The Center Cannot Hold: My Journey Through Madness

Elyn remembers growing up in Miami in the 50s and early 60s. Her parents moved there separately after World War II where they met, fell in love, married, and had three children: Elyn, and her two younger brothers, Warren and Kevin. The family lead a fairly normal life. Elyn’s father works, while her mother stays at home to care for the house and children. They live in a comfortable house with a yard and pool, where they spend time together doing fun things as a family on weekends. As “partly observant” Jews, they occasionally go to Temple (10).

As a couple, Elyn’s parents are close and enjoy each other’s company above all else. Elyn’s mother defers to her father. They are affectionate as parents, but also demanding in their expectations from their children. Elyn and her brothers do not want for material or psychological comfort growing up. She writes that her parents “gave me what I needed to survive” (10).

Around the age of eight, Elyn develops some “quirks”, where she needs to do things a certain way or a certain number of times. She also begins to believe that there is someone waiting outside her window at night. Despite reassurance from her parents, the fear persists. Elyn also has her first experience with “disorganization,” a moment when she feels herself “dissolving” and the physical reality around her growing “fuzzy” and “wobbly”. Although terrified, she does not confide in anyone else about this.

At the age of twelve, Elyn goes on a crash diet. She loses so much weight, her parents address it with her; however, Elyn is insistent that she is still in control. Elyn’s father challenges her to put on weight again, and Elyn wills herself to do so over the next three months. When Elyn thinks of this incident in retrospect, she admires how strong-willed she was, but knows that she was not, in fact, in control at all.

In the summer between her sophomore and junior years at school, Elyn goes to Mexico for a language and culture summer program at “Instituto Tecnológico de Estudios Superiores de Monterrey,” or “Monterrey Tec” (18). Although excited about the trip, being away from a predictable routine leaves Elyn feeling anxious the whole time she is there. While at Monterrey, Elyn tries marijuana for the first time, but does not feel compelled to repeat the experience.

Back home in Miami a few weeks later, Elyn tries mescaline with some friends; this time, the hallucinations start out pleasant but quickly become uncomfortable. Even days after they fade away, Elyn feels not quite right—her mood remains low, and she feels “sluggish” and “nauseated.” Worried that the drug use may have done something irreparable, Elyn tells her parents about the marijuana. Her father reacts strongly, demanding Elyn promise she will never try drugs again; however, Elyn defiantly refuses to do so. Elyn’s attitude causes her parents to enroll her in a rehab program called Operation Re-Entry, nicknamed “The Center.”

Elyn spends every evening after school at The Center for the next two years. Expounding a “no-nonsense, tough-love” (26) attitude, members are harshly and publicly chastised for breaking any rules. A month into the program, Elyn is punished for trying marijuana once again. The punishment, which features a combination of public humiliation, manual labor, and social ostracizing, leads Elyn to never use illicit drugs again.

Elyn’s experiences at The Center begin to leave her quieter and more withdrawn than normal. Around the same time, she also reads The Bell Jar by Sylvia Plath, and identifies strongly with the protagonist. One day, when walking home from school, Elyn hears the houses on the street sending her messages. When she tells her parents this, they are horrified and take her to The Center; Elyn denies using any drugs, and everyone ultimately believes her. Although unsettled, no one addresses the incident with her again.

Elyn ultimately settles into The Center, and it becomes her community. She leaves The Center when she graduates high school with a specific attitude towards illness or weakness drilled into her: “You can fight it, and you can win” (32). Elyn reflects on how this was flawed, as there are some things that cannot be conquered simply by force of will.

Elyn attends Vanderbilt University in the 70s. She struggles to take basic care of herself, as her sense of cleanliness and personal hygiene begins to deteriorate. The deterioration of “self-care skills” is the first sign of her schizophrenia, as it is for many other patients. Without the strong support system of her parents or The Center, Elyn starts to fall apart.

