A tale of mental illness -- from the inside
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0:01 - 0:03So I'm a woman with chronic schizophrenia.
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0:03 - 0:05I've spent hundreds of days
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0:05 - 0:06in psychiatric hospitals.
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0:06 - 0:08I might have ended up spending
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0:08 - 0:10most of my life on the back ward of a hospital,
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0:10 - 0:12but that isn't how my life turned out.
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0:12 - 0:15In fact, I've managed to stay clear of hospitals
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0:15 - 0:17for almost three decades,
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0:17 - 0:19perhaps my proudest accomplishment.
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0:19 - 0:21That's not to say that I've remained clear
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0:21 - 0:23of all psychiatric struggles.
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0:23 - 0:25After I graduated from the Yale Law School and
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0:25 - 0:28got my first law job, my New Haven analyst, Dr. White,
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0:28 - 0:31announced to me that he was going to close his practice
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0:31 - 0:32in three months, several years
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0:32 - 0:34before I had planned to leave New Haven.
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0:34 - 0:37White had been enormously helpful to me,
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0:37 - 0:38and the thought of his leaving
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0:38 - 0:40shattered me.
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0:40 - 0:41My best friend Steve,
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0:41 - 0:43sensing that something was terribly wrong,
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0:43 - 0:45flew out to New Haven to be with me.
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0:45 - 0:47Now I'm going to quote from some of my writings:
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0:47 - 0:50"I opened the door to my studio apartment.
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0:50 - 0:52Steve would later tell me that,
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0:52 - 0:54for all the times he had seen me psychotic, nothing
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0:54 - 0:56could have prepared him for what he saw that day.
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0:56 - 0:59For a week or more, I had barely eaten.
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0:59 - 1:02I was gaunt. I walked
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1:02 - 1:03as though my legs were wooden.
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1:03 - 1:06My face looked and felt like a mask.
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1:06 - 1:09I had closed all the curtains in the apartment, so
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1:09 - 1:10in the middle of the day
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1:10 - 1:12the apartment was in near total darkness.
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1:12 - 1:15The air was fetid, the room a shambles.
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1:15 - 1:18Steve, both a lawyer and a psychologist, has treated
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1:18 - 1:21many patients with severe mental illness, and to this day
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1:21 - 1:24he'll say I was as bad as any he had ever seen.
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1:24 - 1:27'Hi,' I said, and then I returned to the couch,
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1:27 - 1:29where I sat in silence for several moments.
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1:29 - 1:31'Thank you for coming, Steve.
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1:31 - 1:35Crumbling world, word, voice.
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1:35 - 1:37Tell the clocks to stop.
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1:37 - 1:39Time is. Time has come.'
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1:39 - 1:42'White is leaving,' Steve said somberly.
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1:42 - 1:45'I'm being pushed into a grave. The situation is grave,' I moan.
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1:45 - 1:47'Gravity is pulling me down.
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1:47 - 1:49I'm scared. Tell them to get away.'"
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1:49 - 1:53As a young woman, I was in a psychiatric hospital
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1:53 - 1:55on three different occasions for lengthy periods.
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1:55 - 1:58My doctors diagnosed me with chronic schizophrenia,
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1:58 - 2:01and gave me a prognosis of "grave."
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2:01 - 2:04That is, at best, I was expected to live in a board and care,
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2:04 - 2:06and work at menial jobs.
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2:06 - 2:08Fortunately, I did not actually
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2:08 - 2:10enact that grave prognosis.
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2:10 - 2:13Instead, I'm a chaired Professor of Law, Psychology
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2:13 - 2:15and Psychiatry at the USC Gould School of Law,
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2:15 - 2:17I have many close friends
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2:17 - 2:20and I have a beloved husband, Will, who's here with us today.
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2:20 - 2:25(Applause) Thank you.
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2:27 - 2:30He's definitely the star of my show.
