The Outworker
The relationship with oneself is the most important to develop, but the easiest to neglect. These conversations will hopefully allow you to develop that relationship.
The Outworker
#026 - Elyn Saks - Battling Schizophrenia & Redefining Life With Mental Illness
Elyn Saks shares her personal journey with schizophrenia. From the highs of academic success to the lows of psychiatric hospitalizations, Elyn candidly discusses the challenges of navigating mental illness in the pursuit of working towards her personal and professional goals. Her story offers a poignant exploration of identity, acceptance, and the resilience required to live a fulfilling life in the face of daunting obstacles. This episode provides a unique perspective on mental health and the human capacity for growth.
Timestamps:
00:00 Ellen's Personal Journey with Schizophrenia
00:37 Understanding Schizophrenia and Its Symptoms
02:25 When Problems Started
03:50 The Impact of Environment Changes
31:27 Staying in School and Transitioning to Law
34:46 Mental Health Crisis at Yale Law School
38:22 The Identity and Stigma of Schizophrenia
40:41 Reacclimating to Law School and Mental Health Treatment
42:07 Authenticity vs. Acting 'Normal'
45:04 Acceptance and Progress in Life
47:23 The Role of Medication in Mental Health
51:16 Stubbornness to Acceptance
54:35 Progress and Challenges in Everyday Life
56:00 The Process of Writing a Memoir
59:20 Finding Meaning in Challenges
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What’s up Outworkers. Elyn Saks shares her personal journey with schizophrenia. From the highs of academic success to the lows of psychiatric hospitalizations, Elyn candidly discusses the challenges of navigating mental illness in the pursuit of working towards her personal and professional goals. Her story offers a poignant exploration of identity, acceptance, and the resilience required to live a fulfilling life in the face of daunting obstacles. This episode provides a unique perspective on mental health and the human capacity for growth.
Tim (00:02.529)
Ellen, welcome to the show.
Elyn Saks (00:04.664)
I'm Claude Spee here. Thanks for inviting me, Tim.
Tim (00:08.302)
So I really want to dive into your whole personal story, but I think what would be good and productive before that is just setting the table with schizophrenia and everything that has to go into that. What is schizophrenia and the symptoms and what are things that people may get wrong about schizophrenia or may not know?
Elyn Saks (00:36.016)
Yeah, I think there's some confusion. Some people think that schizophrenia is a multiple personality disorder, a split personality. And it's actually not. It's in a different diagnostic category. So split personality is an dissociative disorder, and schizophrenia is a psychotic disorder. And typically with schizophrenia, you have what are called positive symptoms, which are things you have but don't want, like delusions and hallucinations and disorganized speech.
and negative symptoms, which are things you don't have and wish you did, like good relationships, good work situation, good family life. A lot of actually the personal and societal burden of schizophrenia resides in the negative symptoms, surprisingly. Because we have pretty good treatments for positive symptoms, but not for negative symptoms. So with my schizophrenia, I'll have a delusion like...
I've killed hundreds of thousands of people with my thoughts or a hallucination. A man standing in front of me with a raised knife or disorganized thinking and speaking. So I was at a breakdown on the roof of the Yale Law School when I was a student there and said to my classmates, are you having the same experience? I am a forge jumping around the pages. We've got a case of joints. I don't believe in joints, but they do hold your body together. So stuff that loosely was connected but put together really didn't make any sense.
And except for the first couple of years of my illness, I've been fortunate to be spared the negative symptoms.
Tim (02:09.966)
How old were you when you first started dealing with mental issues, not even maybe from the standpoint of consciously knowing your feeling that you had a mental health problem, but just feeling like something was off.
Elyn Saks (02:27.462)
Well, I had lot of obsessions and so on as a child, know, straightening out my shoes. And I used to think that a man was standing outside my window. And even when my parents looked with me and nobody was there, I wasn't persuaded. I thought he was just hiding, that kind of thing. The first kind of Frank episode happened when I was a teenager and I had read Sylvia Plath's, The Bell Jar, which described her experience of mental illness.
It kind of spoke to me and one day at school I just stood up and started walking home, which was like two or three miles away. And as I was walking, the houses became kind of weird. They turned purple. They were wavy. And I started believing things. Things came into my mind. They weren't voices. They were thoughts. But I knew they weren't my thoughts. The houses had put them there.
So things like you're special, you're especially bad, you must see, see, see, that kind of thing. Got home and I told my parents who had no idea what was going on, they thought I was using drugs or something.
Tim (07:40.12)
So you grew up in Miami and then you went to Vanderbilt University for college. throughout your story, and it's a big theme about how these environment changes really affected you. How did that first environment change at that young age affect your state of mind and well -being?
Elyn Saks (07:47.748)
Bye.
Elyn Saks (07:58.406)
Yeah.
Elyn Saks (08:06.604)
So when I went to Vanderbilt, you know, the first year I was there, I had some kind of unusual or bizarre experiences. One day it was kind of cold out and I decided that I was going to put a blanket over my back and told my friends I was going to go fly away. And I just ran around in the snow, which was kind of bizarre behavior.
sort of troubled and morried them, but nothing, nothing came of it. and I don't remember any other episodes of Vanderbilt. it was really an Oxford, but I kind of quote, officially broke down. They started out looking like depression with mild psychotic features, which is often the way schizophrenia begins. But then it turned into a, you know, a Frank psychotic disorder.
