The Center Cannot Hold: My Journey Through Madness by Elyn R. Saks

For anyone, Elyn Saks’s accomplishments would be impressive: multiple degrees from distinguished schools including Vanderbilt, Oxford University, and Yale Law School, plus a PhD in psychoanalysis; four books published and many articles; and important awards, including the MacArthur “genius grant.” Saks did all this while suffering from paranoid schizophrenia. Her story is nothing short of astonishing.

Saks’s descriptions of her delusions and crazy behavior are fascinating and sad. She alarms people by asking “Have you ever killed anyone?” or saying “You are the devil. You are trying to kill me. I am evil. I’ve killed you three times today. I can do it again.” At times she is floridly psychotic, even forcibly committed and put in restraints. (This leaves such an impression that she’s devoted a good part of her professional life to examining issues of consent with mental patients.)

As Saks explains it, the fundamental characteristic of schizophrenia is confusion between what’s real and what’s not, like the feeling when you wake up from a nightmare and aren’t sure yet if it’s over. As crazy as her delusions sound, it takes many years for Saks to accept that they are delusions, not the same things everyone else thinks but doesn’t say. She figures they just have better self-control than she does.

In fact, Saks is amazingly self-controlled, strong, and self-disciplined. She can maintain order and sanity in her life, and being immersed in the work she loves helps keep her sane. Ironically, though—and to me this is one of the most interesting themes in the book—her refusal to surrender keeps her sicker longer. Even when she can be persuaded to take antipsychotic drugs at all, for years she lowers the dose at the first opportunity, despite many, many experiences of getting better at higher doses. After much she work, she can finally accept that yes, she is schizophrenic, and yes, she needs meds.

Slowly, and with the help of talk therapy, Saks does find balance in her life, even meeting someone to love who loves her back. She’s married now, and has good friends too, and that made me want to stand up and cheer. She’s never going to be not schizophrenic, but she has a way to live with it now, and I’m so glad for her.

Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case by Debbie Nathan (2011)

I was 10, in the summer of 1974, when I first read Sybil, utterly fascinated and horrified. (My mother told me to skip the abuse sections, but of course I didn’t.) I re-read it many times over in years to come, and anything else I could find about multiple-personality disorder. As nearly everyone did, I accepted uncritically Flora Rheta Schreiber’s account of Sybil’s illness and recovery under Dr. Cornelia Wilbur. The story made beautifully dramatic sense: A severely abused child who is also intelligent, sensitive, and creative could unconsciously save herself from being destroyed by trauma. She could split herself into separate personalities with separate memories and life experiences, each personality having a role in remembering certain events, expressing forbidden feelings, and otherwise protecting the core self. Through emotional confrontations with the repressed past, and with the help of a caring therapist, the patient could integrate into one whole, healthy person.

Except that’s not what happened, as journalist Debbie Nathan explains in Sybil Exposed. The exposé here is not really of Sybil herself (real name: Shirley Mason), but of  “Sybil” the created product. (There was even talk, after the book’s success, of a Sybil board game, T-shirt, dolls.) Nathan lays bare how, in their different ways, Wilbur, Schreiber, and Mason each needed and contributed to the MPD narrative. Both Wilbur and Schreiber had reputations to make. Wilbur had been wanting an MPD patient; it was a rare diagnosis, a fascinating one, and she felt she could help. Schreiber was tired of writing fluff pieces for women’s magazines and needed a juicy yet serious subject. Mason desperately wanted love and attention, and her diagnosis guaranteed lots of that. Especially when Wilbur started shooting her up with truth serum in hours-long sessions several times a week, demanding to know who had hurt Shirley.

Besides the Pentothal, other drugs Wilbur prescribed include Seconal, Demerol, Dexamyl, Miltown, Edrisal, and Thorazine. She also made house calls, sometimes to inject Pentothal, sometimes with a portable electroshock box:

Connie would carry her apparatus to Shirley’s apartment and climb in bed with her. She would clamp the paddles to Shirley’s temples, twirl the dials, press the buttons. Shirley’s body would arch and crash with convulsions . . . . Connie was relentless, administering Pentothal round the clock.

Of course, we know now that “truth serum” is more likely to produce rambling flights of fancy, but Wilbur was convinced that every word was gospel. When Mason finally wrote a long letter to her doctor saying she had been lying because she’d been distraught and didn’t even know how she came up with these terrible accusations about her mother, Wilbur called it a defensive maneuver. Wilbur cued her intelligent, suggestible, and needy young patient until she got what she wanted, and rewarded her with hugs, gifts, and money, sometimes paying her rent, getting her jobs, sometimes living with her, going on vacations with her, and other shocking boundary violations that would never be accepted today.

