中英文稿

我是一個(gè)患有慢性精神分裂癥的女人 我曾經(jīng)有幾百天都 待在精神病醫(yī)院里面 也許我有可能一生 大部分時(shí)間都待在醫(yī)院的病房里 但是我的人生并沒有這樣 事實(shí)上， 我成功的離開了醫(yī)院 將近三十年了 這可能是我最自豪的成就了 但是這并不代表我沒有 精神上的掙扎 當(dāng)我從耶魯大學(xué)畢業(yè)以后 我得到了第一份法律工作， 我在紐黑文的醫(yī)生， 外特 告訴我他將在三個(gè)月之后 停止他的治療工作。這發(fā)生在 我準(zhǔn)備離開紐黑文的幾年前。 外特對(duì)我有很大的幫助， 想到他的離開幾乎 讓我崩潰

我最好的朋友史蒂夫 感覺到了有東西很不對(duì) 飛到了紐黑文來和我待在一起 現(xiàn)在我要讀一段我自己的筆記了： 我打開我一室一廳的房子 史蒂夫后來告訴我 即使他多次見過我病發(fā)的時(shí)候，也還是 為他當(dāng)天見到的我吃驚。 我有一個(gè)星期沒怎么吃東西了 我很憔悴， 我走路的時(shí)候 感覺自己的腳是木頭做的 我感覺自己的臉是一張面具 我把所有的窗簾都關(guān)起來了 正午的時(shí)候 我的房間幾乎是完全黑暗的 空氣難聞， 屋子凌亂 史蒂夫， 作為一個(gè)律師和心理學(xué)家，治療過 很多有嚴(yán)重精神病的患者， 直到今天 他會(huì)覺得這是他見過的最壞的情況了 “你好”， 我說， 然后回到我沉靜了 一時(shí)的沙發(fā)上 謝謝你的到來 搖搖欲墜的世界，詞， 聲音 告訴鐘停下來 時(shí)間， 時(shí)間來了 “外特要離開了”， 史蒂夫說 “我被推倒墳?zāi)估锪耍?處境就是墳?zāi)埂?我呻吟到 地心引力在把我往下拉 我很害怕， 告訴他門離開“

作為一個(gè)年輕女人， 我在精神病院里 待過三段很長(zhǎng)的時(shí)間。 我的醫(yī)生給我診斷了慢性精神分裂 給了我一個(gè)”不樂觀“的預(yù)測(cè) 就是說， 我只能在看護(hù)下活著 做很低下的工作 但是很幸運(yùn)的是， 我其實(shí)沒有 執(zhí)行這個(gè)預(yù)測(cè) 相反， 我是一個(gè)南加州大學(xué)Gould 法學(xué)院的首席法律教授， 心理學(xué)教授，精神病學(xué)教授。 我有很多親近的朋友 和親愛的丈夫， 他今天也來了

謝謝！ 他當(dāng)然是我人生鐘的明星。

我想和你分享這是怎樣發(fā)生的， 而且向你描述我作為一個(gè)精神病患者 我想說的是，這只是我的經(jīng)歷 因?yàn)槊總€(gè)人的精神病多有不同的癥狀

讓我們從精神分裂的定義開始把， 精神分裂是一種大腦疾病 它的主要癥狀是幻想， 或者是與 現(xiàn)實(shí)脫離 妄想和幻覺 是這個(gè)病的標(biāo)志 妄想是頑固，錯(cuò)誤和不會(huì)因?yàn)楝F(xiàn)實(shí)而改變的信仰 幻覺是不存在的感覺 比如， 當(dāng)我病發(fā)的時(shí)候， 我總是有我用我的想法 殺了幾百個(gè)人的錯(cuò)覺 我有時(shí)候會(huì)覺得 自己腦子里正要發(fā)生核爆炸 也有時(shí)候， 我有幻覺 有個(gè)人在我后面 高舉這一把刀 想象以下在清醒的情況下做噩夢(mèng)

