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So I'm a woman with chronic schizophrenia.

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I've spent hundreds of days

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in psychiatric hospitals.

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I might have ended up spending

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most of my life on the back ward of a hospital,

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but that isn't how my life turned out.

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In fact, I've managed to stay clear of hospitals

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for almost three decades,

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perhaps my proudest accomplishment.

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That's not to say that I've remained clear

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of all psychiatric struggles.

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After I graduated from the Yale Law School and

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got my first law job, my New Haven analyst, Dr. White,

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announced to me that he was going to close his practice

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in three months, several years

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before I had planned to leave New Haven.

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White had been enormously helpful to me,

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and the thought of his leaving

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shattered me.

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My best friend Steve,

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sensing that something was terribly wrong,

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flew out to New Haven to be with me.

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Now I'm going to quote from some of my writings:

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"I opened the door to my studio apartment.

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Steve would later tell me that,

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for all the times he had seen me psychotic, nothing

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could have prepared him for what he saw that day.

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For a week or more, I had barely eaten.

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I was gaunt. I walked

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as though my legs were wooden.

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My face looked and felt like a mask.

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I had closed all the curtains in the apartment, so

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in the middle of the day

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the apartment was in near total darkness.

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The air was fetid, the room a shambles.

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Steve, both a lawyer and a psychologist, has treated

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many patients with severe mental illness, and to this day

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he'll say I was as bad as any he had ever seen.

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'Hi,' I said, and then I returned to the couch,

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where I sat in silence for several moments.

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'Thank you for coming, Steve.

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Crumbling world, word, voice.

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Tell the clocks to stop.

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Time is. Time has come.'

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'White is leaving,' Steve said somberly.

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'I'm being pushed into a grave. The situation is grave,' I moan.

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'Gravity is pulling me down.

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I'm scared. Tell them to get away.'"

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As a young woman, I was in a psychiatric hospital

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on three different occasions for lengthy periods.

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My doctors diagnosed me with chronic schizophrenia,

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and gave me a prognosis of "grave."

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That is, at best, I was expected to live in a board and care,

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and work at menial jobs.

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Fortunately, I did not actually

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enact that grave prognosis.

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Instead, I'm a chaired Professor of Law, Psychology

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and Psychiatry at the USC Gould School of Law,

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I have many close friends

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and I have a beloved husband, Will, who's here with us today.

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(Applause) Thank you.

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He's definitely the star of my show.

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I'd like to share with you how that happened, and also

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describe my experience of being psychotic.

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I hasten to add that it's my experience,

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because everyone becomes psychotic in his or her own way.

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Let's start with the definition of schizophrenia.

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Schizophrenia is a brain disease.

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Its defining feature is psychosis, or being

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out of touch with reality.

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Delusions and hallucinations

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are hallmarks of the illness.

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Delusions are fixed and false beliefs that aren't responsive

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to evidence, and hallucinations are false sensory experiences.

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For example, when I'm psychotic I often have

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the delusion that I've killed hundreds of thousands

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of people with my thoughts.

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I sometimes have the idea that

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nuclear explosions are about to be set off in my brain.

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Occasionally, I have hallucinations,

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like one time I turned around and saw a man

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with a raised knife.

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Imagine having a nightmare while you're awake.

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Often, speech and thinking become disorganized

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to the point of incoherence.

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Loose associations involves putting together words

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that may sound a lot alike but don't make sense,

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and if the words get jumbled up enough, it's called "word salad."

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Contrary to what many people think, schizophrenia is not

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the same as multiple personality disorder or split personality.

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The schizophrenic mind is not split, but shattered.

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Everyone has seen a street person,

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unkempt, probably ill-fed,

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standing outside of an office building muttering

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to himself or shouting.

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This person is likely to have some form of schizophrenia.

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But schizophrenia presents itself across a wide array

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of socioeconomic status, and there are people

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with the illness who are full-time professionals

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with major responsibilities.

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Several years ago, I decided

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to write down my experiences and my personal journey,

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and I want to share some more of that story with you today

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to convey the inside view.

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So the following episode happened the seventh week

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of my first semester of my first year at Yale Law School.

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Quoting from my writings:

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"My two classmates, Rebel and Val, and I had made the date

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to meet in the law school library on Friday night

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to work on our memo assignment together.

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But we didn't get far before I was talking in ways

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that made no sense.

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'Memos are visitations,' I informed them.

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'They make certain points. The point is on your head.

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Pat used to say that. Have you killed you anyone?'

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Rebel and Val looked at me

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as if they or I had been

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splashed in the face with cold water.

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'What are you talking about, Elyn?'