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2:30 - 2:33I'd like to share with you how that happened, and also
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2:33 - 2:35describe my experience of being psychotic.
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2:35 - 2:38I hasten to add that it's my experience,
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2:38 - 2:41because everyone becomes psychotic in his or her own way.
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2:41 - 2:44Let's start with the definition of schizophrenia.
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2:44 - 2:46Schizophrenia is a brain disease.
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2:46 - 2:48Its defining feature is psychosis, or being
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2:48 - 2:50out of touch with reality.
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2:50 - 2:52Delusions and hallucinations
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2:52 - 2:53are hallmarks of the illness.
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2:53 - 2:56Delusions are fixed and false beliefs that aren't responsive
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2:56 - 3:00to evidence, and hallucinations are false sensory experiences.
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3:00 - 3:02For example, when I'm psychotic I often have
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3:02 - 3:04the delusion that I've killed hundreds of thousands
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3:04 - 3:06of people with my thoughts.
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3:06 - 3:08I sometimes have the idea that
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3:08 - 3:10nuclear explosions are about to be set off in my brain.
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3:10 - 3:12Occasionally, I have hallucinations,
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3:12 - 3:14like one time I turned around and saw a man
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3:14 - 3:16with a raised knife.
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3:16 - 3:19Imagine having a nightmare while you're awake.
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3:19 - 3:22Often, speech and thinking become disorganized
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3:22 - 3:23to the point of incoherence.
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3:23 - 3:26Loose associations involves putting together words
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3:26 - 3:29that may sound a lot alike but don't make sense,
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3:29 - 3:31and if the words get jumbled up enough, it's called "word salad."
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3:31 - 3:36Contrary to what many people think, schizophrenia is not
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3:36 - 3:39the same as multiple personality disorder or split personality.
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3:39 - 3:43The schizophrenic mind is not split, but shattered.
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3:43 - 3:45Everyone has seen a street person,
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3:45 - 3:47unkempt, probably ill-fed,
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3:47 - 3:50standing outside of an office building muttering
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3:50 - 3:52to himself or shouting.
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3:52 - 3:54This person is likely to have some form of schizophrenia.
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3:54 - 3:57But schizophrenia presents itself across a wide array
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3:57 - 4:00of socioeconomic status, and there are people
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4:00 - 4:02with the illness who are full-time professionals
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4:02 - 4:04with major responsibilities.
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4:04 - 4:06Several years ago, I decided
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4:06 - 4:09to write down my experiences and my personal journey,
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4:09 - 4:11and I want to share some more of that story with you today
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4:11 - 4:13to convey the inside view.
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4:13 - 4:16So the following episode happened the seventh week
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4:16 - 4:19of my first semester of my first year at Yale Law School.
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4:19 - 4:21Quoting from my writings:
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4:21 - 4:24"My two classmates, Rebel and Val, and I had made the date
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4:24 - 4:27to meet in the law school library on Friday night
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4:27 - 4:30to work on our memo assignment together.
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4:30 - 4:31But we didn't get far before I was talking in ways
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4:31 - 4:33that made no sense.
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4:33 - 4:36'Memos are visitations,' I informed them.
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4:36 - 4:39'They make certain points. The point is on your head.
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4:39 - 4:41Pat used to say that. Have you killed you anyone?'
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4:41 - 4:43Rebel and Val looked at me
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4:43 - 4:45as if they or I had been
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4:45 - 4:46splashed in the face with cold water.
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4:46 - 4:48'What are you talking about, Elyn?'
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4:48 - 4:51'Oh, you know, the usual. Who's what, what's who,
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4:51 - 4:53heaven and hell. Let's go out on the roof.
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4:53 - 4:55It's a flat surface. It's safe.'
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4:55 - 4:56Rebel and Val followed
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4:56 - 4:58and they asked what had gotten into me.
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4:58 - 5:00'This is the real me,' I announced,
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5:00 - 5:01waving my arms above my head.
