A tale of mental illness | Elyn Saks

1,247,934 views ・ 2012-07-02

TED


Please double-click on the English subtitles below to play the video.

00:00
Translator: Morton Bast Reviewer: Thu-Huong Ha
0
0
7000
00:16
So I'm a woman with chronic schizophrenia.
1
16079
1951
00:18
I've spent hundreds of days
2
18030
1809
00:19
in psychiatric hospitals.
3
19839
1487
00:21
I might have ended up spending
4
21326
1805
00:23
most of my life on the back ward of a hospital,
5
23131
1827
00:24
but that isn't how my life turned out.
6
24958
2200
00:27
In fact, I've managed to stay clear of hospitals
7
27158
3448
00:30
for almost three decades,
8
30606
1489
00:32
perhaps my proudest accomplishment.
9
32095
1943
00:34
That's not to say that I've remained clear
10
34038
2194
00:36
of all psychiatric struggles.
11
36232
1607
00:37
After I graduated from the Yale Law School and
12
37839
2425
00:40
got my first law job, my New Haven analyst, Dr. White,
13
40264
3006
00:43
announced to me that he was going to close his practice
14
43270
2585
00:45
in three months, several years
15
45855
1880
00:47
before I had planned to leave New Haven.
16
47735
1697
00:49
White had been enormously helpful to me,
17
49432
2769
00:52
and the thought of his leaving
18
52201
1057
00:53
shattered me.
19
53258
1886
00:55
My best friend Steve,
20
55144
1470
00:56
sensing that something was terribly wrong,
21
56614
1752
00:58
flew out to New Haven to be with me.
22
58366
1832
01:00
Now I'm going to quote from some of my writings:
23
60198
2088
01:02
"I opened the door to my studio apartment.
24
62286
2515
01:04
Steve would later tell me that,
25
64801
2173
01:06
for all the times he had seen me psychotic, nothing
26
66974
2736
01:09
could have prepared him for what he saw that day.
27
69710
2001
01:11
For a week or more, I had barely eaten.
28
71711
2673
01:14
I was gaunt. I walked
29
74384
2560
01:16
as though my legs were wooden.
30
76944
1614
01:18
My face looked and felt like a mask.
31
78558
3027
01:21
I had closed all the curtains in the apartment, so
32
81585
2844
01:24
in the middle of the day
33
84429
955
01:25
the apartment was in near total darkness.
34
85384
2014
01:27
The air was fetid, the room a shambles.
35
87398
2752
01:30
Steve, both a lawyer and a psychologist, has treated
36
90150
3316
01:33
many patients with severe mental illness, and to this day
37
93466
3133
01:36
he'll say I was as bad as any he had ever seen.
38
96599
2688
01:39
'Hi,' I said, and then I returned to the couch,
39
99287
3079
01:42
where I sat in silence for several moments.
40
102366
2124
01:44
'Thank you for coming, Steve.
41
104490
1845
01:46
Crumbling world, word, voice.
42
106335
4051
01:50
Tell the clocks to stop.
43
110386
1869
01:52
Time is. Time has come.'
44
112255
1791
01:54
'White is leaving,' Steve said somberly.
45
114046
3241
01:57
'I'm being pushed into a grave. The situation is grave,' I moan.
46
117287
3431
02:00
'Gravity is pulling me down.
47
120718
1627
02:02
I'm scared. Tell them to get away.'"
48
122345
2133
02:04
As a young woman, I was in a psychiatric hospital
49
124478
3712
02:08
on three different occasions for lengthy periods.
50
128190
2504
02:10
My doctors diagnosed me with chronic schizophrenia,
51
130694
2792
02:13
and gave me a prognosis of "grave."
52
133486
2595
02:16
That is, at best, I was expected to live in a board and care,
53
136081
3430
02:19
and work at menial jobs.
54
139511
1704
02:21
Fortunately, I did not actually
55
141215
2000
02:23
enact that grave prognosis.
56
143215
1775
02:24
Instead, I'm a chaired Professor of Law, Psychology
57
144990
2841
02:27
and Psychiatry at the USC Gould School of Law,
58
147831
2625
02:30
I have many close friends
59
150456
1630
02:32
and I have a beloved husband, Will, who's here with us today.