And so that happened while I was at Oxford. My first year there, I was hospitalized for a month. And my second year there, I was hospitalized for four months. And then when I moved back to the United States, I was hospitalized for five months. All of that is decades ago. And I sometimes say, you know, my proudest accomplishment is staying out of the hospital for so long. But then I have the thought, is it hard work or is it
luck, you know, to have resources and to have friends and family who care and so on. And my friend Richard, who's a neurologist, said, Ellen, for an unlucky person, you're very lucky. And I think he's right about that.
Tim (09:55.16)
Does it ever feel uncomfortable for you to, even in this scenario right now in this setting, thinking back on your life, is it ever uncomfortable for you or not helpful?
Elyn Saks (10:09.254)
It's kind of interesting. There's actually a psychiatrist, a musical person here in LA named Dr. Kenneth Wells. And Ken has done two operas about me, if you can believe it. The first one is about me being hospitalized and restrained and that kind of thing. And the second one is more about my, you know, turning all of that into a decent life with a wonderful husband and a great job and that kind of thing. He's working on a third one. I'm not sure what the third one's about.
but actually watching the opera.
Elyn Saks (10:45.688)
Wasn't that hard? Well actually...
trying to think how to put this.
Elyn Saks (10:59.942)
Thinking about breaking down and being hospitalized was never very traumatic to me. To think about it, to look back on it. And I make an analogy to something much more extreme, which is a Holocaust survivor. Some go back to the camps and take in where they were and remember and process. And some want to stay as far away as possible. And for me, remembering and processing was not painful. It was actually helpful.
I mean, as an example, the first opera that Ken did had me restrained and forcibly medicated and that kind of thing. But he also portrayed the point of view of the young psychiatrist doing that to me, which was really powerful because at the moment I was thinking only of myself and not of this other person. But there was this other person and there was that effect. So that was, you know, that was kind of useful.
Tim (11:58.4)
Was it helpful for you to visually see it?
Elyn Saks (12:02.724)
Yeah, yeah, it works.
Tim (12:06.518)
You were named class valedictorian at Vanderbilt and you say that my illness was beginning to poke through the shell that helped me. Indeed helps all of us maintain a separation between what is real and what is not. That's where things would precariously balance me unwittingly trying to keep the shell strong and my illness trying equally hard to break through. And obviously if you're the class valedictorian academics played a central role.
Elyn Saks (12:21.914)
Okay.
Tim (12:36.224)
in your life with everything that you were dealing with mentally, how did your academics help you to keep that shell strong, so to speak?
Elyn Saks (12:47.098)
That's a really good way to put it, and it helped enormously. I say sometimes that when I'm writing an argument or a counter argument, the crazy stuff recedes to the sidelines. So to the extent that I'm focused on my work and thinking and writing and speaking at places and connecting with people, keeps my symptoms at bay. So that's been really helpful.
And spinning, know, will my husband says psychosis is not like an on off switch, but like a dimmer. And at the far end, I'll have a thought like I've killed hundreds of thousands of my thoughts. Ellen, that's just your illness acting up. Pay it. No mind. Further along the spectrum of we've had house guests. I like people, but I need a lot of alone time. I might go in and out of psychosis for two or three days. And at the far end, I'm crouching in a corner shaking.
thinking daggers are about to be stabbed into my head and that hasn't happened in a good 10 years. So things are going in the right direction. I'm very lucky.
Tim (13:48.078)
So after Vanderbilt, you continue your academic studies at Oxford, and that's the second big environment change that you make.
Elyn Saks (13:53.264)
Yes.
Elyn Saks (13:57.158)
I'm sorry.
Elyn Saks (14:05.158)
I'm doing an interview. I'll call you later.
Sorry, I should just turn this off.
Tim (14:10.114)
No worries.
Elyn Saks (14:17.666)
Power off. There we go. Sorry.
Tim (14:22.158)
No worries. So I'm just gonna. So after Vanderbilt, you continue your academic studies at Oxford and that's the second big environment change that happens in your life. How did moving to England really expose you to the severity of what you were dealing with mentally?
Elyn Saks (14:43.878)
You know, I ended up loving England, but when I first got there, I found it kind of traumatic. So like I would go to the grocery store and when the woman didn't cashier didn't say, have a good day, I think, what did I do wrong? So they have different customs and excuse me, norms, which I wasn't familiar with. And I sort of read them in a negative way toward myself.
So it was stressful in the beginning, but eventually I made some good friends. I still have some friends from there that I visit and speak to by phone, including one American guy who was there and including a British couple and a British friend who I'm still in touch with. Sorry, what was the question headed?
Tim (15:39.138)
just about how moving to Oxford really exposed you to.
Elyn Saks (15:42.19)
Yeah, Well, Yeah, mean, moving, moving, cult moving to different countries or moving to different cultures is stressful because you don't, you don't really know the norms or the values or, or whatever. So you have to kind of learn what they are. And that can take time and it can lead you feeling lonely and isolated because you're not, you're not making the friends and that kind of thing.
