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Elyn Saks: A Scholar's Memoir of Schizophrenia

In The Center Cannot Hold, lawyer and psychiatry professor Elyn R. Saks chronicles her own struggle with schizophrenia. The battle began with early symptoms at age 8 and has continued throughout her life; she had her first full-blown episodes during her terms at Oxford and Yale. Saks, who has for years controlled her condition with daily medication and therapy, is an expert in the field of mental-health law, and teaches at the University of Southern California.


Other segments from the episode on August 7, 2007

Fresh Air with Terry Gross, August 7, 2007: Interview with Jeffrey Blitz; Interview with Elyn Saks.


TIME 12:00 Noon-1:00 PM AUDIENCE N/A

Interview: Filmmaker Jeffrey Blitz on his new film "Rocket

This is FRESH AIR. I'm Dave DAVIES, senior writer for the Philadelphia Daily
News, sitting in for Terry Gross.

Our guest, filmmaker Jeffrey Blitz, has a gift for bringing the joy and
anxiety of adolescence to the screen. His documentary "Spellbound," which
followed eight young finalists for the National Spelling Bee, won wide
critical acclaim and an Oscar nomination. Blitz's new feature film, "Rocket
Science," is about Hal Hefner, a high school kid who has a stutter and is
convinced by senior Ginny Ryerson to go out for the debate team. He struggles
with debate but falls for the girl, who, it turns out, is playing a very
sophisticated game with the underclassman.

Blitz, who wrote and directed "Rocket Science," based the story in part on his
own experiences. He grew up with a stutter and got into debate in high school
in part to overcome it. In this scene from "Rocket Science," Hal, played by
Reece Daniel Thompson, struggles to order food at the school cafeteria.

(Soundbite of "Rocket Science")

Unidentified Actress: (In character) Fish or pizza?

Mr. REECE DANIEL THOMPSON: (As Hal Hefner) Uh, the--uh--ah...

Actress: (In character) The pizza's plain or pep. Fish is not sure. A
general fish.

Mr. THOMPSON: (As Hal Hefner) Yeah, the, the, the, ah, the, ah--not--the--oh
just, just the--I'll just...

Actress: (In character) The fish?

Mr. THOMPSON: (As Hal Hefner) The general fish.

Actress: (In character) Come back for seconds. Plenty left.

Mr. THOMPSON: (As Hal Hefner) Thank you, ma'am.

(End of soundbite)

DAVIES: Well, Jeffrey Blitz, welcome to FRESH AIR. Your film "Rocket
Science," as we noted, is about this young man Hal Hefner, who has a
stuttering problem and ends up getting drawn into the debating club as a way
of--well, he's induced by this interesting character, Jenny. You had a
stuttering problem in high school and, I guess, to some extent still do, and
also got into debate in high school. Was it a way of overcoming that?

Mr. JEFFREY BLITZ: Yeah. I did not get lured onto my debate team by an
attractive girl...

DAVIES: No such luck.

Mr. BLITZ: Yeah, no. I think that I joined the team because I was trying to
prove to myself and to the world that I could do the very thing that it seemed
like I should be incapable of doing, which would be speaking fluently and
engaging in public speaking at all. So while the story sort of becomes the
background for Hal in the movie, it was really a foregrounded story for me in
my life. Debate became the thing that I was obsessed with most as a junior
and senior in high school.

DAVIES: Did you excel?

Mr. BLITZ: Well, I ended up doing much better than Hal necessarily ends up
doing in the movie. I stuck with it beyond the point at which, you know, we
sort of take leave of Hal in the film, but I actually ended up--with my
debating partner won the New Jersey state championships. That was in my
senior year. When I first started, in my sophomore year of high school, I
could barely speak at all, and the first round that I went to debate in, I got
stuck trying to say one word, and I was too pig-headed to move off of that
word, so eight minutes later I was still trying to say that one word. And I
left the poor opposing team to have to respond to the sound "uh."

DAVIES: So you literally stood in front of a room of your opponents and
judges for eight minutes without getting that syllable out?

Mr. BLITZ: That's right, yeah. Yeah, it takes a certain kind of dense brain
to want to do that.

DAVIES: Well, and some fortitude to not give up and run from the room.

Mr. BLITZ: You know, I think one of the things that's interesting and
frustrating about stuttering is that, even to a stutterer, it's a condition
that's hard to fathom. You know the word that you want to say. It's at the
forefront of your thoughts and you just can't make your mouth form that word,
and so I think that you're ever hopeful that it will just slip through
somehow. So at the beginning of that eight minutes of trying to say the word,
I didn't know that I was going to be locked into that eight minutes later. It
just sort of evolved that way.

DAVIES: Well, let's talk a little bit about some of the characters. The
central character, Hal Hefner--one of the interesting little affects that he
has, he carries around not a book bag but a suitcase on rollers, like people
would be seeing pulling through an airport. What was that about?

Mr. BLITZ: Well, it's a suitcase that, in the movie, he inherits from his
father, who leaves the family at the beginning of the film. So in some sense
to me it's a way of keeping the father alive in the movie so that, even though
he's not present in it, his spirit is there somehow. But also I liked the
idea that these are kids who are trapped at a moment in life where they're
locked halfway between childhood and adulthood and that Hal has graduated from
a normal book bag, and instead he's got a more adult suitcase. Feels like
it's the perfect way to underscore the exact moment that he finds himself in.