60
152086
3185
02:35
(Applause) Thank you.
61
155271
4527
02:41
He's definitely the star of my show.
62
161814
3258
02:45
I'd like to share with you how that happened, and also
63
165072
2798
02:47
describe my experience of being psychotic.
64
167870
2769
02:50
I hasten to add that it's my experience,
65
170639
2480
02:53
because everyone becomes psychotic in his or her own way.
66
173119
2656
02:55
Let's start with the definition of schizophrenia.
67
175775
3061
02:58
Schizophrenia is a brain disease.
68
178836
2221
03:01
Its defining feature is psychosis, or being
69
181057
2425
03:03
out of touch with reality.
70
183482
1592
03:05
Delusions and hallucinations
71
185074
1822
03:06
are hallmarks of the illness.
72
186896
1554
03:08
Delusions are fixed and false beliefs that aren't responsive
73
188450
2752
03:11
to evidence, and hallucinations are false sensory experiences.
74
191202
3816
03:15
For example, when I'm psychotic I often have
75
195018
2350
03:17
the delusion that I've killed hundreds of thousands
76
197368
2251
03:19
of people with my thoughts.
77
199619
1577
03:21
I sometimes have the idea that
78
201196
1705
03:22
nuclear explosions are about to be set off in my brain.
79
202901
2495
03:25
Occasionally, I have hallucinations,
80
205396
2336
03:27
like one time I turned around and saw a man
81
207732
1768
03:29
with a raised knife.
82
209500
1577
03:31
Imagine having a nightmare while you're awake.
83
211077
2792
03:33
Often, speech and thinking become disorganized
84
213869
3210
03:37
to the point of incoherence.
85
217079
1546
03:38
Loose associations involves putting together words
86
218625
2879
03:41
that may sound a lot alike but don't make sense,
87
221504
2783
03:44
and if the words get jumbled up enough, it's called "word salad."
88
224287
2390
03:46
Contrary to what many people think, schizophrenia is not
89
226677
4438
03:51
the same as multiple personality disorder or split personality.
90
231115
3415
03:54
The schizophrenic mind is not split, but shattered.
91
234530
3551
03:58
Everyone has seen a street person,
92
238081
2579
04:00
unkempt, probably ill-fed,
93
240660
2023
04:02
standing outside of an office building muttering
94
242683
2577
04:05
to himself or shouting.
95
245260
1813
04:07
This person is likely to have some form of schizophrenia.
96
247073
2597
04:09
But schizophrenia presents itself across a wide array
97
249670
2331
04:12
of socioeconomic status, and there are people
98
252001
2824
04:14
with the illness who are full-time professionals
99
254825
2530
04:17
with major responsibilities.
100
257355
2352
04:19
Several years ago, I decided
101
259707
1211
04:20
to write down my experiences and my personal journey,
102
260918
3435
04:24
and I want to share some more of that story with you today
103
264353
2298
04:26
to convey the inside view.
104
266651
1663
04:28
So the following episode happened the seventh week
105
268314
2785
04:31
of my first semester of my first year at Yale Law School.
106
271099
2863
04:33
Quoting from my writings:
107
273962
2205
04:36
"My two classmates, Rebel and Val, and I had made the date
108
276167
3469
04:39
to meet in the law school library on Friday night
109
279636
2961
04:42
to work on our memo assignment together.
110
282597
2284
04:44
But we didn't get far before I was talking in ways
111
284881
1802
04:46
that made no sense.
112
286683
1523
04:48
'Memos are visitations,' I informed them.
113
288206
3064
04:51
'They make certain points. The point is on your head.
114
291270
2520
04:53
Pat used to say that. Have you killed you anyone?'
115
293790
2455
04:56
Rebel and Val looked at me
116
296245
2016
04:58
as if they or I had been
117
298261
1671
04:59
splashed in the face with cold water.
118
299932
1580
05:01
'What are you talking about, Elyn?'