When I came to the United States and went to Yale Law School the first year, I broke down the seventh week of my first semester and had to leave. Actually, my good friend, my good lawyer friend who has represented me with my books and the movie and stuff like that, unfortunately just passed, but he was very, very kind. And he was with me with one other person on the roof of the Yale Law School when I broke down.
was gibbering and dancing and this and that. And I asked him when he started representing me, did he remember that time? And he said, how could I forget? So that was kind of funny. So going to a new place for me is stressful because any change is stressful. It's stressful for everybody, but some people, it hits some people harder than others and it hits me pretty hard.
Tim (16:51.438)
YONG
Tim (17:03.426)
What was the experience like going to the Warnerford Hospital in Oxford?
Elyn Saks (17:10.923)
it was,
Elyn Saks (17:17.742)
I felt scared, felt ashamed, I felt like I was a failure. I didn't tell anybody, including my parents.
Yeah, you know, it was hard.
Tim (17:37.752)
Why don't you think you told any of your family?
Elyn Saks (17:42.95)
A few reasons, and this is not only just for my hospitalization, but episodes since then. I my parents, when they read my book, were shocked because they thought I broke down at Yale my first year there and everything had been fine since. And in fact, I had multiple episodes. But I say I didn't tell them for a number of reasons. First, when I first broke down, I was already
an adult living independently and I did not want to go back to being the kid in my family of origin. And also my parents worry a lot and I didn't want them to worry. And also they don't do supportive that well anyway so there wasn't much in it for me to tell them. But they would have hurt when they found out how much I had been ill, you know. I still think I made the right decision.
Tim (18:32.812)
What was the?
Elyn Saks (18:33.254)
It's kind of a shame and there's a lot of evidence that family support really helps people in these situations. So it might have really been in my interest to involve them more.
Tim (18:48.81)
Do you think that they would have?
provided that care and help that you were looking for, do you think that it would have been more challenging for you involving them in the moment?
Elyn Saks (19:02.67)
It could be, could have been even.
Tim (19:06.328)
So when you were at the Warrnerford Hospital in Oxford, what was the focus of your care?
Elyn Saks (19:15.501)
I spoke with a psychiatrist once or twice a week. I spoke with the staff a lot. Basically what I did was I sat in the music room upstairs and listened to music like the Beatles once there was a way to get back home were thinking I need to find my way back home. I was upstairs with a woman who was very impaired.
But we kind of hung out together and made friends kind of thing.
Tim (19:53.474)
Yeah, I think another interesting component about your story and getting into your time at the hospital at the Warnerford hospital in Oxford is that it also brings in this other component, not just about your mental health issues, but also about your identity. And you say, when I first gone to the day hospital,
Elyn Saks (20:17.306)
Yeah, that's really right.
Tim (20:22.518)
I at least went back to my Oxford dorm at night and so could continue to tell myself I was a student. Throughout each day, I often felt caught somewhere in between. Was I a mental patient or a student? Where did I really belong? At Oxford or at the Warnerford Hospital? Should I spend my days in the library or in group therapy? The choice is always, the choice always seemed to be mine. But the minute I checked into the inpatient unit, the pretense of being a student no longer held. I was a psychiatric patient.
And obviously your mental issues were a major challenge and that was in the forefront of what you were dealing with. But how did this breakdown of your identity and almost being stripped of your status as an academic increase the severity of everything you were feeling and going through?
Elyn Saks (21:16.696)
no, I mean, I think you point out a really good thing. think it did. It did do that. So with the first opera involves the three Ellen's, which is something that my analyst knew in LA. You know, it was a heuristic device. I'm not.
not multiple personality disorder, or literally different people, but different aspects of myself. So there was Ellen, there was Professor Sachs, and there was a lady at the medical charts. So I had these three different aspects of myself that were hard to integrate with each other. How could I be Professor Sachs, you know, doing important and interesting academic work, and the lady at the medical charts who barely could take care of herself? How could both of them be made?
And the one who really got lost in all of it was Ellen. So I spent most of my time as professor or the medical patient, mental patient. And it was, you know, coming, it was actually coming to terms with the lady of the medical charts that made my life get better. I accepted, I had an illness which I resisted accepting for many years. And once I accepted it, and once I accepted the need for meds, my life got much better.
So I became a convert and accept that I have a psychiatric illness, a mental illness. I also have a great job and I'm also a person with friends and loved ones. So coming to terms with all those three and trying to integrate them was a major life task and a major focus of my therapy here.
Tim (23:08.13)
Yeah, I think that's really interesting. I think that's something that all of us have to a certain extent where we have these.
different components of ourselves where we have the personal, have the professional and we have, you know, in one component looking at my life, I'm doing a podcast, but I also have the professional. I have the personal, I have the active. How do you think those components to yourself and those three different
Elyn Saks (23:22.363)
Yeah.
Elyn Saks (23:31.28)
Yeah. Yeah.
Tim (23:40.664)
personalities of yourself. How do you think they've evolved over the years?
Elyn Saks (23:45.606)
I think Ellen became stronger. I think Professor Sachs did well. And I think the way the medical charts, once I accepted her, became much more less prominent, much less toxic. As I say, the more I accepted that I had a mental illness, the less the illness defined me. It became sort of accident and not essence, at which point.
The riptide that held me down set me free. So working through who I was and how I felt about it and what I could do about it was an important part of my therapy. And I think you're right that everybody has, you know, different components of themselves that they need to be aware of and try to integrate.
Tim (24:27.31)
What do you see as?