DAVIES: Right. Now, there are different ways that people stutter, and I
guess you had some sense of what you wanted in this performance, and you hired
a speech therapist--is that right--to work with him on this part of this

Mr. BLITZ: Yeah, we had a speech therapist for one day because we were a
low-budget film. Ordinarily you probably would have had a speech coach on for
the whole shoot, if you had enough money, if it were a bigger Hollywood
production. We got a speech therapist out for one day who had to essentially
do his work backwards. You know, most days a speech therapist teaches kids
how not to stutter, and here he had to instruct Reece on sort what to do with
his mouth and his breathing, you know, so that Reece could understand what
some of the physical manifestations were of it. And then, I think because I
wrote the stutter to be much like my own stutter, I was able to really guide
Reece and I was able to know when it felt authentic and when it didn't.

DAVIES: You know, one of the interesting things, when I went back, having
looked at the film once and I went back to look at it again, in part to see if
there were some moments I would want to pull out for the interview, I noticed
something I hadn't noticed the first time, which is that you use a narrator in
a few points to describe internal thoughts or to kind of move the story. You
don't use a narrator in your documentary "Spellbound"...

Mr. BLITZ: Right.

DAVIES: ...although you do use type on the screen, and I'm wondering what
role you saw the narrator playing in this film.

Mr. BLITZ: Well, for me, in "Rocket Science," so much of the movie is about
the struggle to find your own voice, meaning a voice in the sort of bigger
sense, the struggle to figure out how you're going to present what's inside
you to the world. And so I loved the idea that my lead character is this
completely inarticulate kid and that there's another character in the film
who's nothing but a pure and disembodied voice. I mean, it's almost like the
way most people associate people on the radio, in a way, that you don't think
of the actual human body that houses that voice. It just, you know, you, sir,
just exist as a voice for most people, I think...

DAVIES: Right.

Mr. BLITZ: And so I really loved the idea of a character in the film that
was nothing but voice. And in some sense, it's the fantasy that Hal has of a
kind of clean and perfect life, where whatever you want to say, you say. You
have, you know, a thought that is particularly eloquent or, you know, or that
has a sentence strung together in a really beautiful way and you're just able
to say it, to come out and say it. I think that's a powerful fantasy for a
kid who's struggling to find his own voice.

DAVIES: I wonder if doing this film that's a story, about an adolescent kid
who stutters, and immersing yourself in that subject has given you any new
insight into your own adolescence as a stuttering kid or just speech in
general in your own life?

Mr. BLITZ: Well, the funny thing is actually that when I was writing the
script for "Rocket Science," I was going through a terrible period of
stuttering myself, which kind of comes and goes in my adult life. But it was
really bad, and I went to see a different speech therapist for it, and I could
barely talk on the telephone, and so all of that stuff that Hal goes through
in the movie related to stuttering, trying to order a particular kind of food
that you want to eat and not being able to say that very thing, those were
things that I not only lived as an adolescent but that I was living while I
was working on the script.

In fact, while I was working on the script, at one point I was visiting a
friend who was shooting a movie in northern Africa and I was in my hotel room
and I was trying to order a hamburger from room service, and hamburger was the
one thing that I could not say. And it just arrived at a point of high comedy
when the room service person read the entire menu back to me so that I could
just say, `Wait, stop, yes that's it,' and she skipped over hamburger. She
kept going, and so it, you know, like it fed into the scenes that I was
writing at the time of Hal's frustration, and it was a very real thing for me
even in that moment.

DAVIES: Well, what do you think was going on? Do you think that your focus
on stuttering was intensifying your own issue?

Mr. BLITZ: I'm sure, I'm sure. Stutterers, I think, end up in the strange
place where, if you think too much about your stuttering, if you focus on it
too much, you tend to screw yourself up. But if you don't think about it
enough, then you can run headfirst into a brick wall with it. So you have to
occupy this very slippery turf where you're aware of it but you pretend not to
be aware of it, and that's the way that you achieve a kind of a fluency.

DAVIES: Wow, it sounds like a fair amount of mental work that you've got to

Mr. BLITZ: Well, it's funny, like there are people who say that a lot of
stutterers are very thin and it's because of how much energy gets put into
just normal speech acts during the day. It can be really exhausting.

DAVIES: I know that stuttering is situational for a lot of people and that
sometimes people overcome it by adopting an accent for example, and I'm
wondering, when you're on a movie set as director, you're the authority
figure, and you've got to tell a lot of people who are all being paid to be
there what to do, and doing it crisply, I suppose, matters. Do you find you
stutter less in that role?

Mr. BLITZ: You know, I think that there are two kind of opposing things that
are going on there. On the one hand, you don't want to stutter when you're
commanding a cast and crew, really, and so I think you do whatever you can to
try to be fluent there. But it is a high-stress situation, and I think
stuttering is generally more likely to come out in situations of high stress.
So I would tend to stutter terribly on the telephone when I was working on
"Rocket Science" to the point where I would routinely have to spell words that
I couldn't say, and I was always deeply embarrassed about that. Because I
thought, `here I am, the guy who made the spelling bee documentary and now I
resort to having...