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5:01 - 5:04And then, late on a Friday night, on the roof
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5:04 - 5:05of the Yale Law School,
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5:05 - 5:07I began to sing, and not quietly either.
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5:07 - 5:10'Come to the Florida sunshine bush.
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5:10 - 5:12Do you want to dance?'
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5:12 - 5:14'Are you on drugs?' one asked. 'Are you high?'
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5:14 - 5:17'High? Me? No way, no drugs.
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5:17 - 5:19Come to the Florida sunshine bush,
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5:19 - 5:22where there are lemons, where they make demons.'
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5:22 - 5:25'You're frightening me,' one of them said, and Rebel and Val
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5:25 - 5:27headed back into the library.
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5:27 - 5:29I shrugged and followed them.
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5:29 - 5:32Back inside, I asked my classmates if they were
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5:32 - 5:35having the same experience of words jumping around
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5:35 - 5:36our cases as I was.
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5:36 - 5:40'I think someone's infiltrated my copies of the cases,' I said.
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5:40 - 5:42'We've got to case the joint.
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5:42 - 5:43I don't believe in joints, but
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5:43 - 5:45they do hold your body together.'" --
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5:45 - 5:47It's an example of loose associations. --
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5:47 - 5:49"Eventually I made my way back to my dorm room,
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5:49 - 5:52and once there, I couldn't settle down.
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5:52 - 5:54My head was too full of noise,
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5:54 - 5:57too full of orange trees and law memos I could not write
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5:57 - 6:00and mass murders I knew I would be responsible for.
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6:00 - 6:03Sitting on my bed, I rocked back and forth,
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6:03 - 6:05moaning in fear and isolation."
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6:05 - 6:08This episode led to my first hospitalization in America.
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6:08 - 6:11I had two earlier in England.
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6:11 - 6:12Continuing with the writings:
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6:12 - 6:15"The next morning I went to my professor's office to ask
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6:15 - 6:16for an extension on the memo assignment,
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6:16 - 6:18and I began gibbering unintelligably
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6:18 - 6:20as I had the night before,
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6:20 - 6:21and he eventually brought me to the emergency room.
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6:21 - 6:25Once there, someone I'll just call 'The Doctor'
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6:25 - 6:27and his whole team of goons swooped down,
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6:27 - 6:29lifted me high into the air,
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6:29 - 6:30and slammed me down on a metal bed
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6:30 - 6:33with such force that I saw stars.
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6:33 - 6:35Then they strapped my legs and arms to the metal bed
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6:35 - 6:37with thick leather straps.
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6:37 - 6:40A sound came out of my mouth that I'd never heard before:
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6:40 - 6:42half groan, half scream,
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6:42 - 6:46barely human and pure terror.
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6:46 - 6:47Then the sound came again,
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6:47 - 6:49forced from somewhere deep inside my belly
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6:49 - 6:51and scraping my throat raw."
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6:51 - 6:55This incident resulted in my involuntary hospitalization.
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6:55 - 6:59One of the reasons the doctors gave for hospitalizing me
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6:59 - 7:00against my will was that I was
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7:00 - 7:01"gravely disabled."
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7:01 - 7:04To support this view, they wrote in my chart that I was unable
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7:04 - 7:06to do my Yale Law School homework.
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7:06 - 7:09I wondered what that meant about much of the rest of New Haven.
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7:09 - 7:11(Laughter)
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7:11 - 7:13During the next year, I would
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7:13 - 7:16spend five months in a psychiatric hospital.
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7:16 - 7:19At times, I spent up to 20 hours in mechanical restraints,
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7:19 - 7:23arms tied, arms and legs tied down,
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7:23 - 7:25arms and legs tied down with a net tied
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7:25 - 7:27tightly across my chest.
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7:27 - 7:29I never struck anyone.
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7:29 - 7:32I never harmed anyone. I never made any direct threats.