言語(yǔ)和思想經(jīng)常變得沒有頭緒 簡(jiǎn)直沒有任何邏輯 當(dāng)人有散漫的聯(lián)想的時(shí)候， 就會(huì)把一些很相似的詞 放在一起， 沒有任何意義 感覺像一個(gè)文字混在一起的“沙拉” 和大部分人以為的恰好相反，精神分裂不是 多重人格或 人格分裂 精神分裂的大腦不是分開的， 是破碎的

每個(gè)人都看到過街上有人 不修邊幅， 營(yíng)養(yǎng)不良 站在外面亂對(duì)自己說話 或者大聲嚷嚷 這種人多半是有精神分裂 但是精神分裂出現(xiàn)在很多不同的 社會(huì)層次中。 其中有很多患者 是有全職工作的， 承擔(dān)著很大責(zé)任的。 幾年前， 我決定 把我的個(gè)人經(jīng)歷寫下來 而且我像和你分享更多我的個(gè)人經(jīng)歷 以此給大家一個(gè)輕身經(jīng)歷的人的角度看待這個(gè)事情

接下載這件事發(fā)生在我上耶魯大學(xué)法學(xué)院 的第一學(xué)期的第七周 從我的筆記中： ”我的兩個(gè)同學(xué)， Rebel和Val 和我約了一個(gè)時(shí)間 星期五一起在圖書館 學(xué)習(xí)我們的備忘錄的作業(yè) 但是我們沒有完成， 因?yàn)槲议_始 胡言亂語(yǔ)

“備忘錄是探訪”， 我告訴他們 “他們有寫觀點(diǎn)， 觀點(diǎn)就在你腦子里， Pat 曾經(jīng)就這么說， 你殺了人嗎？‘ Rebel 和Val看著我， 好像我在 他們臉上潑了冷水一樣 “你在說什么？， Elyn？“ ”哦， 你知道的， 誰是什么， 什么是誰？， 天堂和地獄，讓我們?nèi)ノ蓓敗?那是平的， 那里安全?！?Rebel和Val跟著我 問我怎么了 ”這就是真正的我“ 我說 高高的揮著我的手 然后， 在星期五很晚的時(shí)候， 在法學(xué)院的樓頂上 我開始唱歌，很大聲 ”來到佛羅里達(dá) 陽(yáng)光和灌木 你想跳舞嗎？“ ”你嗑藥了嗎” 有人問， “你high了嗎？” “咳？不可能， 沒有嗑藥。 來到佛羅里達(dá)， 陽(yáng)光灌木， 那里有檸檬， 那里有惡魔 “你嚇倒我了”， 他們一個(gè)人說， Rebel和Val 回到了圖書館。 我聳聳肩， 跟著他們。

回來之后， 我告訴我的同學(xué)他們 有沒有同樣的胡言亂語(yǔ)的經(jīng)歷 像我一樣 “我覺得有人進(jìn)入了我的案件” 我說 “我們要把關(guān)節(jié)裝起來， 我不相信關(guān)節(jié)， 但是 它們能把身體連起來。－－ 這就是一個(gè)散漫聯(lián)想的例子 最終我回到了宿舍 到了后， 我沒有辦法安心。 我腦子里都是噪音 到處都是桔子樹和我寫不出來的法律備忘錄 以及那些我需要為之負(fù)責(zé)任的大規(guī)模謀殺。 坐在床上， 我搖來?yè)u去 在孤獨(dú)和恐懼中呻吟?！?這次發(fā)病讓我第一次在美國(guó)住院了， 我前兩次在英國(guó)