She begins to exhibit strange behavior. One incident sees her taking off her clothes, quacking like a duck, and swallowing a whole bottle of aspirin. Elyn’s friends, are unnerved by this and take her to the ER; the doctors think it was a suicide attempt, but Elyn assures them otherwise.

Even as Elyn’s mind is beginning to “betray” her, she simultaneously discovers philosophy, a subject she loves. Studying the subject helps impose structure and routine to her mind, and Elyn thrives academically, ending every year at university with straight As.

The first summer back home from university, however, the lack of structure leaves Elyn feeling low. She talks to her parents, who arrange for her to see a therapist. However, Elyn does not feel comfortable with the psychiatrist, Karen, and calls off the sessions after just three meetings. Karen tells Elyn that she believes Elyn needs help and should call Karen if she ever decides to take it.

Back at university, Elyn begins to take graduate-level courses where she makes older friends, including Kenny Collins, who used to be her freshman English teacher and is now an English literature Ph.D. student; his wife Margie; and another English graduate student, Pat. The four of them spend all their free time together, and the small group becomes a stabilizing influence for Elyn.

At the beginning of her senior year, however, Kenny receives a teaching position elsewhere, while Pat completes her studies and prepares to move off campus. Her friends’ departures leave Elyn an emotional mess, and her behavior begins to turn frantic and chaotic.

Nevertheless, Elyn finished her studies as class valedictorian, and chooses to continue studying Aristotle in the original Greek. She applies to Oxford and receives the Marshall scholarship, allowing her to attend Oxford University’s Corpus Christi college for a degree in philosophy.

Elyn returns home for the summer after graduating from Vanderbilt. The lack of routine and structure leaves her untethered, and she begins to experience vivid, intrusive fantasies, as well as panic attacks. However, she survives the summer, and goes on to Oxford.

The cultural differences between England and the United States as well as the different academic routine initially throw her off. She also finds it difficult to make friends, as speech and conversation suddenly become a challenge for her. Elyn only befriends a couple of other people: an American woman, Jean, who studies linguistics in London, and her fiancé Richard, a neurologist.

Elyn becomes increasingly more isolated, starting to mutter and gesticulate to herself even in public. She is unable to concentrate on anything, and her academic work suffers. Jean realizes that something is wrong and suggests that Elyn see a psychiatrist, which Elyn declines. Richard then meets her a few weeks later, and a short conversation with Elyn has him reiterating she urgently meet a psychiatrist and start antidepressants. Elyn’s aversion to pills stems from her experience with Operation Re-Entry, as well as a growing self-concept that she is a "bad, defective, stupid, and evil person” (58) fueled by fantasies. A particularly abysmal performance on a paper presentation leaves Elyn feeling suicidal.

Elyn contacts Dr. Johnson, a doctor she had been assigned as a general practitioner upon her arrival at Oxford. He assesses Elyn and sets up an appointment for her at Warneford, the psychiatric division of Oxford’s medical school. She is met there by Dr. Smythe and Dr. Russell, the latter of whom asks Elyn to become a patient at their day facility. Elyn flatly refuses and runs away, believing that she is not “crazy”; however, that night she is gripped by thoughts of being a bad person who deserves to die and is unable to sleep. This leads her to go back to the hospital the next morning and voluntarily become a patient there.

Elyn arrives at Warneford expecting something like Operation Re-Entry but is pleasantly surprised by a daily routine consisting of activities like group therapy, individual sessions with a psychiatrist, board games, and reading plays aloud. Elyn spends two weeks at Warneford; since lectures at Oxford do not mark attendance, her absence goes unnoticed.

Elyn’s thinking continues to grow more disorganized. She is consumed by thoughts that she is evil and is often unable to complete her sentences. The suicidal thoughts worsen, and Elyn finally admits herself to the hospital as an in-patient. Doing so shatters the illusion for herself that she is only a student, and she begins to really feel like a psychiatric patient. Elyn meets and interacts with other patients, some of whom have been hospitalized for the second or third time. Elyn promises herself that unlike them, this will be her only time in the hospital.