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'Oh, you know, the usual. Who's what, what's who,

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heaven and hell. Let's go out on the roof.

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It's a flat surface. It's safe.'

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Rebel and Val followed

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and they asked what had gotten into me.

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'This is the real me,' I announced,

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waving my arms above my head.

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And then, late on a Friday night, on the roof

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of the Yale Law School,

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I began to sing, and not quietly either.

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'Come to the Florida sunshine bush.

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Do you want to dance?'

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'Are you on drugs?' one asked. 'Are you high?'

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'High? Me? No way, no drugs.

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Come to the Florida sunshine bush,

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where there are lemons, where they make demons.'

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'You're frightening me,' one of them said, and Rebel and Val

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headed back into the library.

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I shrugged and followed them.

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Back inside, I asked my classmates if they were

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having the same experience of words jumping around

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our cases as I was.

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'I think someone's infiltrated my copies of the cases,' I said.

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'We've got to case the joint.

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I don't believe in joints, but

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they do hold your body together.'" --

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It's an example of loose associations. --

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"Eventually I made my way back to my dorm room,

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and once there, I couldn't settle down.

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My head was too full of noise,

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too full of orange trees and law memos I could not write

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and mass murders I knew I would be responsible for.

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Sitting on my bed, I rocked back and forth,

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moaning in fear and isolation."

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This episode led to my first hospitalization in America.

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I had two earlier in England.

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Continuing with the writings:

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"The next morning I went to my professor's office to ask

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for an extension on the memo assignment,

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and I began gibbering unintelligably

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as I had the night before,

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and he eventually brought me to the emergency room.

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Once there, someone I'll just call 'The Doctor'

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and his whole team of goons swooped down,

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lifted me high into the air,

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and slammed me down on a metal bed

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with such force that I saw stars.

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Then they strapped my legs and arms to the metal bed

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with thick leather straps.

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A sound came out of my mouth that I'd never heard before:

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half groan, half scream,

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barely human and pure terror.

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Then the sound came again,

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forced from somewhere deep inside my belly

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and scraping my throat raw."

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This incident resulted in my involuntary hospitalization.

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One of the reasons the doctors gave for hospitalizing me

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against my will was that I was

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"gravely disabled."

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To support this view, they wrote in my chart that I was unable

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to do my Yale Law School homework.

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I wondered what that meant about much of the rest of New Haven.

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(Laughter)

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During the next year, I would

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spend five months in a psychiatric hospital.

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At times, I spent up to 20 hours in mechanical restraints,

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arms tied, arms and legs tied down,

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arms and legs tied down with a net tied

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tightly across my chest.

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I never struck anyone.

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I never harmed anyone. I never made any direct threats.

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If you've never been restrained yourself, you may have

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a benign image of the experience.

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There's nothing benign about it.

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Every week in the United States,

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it's been estimated that one to three people die in restraints.

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They strangle, they aspirate their vomit,

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they suffocate, they have a heart attack.

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It's unclear whether using mechanical restraints

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is actually saving lives or costing lives.

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While I was preparing to write my student note

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for the Yale Law Journal on mechanical restraints,

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I consulted an eminent law professor who was also

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a psychiatrist,

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and said surely he would agree

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that restraints must be degrading,

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painful and frightening.

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He looked at me in a knowing way, and said,

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"Elyn, you don't really understand:

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These people are psychotic.

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They're different from me and you.

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They wouldn't experience restraints as we would."

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I didn't have the courage to tell him in that moment that,

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no, we're not that different from him.

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We don't like to be strapped down to a bed

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and left to suffer for hours any more than he would.

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In fact, until very recently,

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and I'm sure some people still hold it as a view,

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that restraints help psychiatric patients feel safe.

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I've never met a psychiatric patient

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who agreed with that view.

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Today, I'd like to say I'm very pro-psychiatry

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but very anti-force.

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I don't think force is effective as treatment, and I think

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using force is a terrible thing to do to another person

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with a terrible illness.

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Eventually, I came to Los Angeles

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to teach at the University of Southern California Law School.

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For years, I had resisted medication,

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making many, many efforts to get off.

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I felt that if I could manage without medication,

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I could prove that, after all,

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I wasn't really mentally ill, it was some terrible mistake.

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My motto was the less medicine, the less defective.

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My L.A. analyst, Dr. Kaplan, was urging me

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just to stay on medication and get on with my life,

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but I decided I wanted to make one last college try to get off.

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Quoting from the text:

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"I started the reduction of my meds, and within a short time

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I began feeling the effects.

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After returning from a trip to Oxford, I marched into

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Kaplan's office, headed straight for the corner, crouched down,

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covered my face, and began shaking.

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All around me I sensed evil beings poised with daggers.