繼續(xù)我的筆記： “第二天， 我來到我教授辦公室， 問 我能不能晚點(diǎn)交作業(yè)， 然后喔喔喔歐開始胡言亂語(yǔ)， 就像前一天晚上一樣 他最后把我送到急診室 到了之后，有一個(gè)人， 我就叫他“醫(yī)生”吧， 和他的野蠻助手們，飛撲下來 把我舉的高高的 然后狠狠的摔在了一張金屬床上 重的我都看到星星了 然后它們把我的手腳都幫起來了 用很厚的皮帶 一個(gè)我叢沒有聽到過的聲音叢我嘴里說出來： 一半呻吟， 一半尖叫 慘無人性，純粹恐懼 然后這個(gè)聲音又出現(xiàn)了 從我的肚子了逼出來的 刮著我的喉嚨 這個(gè)事情導(dǎo)致了我被強(qiáng)制住院 其中一個(gè)理由我醫(yī)生給的強(qiáng)制住院的理由是 我嚴(yán)重 生活不自理 為了支持這個(gè)說法， 它們?cè)谖业臋n案里寫說我 不能完成我耶魯法學(xué)院的作業(yè)。 我不知道這對(duì)其他的紐黑文的人意味著什么 （笑聲）

在第二年， 我又 在醫(yī)院里待了五個(gè)月 有時(shí)候， 我會(huì)再機(jī)械限制中度過20小時(shí)， 手被捆這， 手和腳被緊緊的捆著 手和腳被捆著， 而且胸前 還有一個(gè)網(wǎng)子綁著 我沒有打任何人 我沒有害任何人， 我沒有直接威脅任何人 如果你沒有被限制過， 你可能 對(duì)這個(gè)經(jīng)歷有個(gè)不差的印象 但是其實(shí)糟透了

再美國(guó)， 每周 都有一到三個(gè)人死于這種限制 他們被縲， 吸著自己的嘔吐物 他們被窒息， 他們心臟病發(fā)作 不知道這種機(jī)械限制是在 救人還是害人 當(dāng)我在耶魯法學(xué)院刊物上給學(xué)生準(zhǔn)備關(guān)于機(jī)械限制的 講義時(shí)， 我咨詢了一位知名的法學(xué)教授 和精神病學(xué)家 并向他肯定了這種 限制時(shí)傷人自尊， 痛苦和可怕的 他理解的看著我， 說 “Elyn， 你還是不明白： 這些人又精神病。 他們和你和我都不一樣 他們不會(huì)像你我一樣經(jīng)歷限制。 我當(dāng)時(shí)沒有勇氣告訴他 不， 我們和你并沒有什么不同 我們不喜歡被捆綁在床上 跟他一樣不喜歡在那里受苦 事實(shí)上， 最近 我肯定現(xiàn)在還是有人覺得 這些限制能幫助病人感到安全 我從來沒有遇到過一個(gè)精神病 同意這種說法 今天， 我非常贊成心理治療 但是非常反對(duì)強(qiáng)制型治療 我覺得強(qiáng)迫沒有效果， 而且對(duì)一個(gè)有嚴(yán)重精神病的人 實(shí)施強(qiáng)制手段 是很可怕的

最終， 我來到了洛杉磯 在南加州法學(xué)院教書 這些年來， 我一直反對(duì)用藥 為此會(huì)付出一切。 我感覺到我不服用藥物也可以保持 我想要證明畢竟 我精神上沒問題,只不過是診斷上犯得錯(cuò)誤而已 我的理念是服藥越少,瑕疵就越少 我的分析師 Kaplan博士,當(dāng)時(shí)勸我 堅(jiān)持服藥并且就這樣生活下午 但是我決定我想要最最后一次嘗試 從文中引用: "我開始減少我的用藥量,而在短時(shí)間之內(nèi) 我就感覺到了一些變化 在從牛津旅行回來后,我沖進(jìn)了Kaplan 的辦公室,沖向角落,蹲了下來 捂住我的臉,開始顫抖 在我周圍我感覺到了拿了匕首的惡魔 他們把我切成了碎片 或者讓我吞下滾燙的煤球 Kaplan后來把我當(dāng)時(shí)情景描述為"在撕心裂肺的痛苦中蠕動(dòng)" 即使在這個(gè)狀態(tài)下,他準(zhǔn)確地描述為 急性神經(jīng)病 我拒絕服用更多的藥物 因?yàn)槿蝿?wù)還沒有完成

