Elyn Saks, J.D., Ph.D., the University of Southern California (USC) law professor who became famous after publicly revealing the story of her life-long struggle with schizophrenia, continues to make news as she goes about allocating the $500,000 grant she was awarded when named a MacArthur Fellow.
Last month, Saks, in conjunction with her grant committee, awarded the first of a planned series of grants aimed at humanizing the treatment of schizophrenia by advancing the application of psychoanalysis to the psychotherapeutic treatment of individuals suffering with psychoses. “I'd been so helped by psychoanalysis myself,” Saks said in an interview, “that I wanted to give back in whatever way I could.”
Initially opposed to the idea of being medicated, Saks alternately elected to undergo psychoanalysis, which she credits with having helped her live a fruitful and productive life…
In her 2007 best-seller, The Center Cannot Hold: My Journey Through Madness, Saks exquisitely details what life had been like from the time she suffered the first of many psychotic breaks at the age of 21 while studying in a master's program in philosophy at Oxford. Initially opposed to the idea of being medicated, Saks alternately elected to undergo psychoanalysis, which she credits with having helped her live a fruitful and productive life in spite of the rigors of schizophrenia that all too often sideline those similarly afflicted. Her first analysis, with an English Kleinian analyst, lasted three years and was conducted on a five-day-a-week basis. After returning to the States, Saks continued her analysis with a more “classically-oriented” ego psychoanalyst and is presently in treatment with an analyst she refers to as “more mentalization-based.” Fascinated and impressed with the power of psychoanalysis, Saks went on to study psychoanalysis at the New Center for Psychoanalysis (NCP) in Los Angeles, earning a research Ph.D. in psychoanalytic science in 2010.
While Saks struggled mightily with the question of whether to go public with her condition, she now feels that doing so was well worth the risk. Appearing in a number of nationally televised interviews has provided Saks a forum to educate the public about the plight of patients suffering from severe mental illness. Triumphing over the inherent indignity of involuntary psychiatric hospitalization and mechanical restraint, Saks has gone on to become a strong advocate for the humanization of the treatment of severe mental illness and the destigmatization of the plight of those like her who struggle with hallucinations and delusions that frighten and confuse the public.
Though she had already become an effective spokesperson for this largely disenfranchised group of patients with the publication of her book, Refusing Care: Forced Treatment and the Rights of the Mentally Ill, becoming a MacArthur Fellow furthered Saks's ability to make a difference in the lives of psychotic patients. Each year the John D. and Catherine T. MacArthur Foundation identifies 20-25 individuals working in a wide variety of fields who have demonstrated exceptional creativity and seem likely to continue to make significant contributions given their proven track record. MacArthur Fellows are each awarded $500,000 to do with as they please. When USC celebrated the announcement of her award, which is also referred to as “the genius grant” given the intellectual caliber of those chosen to receive the honor, Saks was given a T-shirt showing her face aside that of Albert Einstein beneath which was written: “Only one is a certified genius.” Without missing a beat, Saks quickly quipped: “I've been certified many times in the past but never in quite this way.”
Flush with grant funds, Saks went to work deciding how best to use the money. Having trained at NCP, Saks decided to award grants to clinicians in psychoanalytic training at NCP who demonstrate an active interest in treating patients suffering with psychosis. Last December, the first of five Saks Scholarship grants was awarded to psychologist Jill Lummus, a fifth-year clinical associate whose practice is largely focused on treating this particular population of patients. Lummus, who grew up around family members with severe mental illness, had became comfortable with the manifestations of psychosis, which gave her the personal comfort and grounding needed to treat those who suffer with psychosis. The grant comes with the stipulation that recipients educate other clinicians by publishing papers or lecturing on the subject.
Richard Tuch, M.D., is dean of training, the New Center for Psychoanalysis, Los Angeles; training and supervising analyst at the New Center for Psychoanalysis and the Psychoanalytic Center of California; clinical professor of psychiatry, David Geffen School of Medicine, UCLA.
Beyond granting scholarship funds to NCP trainees, Saks earmarked some of the MacArthur funds to establish the Saks Institute for Mental Health, Law, Policy, and Ethics at USC, which is dedicated to improving the lives of those suffering with psychosis. April 11-12, the institute will hold a conference in Los Angeles focused on the criminalization of mental illness. Psychiatric patients increasingly end up incarcerated, which Saks calls “a national scandal and tragedy,” noting that the Los Angeles County Jail and Riker's Island in New York City have become two of our country's largest psychiatric facilities. Saks has also begun to study the lives of individuals who, like her, go on to become remarkably accomplished and remain highly productive in spite of the fact that they grapple with hallucinations and delusions on a daily basis.
In an era when the pharmacologic approach to schizophrenia predominates, it is heartening to hear that efforts are being made to advance the application of psychoanalytic principles to the treatment of these conditions. In spite of the pharmacologic advances made in the treatment of schizophrenia, many of those suffering from this illness remain quite disabled. Though she had initially refused to take medication, Saks ultimately agreed to permit her doctors to pharmacologically supplement her ongoing psychoanalytic treatment. Medication has made it easier for her to cope with hallucinations and delusions, admits Saks, but she remains steadfast in her belief that psychoanalytic treatment has made a world of difference helping her live without becoming dragged down into the mire of potentially derailing thoughts and the disquieting noise of the voices within.
Colleagues at NCP routinely comment not only on the warmth of her personality but also on her substantial intellect. Saks graduated summa cum laude from Vanderbilt University, where she was class valedictorian. She studied philosophy at Oxford University as a Marshall Scholar, then went on to receive her J.D. from Yale University.
While she does not evidence the common and obvious outward signs of schizophrenia, such as flat affect, bizarre behavior, interpersonal disengagement, and a preoccupation with distracting internally generated stimuli, Saks nevertheless found herself ostracized when certain of her friends learned of her condition. “Society always marginalizes people who are different,” Saks notes, adding that certain of her friends looked confused, even scared when she told them about her illness. “I lost some friends, which was quite painful,” admits Saks. “As a result, I understand firsthand the effect stigma can have. Stigma is out there and it makes people feel damaged, lesser. It encourages people to remain in the closet and, worst of all, deters them from accepting their illness and getting the help they desperately need.”
When it comes to enlightenment, the history of public attitudes toward mental illness has been one of two steps forward and one step back. A deranged mind has a way of playing havoc with the public's sense of safety and security. Someone running amok, as happened recently with the senseless massacre of young, innocent children and adults, is a tragedy on many fronts—particularly when the perpetrator is identified as a person suffering from mental illness. In its wake, the subtle backlash of fear threatens to again render the mentally ill as victims. Against this backdrop, the triumphant narrative of Saks's life is an inspiration as well as a testament to the positive and constructive attempts at restitution, making her evolving story worth retelling.