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In the prologue of The Center Cannot Hold, Elyn Saks immediately introduces the imagery of her disorder, madness, mayhem, apocalypse, and guilt. With her first question—“Have you ever killed anyone?”—she presents a murderous-mindedness in the midst of self/other confusion. In her feverish, psychotically commandeered mind, in which her superego runs amok, her two companions morph into “partners in crime.” The room/roof architecture dissolves, to be replaced by areas of safety and danger. She introduces her origins ominously as golden Florida lemons metaphorically morph into dark demons. There is paranoid talk of “casing the joint” as her friends ambiguously become linked in a psychotic mind crime. A piece of wire is found and secreted along with a nail. Are they for protection or assault, for self-defense or to inflict mayhem? Throughout her story this question hovers around her intents—an enduring psychotic confusion. By the time Elyn reaches the hospital, her internal collapse is complete, and the psychotic betrayal that set firestorms in her mind and consumed most of her rational self has been projected onto the hospital staff. The actions of the staff, rough handling and callous, insensitive interactions, play into her persecutory anxieties. Their maneuvers, ostensibly taken to protect her and them from unbridled instinctual rage, are more easily interpreted by her as abusive and demonic. This distrust of staff through many hospitalizations and psychotic iterations seems to be more than mere paranoia. A neurophysiological collapse in the functioning of the brain is almost inevitably read by what is left of a meaning-making mind as a catastrophic helplessness in the face of tyrannical external authorities, rather than internal chaos.
Elyn Saks takes the title of her memoir from Yeats's “The Second Coming” (1920), a song of fury about a loveless world of Christian decay. Curiously, Saks uses the American spelling “center,” with consonants bracketing the word, rather