119
301512
1556
05:03
'Oh, you know, the usual. Who's what, what's who,
120
303068
3009
05:06
heaven and hell. Let's go out on the roof.
121
306077
2255
05:08
It's a flat surface. It's safe.'
122
308332
1576
05:09
Rebel and Val followed
123
309908
1584
05:11
and they asked what had gotten into me.
124
311492
1449
05:12
'This is the real me,' I announced,
125
312941
1863
05:14
waving my arms above my head.
126
314804
1545
05:16
And then, late on a Friday night, on the roof
127
316349
2775
05:19
of the Yale Law School,
128
319124
1157
05:20
I began to sing, and not quietly either.
129
320281
2292
05:22
'Come to the Florida sunshine bush.
130
322573
3104
05:25
Do you want to dance?'
131
325677
1311
05:26
'Are you on drugs?' one asked. 'Are you high?'
132
326988
2475
05:29
'High? Me? No way, no drugs.
133
329463
2456
05:31
Come to the Florida sunshine bush,
134
331919
2567
05:34
where there are lemons, where they make demons.'
135
334486
3273
05:37
'You're frightening me,' one of them said, and Rebel and Val
136
337759
2694
05:40
headed back into the library.
137
340453
1779
05:42
I shrugged and followed them.
138
342232
2117
05:44
Back inside, I asked my classmates if they were
139
344349
3367
05:47
having the same experience of words jumping around
140
347716
2217
05:49
our cases as I was.
141
349933
1344
05:51
'I think someone's infiltrated my copies of the cases,' I said.
142
351277
4023
05:55
'We've got to case the joint.
143
355300
1504
05:56
I don't believe in joints, but
144
356804
1583
05:58
they do hold your body together.'" --
145
358387
1465
05:59
It's an example of loose associations. --
146
359852
2369
06:02
"Eventually I made my way back to my dorm room,
147
362221
2384
06:04
and once there, I couldn't settle down.
148
364605
2359
06:06
My head was too full of noise,
149
366964
1825
06:08
too full of orange trees and law memos I could not write
150
368789
3687
06:12
and mass murders I knew I would be responsible for.
151
372476
2632
06:15
Sitting on my bed, I rocked back and forth,
152
375108
3345
06:18
moaning in fear and isolation."
153
378453
2032
06:20
This episode led to my first hospitalization in America.
154
380485
3127
06:23
I had two earlier in England.
155
383612
2240
06:25
Continuing with the writings:
156
385852
1561
06:27
"The next morning I went to my professor's office to ask
157
387413
2464
06:29
for an extension on the memo assignment,
158
389877
1577
06:31
and I began gibbering unintelligably
159
391454
2157
06:33
as I had the night before,
160
393611
1346
06:34
and he eventually brought me to the emergency room.
161
394957
1673
06:36
Once there, someone I'll just call 'The Doctor'
162
396630
3801
06:40
and his whole team of goons swooped down,
163
400431
1967
06:42
lifted me high into the air,
164
402398
1409
06:43
and slammed me down on a metal bed
165
403807
1673
06:45
with such force that I saw stars.
166
405480
2352
06:47
Then they strapped my legs and arms to the metal bed
167
407832
2558
06:50
with thick leather straps.
168
410390
1667
06:52
A sound came out of my mouth that I'd never heard before:
169
412057
3346
06:55
half groan, half scream,
170
415403
2028
06:57
barely human and pure terror.
171
417431
3344
07:00
Then the sound came again,
172
420775
1671
07:02
forced from somewhere deep inside my belly
173
422446
1924
07:04
and scraping my throat raw."
174
424370
1597
07:05
This incident resulted in my involuntary hospitalization.
175
425967
4279
07:10
One of the reasons the doctors gave for hospitalizing me
176
430246
3541
07:13
against my will was that I was
177
433787
1285
07:15
"gravely disabled."
178
435072
1407
07:16
To support this view, they wrote in my chart that I was unable
179
436479
3096
07:19
to do my Yale Law School homework.
180
439575
1792
07:21
I wondered what that meant about much of the rest of New Haven.
181
441367
3041
07:24
(Laughter)
182
444408
1606
07:26
During the next year, I would
183
446014
2689
07:28
spend five months in a psychiatric hospital.