Nathan makes depressingly clear that poor Shirley Mason was made far worse by Wilbur’s treatment. She did need help. Since childhood, she’d been troubled, unhappy, and anxious. Artistically gifted, she was burdened by her parents’ extremely strict Seventh-Day Adventist beliefs, which forbade imaginative play, fictional stories, and art done in non-realistic colors. A lonely only child, she invented imaginary playmates; this too was a sin, but she couldn’t stop herself from escaping into pretend adventures with Vicky and Sam. Sometimes she became so involved she couldn’t remember what was real and what was fantasy. By the time she started seeing Wilbur regularly, Mason had had a lifetime of dreaming up other selves and imagining heroic adventures.

Schreiber never mentions this in the book. Nor does she mention that no one in Mason’s tiny hometown, where everyone knows everyone, could corroborate the savage abuse described in Sybil. Yes, Mattie (“Hattie” in the book) was a bit nervous and strange, and when depressed would ignore her daughter. But no one had a story about her wandering around the neighborhood defecating on people’s lawns. Not a single rumor about the teenage lesbian orgy in the woods Sybil supposedly witnessed. Dodge Center doesn’t even have woods. Although the TV movie claims that doctor’s records validate scars from sexual abuse, no such records were found.

Near the end of the book, we learn that Wilbur mentions in passing that one reason Mason was always so tired is that she had pernicious anemia. The symptoms? Exactly those Mason went into treatment for, including depression, anxiety, headaches, mood swings, hallucinations, and confusion about identity. If she’d just taken some vitamin B12, instead of having MPD iatrogenically produced through powerful, addictive drugs and a dangerously enmeshed psychiatrist, she could most likely have lived a much happier, healthier, more independent life. Schreiber and Wilbur made their careers on her. Mason died nearly penniless. If she’d been willing to sell her paintings as Sybil, she’d have had plenty to live on. But she refused.

As for why, besides inherent fascination, Sybil became a huge bestseller and introduced a new psychiatric diagnosis, Nathan says it’s about female identity after the sexual revolution and how the book was published during a time in history when women were experiencing fragmented selves, needing to integrate their roles as wife, mother, professional, and so on. Maybe; Mason wouldn't be the first woman to be wrongly diagnosed because a woman's symptoms must indicate hysteria. I don’t think you have to look that far, though. The idea that the one who is supposed to love you best is actually a frightening monster out to get you has its own inherent fascination—one that doesn’t need a push from historical currents. After all, I had no role confusion at age 10, and I was agog. It’s ironic that the story of monster disguised as helper winds up being true after all, although the monster is named Doctor, not Mother.

The Spiral Staircase: My Climb out of Darkness by Karen Armstrong

Karen Armstrong became a nun in 1962, when she was 17, and left the convent seven years later. She'd already written a memoir--since revised--about that experience, called Through the Narrow Gate. I read the unrevised (I think) edition years and years ago, so it was very interesting to read her reflections now on the nunnery and what happened when she left.

Her life wasn't easy afterward, particularly when it came to her epilepsy, which unbelievably enough went undiagnosed for years. She was told she was repressed, hysterical, oversensitive--and this, with a disease that's been described and known since antiquity. All those years of fearing she was going crazy, would wind up in a locked ward, for an illness she now manages well with medication! (Her previous doctors were just lucky that Britain isn't as malpractice-suit-happy as America.)

The spiral staircase image is from Eliot's poem "Ash-Wednesday," the first long poem he wrote after converting to Anglicism. The staircase, where it seems one is always returning to the same place and making no progress, but actually slowly ascending, signifies for Armstrong the pattern of her spiritual and emotional life.

Though she couldn't pray after leaving the convent, and couldn't feel any closeness or belief in God, religion was always her subject. After her failed attempt (in highly unfair circumstances) to get an Oxford doctorate--her topic was Tennyson--she wrote books and presented TV programs on subjects like Jerusalem, St. Paul, the Crusades, mystic poets, and one book titled The History of God: The 4000-Year Quest of Judaism, Christianity, and Islam.

But does she believe in God now, or what? Her answer is that these words are too small and limited for anything but a small and limited concept of God. She rejects the litmus test of "belief" and says of faith, paraphrasing theologian Cantwell Smith:

Quote:

Faith was really the cultivation of a conviction that life had some ultimate meaning and value, despite the tragic evidence to the contrary--an attitude also evoked by great art.

That doesn't mean you can believe anything you like. There is a test:

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The one and only test of a valid religious idea, doctrinal statement, spiritual experience, or devotional practice was that it must lead directly to practical compassion.