Tim (24:36.93)
What do you see is the difference between acceptance and just trying to will your way through something and work through something?
Elyn Saks (24:52.609)
Elyn Saks (24:55.952)
But I guess.
willing your way through something can lead to acceptance. So they're not inconsistent with each other. But acceptance may involve other things like admitting that you need sort of help from other people and you can't you know, pretend that if you just try harder, everything will be okay.
I mean, that's a kind of road to failure, I think, for people, most people with serious mental illness. And it's very understandable that people want to try to do that. And it's totally up to the individual how much they try and what they try. But willpower doesn't usually result in, you know.
a better mental health outcome than if you try to understand what's going on, accept it, and accept help.
Tim (26:04.718)
This is something that I want to discuss later on as well, because it's an evolving component to your journey. But at the start of your journey with your mental health, what were the main reasons why you were so strongly against medication?
Elyn Saks (26:12.24)
Yeah.
Elyn Saks (26:24.806)
two. So when I was a teenager, I smoked pot and my parents brought me to a, an afterschool rehab program, I guess you would call it. and they sort of drummed into you that many drugs of any kind were forgotten, that you should do stuff because you try hard and it's up to you and you shouldn't use, you know, help like that.
you shouldn't use medication. So that was one thing. And that was a shame. But the second thing was
Elyn Saks (27:08.558)
I didn't want to admit to the idea that I had a mental illness. This was what we call in the business a narcissistic injury. It was painful for me to think that I had that. So I tried to prove I didn't have it by getting off. If I could get off medication and do well, could prove that the lady of the medical charts was gone or was just a figment all along or whatever. I think those are the...
the tooth that that drove that.
Tim (27:42.072)
So when you were in England, you had a lot of people initially advising you to drop out of your academic program at Oxford. And this is also getting back into the component of your identity where understanding yourself as a mental patient rather than as an academic and you end up leaving
Elyn Saks (27:55.653)
Right.
Tim (28:11.596)
the Warnerford hospital. How important was it for your psyche, but also your identity that the new doctor that you start working with thought that it was actually the exact opposite and that it was important for you to continue your program at Oxford.
Elyn Saks (28:31.135)
I was incredibly lucky. went to see a very well -known psychiatrist. And he basically said two things. That I should get into intensive therapy, four or five days a week treatment. And then I continue as a student because being productive and working gave me a sense of mission and a sense of wellbeing. And he was totally right about both. And I think if
It had been an American doctor. They would have said, you know, you're ill, go back home to your parents, get a, you know, get an easy job like being cashier. Although to me, that would sound horrible. I was just so lucky that that, provider was able to give me the advice he gave me, because I think it was so true. made such a difference.
Tim (29:24.194)
fact that you were in England and you were alone and didn't have your family with you. Obviously, you didn't have that support system and that structure behind you. But to a certain extent, do feel like that was almost a necessity for you to be able to work your way through this on your terms?
Elyn Saks (29:37.435)
Right.
Elyn Saks (29:48.954)
Yeah, I never really thought about it that way, but I think that's true. mean, I think, you know, figuring out what was going on and what I could do about it and so on was something that I needed to do for myself and my own way in my own time. So I think it was really important that that happened. England was interesting in another way, because like American professors in some ways kind of coddle their students.
help them pick up topic statements, read multiple drafts, this and that. In England, I met with my supervisor, which was the name given to an advisor of a graduate student, maybe once a month, once every other month. And we would drink a little sherry and he would talk about his garden. With my dissertation, my thesis, my master's thesis, he...
He made one comment, like, don't keep using this phrase over and over. And that was the only thing he said. So he said very nice things about it. was the soap and scale was that of a master's thesis, but the quality was of a dissertation. So that felt nice to hear. But I think it's kind of too bad that I didn't get more input from him. But in a way, it developed independence of thinking.
And I thought, you I think that was a very useful thing for me, you know, going forward in my life.
Tim (31:22.811)
An important point that you note through doing therapy, my thoughts and feelings were not right or wrong, good or bad. They just were. And I think we all try to characterize ourselves and what we experience rather than simply just. Yeah, accepting, allowing it to be allowed to exist.
Elyn Saks (31:42.15)
except,
Tim (31:48.908)
You've obviously experienced it firsthand in your life. How do you think we can go about all of us improving upon this? Where shifting from always trying to define what we're going through rather than just simply going through it.
Elyn Saks (31:49.062)
That's a very important point.
Elyn Saks (32:08.162)
I think people coming forward and telling their stories is extremely helpful. People say with stigma that people coming to see mental health disorders as brain disorders doesn't much reduce stigma, but putting a human face on does. And I've tried to do that in my work and I've also invited people for programs like MetaWorld Peace, the basketball player.
kind of funny, he suffered from depression and anxiety and was actually went to a therapist when he was like five or six, which was very unusual, especially for that demographic. But I remember he was getting an honor at the analytic Institute that I'm part of and he asked me to bestow it on me, which on him, which made me feel really good. And after I said a bunch of nice things about him, I said, and as a five, 10,
woman of my generation. I was a really big giant, standing next to him at six foot seven, I felt like a shrimp. It was kind of funny. So he talked, we brought Patrick Kennedy in who has suffered with bipolar and substance use disorder. And he basically said something I thought really profound, which was mental health is this generation's main civil liberties issue, which I thought was true.