DAVIES: Right.

Mr. BLITZ: ...`to spell words out to people.' It was just an embarrassment.
But when I was on set, I tended to do quite well with it and I don't know
whether there's a part of my brain that just jumped back to my days of public
speaking in high school and I adopted that more authoritative tone. I'm not
exactly sure. Because, again, when it's working quite well, you try not to
think so much about it.

DAVIES: I read that you're a big fan of Hal Ashby's films, who made, what,
"Shampoo," and "Harold and Maude," "Being There"...

Mr. BLITZ: "Being There," "Coming Home."

DAVIES: There's sort of an absurdist sort of feel to some of these

Mr. BLITZ: Yeah. I'll tell you what, I watched a lot of Hal Ashby films
over and over again when I was working on the script and when I was prepping
"Rocket Science," because I felt like Ashby is amazing at having characters
that you feel deeply for. I mean, they feel like they're people that you
recognize from your own world but, at the same time, they're doing things that
are patently absurd. And he was able to blend absurdist comedy and sort of a
naturalism of character and performance in a way that I just love and that I
try to emulate in "Rocket Science."

DAVIES: My guest is Jeffrey Blitz. He made the documentary "Spellbound." His
new film is "Rocket Science." We'll talk more after a break. This is FRESH


DAVIES: If you're just joining me, my guest is film director Jeffrey Blitz.
He made the documentary "Spellbound." His new film is "Rocket Science."

Well, let's talk about "Spellbound," which is, you know, a tremendous success.
It was nominated for an Academy Award for Best Documentary. You know, a
reviewer said that this movie held as much tension as "Apollo 13," and I'm
wondering what made you think a spelling bee would be a great dramatic story?

Mr. BLITZ: I was actually, I was determined to put "Apollo 13" in its place.
No, when I was getting out of grad school in film, I one day happened to be
watching ESPN--and I can't even remember what the sporting event was that I
was watching--it ended, and the final rounds of the National Spelling Bee came
on. This was in 1997, and I was blown away by it. I had never been in a
spelling bee at all. I think they were considered too kind of quaint or
low-brow for the schools that I went to, and I'd never seen a bee before, and
I was just instantly rapt. I just thought it was amazing, and for anyone
who's seen the national bee, you know that there's a crazy amount of tension
that is sort of built up there. And it's also something akin, I think, to
watching a great magic trick but instead of a rabbit being pulled out of a
hat, there is an amazing SAT word that's being pulled out of a little kid, you
know, who has, you know, no right to know what that word means...


Mr. BLITZ: ...or how to spell it. So I just knew instantly that there was a
great story in there. And then I spent most of 1998 doing research to figure
out which kids to cover and then Sean Welch--he's my producing partner--and I
hit the road in 1999 to cover these kids in the national bee.

DAVIES: Well, I wanted to play a clip from it, and this is April, who is a
speller from Ambler, Pennsylvania, actually not so far from the studio where
we are today, and in this clip we hear her talking about herself and then we
hear her not-so-intellectual parent, and her dad owns a bar called the Easy
Street Club. So let's listen to this clip from "Spellbound."

(Soundbite of "Spellbound")

Ms. APRIL DeGIDEO: Besides spelling, I like to ride roller coasters, and I'm
a vegetarian and I like to drink coffee.

Ms. GALE DeGIDEO: Here's another one, look. I can't even pronounce these
words. It's rather sad, but I know she can. It's just a world of knowledge
here, and I want to go back to school, tell you the truth.

Mr. AL DeGIDEO: Now, I've been working in the bar business 45 years. Yeah,
I was born across the tracks. That was the depression center back there.
That was all the houses for the people that worked for the asbestos mill, and
then they found out that the asbestos--the stuff was coming up seeping through
the ground, so they closed it all off now. There's a lot of people in this
town have asbestosis, died from cancer. (Unintelligible). I went from that
side of the street to this side of the street. Really--not a real success

(Soundbite of music)

(End of soundbite)

DAVIES: And that's from the film "Spellbound," which was the documentary made
by my guest, Jeffrey Blitz. You know, this is one of many moments in the film
where we see kids, and their parents in some cases, in moments that, you know,
expose some things about them that some of them--some people might not find so
flattering. We see, you know, Harry, the kid with all of these weird kind of
affects. And I wondered, you know, there's sometimes a fine line between a
presentation that can mock a kid's awkwardness and something that really
appreciates him as an individual, and I wondered if you confronted and
wrestled with that as you made the film.

Mr. BLITZ: Well, sure. I mean, I do think it's something that we talked a
lot about, Yana Gorskaya, who edited the movie, and I had long conversations
about what was too much, you know, when it wasn't enough. But I think that if
you treat your subjects with honesty and with decency, that comes through, and
that if your intention from the beginning with them is not to mock or make fun
of but to embrace them, in terms of all of who they are--not just the stuff
that is overwhelmingly positive but all these things that people have, the
tics that people have. It's a way of embracing humankind there, you know.
And I think that comes through in a strong way. I hope, you know.

I think it's OK to laugh with, or even laugh at people when they say or do
things that are funny, and I don't think that you feel any less for them. In
fact, in some respects, I think that you feel even more for them because they
were so willing to upon up and share of themselves like that. I think it's an
act of dishonesty when a portrait of someone is carved up in a way so that you
try to not offend. I don't think you're showing the real human being anymore.