在與Kaplan的面會(huì)結(jié)束后, 我去看了Marder醫(yī)生,一位精神分裂癥專家 他是負(fù)責(zé)觀察我用藥的副作用的 他覺得我可能有一定程度上的精神分裂 一次在他的辦公室,我坐在沙發(fā)上,蜷縮起來, 然后開始喃喃自語(yǔ) "頭破血流,人們?cè)噲D殺戮, 我能不能把你的辦公室徹底當(dāng)垃圾處理?" "如果你那么想的話,你需要現(xiàn)在離開." Marder說 "好吧.小一點(diǎn).在冰上的火.告訴他們不要?dú)⑽? 告訴他們不要?dú)⑽?我做錯(cuò)什么了? 成百上千個(gè)想法被封鎖 "Elyn,你是不是覺得 你對(duì)自己或他人很危險(xiǎn)? 我認(rèn)為你應(yīng)該待在醫(yī)院里 我可以現(xiàn)在就讓你被容納進(jìn)來,整個(gè)事情會(huì)變得 十分分散." "哈哈哈, 你想把我放在醫(yī)院里? 醫(yī)院是不好的,它們都瘋了,它們都十分難過 任何一個(gè)人都得遠(yuǎn)離醫(yī)院.我就是上帝,或者我以前是." 在那個(gè)情況下, 當(dāng)我說"我是上帝,或者我以前是"的時(shí)候,我的丈夫 在邊上記了一筆 他問:"那你是退出了還是被開除了?" (笑聲) "我創(chuàng)造生命然后我拿走他們, 原諒我吧,因?yàn)槲也恢涝撟鍪裁?"

最后,我在朋友面前倒塌了, 然后每個(gè)人都想說服我去繼續(xù)服用藥物 我在也不能否定事實(shí)了, 而且我無法改變這樣一個(gè)事實(shí) 那堵隔離我,Elyn還有Saks教授的墻 與那個(gè)瘋女人住院的年頭所隔離 在廢墟中倒塌."

任何關(guān)于此疾病都暗示我不應(yīng)該在這里 但是我還是在這里.我覺得吧..有三個(gè)原因: 第一,我已經(jīng)有了極好的治療了 一周四到五次的心理分析和心理治療 持續(xù)了幾十年,以及非常先進(jìn)的心理配藥 第一,我有我的家庭成員都朋友都知道 我和我的疾病 這些關(guān)系給我的人生 一個(gè)意味和一個(gè)深度,他們還幫助我 在這些癥狀面前找到生活的方向 第三,我在一個(gè)極具支持力的工作環(huán)境里工作 就在USC法律學(xué)校 這是一個(gè)不僅僅滿足我需求的地方 而且實(shí)際上它擁抱我的需求 它也同樣是一個(gè)刺激思考的地方 能夠使我的腦子充滿各種復(fù)雜的問題 這些都是最強(qiáng)有力最有依賴性的抵御 我精神疾病的武器

即使這些全都有---良好的治療,融合的家庭和 朋友,和諧的工作環(huán)境-- 直到很晚我才公開了 我這個(gè)疾病 因?yàn)榕c精神疾病作斗爭(zhēng)的烙印 太強(qiáng)大了以至于我想讓別人知道 如果你今天啥都沒聽到, 你一定得記住這一點(diǎn):這些都不是"精神分裂癥" 而是患有精神分裂癥的人們,而這些人可能 是你的配偶,也可能是你的孩子 可能是你的鄰居,也可能是你的朋友 還有可能是你的同事