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7:32 - 7:35If you've never been restrained yourself, you may have
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7:35 - 7:37a benign image of the experience.
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7:37 - 7:39There's nothing benign about it.
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7:39 - 7:41Every week in the United States,
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7:41 - 7:44it's been estimated that one to three people die in restraints.
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7:44 - 7:47They strangle, they aspirate their vomit,
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7:47 - 7:49they suffocate, they have a heart attack.
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7:49 - 7:51It's unclear whether using mechanical restraints
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7:51 - 7:54is actually saving lives or costing lives.
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7:54 - 7:57While I was preparing to write my student note
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7:57 - 7:59for the Yale Law Journal on mechanical restraints,
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7:59 - 8:01I consulted an eminent law professor who was also
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8:01 - 8:02a psychiatrist,
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8:02 - 8:04and said surely he would agree
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8:04 - 8:06that restraints must be degrading,
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8:06 - 8:08painful and frightening.
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8:08 - 8:10He looked at me in a knowing way, and said,
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8:10 - 8:12"Elyn, you don't really understand:
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8:12 - 8:14These people are psychotic.
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8:14 - 8:15They're different from me and you.
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8:15 - 8:18They wouldn't experience restraints as we would."
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8:18 - 8:21I didn't have the courage to tell him in that moment that,
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8:21 - 8:23no, we're not that different from him.
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8:23 - 8:25We don't like to be strapped down to a bed
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8:25 - 8:28and left to suffer for hours any more than he would.
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8:28 - 8:30In fact, until very recently,
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8:30 - 8:32and I'm sure some people still hold it as a view,
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8:32 - 8:35that restraints help psychiatric patients feel safe.
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8:35 - 8:37I've never met a psychiatric patient
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8:37 - 8:39who agreed with that view.
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8:39 - 8:41Today, I'd like to say I'm very pro-psychiatry
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8:41 - 8:43but very anti-force.
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8:43 - 8:46I don't think force is effective as treatment, and I think
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8:46 - 8:49using force is a terrible thing to do to another person
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8:49 - 8:50with a terrible illness.
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8:50 - 8:53Eventually, I came to Los Angeles
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8:53 - 8:55to teach at the University of Southern California Law School.
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8:55 - 8:58For years, I had resisted medication,
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8:58 - 9:00making many, many efforts to get off.
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9:00 - 9:02I felt that if I could manage without medication,
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9:02 - 9:04I could prove that, after all,
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9:04 - 9:07I wasn't really mentally ill, it was some terrible mistake.
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9:07 - 9:10My motto was the less medicine, the less defective.
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9:10 - 9:13My L.A. analyst, Dr. Kaplan, was urging me
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9:13 - 9:16just to stay on medication and get on with my life,
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9:16 - 9:19but I decided I wanted to make one last college try to get off.
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9:19 - 9:21Quoting from the text:
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9:21 - 9:24"I started the reduction of my meds, and within a short time
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9:24 - 9:27I began feeling the effects.
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9:27 - 9:29After returning from a trip to Oxford, I marched into
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9:29 - 9:33Kaplan's office, headed straight for the corner, crouched down,
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9:33 - 9:35covered my face, and began shaking.
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9:35 - 9:38All around me I sensed evil beings poised with daggers.
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9:38 - 9:40They'd slice me up in thin slices
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9:40 - 9:42or make me swallow hot coals.
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9:42 - 9:45Kaplan would later describe me as 'writhing in agony.'
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9:45 - 9:48Even in this state, what he accurately described as
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9:48 - 9:50acutely and forwardly psychotic,
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9:50 - 9:52I refused to take more medication.
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9:52 - 9:55The mission is not yet complete.
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9:55 - 9:58Immediately after the appointment with Kaplan,
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9:58 - 10:00I went to see Dr. Marder, a schizophrenia expert
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10:00 - 10:02who was following me for medication side effects.
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10:02 - 10:05He was under the impression that I had a mild psychotic illness.