DAVIES: Tell us a little bit about the opening scene with Harry--Harry's the
kid, right...

Mr. BLITZ: Harry, yeah.

DAVIES: ...struggling over this?

Mr. BLITZ: Yeah, right. The word was banns and it was one of the great
moments at that year's nationals. He just--he was incredibly persistent in
trying to spell this word right and to figure it out, and he is such an open
kid. I mean, he shares the emotion that he feels, he shares on his face
immediately. And he was in agony over it, trying to figure out what the
proper spelling for it was. So we do a condensed version of it in the movie
but I...

DAVIES: Really?

Mr. BLITZ: ...I have a palpable memory of it. It goes on for a long time.
I mean, he was up on stage probably for about five minutes trying to battle
through that word. I think there's--I mean, there's obviously something
that's entertaining and funny about it, but there's something really brave.
There's a kind of courage that it takes to stand up there and to fight to go
after a word you don't know. I just, I thought it was as marvelous moment.

DAVIES: And did he get it right?

Mr. BLITZ: He did not.

DAVIES: Well, why don't we listen to that clip? This is the opening scene
from Jeffrey Blitz's documentary "Spellbound." This is Harry struggling over a
very difficult word.

(Soundbite of "Spellbound")

Announcer: The word is "banns."

HARRY: (whispers) Banns, banns, banns, banns, banns. It's got to be
something I can think of it.

With a "d" sound or without a "d" sound? Um, you said it's a homonym and you
told me what it means, but am I allowed to ask what its homonym means? All
right, I'm starting over. B-a-n-d--I have so far is b-a-n-d--I don't know if
that was a great idea but--oops, maybe I shouldn't have said that out loud.

(Soundbite of breathing)

(Soundbite of cameras flashing)

(Soundbite of music)

(End of soundbite)

DAVIES: And that's a scene from the Oscar-nominated documentary "Spellbound,"
directed by my guest Jeffrey Blitz. His new feature film is "Rocket Science."
He'll be back in the second half of the show. I'm Dave Davies, and this is



(End of soundbite)

DAVIES: This is FRESH AIR. I'm Dave Davies sitting in for Terry Gross.
We're speaking with filmmaker Jeffrey Blitz. He directed the Oscar-nominated
the documentary "Spellbound" and has a new feature film called "Rocket
Science." He also directed a couple of episodes of the NBC comedy "The
Office." Here's a taste of one of the episodes called "The Negotiation."

(Soundbite of "The Office")

(Soundbite of a sigh)

Unidentified Actor #1: (In character) Darryl, you are a good worker and a
good man.

Unidentified Actor #2: (As Darryl) Are you wearing lady clothes?

Actor #1: (In character) What?

Actor #2: (As Darryl) That there's a woman's suit.

Actor #1: (In character) OK, all right.

Actor #2: (As Darryl) This is going to make you feel better. This is too

(End of soundbite)

DAVIES: I asked Jeffrey Blitz how he got involved with "The Office."

Mr. BLITZ: Right after "Spellbound" came out, I went in to meet with Greg
Daniels, who's the show runner on "The Office," and they hadn't yet done the
pilot for the American version, and so I was taking a meeting essentially
about doing the pilot for that, and I think NBC very quickly told Greg that he
was high if he thought that they were going to let him hire a guy who had just
done one documentary about a spelling bee. So later, after the show turned
into a hit, and I think they gave Greg a lot more latitude as to who to hire,
he very kindly said, `I want that Blitz guy back.' So I ended up doing a
couple episodes for them last season, and I'm hoping I'm going to get to do
some more this upcoming season.

DAVIES: Well, it's interesting, you know, you did "Spellbound," which is a
documentary, and then you've got this feature film and then "the Office," is
fictional, made as a documentary.

Mr. BLITZ: Yes, yeah, yeah. That's absolutely right. And one of the great
things about that show, when we talk about a shot on the show or, you know,
how to set up a camera move, you don't just say, `You start wide and then you
go into a close-up' in the way that you would on a feature film. The whole
thing has to be motivated as if it's a real documentary. So you discuss it by
saying, `The cameraman sees this thing, you know. He's focused on Jim and
Pam, you know, at the front desk, but then he sees Michael is doing something
in his office and he swings the camera over.' So it's all motivated in the way
that it really would be were there a real documentary crew there. Of course,
you have the luxury of a phenomenally funny and talented cast...

DAVIES: Right.

Mr. BLITZ: ...a great writing staff and multiple takes, so it's not really
true to the documentary form in that way.

DAVIES: You know, there are many moments in "The Office" where the characters
have these pained expressions as these embarrassing things are happening, and
there are moments, awkward moments in "Spellbound" with these kids and
certainly in "Rocket Science," and probably a lot of things that makes
audiences uncomfortable. I mean, are you kind of drawn to that kind of movie

Mr. BLITZ: Sure. I mean, I do think--people have pointed out that there's a
cringe factor in "Rocket Science" and in "Spellbound" and in "The Office, for
sure. What's funny is--and I think this is just where I'm not in sync with
the rest of the world because the things that other people cringe at, I just
take pure pleasure in. And I think it's because I can sort of wander into
those minefields so happily that I'm comfortable tapping into all of that sort
of stuff. I guess I just--maybe growing up as a stutterer means that you
don't embarrass as easily as a lot of other people would.

