; in fact, I felt small and helpless, unlikely (and unable) to hurt anyone. Nevertheless, out of my mouth came the words, unbidden and scary”
- “Part of the problem was that I was behaving like a patient in psychoanalysis. When Mrs. Jones and I were working together, I was encouraged to say exactly what was on my mind, always, no matter how crazy it sounded — that was how analysis worked. That was the point. Otherwise, how would she know what was going on inside me? But the people at MU10 didn’t want to know. If they couldn’t tolerate what was in my head, why were any of them in this business? When my scrambled thinking revealed itself, they put me in the hospital version of “time out.” Where was the “treatment” in this? Were they wanting to help me get better, or did they just want me to be socially appropriate? Overall, the sole message they seemed to want me to get was “behave yourself!” … This is a classic bind for psychiatric patients. They’re struggling with thoughts of wanting to hurt themselves or others, and at the same time, they desperately need the help of those they’re threatening to harm. The conundrum: Say what’s on your mind and there’ll be consequences; struggle to keep the delusions to yourself, and it’s likely you won’t get the help you need.”
- The three options after a Physician’s Emergency Certificate expires: the hospital letting her go; her agreeing to stay in the hospital/ ‘voluntary’; and a civil commitment hearing (held before a judge; the judge makes the ultimate decision). The consequences of being civilly committed to a psychiatric hospital are severe and can be long-lasting.
- MU10, without Saks’ permission or knowledge, called the dean of students at the law school to confirm that Saks couldn’t return that year; in effect, MU10 withdrew her from law school. → how is this okay?!?!
- “It felt more like a death sentence than a medical diagnosis.”
- “Different bodies respond differently to different medication; finding the magic potion is pretty much hit-and-miss. This seems obvious, even simplistic, but it’s the only consistently true fact in treating mental illness.”
- “One of the worst aspects of schizophrenia is the profound isolation — the constant awareness that you’re different, some sort of alien, not really human.”
- “The research I did showed that restraints hadn’t been used in England in more than two centuries; certainly I’d never seen any sign of them when I was there (and I’d been neither a docile nor a particularly cooperative patient). Yet they were used liberally in the United States. Was this truly the best we could do? What were the rules, what were the parameters, what was reasonable (and unreasonable) care when treating patients who were already terrified at that moment when someone in authority forcibly tied them down? In my Note, I proposed a Model Statute (a statute that could serve as a model for legislation in individual states); in addition, I argued for a greater degree of negligence before a doctor could be held liable for not restraining someone — in short, I wished to change the incentives for doctors. My doctors, everyone’s doctors.”
- “…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 wish 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. … If you are a person with mental illness, the challenge is to find the life that’s right for you. But in truth, isn’t that the challenge for all of us, mentally ill or not? My good fortune is not that I’ve recovered from mental illness. I have not, nor will I ever. My good fortune lies in having found my life.”
