Book Review: The Center Cannot Hold

I just finished reading the National Bestseller “The Center Cannot Hold” by Elyn R. Saks.  Saks is a Dean, law professor, psychanalyst, mental health advocate, and an individual who has lived her entire adult life with schizophrenia.

In “The Center Cannot Hold” Saks begins with a prolog that gives you an idea of what her illness is to become.  She then starts chapter one by talking about her childhood in sunny Miami.  Though not a drug addict, her parents sent her to an afterschool facility that was anti substance, whether that substance be drugs, alcohol, or prescription medication.

Saks’ educational journey started at Vanderbilt University; while there she began having mild symptoms of her illness.  After graduating from Vanderbilt, Saks moved to England and began attending Oxford.  While at Oxford, Saks experienced her first true episode of schizophrenia.  While there she was hospitalized and started psychoanalysis.

Saks discusses her illness, and her struggle to accept that it exists throughout the book.  This struggle to accept her illness started from her first episode.  Despite her illness causing her to miss time at Oxford, Saks was still able to not only graduate, but to exceedingly well while at Oxford.

Saks next went to Yale to study law and received her Juris Doctorate (JD).  It was during this time that she was hospitalized for the first time in the United States.  The reader immediately sees what the difference is in treatment is between the UK and the US.  For her entire stay in the hospital at Oxford Saks was not once restrained.  In the US, restraints were liberally used on the mentally ill at the time.  Some even believed that the restraints were therapeutic.

Saks details the horror and anguish that being restrained for hours at a time caused.  Since Saks did not believe she was ill, she often tried to refuse medication.  There were times that she was restrained and injected, all the while being told it was for her own good.

Due to her illness and her hospitalizations she had to miss a few years of law school.  Despite this, she once again graduated with honors.  It was while at law school that Saks started to take an interested in Mental Health law.

Saks was interested in a patients right to refuse treatment, especially the right to not take medication.  This academic interest paralleled her personal life, where she was almost constantly trying to tapper off her meds.

Where many may have given up due to the struggles they suffered due to their mental illness, Saks kept going.  She moved to Los Angeles which is where she worked for the rest of her career.  Saks did an admirable job of balancing intensive treatment for her illness while keeping her career a top priority.  In addition, throughout the book the reader learns of some truly wonderful friendships she forges along her way.

Saks’ book is both a look at the growth of the mental health system in the United States, as well as a story of hope.  During and after her hospitalizations, Saks’ prognosis was poor at best, but through hard work, abundant resources, and supportive friends, Saks was able to have an amazing career.

I highly recommend this book to anyone who wants to learn more about living with schizophrenia, or who just enjoys well written memoirs.

Click on the image below to order the book from Amazon.


  1. I have this book, read it a few years ago. It’s great. Her therapist (I think in Oxford? I can’t remember), was amazing. That fact that her therapist could reflect what she THOUGHT Saks was telling her in her disorganization, and continue that session after session, is a sign of someone truly understanding what it’s like to be in that mind state. I’ve been there before, blabbering “nonsense”, I’ve had my ins and outs with delusions and hallucinations and now that I do outreaches in Psychiatric hospitals to share about the peer respite house I work for, I use that same technique and it’s great. People think just because we’re gone babbling nonsense that we don’t need some kind of catharsis, some kind of gentle understanding. That kind of connection has done more for me in the past than medication ever has.
    Which says a lot, considering I’m not on any now.


    • It’s so great to hear of such a positive experience with talk therapy and your recovery! I agree, Saks’ psychoanalyst in Oxford was great. It’s so important to feel valued and understood, especially when your words don’t always make perfect sense to the average person.

      Liked by 1 person

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