DAVIES: How did you get into filmmaking?

Mr. BLITZ: Yeah, when I got to college I thought I was going to be a lawyer,
and actually my parents set me up to do an internship the summer after my
freshman year with a friend of theirs who's a lawyer at a big New York firm.
And when I went at the beginning of the summer to meet the person who was
going to hire me, I walked through this row of offices of lawyers in the law
firm, and they looked so miserable, they all looked so miserable, that by the
time I got to the office where I was going to have my interview, I said,
`Thanks but no thanks,' and I turned around and I left, which is a really
obnoxious thing to do after my parents had set that up. But I just decided
that I couldn't have a life that would sort of have me arrive in one of these
offices at some point.

So I decided to get into creative writing...

DAVIES: I've just got to interrupt and say, that's like a moment out of a

Mr. BLITZ: Yeah.

DAVIES: It's like this turning point in your life.

Mr. BLITZ: I know, and the thing is--and I had an awareness that it felt
like a strong kind of movie moment. I also remember looking down at my shoes
and realizing that the shoes that I had chosen to wear were all wrong and if I
was meant to be a lawyer, I would've chosen the right shoes somehow.

Anyway, so, through the writing department, there were film classes offered,
and now that I was liberated from the fear of going to law school, I could
take classes--even though they might not look good, you know, on my college
transcript. So I took a film of Alfred Hitchcock class and it changed
everything for me. I suddenly saw that movies could be works of art in
addition to pieces of entertainment, and up until that time it had never
really occurred to me what they could be. And suddenly, from the very first
movie we saw, which was "The 39 Steps," my whole understanding of film just
got turned upside down.

DAVIES: Well, Jeffrey Blitz, it's been great having you. Thanks so much for
talking with us.

Mr. BLITZ: My pleasure. Thank you.

DAVIES: Filmmaker Jeffrey Blitz. His new movie is called "Rocket Science."

Coming up, the law professor who suffers from schizophrenia. This is FRESH

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Elyn Saks, author of "The Center Cannot Hold," on
living with schizophrenia

"Schizophrenia," Elyn Saks writes, "rolls in like a fog, becoming
imperceptibly thicker as time goes on." Saks is a professor of law, psychology
and psychiatry and the behavioral sciences, and she's written widely on mental
health and the law. But her knowledge of schizophrenia is deep and personal.
Though many of her colleagues and students are just now learning it, Saks
herself suffers from the disease. It emerged when she was in college and
strengthened in graduate school. She suffered serious episodes of delusions
and paranoia, at times mumbling to herself in hallways and forgetting to eat
and bathe. Remarkably, despite several hospitalizations, Saks managed to
graduate as class valedictorian at Vanderbilt and complete studies at Oxford
and Yale law school. She's told her story in a new memoir. It's called "The
Center Cannot Hold: My Journey Through Madness."

Well, Elyn Saks, welcome to FRESH AIR. Schizophrenia typically presents
itself, I guess, in early adulthood, I guess, often a little earlier with men
than women.

Ms. ELYN SAKS: Mm-hmm.

DAVIES: As you reflect on your childhood...

Ms. SAKS: Mm-hmm?

DAVIES: ...are there moments that you think might have been early
manifestations of your illness?

Ms. SAKS: You know, I had a bunch of symptoms when I was growing up. I
think a lot of them were within normal limits. You know, I was fearful. I
had some phobias. I had some obsessions. I had some kind of intense fears
that, in retrospect, might have been a kind of beginning of the almost poking
through, but the first real clear sign of it was when I was 15 or 16, and I
was sort of walking home from school precipitously. I left, I just suddenly
got up and walked home, and I felt as if the houses were sending me messages
and getting all weird and frightening, and I was terrified. So that was kind
of the first episode, but I brought it to an end fairly quickly, and it didn't
come back in that kind of florid form until I went to Oxford as a graduate

DAVIES: What did you make of it at the time?

Ms. SAKS: I didn't know what to make of it. It was just something that
happened to me. It was weird. I was worried about it. In retrospect, I wish
I would have, you know, gotten some good treatment at the time. My parents
were very good parents and very kind and caring parents, but I don't think
they really understood that I needed treatment for the things that I was
experiencing. Who knows if it would have made a difference, but maybe it
would have.

DAVIES: There's a moment you describe when you were eight years old. You ask
your dad if you can go out to the cabana for a swim?

Ms. SAKS: Right.

DAVIES: Describe what happened then.

Ms. SAKS: Basically, you know, I asked my dad if we could go out to the
cabana for a swim, and he kind of snapped at me and said he had work to do and
didn't I--didn't hear what he tell me, that it might rain and it wouldn't be a
good idea to go. And at that moment my heart sinks. `I've disappointed my
dad' but then something else happens that is a little bit, I think, out of the
ordinary, and people don't really understand, which is kind of my self
dissolving. It's sort of consciousness gradually losing its coherence.