Dr. Smythe and the other staff try and convince Elyn to take antidepressants, which she is still resistant to. One day, however, she catches a glimpse of herself in the mirror; terrified by how emaciated and gaunt she looks, Elyn agrees to take the medicines to get better. Dr. Smythe introduces Elyn to Dr. Hamilton, who will be Elyn’s new doctor as Dr. Smythe will be traveling for a while.

Elyn begins to take amitriptyline, an antidepressant, which leaves her slightly sedated and dizzy as a side-effect. She also begins therapy sessions with Dr. Hamilton, whom Elyn takes to almost immediately as he is open, approachable, and handsome. Dr. Hamilton does not seem interested in going to the root of Elyn’s worries and thoughts; he focuses on the present, helping her with strategies that make her feel better in the current moment. Eager to please Dr. Hamilton, Elyn works hard at getting better.

A week later, Elyn decides she is ready to leave, despite the hospital staff’s reservations. She returns to Oxford but continues to see Dr. Hamilton regularly for therapy. At first, the amitriptyline works well, however she experiences a setback at the end of the term. Unable to complete a final paper, she is beset by uncontrollable anxiety and begins to lose weight again. Mr. Hamilton’s response to Elyn’s condition is simplistic; he does not seem alarmed by her weight loss, asking her to eat more and focus on completing her work. This is not helpful to Elyn, and she continues to fall apart, muttering to herself again and losing more weight.

During this time Elyn’s parents visit Paris and ask her to join them for some time. They are alarmed at her appearance, but when Elyn tells them that it is depression, they are relieved. They don’t talk about it anymore, which is neither comforting nor reassuring to Elyn; nevertheless, she is glad that they do not disown her or think her a failure.

Things continue to worsen once Elyn is back at Oxford, with the fantasies and suicidal thoughts growing more intense. Elyn does not share all of her thoughts with Dr. Hamilton, for fear of driving him away. However, her condition sharply deteriorates when Dr. Hamilton informs her that he will have to soon stop working with her, and she is hospitalized again . Elyn’s admission note describes her: “Thin, tall, chain-smoking, sad, inappropriate laughter at times, seems physically and mentally retarded” (77).

Elyn is evaluated by a group of doctors who present their recommendations. She appreciates how they are presented without coercion, which feels like a “demonstration of respect” (79).

Elyn accepts the recommendations of restarting amitriptyline and staying at the hospital for a while, but outright rejects their suggestion that she drop out of Oxford and contact her parents. Elyn’s parents have not paid much attention to Elyn’s health even after Paris, and Elyn continues to keep them mostly in the dark about her condition. She is determined to manage without their help or disapproval.

Elyn’s second hospitalization sees her unable to participate in any of the usual daily activities, as she is in terrible physical and emotional pain. She isolates herself and feels overwhelmed by the barrage of thoughts constantly crashing through her mind. Elyn begins to feel like she is receiving commands to do things, such as walk alone through the tunnels that lie underneath the hospital, and continually hurt herself, which she does using cigarettes and lighters.

After four months in the hospital that only sees her condition worsen, Elyn is referred to Dr. Anthony Storr, a consultant psychiatrist and psychoanalyst. Sensing that Dr. Storr is genuinely and non-judgmentally interested in what she has to say, Elyn tells him everything on her mind. Dr. Storr recommends that Elyn continue to stay at Oxford, as the program challenges her and gives her purpose; however, she must simultaneously begin intensive talk therapy.

This recommendation leads Elyn to Elizabeth Jones, a psychoanalyst. Mrs. Jones will see Elyn five times a week, and Elyn is to tell her everything that is on her mind, “no matter how embarrassing, trivial, or inappropriate it might seem” (88). Elyn is discharged from Warneford three weeks later.