What largely led Armstrong to this point of view was writing The History of God. First, she found, she needed to write about Muhammed and Islam first, to understand it and to present a counternarrative to the hatred swirling around after Ayatollah Khomeini and the Salman Rushdie fatwa. No accessible life of the Prophet that Westerners could understand existed. So Armstrong wrote it.

To do so, she had to edit out her ego, she says, a practice that became, without her intent, spiritual, as she worked "to penetrate another culture and develop a wholly different way of looking at the world. It required a constant concentration of mind and heart that was in fact a type of meditation." And in writing her History of God, she finds this concentration to be central to all religions at their best and when unsullied by fear or politics.

The spiral staircase does seem an apt metaphor for Armstrong's life. As much as she longed to break free from the nunnery, everything about her life seems nun-like except for the obedience to authority.

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I tried to break away from the convent but I still live alone, spend my days in silence, and am almost wholly occupied in writing, thinking, and speaking about God and spirituality.

Indeed, a problem in the book is that Armstrong can seem bloodless even when she's suffering and lonely, as if she's someone without any strong carnal desires. (She dismisses her meager love life in a few paragraphs, and herself as a non-starter.) But then, she seldom gives herself sufficient credit for her powerful achievements.

Armstrong writes with great clarity about spiritual and human loneliness. Her account of a mind opening, an intellect finding its subject, and a spirit breaking free from oppression, is moving and thoughtful. Her understanding of faith and hope is blessedly free from pink-cloud sentiment. I'm really glad I read this.

The Notting Hill Mystery, Compiled by C. Felix, From the Papers of the Late R.H. Esq.

Published as part of the British Library's historical collection; originally published in Once a Week, 1865.

This is a thriller detective novel in the form of letters, statements, a crime scene map, and journal extracts. They've been compiled by an insurance investigator to examine claims made by Baron R** following the mysterious death of his wife, Madame R**—a death closely linked to two others.

Madame R** drank poison while sleepwalking—but Baron R** is a well-known mesmerist. So did she die of her own will or of his? The narrator refuses to decide, so has laid out all the evidence for his readers to make a final judgment.

When, by page 29, I had already encountered mesmerism, sleepwalking, and a child stolen by gypsies, I figured I was in for a thumping good read in the manner of Wilkie Collins's thrillers. The Notting Hill Mystery actually predates 1868's The Moonstone, also an epistolary novel, and both books have been called "the first detective novel" in English. However, while I enjoyed the novel, it's clear why Collins is remembered and Felix is not.

With Collins, you have believable, varied characters with psychological complexity and a mystery that unravels as the novel goes on. Felix's characters are thin, just coat hangers for the few attributes to keep the story moving, like "jealous of family pride" or "weak constitution." Also, and worse, the heart of the mystery is laid out so early there's no real suspense. Every fresh document just adds weight to what we already have been told must be the solution--if you can accept the reality of mesmeric control. Otherwise you must accept some amazing coincidences. Either way, it's unsatisfying.

"Charles Felix" is a pseudonym, some think for Charles Warren Adams. He was a lawyer whose firm published another book by "Charles Felix" called Velvet Lawn.

The Biographer's Tale by A.S. Byatt

The narrator, Phineas G. Nanson, is doing grad study in English literature (sometime in the 90s) and becomes disenchanted with the abstractions of literary theory, wanting something more thing-y to study, more real. An advisor recommends that Phineas investigate Scholes Destry-Scholes, magisterial biographer of a 17th-century explorer/scientist/diplomat.

Destry-Scholes, Phineas discovers, had written some biographical fragments--not all factual--of three different historical figures. Threads woven throughout include travel, exploration, natural history, drama, doubles, polymaths, and spiritual experiences.

In trying to track down facts and things related to his subject, Phineas finds himself going down some odd pathways, taking him more and more out of the library and into thing-ness, but never far away from magic, either. Like Darwin, Phineas finds literature losing appeal in favor of the natural world and its own magic.

The connection between biography and natural history, we come to see, is the magic of sorting, arranging, classification, taxonomy, order: how meaning is both discovered and made and named. (A fascinating bit involves some beautiful glass marbles and a list of names, with endless attempts to rearrange both names and marbles in a way that makes sense.) But our systems also have real-world effects, as a passionate bee taxonomist makes Phineas understand.

I'm making the book sound too remote and intellectual, but in fact it's deeply involving, as much as Phineas tries not to make the book about himself, and often quite funny. There's a strange and wonderful episode involving a sinister customer at the travel guide shop where Phineas works, for example. I loved this book.