184
448703
2152
07:30
At times, I spent up to 20 hours in mechanical restraints,
185
450855
3479
07:34
arms tied, arms and legs tied down,
186
454334
3490
07:37
arms and legs tied down with a net tied
187
457824
2519
07:40
tightly across my chest.
188
460343
1808
07:42
I never struck anyone.
189
462151
2047
07:44
I never harmed anyone. I never made any direct threats.
190
464198
2906
07:47
If you've never been restrained yourself, you may have
191
467104
2774
07:49
a benign image of the experience.
192
469878
2697
07:52
There's nothing benign about it.
193
472575
1975
07:54
Every week in the United States,
194
474550
1785
07:56
it's been estimated that one to three people die in restraints.
195
476335
2920
07:59
They strangle, they aspirate their vomit,
196
479255
2616
08:01
they suffocate, they have a heart attack.
197
481871
2153
08:04
It's unclear whether using mechanical restraints
198
484024
2526
08:06
is actually saving lives or costing lives.
199
486550
2520
08:09
While I was preparing to write my student note
200
489070
2794
08:11
for the Yale Law Journal on mechanical restraints,
201
491864
2200
08:14
I consulted an eminent law professor who was also
202
494064
2352
08:16
a psychiatrist,
203
496416
1085
08:17
and said surely he would agree
204
497501
1713
08:19
that restraints must be degrading,
205
499214
2296
08:21
painful and frightening.
206
501510
1536
08:23
He looked at me in a knowing way, and said,
207
503046
2111
08:25
"Elyn, you don't really understand:
208
505157
2329
08:27
These people are psychotic.
209
507486
1738
08:29
They're different from me and you.
210
509224
1521
08:30
They wouldn't experience restraints as we would."
211
510745
2764
08:33
I didn't have the courage to tell him in that moment that,
212
513509
2834
08:36
no, we're not that different from him.
213
516343
2001
08:38
We don't like to be strapped down to a bed
214
518344
2358
08:40
and left to suffer for hours any more than he would.
215
520702
2330
08:43
In fact, until very recently,
216
523032
2152
08:45
and I'm sure some people still hold it as a view,
217
525184
1982
08:47
that restraints help psychiatric patients feel safe.
218
527166
3032
08:50
I've never met a psychiatric patient
219
530198
2432
08:52
who agreed with that view.
220
532630
1394
08:54
Today, I'd like to say I'm very pro-psychiatry
221
534024
2711
08:56
but very anti-force.
222
536735
1503
08:58
I don't think force is effective as treatment, and I think
223
538238
2991
09:01
using force is a terrible thing to do to another person
224
541229
2737
09:03
with a terrible illness.
225
543966
1359
09:05
Eventually, I came to Los Angeles
226
545325
2721
09:08
to teach at the University of Southern California Law School.
227
548046
2498
09:10
For years, I had resisted medication,
228
550544
2320
09:12
making many, many efforts to get off.
229
552864
1990
09:14
I felt that if I could manage without medication,
230
554854
2675
09:17
I could prove that, after all,
231
557529
2038
09:19
I wasn't really mentally ill, it was some terrible mistake.
232
559567
2750
09:22
My motto was the less medicine, the less defective.
233
562317
3307
09:25
My L.A. analyst, Dr. Kaplan, was urging me
234
565624
3088
09:28
just to stay on medication and get on with my life,
235
568712
2500
09:31
but I decided I wanted to make one last college try to get off.
236
571212
3475
09:34
Quoting from the text:
237
574687
1432
09:36
"I started the reduction of my meds, and within a short time
238
576119
3640
09:39
I began feeling the effects.
239
579759
2112
09:41
After returning from a trip to Oxford, I marched into
240
581871
2841
09:44
Kaplan's office, headed straight for the corner, crouched down,
241
584712
3377
09:48
covered my face, and began shaking.
242
588089
2233
09:50
All around me I sensed evil beings poised with daggers.
243
590322
3155
09:53
They'd slice me up in thin slices
244
593477
2168
09:55
or make me swallow hot coals.