好吧.我就說說我最后的想法 我們需要為精神疾病的研究和治療 進(jìn)行更多的資源投資 我們理解這些疾病越到位, 我們能提供的治療就越先進(jìn),這樣一來, 我們就能給人們帶來更多的關(guān)懷 而且不需要使用外力 而且,我們應(yīng)該停止將精神疾病最惡化 說洛杉磯監(jiān)獄是美國(guó)最大的心理醫(yī)療機(jī)構(gòu) 是國(guó)家的悲劇和謠言 美國(guó)的監(jiān)獄是那些被精神疾病所折磨的人 占領(lǐng)的,而且很多人在那 是因?yàn)樗麄儚奈唇邮苓^足夠的治療 我當(dāng)初可以輕松地淪落到大家上 一條對(duì)娛樂行業(yè)和新聞業(yè)的建議: 整體來說,你們?cè)谂c烙印和各種偏見斗爭(zhēng)中 干得很不錯(cuò) 拜托了,繼續(xù)讓我們?cè)谀銈兊碾娪爸?你的戲劇中, 你們的專欄中, 看到那些受嚴(yán)重精神疾病折磨的人 同情地描述他們, 并且有深度地挖掘他們, 通過他們親身的經(jīng)驗(yàn)而不是簡(jiǎn)單的一個(gè)診斷

最近,我朋友提出一個(gè)問題: 如果我手里有一片瞬間可以 治好我的藥片,我吃不吃它? 詩(shī)人Rainer Maria Rilke 被提供了心理分析 他拒絕了,說到:"不要把我的邪惡拿走, 因?yàn)槲业奶焓挂灿锌赡芴优?" 而我的精神病 是一個(gè)現(xiàn)實(shí)的噩夢(mèng),里面的惡魔十分可怕 以至于所有的天使都逃走了 那么我會(huì)不會(huì)吃掉那個(gè)藥片了? 我不希望被看作是對(duì)于如果我沒有精神疾病我會(huì) 擁有的生活所后悔 而我也不是在向任何人尋求憐憫 我實(shí)際想說的是我們所共享的人性 比精神疾病要重要的多 那些經(jīng)歷過精神疾病的人想要的 要是其他所有人想要的 Sigmund Freud說到:"去工作,去愛."

謝謝.

謝謝.謝謝.你們真善良.

So I'm a woman with chronic schizophrenia. I've spent hundreds of days in psychiatric hospitals. I might have ended up spending most of my life on the back ward of a hospital, but that isn't how my life turned out. In fact, I've managed to stay clear of hospitals for almost three decades, perhaps my proudest accomplishment. That's not to say that I've remained clear of all psychiatric struggles. After I graduated from the Yale Law School and got my first law job, my New Haven analyst, Dr. White, announced to me that he was going to close his practice in three months, several years before I had planned to leave New Haven. White had been enormously helpful to me, and the thought of his leaving shattered me.

My best friend Steve, sensing that something was terribly wrong, flew out to New Haven to be with me. Now I'm going to quote from some of my writings: "I opened the door to my studio apartment. Steve would later tell me that, for all the times he had seen me psychotic, nothing could have prepared him for what he saw that day. For a week or more, I had barely eaten. I was gaunt. I walked as though my legs were wooden. My face looked and felt like a mask. I had closed all the curtains in the apartment, so in the middle of the day the apartment was in near total darkness. The air was fetid, the room a shambles. Steve, both a lawyer and a psychologist, has treated many patients with severe mental illness, and to this day he'll say I was as bad as any he had ever seen. 'Hi,' I said, and then I returned to the couch, where I sat in silence for several moments. 'Thank you for coming, Steve. Crumbling world, word, voice. Tell the clocks to stop. Time is. Time has come.' 'White is leaving,' Steve said somberly. 'I'm being pushed into a grave. The situation is grave,' I moan. 'Gravity is pulling me down. I'm scared. Tell them to get away.'"

As a young woman, I was in a psychiatric hospital on three different occasions for lengthy periods. My doctors diagnosed me with chronic schizophrenia, and gave me a prognosis of "grave." That is, at best, I was expected to live in a board and care, and work at menial jobs. Fortunately, I did not actually enact that grave prognosis. Instead, I'm a chaired Professor of Law, Psychology and Psychiatry at the USC Gould School of Law, I have many close friends and I have a beloved husband, Will, who's here with us today.

(Applause) Thank you. He's definitely the star of my show.

I'd like to share with you how that happened, and also describe my experience of being psychotic. I hasten to add that it's my experience, because everyone becomes psychotic in his or her own way.