Georgiana Steinberg, Darrell Steinberg is the mayor of Sacramento. She had issues. Maria Bamford, the comedian and sitcom person, she had issues. And I think people coming forward and putting a face on is a very powerful way to destigmatize mental illness and to help people understand that it can affect anybody and we all really need to hang together and support each other.
Tim (34:03.566)
So you completed your graduate degree at Oxford in twice of the amount of time that it should have taken due to your mental health. And obviously a major component that we've talked about thus far is how environment changes are things that all people challenge with people struggle with, but especially yourself. And you made the important decision that
Elyn Saks (34:13.999)
Okay.
Tim (34:33.568)
Even though you finished your Oxford program, you were going to stay in England for another year to continue your same routine, especially with talk therapy. How important was that year after that program?
Elyn Saks (34:39.994)
Huh?
Elyn Saks (34:45.563)
Yes.
Elyn Saks (34:50.818)
I think it was incredibly important because I was really getting a lot of benefit from the therapy. And I wanted to continue it to continue to get benefit. And there weren't huge costs to my not going back right away. My family was very generous in helping me meet my financial obligations.
So I think staying that extra year was a good thing to do. And if I had to do it over again, I would do the same thing.
Tim (35:30.848)
Yeah, it's also at this time that you want a fresh start with your studies and you make the decision that instead of moving forward with your philosophy degrees, you wanted to go to law school. What was your main motivation behind wanting to go to law school?
Elyn Saks (35:53.594)
You know, I felt that philosophy was just too abstract and too disconnected from the real world. And that was something like law and you could actually do things to make people's lives better. And I thought that was really important. I went back and forth. Should I go to law school or should I get a PhD in psychology?
I mean, in the end, I chose law school. I felt like I was more of an analytic thinker than an intuitive thinker. Of course, then I went on to get an analytic degree, a psychoanalytic degree, eventually. But again, I thought philosophy was just too arid in a way. And it also had a lot of bad memories associated with it. So I left philosophy.
Tim (36:47.598)
So you took the LSAT in England and you ultimately got accepted to Yale Law School. So up until this point, you've graduated from Vanderbilt where you were the valedictorian. You got a graduate degree from Oxford on a scholarship and now you've been accepted to Yale Law School. So if you were to put
your accomplishments on a resume and you gave it to somebody, you know, everyone would probably be thinking, Ellen Sachs has it all figured out. She's very accomplished. With how broken you were at this point mentally. At this point in your life, were there ever moments where you were able to see through that?
Elyn Saks (37:30.394)
Yeah. Yeah.
Tim (37:47.148)
And were you capable of appreciating how gifted you were?
Elyn Saks (37:55.954)
Not really. I've always thought of myself as like middle of the pack and where I am, you know, so I'm at USC law school, I'm middle of the pack. At Oxford, I was middle of the pack. It was a high pact, but, you know, but it was, I didn't feel especially gifted or whatever. Just, I used to think of myself as, you know, a hard worker and that's, you know, that's why I did well. That's how I thought about it.
Tim (38:25.898)
Yeah, I think that's fascinating. think a lot of people think that you need to be special to do special things, but it really does just come back to the work.
Elyn Saks (38:34.843)
Yeah.
Tim (38:42.68)
So when you got to Yale law school, that's obviously the next big environment change. When was it that your mental health started to negatively impact you at Yale? How long into the program?
Elyn Saks (38:58.303)
It was the seventh week of my first semester there. I broke down on the roof of the Yale Law School with a couple of friends who brought me to my professor who brought me to the emergency room.
Elyn Saks (39:16.974)
I actually had a six inch nail with me that I had picked up. I also had a telephone wire belt that I made the night before when I was on the roof of the Yale Law School on the side of the year I needed to accessorize. So I made a belt and the staff person there asked for the belt and I gave it to him and then I said, you can't have my six inch nail because I need it for protection. And then the doctor came in with another tack.
who wasn't as nice as the first one and they surrounded me and they lifted me up in the air and they slammed me on a bed with such force that I saw stars and they tied my arms and feet to the bed, four point restraints and then put a net over my body. So that's called six point restraints. And it was, you know, it was really, really scary and very, very toxic. I was restrained.
20 hours a day for two days and then five to 15 hours a day for the next two or three weeks. And my chart had this notation, use restraints liberally. When I look back on all my forced treatment, forced hospitalization, forced medication, restraints, restraints is always the worst. And I think as I said, England hasn't used them for a long time. So, you we need to try to do better with that. Maybe we are doing better because this happened, you know, a couple of decades ago.
Tim (40:44.418)
And you finally got diagnosed with schizophrenia when you were in Connecticut. How did you go about processing this?
Elyn Saks (40:50.489)
I did.
Elyn Saks (40:55.14)
was very traumatic because I knew that schizophrenia was a, you know, kind of the worst of the worst of mental illnesses and that most people had a very poor prognosis. And would I live in a halfway house or a problem the rest of my life and be unable to do anything other than be a cashier or something? So I was, it was a big shock. It was a big blow and it left me feeling very pessimistic. And I remember
calling my dad and mom from the hospital. And I was saying, you know, very pessimistic and negative things to my dad. said, Ellen.