245
595645
1642
09:57
Kaplan would later describe me as 'writhing in agony.'
246
597287
3377
10:00
Even in this state, what he accurately described as
247
600664
3085
10:03
acutely and forwardly psychotic,
248
603749
1691
10:05
I refused to take more medication.
249
605440
2013
10:07
The mission is not yet complete.
250
607453
2800
10:10
Immediately after the appointment with Kaplan,
251
610253
2618
10:12
I went to see Dr. Marder, a schizophrenia expert
252
612871
2298
10:15
who was following me for medication side effects.
253
615169
2308
10:17
He was under the impression that I had a mild psychotic illness.
254
617477
3021
10:20
Once in his office, I sat on his couch, folded over,
255
620498
3428
10:23
and began muttering.
256
623926
1639
10:25
'Head explosions and people trying to kill.
257
625565
2230
10:27
Is it okay if I totally trash your office?'
258
627795
2465
10:30
'You need to leave if you think you're going to do that,'
259
630260
2632
10:32
said Marder.
260
632892
983
10:33
'Okay. Small. Fire on ice. Tell them not to kill me.
261
633875
3152
10:37
Tell them not to kill me. What have I done wrong?
262
637027
1648
10:38
Hundreds of thousands with thoughts, interdiction.'
263
638675
2577
10:41
'Elyn, do you feel like you're
264
641252
1735
10:42
dangerous to yourself or others?
265
642987
1497
10:44
I think you need to be in the hospital.
266
644484
2415
10:46
I could get you admitted right away, and the whole thing
267
646899
1857
10:48
could be very discrete.'
268
648756
1135
10:49
'Ha, ha, ha.
269
649891
1681
10:51
You're offering to put me in hospitals?
270
651572
2337
10:53
Hospitals are bad, they're mad, they're sad.
271
653909
2943
10:56
One must stay away. I'm God, or I used to be.'"
272
656852
3664
11:00
At that point in the text,
273
660516
1583
11:02
where I said "I'm God, or I used to be," my husband
274
662099
1905
11:04
made a marginal note.
275
664004
1025
11:05
He said, "Did you quit or were you fired?"
276
665029
1607
11:06
(Laughter)
277
666636
2231
11:08
"'I give life and I take it away.
278
668867
3752
11:12
Forgive me, for I know not what I do.'
279
672619
1697
11:14
Eventually, I broke down in front of friends, and
280
674316
3314
11:17
everybody convinced me to take more medication.
281
677630
2508
11:20
I could no longer deny the truth,
282
680138
1946
11:22
and I could not change it.
283
682084
1522
11:23
The wall that kept me, Elyn, Professor Saks,
284
683606
2649
11:26
separate from that insane woman hospitalized years past,
285
686255
3113
11:29
lay smashed and in ruins."
286
689368
2111
11:31
Everything about this illness says I shouldn't be here,
287
691479
2673
11:34
but I am. And I am, I think, for three reasons:
288
694152
2874
11:37
First, I've had excellent treatment.
289
697026
2392
11:39
Four- to five-day-a-week psychoanalytic psychotherapy
290
699418
2946
11:42
for decades and continuing, and excellent psychopharmacology.
291
702364
2984
11:45
Second, I have many close family members and friends who know me
292
705348
4044
11:49
and know my illness.
293
709392
1254
11:50
These relationships have given my life a meaning
294
710646
2324
11:52
and a depth, and they also helped me navigate
295
712970
2167
11:55
my life in the face of symptoms.
296
715137
1968
11:57
Third, I work at an enormously supportive workplace
297
717105
3168
12:00
at USC Law School.
298
720273
1585
12:01
This is a place that not only accommodates my needs
299
721858
3025
12:04
but actually embraces them.
300
724883
1391
12:06
It's also a very intellectually stimulating place,
301
726274
3031
12:09
and occupying my mind with complex problems
302
729305
2592
12:11
has been my best and most powerful and most reliable
303
731897
3433
12:15
defense against my mental illness.