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10:05 - 10:09Once in his office, I sat on his couch, folded over,
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10:09 - 10:10and began muttering.
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10:10 - 10:13'Head explosions and people trying to kill.
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10:13 - 10:15Is it okay if I totally trash your office?'
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10:15 - 10:18'You need to leave if you think you're going to do that,'
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10:18 - 10:19said Marder.
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10:19 - 10:22'Okay. Small. Fire on ice. Tell them not to kill me.
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10:22 - 10:23Tell them not to kill me. What have I done wrong?
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10:23 - 10:26Hundreds of thousands with thoughts, interdiction.'
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10:26 - 10:28'Elyn, do you feel like you're
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10:28 - 10:29dangerous to yourself or others?
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10:29 - 10:32I think you need to be in the hospital.
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10:32 - 10:33I could get you admitted right away, and the whole thing
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10:33 - 10:35could be very discrete.'
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10:35 - 10:36'Ha, ha, ha.
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10:36 - 10:39You're offering to put me in hospitals?
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10:39 - 10:42Hospitals are bad, they're mad, they're sad.
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10:42 - 10:45One must stay away. I'm God, or I used to be.'"
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10:45 - 10:47At that point in the text,
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10:47 - 10:49where I said "I'm God, or I used to be," my husband
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10:49 - 10:50made a marginal note.
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10:50 - 10:51He said, "Did you quit or were you fired?"
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10:51 - 10:54(Laughter)
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10:54 - 10:57"'I give life and I take it away.
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10:57 - 10:59Forgive me, for I know not what I do.'
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10:59 - 11:02Eventually, I broke down in front of friends, and
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11:02 - 11:05everybody convinced me to take more medication.
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11:05 - 11:07I could no longer deny the truth,
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11:07 - 11:08and I could not change it.
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11:08 - 11:11The wall that kept me, Elyn, Professor Saks,
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11:11 - 11:14separate from that insane woman hospitalized years past,
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11:14 - 11:16lay smashed and in ruins."
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11:16 - 11:19Everything about this illness says I shouldn't be here,
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11:19 - 11:22but I am. And I am, I think, for three reasons:
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11:22 - 11:24First, I've had excellent treatment.
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11:24 - 11:27Four- to five-day-a-week psychoanalytic psychotherapy
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11:27 - 11:30for decades and continuing, and excellent psychopharmacology.
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11:30 - 11:34Second, I have many close family members and friends who know me
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11:34 - 11:35and know my illness.
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11:35 - 11:38These relationships have given my life a meaning
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11:38 - 11:40and a depth, and they also helped me navigate
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11:40 - 11:42my life in the face of symptoms.
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11:42 - 11:45Third, I work at an enormously supportive workplace
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11:45 - 11:47at USC Law School.
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11:47 - 11:50This is a place that not only accommodates my needs
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11:50 - 11:51but actually embraces them.
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11:51 - 11:54It's also a very intellectually stimulating place,
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11:54 - 11:57and occupying my mind with complex problems
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11:57 - 12:00has been my best and most powerful and most reliable
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12:00 - 12:02defense against my mental illness.
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12:02 - 12:05Even with all that — excellent treatment, wonderful family and
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12:05 - 12:07friends, supportive work environment —
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12:07 - 12:09I did not make my illness public
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12:09 - 12:11until relatively late in life,
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12:11 - 12:13and that's because the stigma against mental illness
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12:13 - 12:16is so powerful that I didn't feel safe with people knowing.
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12:16 - 12:18If you hear nothing else today,
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12:18 - 12:22please hear this: There are not "schizophrenics."
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12:22 - 12:25There are people with schizophrenia, and these people
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12:25 - 12:27may be your spouse, they may be your child,
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12:27 - 12:29they may be your neighbor, they may be your friend,
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12:29 - 12:31they may be your coworker.
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12:31 - 12:34So let me share some final thoughts.