I also loved it because this was all right up my alley: my PhD dissertation, had I written it, was going to be about literary biography and how biographers resconstruct lives, and bodies of work, in terms of literary genres like comedy, tragedy, farce, and so on. Byatt provides tons to chew on in considering the biographer's art, and the chewing is delicious.

The Hilliker Curse: My Pursuit of Women by James Ellroy

This is a second memoir from Ellroy, following My Dark Places in 1996. I'm a fan of his L.A. noir crime novels; My Dark Places was a pretty fascinating investigation into Ellroy's childhood and his mother's murder when he was 10, something that's strongly shaped the rest of his life.

Hilliker was Ellroy's mother's maiden name, and the curse is that three months before her murder, he wished her dead during a big argument. He believes at some deep-down level that he's gotten what he wants in life at the cost of his mother's life.

A lot of this memoir retreads the same ground as My Dark Places, retailing Ellroy's creepy adolescence as a window peeper, shoplifter, and compulsive masturbator. And Ellroy's adulthood--even with him cleaned up, rich, and famous--is just as creepy.

It turns out that he spends most of non-work life holed up in dark rooms, listening to music and fantasizing about women. Sometimes they're real women; sometimes it's a woman he saw briefly once somewhere, and has constructed a whole fantasy around. Often they are, like his dead mother, tall and red-haired. On a book tour through Europe, he yanks the drapes shut in his Paris or Rome hotel room, turns off the lights, and "broods," because travel is stupid and boring compared to fantasizing.

Such arrogance always lies alongside Ellroy's frequent acknowledgements of being unlikeable, uncouth, selfish, and so on. He presents these qualities as if they have nothing to do with him, anymore than eye color or height.

He often talks about wanting to "contain" the women in his life (real or fantasy) and his fantasies overwhelmingly involve rescuing these women. It doesn't take Freud to see how this all connects back to his mother, to yearning for her and guilt for her. It also seems obvious that the one he wants contained is himself, all curled up in the dark as he is, in another of his womb-like rooms.

Ellroy is a talented novelist, but reading this book becomes increasingly creepy--and also just plain boring. For all the huge drama he puts around his obsessions, they never change. The next woman is always Her.

The Unnamed by Joshua Ferris (2010)

I've been thinking a lot about this one. This book has been widely reviewed, so you probably know the plot: Tim, a successful lawyer, is smitten with a mysterious disease that compels him to take long walks, immediately and no matter where he is. He falls into a kind of trance on these walks, and finally falls asleep with exhaustion, wherever his legs lead him.

The first half is brilliant in its exploration of what it's like to have a chronic, mysterious disease. Tim's dilemma reminded me immediately of my own, much less extreme, experience with epilepsy, the sickening feeling after a seizure of it's back, I had another one. (And after I thought that, I find Ferris explicitly making the comparison.) Ferris perfectly evokes the gerbil-wheel frustrations of doctor visits, tests that show nothing, medication that doesn't work, and especially, the cruelty of disappointed hope.

Because Tim's condition has no cure. It's a great virtue in our society to never give up, and that expectation can be just a heavy a burden as the original disease--the idea that one must keep fighting no matter what. Ferris gets this so well, how when hopes have been crushed over and over, hopes are worse than having none.

Ferris makes Tim's condition extreme, I think, in order to explore the suffering we all experience because we're human and have bodies, needs, we can't escape from. Wherever you go--or however far you walk--there you are. Even Tim's literal at times mortification of the flesh can't separate soul from body. Anyone with a serious illness knows this in a way the healthy can't.

Because Ferris wants to explore this honestly, without false hopes or easy answers or God, he gets himself into a bind. I think that's why the second half of the novel is so unfocused, as aimless as Tim's wanderings. Every episode or ending that occurs to Ferris--Tim returns to his dying wife, Tim gets answers on an old client, Tim reconnects with his daughter, Tim for some reason reaches out to a security guard from his law building--fades away into nothing much. No epiphanies. No miracle cures.

Ferris's bind arises because he wants to be honest, and good storytelling is inherently dishonest in how it imposes a meaningful pattern. That's what we love stories for. They have a beginning, a middle, and an end, and each leads to the other and makes sense of the whole. But suffering doesn't make sense. It just is.

What Ferris says is true (the way I read it) but the problem is, noble truths like Buddha's "life is suffering--get over it" (loose translation) aren't very dramatic.

But I was amazed by this book. The word that kept coming to mind was "perceptive." I can't believe how well a young writer can understand middle age and its indignities. I was even more impressed by Ferris's earlier novel Then We Came to the End, and I'll certainly be watching for his next one.