You don't need to feel this way. There are people who have much more serious challenges than you, like terminal cancer or whatever, and go on and live lives with dignity and well -being, even though also pain. And this is a piece of cake. You can do this if you try. And my first thought was he just doesn't get how horrible it is. But then when I thought about it, I thought, you know, maybe he's right. Maybe he's right.
you know, this isn't so bad and it's something that can be managed and it's something that I will manage. It sort of incentivized me to try harder to have a good and decent and productive life even in the face of the illness. So it turned out to be a pretty, you know, powerful thing that he did, even though, as I said, I didn't think he understood it at the time.
Tim (42:25.654)
In some ways was dealing with the identity and the diagnosis of the problem in this new label were you given? Was that more challenging than simply dealing with what you were going through?
Elyn Saks (42:40.74)
Yeah, because the name is so stigmatized. It has such a bad prognosis and that kind of thing. Actually, I'm part of a group that is thinking about, or maybe we've done it already, name change for schizophrenia. And like almost everybody, patients, families, doctors, psychologists, think that schizophrenia is a bad name.
And there was a range of other possibilities. So one was being descriptive, like altered perception disorder or disorganization disorder. Some were things like Creplins or Bloilers. So there are very famous people in the schizophrenia world, like Alzheimer's for dementia. there was a range of different possibilities. It was kind of interesting. The interesting thing is almost everybody thought that the name should change.
There was some disagreement about what it should change to. And I think names and words matter.
Tim (43:45.196)
You would read your law books while you were in the psych hospital in Connecticut. How important was that goal of getting back to law school and actually feeling like you were working towards something and staying in a good mental frame?
Elyn Saks (43:49.366)
I did,
Elyn Saks (44:01.42)
it was very important. You know, I was not giving up. was going forward. It didn't help at all because I read the books. But when I started the following year, I had no memory of what I read. So it didn't give me a leg up, but it did give me something to do when I was in the hospital that made me feel less pathetic, if I can put it that way and more. Yeah.
Tim (44:21.686)
My determination to go back to school was not part of my delusional thinking. It was part of myself. I believed myself to be the person who would go back to law school and finish it. That's who I believed myself to be. And that wasn't delusional. So you commit to that goal and you accomplish that goal of going back to law school. What was that process like of react, acclimating to
Elyn Saks (44:44.816)
Yeah.
Tim (44:49.888)
in academic environment and what was your mental health treatment like when you went back to law school?
Elyn Saks (44:57.85)
Well, I got into four day a week psychoanalytic treatment because I knew that had worked for me in the past. And that was helpful. And, you know, you know, law school is kind of a special place. They don't really grade you or anything like that. And everybody here like really is interested in learning and thinking. And so it was a lot of a lot of fun. Actually, there's a funny story about my being readmitted. I think this is in my book.
Yale had a policy that if you had been withdrawn from school for psychiatric reasons, you had to be evaluated by a Yale psychiatrist to see if you were ready to go back. And like any good student, I looked them up. This is before the days of the web. So I'm like looking at it in periodical indices and pulling books from shelves. I find an article by this guy. Students withdrawn from school for psychiatric reasons. Questions that you want to ask them and answers you want to hear.
So when I went into the interview, I was totally well prepared. I may not have been ready to go back, but I was enterprising enough that I should have been readmitted and I was. It was kind of fun.
Tim (46:11.81)
A lot of the conversations that I have with people revolve around having the courage and the confidence to allow the realist most authentic version of yourself come to the surface where
At times to fit in with the crowd or a certain environment that we're in, we kind of put on a not necessarily a facade, but we don't show our truest colors, maybe at times. And you've said that I was becoming adept at acting normal, even when I wasn't feeling it, perfecting this acting, this seeming
was vitally important if I were going to make my way in the real world. And I think this is interesting because it gets into this relationship between seeming like something versus just being who you are. And like I've said, I've talked with people about how can you be your most authentic self for you?
in your own well -being. Do you think it was actually the opposite though, where you almost had to have a manufactured identity to a degree and keep the real essence of yourself buried so that you kept yourself grounded and in a strong mental frame of mind.
Elyn Saks (47:45.348)
Yeah, no, that's a really good point. I actually have a group of friends we get together maybe once a month here in LA and we have, it's me, it's a bipolar lawyer, it's a bipolar clinical psychologist, and a couple of other people, someone who's going, getting her PhD. And we all have mental illness. We all talk about passing as normal.
you know, and then that's kind of one of the things that we do to make our way in the world and not to scare people and not to upset people or whatever. So there's, you know, there's use in doing that. I think if you have to do that all the time and you can never show your true self, that's pretty toxic too and pretty, you know, powerfully bad if you if you just basically are always quote acting.
But I think there's a role for acting, just to kind of make social interactions go smoother and so on. But again, to never be able to reveal who you are would feel really kind of...
Tim (49:04.128)
at this point in your life.
Or I guess, how do you think that relationship has evolved for you over the course of your life between being your real self and acting? Like right now in your life, do you think you still have to act more than you can be your real self?
Elyn Saks (49:26.342)
Yeah. No, think mostly, you know, my illness is very well managed and I'm not having to hide things or act or whatever. One of the really great things that happened for me was meeting and falling in love with my husband. And I went for like 15 years not dating because I was I dated normal in high school and college. But when I got ill, I stopped dating because I was just too tormented by internal demons. And then
My husband who worked at the law library at USC invited me to lunch and then he invited me to see the pet poppies in Lancaster, which is about an hour away. I must've liked him because I said yes, because I usually work seven days a week. I kept saying I was cold, hinting he put his arm around me, which he never did because I don't know why, but I felt very deflated. But at the end of the evening, he kissed me a long one, and I kissed goodnight.
