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Four Lessons to Learn from “The Center Cannot Hold”



I recently read The Center Cannot Hold by Elyn R. Saks, an autobiography about the Yale-educated law professor’s life-long struggle with schizophrenia. It would be easy to write a book review, judging the work solely on its entertainment value and well-crafted prose. Yet, the core of the book contains serious messages about mental health, mental illness and humanity that cannot be explored with a simple book review. I may not have a mental illness, but I found that I could still learn from Elyn’s writing. While reading The Center Cannot Hold, I noticed several reoccurring messages that made me take stock of my own life and my own mental health. These messages were able transcend the topic of mental illness speaking truthfully about the human condition so that anyone can learn from them.


Four Lessons to Learn from The Center Cannot Hold 


1. Failure is a part of life

The book gives a detailed account of Elyn’s life starting in childhood when she began to feel the first signs of what would later be diagnosed as schizophrenia. After a slight teenage rebellion that included some experimentation with marijuana, Elyn found herself thrown in a grueling rehab program for “troubled youths”. Here Elyn internalized a harsh and unrealistic value system that hinged on two beliefs: “All drugs, including medication, are bad” and “If you try hard enough you can always win”. As Elyn grew into young adulthood, she struggled to take her psychiatric medication as she felt if she just tried harder she would be able to conquer her psychosis sans-pills. She interpreted her need for medication as weakness and failure. As she grew older, she realized that her medication was helping her and her mental illness was something she had to manage not conquer.

This is an important message for everyone to hear. We live in a culture that praises achievement and perseverance but this can lead to internal dilemmas as so many of us will fail at something and feel ashamed by it. I don’t want to discourage anyone from optimistically pursuing their goals but, I want to make it clear that failure is inevitable and normal. We should grow from our failures and learn how to manage our problems instead of always trying to fight them.

2. Know your triggers

Elyn has spent most of her life in academia which meant that there was a clear pattern to the year: two semesters and a long summer break. It was during these summer breaks that Elyn would have the hardest time with her disorder. The change from her active and engaging life on campus would suddenly come to a close and she found herself isolated and bored back home with her parents.

This prompted me to look at the times in my life I was the most miserable and when I was the happiest. I noticed my triggers were a noisy chaotic living situation (the dorms), a full and inflexible schedule and a lack of self-care. At the time, I thought I could just push through without adequate sleep, healthy meals or letting myself relax. Now I know that what types of situations cause me discomfort and how I can prepare for and recover from them. When my calendar gets full and I feel the first affects of stress on my mind, I know I need to put my self care: I schedule alone time, I treat myself to my favorite food, I get in a massage or workout. I encourage everyone to look at their life and take note of what situations or circumstances have caused them most distress.

3. Pay attention to all sides of your self

Elyn’s psychoanalyst helped her discover this very profound piece of advice. He points out that there are three parts to herself: one that focuses on career, one that focuses on her mental illness and one that focuses on her inner needs. She realizes that she gave all of her time and energy to the professional self and the mentally ill self but neglected everything else. When she started to incorporate self-care and some socializing in her life, she noted that she did see some improvement in her condition. This message can ring to true for anyone but it is especially important for someone with a mental health disorder.

Sometimes a person’s diagnosis and the stigma surrounding mental illness become so ingrained in his or her identity that other parts of life fade into the background. This was often true for Elyn. Not only did she spend tremendous amounts of energy preventing her mental illness from affecting her work, she would read the notes doctors were leaving in her medical chart and would become very upset by what they were saying about her. Her psychoanalyst helped realize there was an “Elyn” outside of her work and her diagnosis.

4. Be kind, you don’t know what might be plaguing others

People who did not know about Elyn’s psychiatric condition would often make cruel and ignorant comments about mental illness. From a student declaring she would never trust someone on psychiatric medication to be capable of working to a professor stating that people who are psychotic don’t experience suffering like “the rest of us”. No matter how “normal” or highly functioning people may seem on the outside, it is impossible to know what they struggle with in silence. It could be a mental health issue, a chronic illness, a past trauma, or ongoing troubles with their family members. The point is to be compassionate instead of judgmental whenever possible. It may appear that others are effortless going through life when in reality they could be using all their strength just to get through the day. Quoting Sigmund Freud, Elyn says “people wit mental illness want what we all want, to work and to love.”


I highly recommend Elyn Saks’ The Center Cannot Hold as it gives the reader a powerful account of a severe mental health disorder. This book has and still can do wonders for the mental health community as it brings empathy and understanding to something that is often marginalized in our society. For those who have loved ones with a mental health disorder, especially a psychotic-related disorder, it is a good way to gain insight their experience. I hope the readers of this book take away the message that mental health and mental illness are a legitimate part of the human experience–one that is full of joys, miseries, challenges and triumphs.

Learn more about Elyn Saks’ experience through her viral TEDTalk: A Tale of Mental Illness.

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The Center Cannot Hold: My Journey Through Madness
Schizophrenia Symptoms & Treatment

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4 thoughts on “Four Lessons to Learn from “The Center Cannot Hold”

  1. Rick Klimowicz says:

    I appreciated the autobiography and the Ted Talk, as well. Thank you for your review…

    Elyn Saks’s compelling account of her struggle with mental illness helps me to better understand the people I work with on a daily basis and the sister in my household growing up who has a mental disorder too.

  2. Veronique Hoebeke, Associate Editor says:

    Thanks for commenting, Rick. I’m glad you liked the review. Elyn’s story is an important and powerful one.

  3. Denise Vestuti, Resource Specialist says:

    Veronique I finished Ellen Saks book “The Center Cannot Hold” and I think you wrote a brilliant piece. In my opinion her book should be on the top 10 books to read on mental health. Her incredibly honest and powerfully written book has me thinking even more about the importance of relationships, all types’ friendships, professional, therapeutic, personal and family. All of these relationships can contribute to one’s health and wellbeing.

  4. Laura Herold says:

    I am cleaning out hundreds of my Mothers books. She died from Alzheimers 3 years ago and this task is now mine alone. The last book I touched was THE CENTER CANNOT HOLD by DR SAKS. I found her on TED and watched the taIk. I now realize my Mother has quite a few books on schizophrenia in her collection. Hmmm I ask myself was this part of her mental illness?

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