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12:34 - 12:37We need to invest more resources into research and treatment
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12:37 - 12:38of mental illness.
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12:38 - 12:40The better we understand these illnesses, the better
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12:40 - 12:43the treatments we can provide, and the better the treatments
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12:43 - 12:45we can provide, the more we can offer people care,
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12:45 - 12:47and not have to use force.
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12:47 - 12:49Also, we must stop criminalizing mental illness.
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12:49 - 12:54It's a national tragedy and scandal that the L.A. County Jail
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12:54 - 12:56is the biggest psychiatric facility in the United States.
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12:56 - 13:00American prisons and jails are filled with people who suffer
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13:00 - 13:03from severe mental illness, and many of them are there
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13:03 - 13:05because they never received adequate treatment.
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13:05 - 13:08I could have easily ended up there or on the streets myself.
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13:08 - 13:11A message to the entertainment industry and to the press:
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13:11 - 13:15On the whole, you've done a wonderful job fighting stigma
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13:15 - 13:17and prejudice of many kinds.
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13:17 - 13:20Please, continue to let us see characters in your movies,
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13:20 - 13:22your plays, your columns,
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13:22 - 13:24who suffer with severe mental illness.
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13:24 - 13:26Portray them sympathetically,
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13:26 - 13:28and portray them in all the richness and depth
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13:28 - 13:32of their experience as people and not as diagnoses.
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13:32 - 13:34Recently, a friend posed a question:
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13:34 - 13:36If there were a pill I could take
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13:36 - 13:38that would instantly cure me, would I take it?
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13:38 - 13:41The poet Rainer Maria Rilke
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13:41 - 13:42was offered psychoanalysis.
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13:42 - 13:44He declined, saying, "Don't take my devils away,
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13:44 - 13:46because my angels may flee too."
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13:46 - 13:48My psychosis, on the other hand,
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13:48 - 13:51is a waking nightmare in which my devils are so terrifying
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13:51 - 13:53that all my angels have already fled.
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13:53 - 13:57So would I take the pill? In an instant.
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13:57 - 13:59That said, I don't wish to be seen as regretting
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13:59 - 14:02the life I could have had if I'd not been mentally ill,
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14:02 - 14:04nor am I asking anyone for their pity.
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14:04 - 14:07What I rather wish to say is that the humanity we all share
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14:07 - 14:10is more important than the mental illness we may not.
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14:10 - 14:12What those of us who suffer with mental illness want
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14:12 - 14:14is what everybody wants:
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14:14 - 14:16in the words of Sigmund Freud, "to work and to love."
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14:16 - 14:19Thank you. (Applause)
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14:19 - 14:20(Applause)
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14:20 - 14:25Thank you. Thank you. You're very kind. (Applause)
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14:25 - 14:31Thank you. (Applause)
- Title:
- A tale of mental illness -- from the inside
- Speaker:
- Elyn Saks
- Description:
-
"Is it okay if I totally trash your office?" It's a question Elyn Saks once asked her doctor, and it wasn't a joke. A legal scholar, in 2007 Saks came forward with her own story of schizophrenia, controlled by drugs and therapy but ever-present. In this powerful talk, she asks us to see people with mental illness clearly, honestly and compassionately.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 14:52
Thu-Huong Ha edited English subtitles for A tale of mental illness -- from the inside | ||
Thu-Huong Ha approved English subtitles for A tale of mental illness -- from the inside | ||
Thu-Huong Ha accepted English subtitles for A tale of mental illness -- from the inside | ||
Thu-Huong Ha edited English subtitles for A tale of mental illness -- from the inside | ||
Thu-Huong Ha edited English subtitles for A tale of mental illness -- from the inside | ||
Morton Bast edited English subtitles for A tale of mental illness -- from the inside | ||
Morton Bast edited English subtitles for A tale of mental illness -- from the inside | ||
Joseph Geni edited English subtitles for A tale of mental illness -- from the inside |