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They'd slice me up in thin slices

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or make me swallow hot coals.

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Kaplan would later describe me as 'writhing in agony.'

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Even in this state, what he accurately described as

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acutely and forwardly psychotic,

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I refused to take more medication.

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The mission is not yet complete.

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Immediately after the appointment with Kaplan,

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I went to see Dr. Marder, a schizophrenia expert

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who was following me for medication side effects.

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He was under the impression that I had a mild psychotic illness.

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Once in his office, I sat on his couch, folded over,

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and began muttering.

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'Head explosions and people trying to kill.

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Is it okay if I totally trash your office?'

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'You need to leave if you think you're going to do that,'

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said Marder.

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'Okay. Small. Fire on ice. Tell them not to kill me.

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Tell them not to kill me. What have I done wrong?

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Hundreds of thousands with thoughts, interdiction.'

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'Elyn, do you feel like you're

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dangerous to yourself or others?

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I think you need to be in the hospital.

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I could get you admitted right away, and the whole thing

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could be very discrete.'

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'Ha, ha, ha.

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You're offering to put me in hospitals?

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Hospitals are bad, they're mad, they're sad.

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One must stay away. I'm God, or I used to be.'"

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At that point in the text,

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where I said "I'm God, or I used to be," my husband

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made a marginal note.

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He said, "Did you quit or were you fired?"

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(Laughter)

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"'I give life and I take it away.

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Forgive me, for I know not what I do.'

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Eventually, I broke down in front of friends, and

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everybody convinced me to take more medication.

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I could no longer deny the truth,

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and I could not change it.

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The wall that kept me, Elyn, Professor Saks,

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separate from that insane woman hospitalized years past,

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lay smashed and in ruins."

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Everything about this illness says I shouldn't be here,

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but I am. And I am, I think, for three reasons:

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First, I've had excellent treatment.

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Four- to five-day-a-week psychoanalytic psychotherapy

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for decades and continuing, and excellent psychopharmacology.

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Second, I have many close family members and friends who know me

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and know my illness.

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These relationships have given my life a meaning

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and a depth, and they also helped me navigate

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my life in the face of symptoms.

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Third, I work at an enormously supportive workplace

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at USC Law School.

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This is a place that not only accommodates my needs

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but actually embraces them.

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It's also a very intellectually stimulating place,

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and occupying my mind with complex problems

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has been my best and most powerful and most reliable

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defense against my mental illness.

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Even with all that — excellent treatment, wonderful family and

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friends, supportive work environment —

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I did not make my illness public

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until relatively late in life,

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and that's because the stigma against mental illness

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is so powerful that I didn't feel safe with people knowing.

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If you hear nothing else today,

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please hear this: There are not "schizophrenics."

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There are people with schizophrenia, and these people

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may be your spouse, they may be your child,

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they may be your neighbor, they may be your friend,

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they may be your coworker.

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So let me share some final thoughts.

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We need to invest more resources into research and treatment

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of mental illness.

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The better we understand these illnesses, the better

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the treatments we can provide, and the better the treatments

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we can provide, the more we can offer people care,

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and not have to use force.

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Also, we must stop criminalizing mental illness.

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It's a national tragedy and scandal that the L.A. County Jail

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is the biggest psychiatric facility in the United States.

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American prisons and jails are filled with people who suffer

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from severe mental illness, and many of them are there


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because they never received adequate treatment.

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I could have easily ended up there or on the streets myself.

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A message to the entertainment industry and to the press:

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On the whole, you've done a wonderful job fighting stigma

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and prejudice of many kinds.

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Please, continue to let us see characters in your movies,

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your plays, your columns,

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who suffer with severe mental illness.

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Portray them sympathetically,

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and portray them in all the richness and depth

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of their experience as people and not as diagnoses.

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Recently, a friend posed a question:

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If there were a pill I could take

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that would instantly cure me, would I take it?

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The poet Rainer Maria Rilke

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was offered psychoanalysis.

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He declined, saying, "Don't take my devils away,

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because my angels may flee too."

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My psychosis, on the other hand,

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is a waking nightmare in which my devils are so terrifying

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that all my angels have already fled.

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So would I take the pill? In an instant.

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That said, I don't wish to be seen as regretting

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the life I could have had if I'd not been mentally ill,

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nor am I asking anyone for their pity.

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What I rather wish to say is that the humanity we all share

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is more important than the mental illness we may not.

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What those of us who suffer with mental illness want

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is what everybody wants:

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in the words of Sigmund Freud, "to work and to love."

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Thank you. (Applause)

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(Applause)

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Thank you. Thank you. You're very kind. (Applause)

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Thank you. (Applause)