65 pages 2 hours read

Elyn R. Saks

The Center Cannot Hold: My Journey Through Madness

Nonfiction | Autobiography / Memoir | Adult | Published in 2007

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Important Quotes

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“I’ve sweated through my share of nightmares, and this is not the first hospital I’ve been in. But this is the worst ever. Strapped down, unable to move, and doped up, I can feel myself slipping away. I am finally powerless.”


(Prologue, Page 4)

In the prologue, Elyn recounts her experience of being hospitalized for a psychotic episode at Yale. She terms it her worst experience owing to being forcibly restrained and made to take medication. At the very outset, Elyn calls attention to the lack of autonomy and respect accorded to patients in mental institutions, something that is particularly painful to her.

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“…explaining what I’ve come to call ‘disorganization’ is a different challenge altogether. Consciousness gradually loses its coherence. One’s center gives way. The center cannot hold. The ‘me’ becomes a haze, and the solid center from which one experiences reality breaks up like a bad radio signal.”


(Chapter 1, Page 13)

Elyn recounts her first encounter with psychosis, a moment in her childhood where she experiences a disconnect with the physical reality around her. Her description of this experience is vivid and detailed, as she explains how one loses the “vantage point” from which to make sense of the world. This experience, and Elyn’s description of it, is what gives birth to the book’s title.

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“Most of us figure out, as we grow up, that we will ultimately belong to (or struggle with) two families: the one we’re born into and the one we make. […] For me, the process of making the second family began at the Center. We all had something in common—committing to live in a world without using drugs, without, in fact, relying on anything artificial or chemical in order to get through our days.”


(Chapter 2, Page 30)

Although initially resentful of it, Elyn eventually grows comfortable at Operation Re-Entry. This particular passage highlights two important things: Elyn’s need for and delight in a social group or community, and the genesis of her negative attitude towards drugs and medication. The former stands her in good stead throughout her illness, while the latter presents substantial obstacles along the way.