Let's start with the definition of schizophrenia. Schizophrenia is a brain disease. Its defining feature is psychosis, or being out of touch with reality. Delusions and hallucinations are hallmarks of the illness. Delusions are fixed and false beliefs that aren't responsive to evidence, and hallucinations are false sensory experiences. For example, when I'm psychotic I often have the delusion that I've killed hundreds of thousands of people with my thoughts. I sometimes have the idea that nuclear explosions are about to be set off in my brain. Occasionally, I have hallucinations, like one time I turned around and saw a man with a raised knife. Imagine having a nightmare while you're awake.

Often, speech and thinking become disorganized to the point of incoherence. Loose associations involves putting together words that may sound a lot alike but don't make sense, and if the words get jumbled up enough, it's called "word salad." Contrary to what many people think, schizophrenia is not the same as multiple personality disorder or split personality. The schizophrenic mind is not split, but shattered.

Everyone has seen a street person, unkempt, probably ill-fed, standing outside of an office building muttering to himself or shouting. This person is likely to have some form of schizophrenia. But schizophrenia presents itself across a wide array of socioeconomic status, and there are people with the illness who are full-time professionals with major responsibilities. Several years ago, I decided to write down my experiences and my personal journey, and I want to share some more of that story with you today to convey the inside view.

So the following episode happened the seventh week of my first semester of my first year at Yale Law School. Quoting from my writings: "My two classmates, Rebel and Val, and I had made the date to meet in the law school library on Friday night to work on our memo assignment together. But we didn't get far before I was talking in ways that made no sense.

'Memos are visitations,' I informed them. 'They make certain points. The point is on your head. Pat used to say that. Have you killed you anyone?' Rebel and Val looked at me as if they or I had been splashed in the face with cold water. 'What are you talking about, Elyn?' 'Oh, you know, the usual. Who's what, what's who, heaven and hell. Let's go out on the roof. It's a flat surface. It's safe.' Rebel and Val followed and they asked what had gotten into me. 'This is the real me,' I announced, waving my arms above my head. And then, late on a Friday night, on the roof of the Yale Law School, I began to sing, and not quietly either. 'Come to the Florida sunshine bush. Do you want to dance?' 'Are you on drugs?' one asked. 'Are you high?' 'High? Me? No way, no drugs. Come to the Florida sunshine bush, where there are lemons, where they make demons.' 'You're frightening me,' one of them said, and Rebel and Val headed back into the library. I shrugged and followed them.

Back inside, I asked my classmates if they were having the same experience of words jumping around our cases as I was. 'I think someone's infiltrated my copies of the cases,' I said. 'We've got to case the joint. I don't believe in joints, but they do hold your body together.'" -- It's an example of loose associations. -- "Eventually I made my way back to my dorm room, and once there, I couldn't settle down. My head was too full of noise, too full of orange trees and law memos I could not write and mass murders I knew I would be responsible for. Sitting on my bed, I rocked back and forth, moaning in fear and isolation." This episode led to my first hospitalization in America. I had two earlier in England.

Continuing with the writings: "The next morning I went to my professor's office to ask for an extension on the memo assignment, and I began gibbering unintelligably as I had the night before, and he eventually brought me to the emergency room. Once there, someone I'll just call 'The Doctor' and his whole team of goons swooped down, lifted me high into the air, and slammed me down on a metal bed with such force that I saw stars. Then they strapped my legs and arms to the metal bed with thick leather straps. A sound came out of my mouth that I'd never heard before: half groan, half scream, barely human and pure terror. Then the sound came again, forced from somewhere deep inside my belly and scraping my throat raw." This incident resulted in my involuntary hospitalization. One of the reasons the doctors gave for hospitalizing me against my will was that I was "gravely disabled." To support this view, they wrote in my chart that I was unable to do my Yale Law School homework. I wondered what that meant about much of the rest of New Haven. (Laughter)

During the next year, I would spend five months in a psychiatric hospital. At times, I spent up to 20 hours in mechanical restraints, arms tied, arms and legs tied down, arms and legs tied down with a net tied tightly across my chest. I never struck anyone. I never harmed anyone. I never made any direct threats. If you've never been restrained yourself, you may have a benign image of the experience. There's nothing benign about it.