304
735330
1720
12:17
Even with all that — excellent treatment, wonderful family and
305
737050
3303
12:20
friends, supportive work environment —
306
740353
1916
12:22
I did not make my illness public
307
742269
2333
12:24
until relatively late in life,
308
744602
1433
12:26
and that's because the stigma against mental illness
309
746035
2519
12:28
is so powerful that I didn't feel safe with people knowing.
310
748554
2608
12:31
If you hear nothing else today,
311
751162
2416
12:33
please hear this: There are not "schizophrenics."
312
753578
3434
12:37
There are people with schizophrenia, and these people
313
757012
3151
12:40
may be your spouse, they may be your child,
314
760163
2095
12:42
they may be your neighbor, they may be your friend,
315
762258
2424
12:44
they may be your coworker.
316
764682
1424
12:46
So let me share some final thoughts.
317
766106
2856
12:48
We need to invest more resources into research and treatment
318
768962
3432
12:52
of mental illness.
319
772394
1240
12:53
The better we understand these illnesses, the better
320
773634
2056
12:55
the treatments we can provide, and the better the treatments
321
775690
2208
12:57
we can provide, the more we can offer people care,
322
777898
2440
13:00
and not have to use force.
323
780338
1448
13:01
Also, we must stop criminalizing mental illness.
324
781786
2952
13:04
It's a national tragedy and scandal that the L.A. County Jail
325
784738
4048
13:08
is the biggest psychiatric facility in the United States.
326
788786
2642
13:11
American prisons and jails are filled with people who suffer
327
791428
3916
13:15
from severe mental illness, and many of them are there
328
795344
2484
13:17
because they never received adequate treatment.
329
797828
1977
13:19
I could have easily ended up there or on the streets myself.
330
799805
3429
13:23
A message to the entertainment industry and to the press:
331
803234
3224
13:26
On the whole, you've done a wonderful job fighting stigma
332
806458
4064
13:30
and prejudice of many kinds.
333
810522
1816
13:32
Please, continue to let us see characters in your movies,
334
812338
3000
13:35
your plays, your columns,
335
815338
2128
13:37
who suffer with severe mental illness.
336
817466
1824
13:39
Portray them sympathetically,
337
819290
1760
13:41
and portray them in all the richness and depth
338
821050
2639
13:43
of their experience as people and not as diagnoses.
339
823689
3527
13:47
Recently, a friend posed a question:
340
827216
2276
13:49
If there were a pill I could take
341
829492
1775
13:51
that would instantly cure me, would I take it?
342
831267
1811
13:53
The poet Rainer Maria Rilke
343
833078
2693
13:55
was offered psychoanalysis.
344
835771
1472
13:57
He declined, saying, "Don't take my devils away,
345
837243
2312
13:59
because my angels may flee too."
346
839555
1759
14:01
My psychosis, on the other hand,
347
841314
2193
14:03
is a waking nightmare in which my devils are so terrifying
348
843507
2672
14:06
that all my angels have already fled.
349
846179
1936
14:08
So would I take the pill? In an instant.
350
848115
3904
14:12
That said, I don't wish to be seen as regretting
351
852019
2681
14:14
the life I could have had if I'd not been mentally ill,
352
854700
2393
14:17
nor am I asking anyone for their pity.
353
857093
2282
14:19
What I rather wish to say is that the humanity we all share
354
859375
3131
14:22
is more important than the mental illness we may not.
355
862521
2618
14:25
What those of us who suffer with mental illness want
356
865139
2458
14:27
is what everybody wants:
357
867597
1454
14:29
in the words of Sigmund Freud, "to work and to love."
358
869051
2534
14:31
Thank you. (Applause)
359
871585
3023
14:34
(Applause)
360
874608
677
14:35
Thank you. Thank you. You're very kind. (Applause)
361
875285
4793
14:40
Thank you. (Applause)
362
880078
6607
About this website

This site will introduce you to YouTube videos that are useful for learning English. You will see English lessons taught by top-notch teachers from around the world. Double-click on the English subtitles displayed on each video page to play the video from there. The subtitles scroll in sync with the video playback. If you have any comments or requests, please contact us using this contact form.

https://forms.gle/WvT1wiN1qDtmnspy7