It was my first experience, actually probably, I should say this is the first
experience, but it was the first experience I had of what I call
disorganization. And imagine a sand castle with the sand starting to slide
away. That's what it's like. it's like your center, your self, starts
gradually disappearing, falling apart. There's no one there, as it were, to
take in sensations and thoughts and ideas and put them together. You're just
falling apart. And it's terrifying. It's terrifying without a kind of sturdy
vantage point or without a self, you know, you're very disabled, to say the
least and...

DAVIES: And reflecting...

Ms. SAKS: was obviously very scary.

DAVIES: And reflecting back, decades later, you remember that moment when you
were only eight?

Ms. SAKS: I do.

DAVIES: Something about it was very vivid to you.

Ms. SAKS: Yes, it was very...

DAVIES: Right.

Ms. SAKS: Yes, it was. Yeah, yeah. And it's something that defines what
happens when I get ill now. It's one of the things that happens that I get
what I called disorganized and I'm not able to hold things together or stay
focused or stay solid.

DAVIES: There are a few points in the book where you describe in really vivid
detail what your psychotic episodes look like, particularly to others, and I
was going to ask you to read one of these. This is one--actually you begin
the book with this because, I think, maybe because it's such a great example
although it chronologically comes later when you're at Yale law school. If
you would, just kind of set this up and read this section for us.

Ms. SAKS: OK, sure. So this is the beginning of the prologue, starting now.

"It's 10:00 on a Friday night. I am sitting with my two classmates in the
Yale law school library. They aren't too happy about being here. It's the
weekend, after all. There are plenty of other fun things they could be doing.
But I'm determined that we hold our small group meeting. We have a memo
assignment. We have to do it. Have to finish it. Have to produce it. Have
to--wait a minute, no, wait. `Memos are visitations,' I announce. `They make
certain points. The point is on your head. Have you ever killed anyone?' My
study partners look at me as if they, or I, have been splashed with ice water.

"`This is a joke, right?' one asks.

"`What are you talking about, Elyn?' asks the other.

"`Oh, the usual. Heaven and hell. Who's what, what's who. Hey,' I say,
leaping out of my chair, `let's go out on the roof.' I practically sprint to
the nearest large window, climb through it and step out onto the roof,
followed a few minutes later by my reluctant partners in crime.

"`This is the real me,' I announce, my arms waving above my head. `Come to
the Florida lemon tree. Come to the Florida sunshine bush, where they make
lemons. Where there are demons. Hey, what's the matter with you guys?'

"`You're frightening me,' one blurts out, a few uncertain moments later.

"`I'm going back inside,' says the other. They look scared. Have they seen a
ghost or something? And, hey--wait a minute. They're scrambling back through
the window.

"`Why are you going back in?' I ask, but they're already inside and I'm alone.
A few minutes later, somewhat reluctantly, I climb back through the window,

"Once we're all seated around the table again, I carefully stack my textbooks
into a small tower, then rearrange my note pages. Then I rearrange them
again. I can see the problem, but I can't see its solution. This is very
worrisome. `I don't know if you're having the same experience of words
jumping around the pages as I am,' I said. `I think someone's infiltrated my
copies of the cases. We've got to case the joint. But I don't believe in
joints. But they do hold your body together.' I glance up from my papers to
see my two colleagues staring at me.

"`I--I have to go,' says one.

"`Me too,' says the other.

"They seem nervous as they hurriedly pack up their stuff and leave with a
vague promise about catching up with me later and working on the memo then."

DAVIES: And that's from the beginning of the book "The Center Cannot Hold."
It's by our guest, Elyn Saks, about her battle with schizophrenia.

You know, that's such a vivid description, and those monologues that you go
into where there are these weird associations about...

Ms. SAKS: Mm-hmm. Mm-hmm.

DAVIES: know, points and all that. How did you reconstruct those for
the book?

Ms. SAKS: You know, it's kind of interesting because people ask how could I
possibly remember, but I remember the same way that everyone who writes a
memoir remembers. You try to think back to what you were thinking and feeling
and, you know, capture it as best you can. There are certainly occasions in
the book where I know on this particular day and this particular episode, I
had this particular delusion. Like my therapist and my best friend, Steve
Behnke, were taken over by aliens.

And then there are other times where I say, `I was feeling such and such and,
you know, this is the kind of thought I tend to have when I'm feeling such and
such, such as I've killed hundreds of thousands of people with my thoughts.'
But some people with psychotic episodes don't remember their episodes, and I'm
not one of those people. I do remember, so I'm basically in the same position
that anyone is in who's trying to faithfully recount their thoughts and
feelings at some time in the past.

DAVIES: Is it a burden to have all those memories?

Ms. SAKS: That's a good question. I don't think so. I think it's part of
my history. It's part of who I am. It's part of what makes me who I am, and
so I wouldn't want to lose the memories. I actually have had some physical
health problems so I had a subarachnoid hemorrhage. A stroke...

DAVIES: Right.

Ms. SAKS: And after that I stopped being able to remember dreams. And my
dreams had been very disturbing and really more nightmares than dreams, but I
regret that I don't have that kind of window into my soul anymore, probably as
a result of the bleed. And that's the case, even though those dreams were
sometimes horrifying and scary as anything.

DAVIES: You know, the interesting thing, of course, is that one of the
problems with schizophrenia is that when people begin to get ill, they don't
realize they're getting ill...