And the thought I had, and this is literally the thought that went into my mind was, huh, this is even better than getting an article accepted. And then the next day he brought a feather from his parrot and pasted it on my computer. And that night I asked my college friend, Kenny, you think a guy who plucks a feather from his parrot and pasted it on your computer means he likes you? And Kenny said without missing a beat, I don't know, Ellen, but one thing for sure, he likes you better than he likes his parrot.
which actually at that moment wasn't true. He definitely liked his power better. But there are some funny stories, but know, falling in love with and marrying Will is kind of the best thing that ever happened to me. So I consider myself very fortunate that that happened.
Tim (51:09.454)
So taking a step back from that and how you got to USC. So you graduated from Yale Law School and instead of getting into the legal space, you get into the teaching space and you move out to California where you currently are now. You start teaching at USC and bringing your medication back into the conversation. Now that's obviously been a central part of your journey throughout your entire life.
Elyn Saks (51:38.533)
Yeah.
Tim (51:40.64)
And I know you've tried many times to get off your medication.
Elyn Saks (51:43.206)
Thank you.
Elyn Saks (51:48.251)
Yeah.
Tim (51:51.074)
but you finally come to grips with the fact that you'll need your medication to deal with your mental health issues. What did that acceptance process look like for you?
Elyn Saks (52:07.686)
Well, I went to about 10 years making multiple efforts to get off meds, which I undertook with great gusto and failed miserably at every time. and the reason I did it was partly the side effects, but more because of the quote narcissistic injury of having a mental illness and needing medicine. I wanted to prove that it just wasn't so. So I kept trying and trying and trying. Eventually my analysts said, you know, why don't you just stay on the meds and get on with your life?
And I was a little upset about that, but I decided to try it. And you know, my life just got much better. So I'm a convert now. I need the medication. It's not a sin. It's not a shame. It's just a medical fact. And it makes my life better. So I would never try to get off meds at this point.
I'm on the really best med there is. It's a catalog in terms of efficacy. It's called Clozapine. And most people don't use it unless their patients fail on other meds because it's very cumbersome. The first six months you have to have a weekly blood test and then the next six months every other week and then once a month the rest of your life. So it's cumbersome, but it's really good. It really works well. I don't have no symptoms, but I have many fewer symptoms.
As I said, I'm a convert, I'm not gonna try to get off.
Tim (53:37.048)
I love this quote that you have in your book that describes your process of coming to this acceptance with your medication. You say, as exasperating and frightening as my years long process of tinkering with my meds was for my friends and physicians, I understand now that it was hugely important for me to do it. It was a necessary stage of development that I needed to go through.
Elyn Saks (53:59.49)
Thank
Tim (54:04.446)
For my full -fledged self. It was the only way I could come to terms with the illness. I think this is such an interesting point because Whether it's you with Your medication in this process or everyone Dealing with something in your life. I Think you need to follow your heart and your intuition to a certain extent where
Elyn Saks (54:31.086)
Thanks
Tim (54:33.226)
You need to be able to get to a place or a mindset on your own. And it can't be forced on you by someone else where maybe it'll take much longer. Maybe it won't be the most direct route to take, but you need to be able to get to that level of acceptance and be in that right frame of mind on your own time rather than somebody else trying to force it upon you.
Elyn Saks (55:02.98)
Right, you put that very well. mean, force is easy, but it's a very unstable solution because once you stop administering it, the person has no incentive not to go back to where they were. And if someone comes to see that they need the medication and want it, it's a much more sustainable solution.
Tim (55:25.058)
You had always been very stubborn and unaccepting of everything that you were going through. Obviously with the medication, were very stubborn throughout your life, always trying to beat it to a certain extent. Obviously it was a very positive sort of mindset that you have of trying to come off your medication. You were unaccepting of sort of the
identity and the diagnosis of schizophrenia. And you were obviously also unaccepting of the notion or the fact that you wouldn't be able to create a successful life for yourself, given everything that you were dealing with. When you finally came to the understanding or that level of acceptance that as you put it, you know, the
the lady of the charts did exist, you know, that was a major component of your identity. How did that acceptance allow you to finally really progress professionally and personally?
Elyn Saks (56:41.026)
I didn't have to spend all my energy fighting it and trying to prove that it wasn't true. So that gave me a lot more space to do other more productive and more, you know, empowering and happy things. So, you know, it took a lot of energy to try to get off the beds. And once I stopped doing that, I had so much more in my legs that I could turn to. I guess the biggest
bad thing about my illness for me is never having children. I always wanted children, but I felt like...
Elyn Saks (57:23.812)
being pregnant off meds would have been very dangerous and being pregnant on meds could be dangerous for the child, the fetus. But also, kids are really stressful. It's really stressful to raise kids and you can't very well say, oops, I made a mistake by, you your N4 for, you know, decades. So I think it was a right decision for me not to have kids.
I asked my husband, I said, would you be interested in being a stay at home dad? And he was like, not really. So it wasn't a hard decision in the sense of being hard to make, but it was a hard decision in the sense of being very disappointing.