Ms. SAKS: Right.

DAVIES: They think they're understanding reality as it is...

Ms. SAKS: Right. Right.

DAVIES: ...when in fact it's quite distorted, and I'm wondering if your
ability to remember your previous episodes was ever a tool that you could say,
`Wait a minute. I recognize...

Ms. SAKS: Oh.

DAVIES: ...`this thought pattern. This is what I do when I get sick.'

Ms. SAKS: Oh, absolutely. Absolutely. I mean, you know, a psychosis is not
like an on-off button but a kind of a dimmer switch; it ranges in degrees of
intensity. And by this time I know my illness fairly well and it's not
uncommon for me to have a kind of transient psychotic thought and say, `Oh,
that's just my illness acting up.' And one thing that's stood me in good stead
is, even when it gets worse, when I am really, really believing the crazy
things, I always know that other people will think they're crazy, and I'm
motivated to not appear crazy so I'm able to kind of make my way in the world
in that way. And then occasions where it's just so intense and so profound, I
just know not to be around people. Because I, you know, I don't know what
I'll say. So for the most part I can control what I say even though I really
can't control what I think.

DAVIES: When you were in Oxford, you had this really important relationship
with this psychiatrist, Dr. Elizabeth Jones...

Ms. SAKS: Mm-hmm.

DAVIES: And one of the things that's interesting about this part of the story
is that I think we tend to think of effective treatment for schizophrenia as
being anti-psychotic medications, but this--she was a psychoanalyst and what
you really did was talk therapy, so...

Ms. SAKS: Right.

DAVIES: Tell us about that relationship and that treatment.

Ms. SAKS: Yeah, yeah. It's often said that people with schizophrenia don't
benefit from psychoanalysis or psychoanalytic psychotherapy, and for me that's
been one of the key parts of my treatment and my recovery--or my recovering,
so to speak. I still have symptoms sometimes. But how did psychoanalysis
work for me? Well, that's always the $60,000 question. How does it work?
And two possibilities--and I think they're both active in my case--are insight
and the relationship.

And I think what psychoanalysis helped me with is, first of all, identifying
and coping with stress, because stress is bad for all illnesses, especially
mental illness. It helped me come to terms with having an illness and needing
treatment. That's a kind of blow to your self-esteem, if I can put it that
way. It gave me a place where I can talk about the things that were haunting
me and troubling me and scaring me. It detoxified symptoms by interpreting
them. You know, `I think you're saying such and such because you're jealous
or fearful or whatever,' and it made it more meaningful and easier to cope
with, and then the relationship with a kind, nonjudgmental, tolerant person
who accepts everything in you--the good, the bad, and the ugly--and stays
strong, kind of contains you and holds you together. So I think all of those
things had helped.

DAVIES: And were you taking anti-psychotic medicines when you were seeing Dr.

Ms. SAKS: I did not take any medicine when I was seeing her, no.

DAVIES: Later in your story, when you're in different care...

Ms. SAKS: Mm-hmm. Right.

DAVIES: ...and you were given anti-psychotic drugs and there are...

Ms. SAKS: Right. Right.

DAVIES: ...moments when you get ill, and you take larger dosages and the
effect is immediate...

Ms. SAKS: Right.

DAVIES: brings under the psychosis...

Ms. SAKS: Right.

DAVIES: ...under control...

Ms. SAKS: Right.

DAVIES: Did these talking sessions with Dr. Jones, did they have the same
kind of immediate effect of reducing and easing your psychotic symptoms?

Ms. SAKS: They could reduce and ease them. They could not get rid of them.
I don't believe that psychoanalysis, psychotherapy, cognitive behavioral
therapy, anything can really control the symptoms of delusions, and
hallucinations and things like that. They can make them less. They can make
them so that you can live your life even in the face of having them, but I
firmly believe at this point, after many years of struggling against the idea,
that the anti-psychotics are also an essential part of the picture and that
I'm much better off on the anti-psychotics than off them.

For me, Mrs. Jones, in a way, kind of interrupted the normal--what they call
negative--symptoms of schizophrenic, inability to, you know, do work and
inability to socialize and have friends. Once I got into treatment with her,
all that, which had been gone for two years while I was becoming
schizophrenic, so to speak, went away, and I was able to have friends and be
able to work and things like that. But the delusions and hallucinations,
yeah, every once in a while, an interpretation would make one go away. But in
order to make it really go away, I need medication as well. But again, that's
not enough, particularly all those years when I was taking medications that
were less good than the ones that I'm on today.

DAVIES: Mm-hmm.

Ms. SAKS: That's to say, I was always kind of on the edge. It could go
either way and having the therapy kept me on the right side of the line most
of the time.

DAVIES: USC law Professor Elyn Saks. We'll hear more after a break. This is


DAVIES: We're speaking with USC professor of law and psychology Elyn Saks.
Her memoir of her battle with schizophrenia is called "The Center Cannot

You know, an inspiring part of this book is the fact that you, despite your
illness, completed law school at Yale and, after a stint as a legal services
lawyer, became a law professor at USC and went on and got psychoanalytic
training and have written books and articles and have a distinguished academic
career as a legal scholar. How much do people know about your illness now,
and how much are they going to be learning as they read this book and hear
these interviews?