Tim (58:08.408)
what was the acceptance process for that look like for you over time?
Elyn Saks (58:16.016)
just coming to realize, watching people raise kids and seeing some of the challenges and just, you I think over time, I mean, you're pointing out, you know, in a number of contexts, going through things over time kind of helps you understand and accept in a way that you really can't at the moment that it's happening. So that's what that was.
Tim (58:46.038)
In your everyday life today, where do you think you've made the most progress and what still challenges you a lot?
Elyn Saks (58:59.173)
May not guess.
guess I've made progress in not living up to my grave prognosis and having a decent and a happy life and a successful life. feel like I'm, you know, within reason I'm successful. So what was the question? What were the good things and what were the challenging things?
Tim (59:22.432)
Yeah, what was what you felt like you where you've made the most progress and where what still challenges you on a everyday basis.
Elyn Saks (59:30.968)
I think I made the most progress in falling in love and marrying because pretty much I was always kind of successful occupationally kind of thing. But I went many years without dating. So the idea that I could fall in love and marry is something that I didn't take for granted. It was a big good thing that happened in my life.
and challenges, you know, I guess, you know, as you get older, you get more vulnerable to physical illness and that kind of thing. And I've had a bunch of physical illnesses and kind of making it through that has been hard and will probably continue to be hard, but you know, doing the best I can. I've had four episodes of cancer and a seborrheic hemorrhage or brain bleed. So.
Elyn Saks (01:00:31.642)
That's something I worry about and think about.
Tim (01:00:36.054)
What's it like for you going through physical challenges like that compared to mental challenges?
Elyn Saks (01:00:45.23)
Well, they feel different, but they're the same in the sense that they're both challenges.
Tim (01:00:53.43)
What did the process feel like for you for writing your book?
Elyn Saks (01:00:59.546)
You know, I actually wrote it very quickly. I wrote the first draft like in three weeks, but then I spent a long time editing and revising. And it was, you know.
As I said, kind of looking back on it could have been very traumatic, but it wasn't. It was kind of interesting and kind of showed me things that I hadn't thought about. So it was a nice process. It was good. Writing a sequel, memoir sequel. Right now it's organized thematically, work, relationships, therapy.
And my agent wants more of a chronological story. And the chronology of the first book was clear. I got sick. I took med, got treated, got better. And I'm not really sure what the narrative arc is yet of the second one, but that's something I'm working on and I hope I can come up with something that will be useful. There's also a movie in the works, if you can believe it. Although I think there are probably like a thousand options taken for every movie actually made, so I'm not holding my breath.
Tim (01:02:11.02)
That'd be a great sequel to A Beautiful Mind with Russell Crowe.
Elyn Saks (01:02:16.666)
Yeah, yeah, yeah, yeah.
Tim (01:02:19.106)
Who would you want to play if the movie gets made?
Elyn Saks (01:02:21.414)
I don't know, because it would have to be someone who probably in her early 20s and I'm in my late 60s now. mean, my generation, Meryl Streep and Anne Hathaway and that kind of thing, but we need a younger person now. I don't really. know, wouldn't she? She could be my therapist. Meryl Streep could be my therapist.
Tim (01:02:35.842)
Meryl Streep would be great.
Tim (01:02:43.544)
There's a lot that I can't appreciate and understand about your story because I just, yeah, it's challenging for me and I think a lot of people just to completely understand what you've gone through and what you've experienced. But I also think there's a lot that people could resonate with, especially if they read your book.
Elyn Saks (01:02:52.848)
you've never experienced.
Tim (01:03:12.744)
And there's a lot that I definitely do resonate with. There were parts of your book and certain passages that really made me.
think about myself and the relationship with myself. Generally speaking, what do you think it is about your story that you think the general public could relate to?
Elyn Saks (01:03:28.634)
Good.
Elyn Saks (01:03:42.454)
I I guess just the notion that all of us have challenges of different kinds. And it's just one story of living through and overcoming the challenges. People have different challenges, health challenges, financial challenges, relationship challenges. You know, almost nobody goes through life unscathed by anything. So I think, you know, maybe that makes it meaningful for people to hear my story.
Tim (01:04:14.04)
Yeah, I think it sounds cliche, but I think the last line of your book really sums it up well. My good fortune is not that I've recovered from mental illness. I have not nor will I ever. My good fortune lies in having found my life. And obviously everything that you've gone through has challenged you and
Elyn Saks (01:04:32.134)
Yeah.
Tim (01:04:43.786)
made you doubt yourself and it has broken you down.
but I also see it as...
a way that has allowed you to become more connected with yourself and all of your mental health challenges acted as the bridge or the key to unlock yourself internally where you could examine yourself. And I don't think people necessarily have to do that in everyday life. I think a lot of people can just
aimlessly go through life where they don't need to do that internal work where they truly find themselves. But you needed to do it to a certain extent. If you wanted to not just survive or exist in the world, but also thrive and make a life for yourself. And it's truly incredible to say
Elyn Saks (01:05:43.76)
Yeah. Yeah.
Elyn Saks (01:05:49.486)
Thank you so much. Thank you.
Tim (01:05:52.352)
Ellen, I really appreciate you for coming on the show.
Elyn Saks (01:05:55.834)
Thank you, Tim. Great questions, really great questions.