Ms. SAKS: You need to proceed cautiously. It's sort of another dilemma for
psychiatric patients, because the way people deal with trauma is by talking
about it, but this is something that it's hard to talk about with people,
especially in the beginning. I've been very fortunate that I've had close
friends and my husband who really know me well and help me. My friend Steve,
who I went to law school with, and who became a clinical psychological and is
now director of ethics at the APA, were like dear, dear friends. He knows me
as well as anybody knows me. We speak on the phone almost every day. And he
can sometimes tell when I'm starting to lose it before I can. So having
friends who know and understand is extremely important. It's not only true
for psychiatric patients, it's for everybody. Everybody needs someone that
they can talk to, or some people that they can talk to and turn to.

But then, I've had weird experiences. I remember in law school, I disclosed
to one of my classmates that I had had this illness and that I had the
breakdown, was on the roof of the law school made a belt out of television
wire, and she said, `Oh, do you still feel like making belts?' Like, totally
not getting what the thing is like.

DAVIES: Right.

Ms. SAKS: And then there, you know, there are times--I remember I was
writing my article on restraints and one of the professors at Yale, a
psychiatrist--I was talking about how--putting it onto the third person--how
it must be so degrading and painful. And he looked at me and he said, `Elyn,
those people are psychotic. They are not like you and me. They have
different experiences,' and I so wanted to say, `Well, yeah, they are like
me.' But, you know, you have to be careful. You have to be cautious.

DAVIES: Well, before writing this book, did your colleagues at the law
school--did students at the law school know that you, you know, had been
hospitalized as a schizophrenic?

Ms. SAKS: No. No, no, no. None of my students. At this point, one person
knows. But probably like my second or third year I told my closest friends
and then, you know, over time told more people, once the book was about--was
definitely being published, I started telling more and more people, so I'd say
at this point, you know, maybe three-quarters of the faculty and staff know.
In fact, the book has been passed around among the staff a lot, which is kind
of a kick.

DAVIES: Apart from staying on your medications, what restrictions does your
illness place on your life today?

Ms. SAKS: You know, it does place restrictions. It's easy to be
overstimulated, as we were discussing, so I try to manage things by having a
very kind of strict regimen or strict routine that I follow and try to keep
change to a minimum, stimulation to a minimum. There are times when I need to
be alone, or I always need some alone time. You know, some of this can be
difficult for people close to me. Like, my husband loves to travel, but I
find it difficult, and so we just kind of negotiate it and do the best that we

It's also the case that I'm very vulnerable to stress so, you know, bad
medical news or bad this news or that news. I know there are sometimes I just
kind of shut down and withdraw a bit from life. So that's another kind of
limitation. It's one of the things that make me work as hard as I do because
I know there'll be down times. But for the most part, I feel pretty well and
pretty happy, and you know.

DAVIES: You wrote that there were points in your life and treatment where you
were on, you know, doses of medications that kept the symptoms under control
but you could still feel these forces, these demons sort of out there, that
you were just sort of keeping them at bay.

Ms. SAKS: Right, right.

DAVIES: Are they still there? Do you feel them?

Ms. SAKS: No, you know, the new medications--I can't say they're not there
completely. I have what they call breakthrough symptoms, transient symptoms.
You know, probably not a week goes by that I don't have a thought or two like
that. But I just dismiss them. But for the most part, I mean, when I was on
the older medications, it was like I was having to lean against the door to
keep the demons from breaking through, and now I mostly feel fine, and even
though I can get symptomatic, it's less often, it's less long-lasting, it's
less intense, easier to bring to a close. And most of the time I don't feel
anything different from what anybody else feels. You know, I have the usual,
you know, anxiety and concerns. I'm, you know, worried about health or sad
about this but not really the demons banging on the door to get out. It's
terrifying, it's terrifying, without the kind of sturdy vantage point or
without a self. You know, you're very disabled, to say the least.

DAVIES: How long has it been since you had what you would call a real
psychotic break?

Ms. SAKS: Gosh. If we're talking about a couple of days, I guess within the
month. I had a couple of days when I was out of the office. I needed to be
out of the office. And by the end of the second day, I was symptomatic. If
we're talking about, like, a week or more, it's been since like 2000, 2001,
when I was trying to change medications.

DAVIES: Hm. And when you had it for a couple of days, what kinds of things
were you experiencing?

Ms. SAKS: I just felt like I was--there were people who wanted to hurt me
and kill me and maybe I had told other people I was being attacked, and my
thoughts got disjointed and confused. And, you know, that kind of thing.

DAVIES: And then when that happened, what was your response?

Ms. SAKS: Basically I called my therapist and my psychiatrist, and I went up
on my meds. So that got things back under control in a fairly short time, a
day or two.

DAVIES: Well, it's a great book, and I really wish you the best. Elyn Saks,
thanks so much for spending some time with us

Ms. SAKES: Oh, thank you so much, I really enjoyed speaking.

DAVIES: USC professor of law and psychology Elyn Saks. Many of her
colleagues will learn more of her illness when she speaks at the American
Psychological Association Convention in San Francisco later this month. Her
memoir is called "The Center Cannot Hold: My Journey Through Madness."


DAVIES: For Terry Gross, I'm Dave Davies.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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