Every week in the United States, it's been estimated that one to three people die in restraints. They strangle, they aspirate their vomit, they suffocate, they have a heart attack. It's unclear whether using mechanical restraints is actually saving lives or costing lives. While I was preparing to write my student note for the Yale Law Journal on mechanical restraints, I consulted an eminent law professor who was also a psychiatrist, and said surely he would agree that restraints must be degrading, painful and frightening. He looked at me in a knowing way, and said, "Elyn, you don't really understand: These people are psychotic. They're different from me and you. They wouldn't experience restraints as we would." I didn't have the courage to tell him in that moment that, no, we're not that different from him. We don't like to be strapped down to a bed and left to suffer for hours any more than he would. In fact, until very recently, and I'm sure some people still hold it as a view, that restraints help psychiatric patients feel safe. I've never met a psychiatric patient who agreed with that view. Today, I'd like to say I'm very pro-psychiatry but very anti-force. I don't think force is effective as treatment, and I think using force is a terrible thing to do to another person with a terrible illness.

Eventually, I came to Los Angeles to teach at the University of Southern California Law School. For years, I had resisted medication, making many, many efforts to get off. I felt that if I could manage without medication, I could prove that, after all, I wasn't really mentally ill, it was some terrible mistake. My motto was the less medicine, the less defective. My L.A. analyst, Dr. Kaplan, was urging me just to stay on medication and get on with my life, but I decided I wanted to make one last college try to get off. Quoting from the text: "I started the reduction of my meds, and within a short time I began feeling the effects. After returning from a trip to Oxford, I marched into Kaplan's office, headed straight for the corner, crouched down, covered my face, and began shaking. All around me I sensed evil beings poised with daggers. They'd slice me up in thin slices or make me swallow hot coals. Kaplan would later describe me as 'writhing in agony.' Even in this state, what he accurately described as acutely and forwardly psychotic, I refused to take more medication. The mission is not yet complete.

Immediately after the appointment with Kaplan, I went to see Dr. Marder, a schizophrenia expert who was following me for medication side effects. He was under the impression that I had a mild psychotic illness. Once in his office, I sat on his couch, folded over, and began muttering. 'Head explosions and people trying to kill. Is it okay if I totally trash your office?' 'You need to leave if you think you're going to do that,' said Marder. 'Okay. Small. Fire on ice. Tell them not to kill me. Tell them not to kill me. What have I done wrong? Hundreds of thousands with thoughts, interdiction.' 'Elyn, do you feel like you're dangerous to yourself or others? I think you need to be in the hospital. I could get you admitted right away, and the whole thing could be very discrete.' 'Ha, ha, ha. You're offering to put me in hospitals? Hospitals are bad, they're mad, they're sad. One must stay away. I'm God, or I used to be.'" At that point in the text, where I said "I'm God, or I used to be," my husband made a marginal note. He said, "Did you quit or were you fired?" (Laughter) "'I give life and I take it away. Forgive me, for I know not what I do.'

Eventually, I broke down in front of friends, and everybody convinced me to take more medication. I could no longer deny the truth, and I could not change it. The wall that kept me, Elyn, Professor Saks, separate from that insane woman hospitalized years past, lay smashed and in ruins."

Everything about this illness says I shouldn't be here, but I am. And I am, I think, for three reasons: First, I've had excellent treatment. Four- to five-day-a-week psychoanalytic psychotherapy for decades and continuing, and excellent psychopharmacology. Second, I have many close family members and friends who know me and know my illness. These relationships have given my life a meaning and a depth, and they also helped me navigate my life in the face of symptoms. Third, I work at an enormously supportive workplace at USC Law School. This is a place that not only accommodates my needs but actually embraces them. It's also a very intellectually stimulating place, and occupying my mind with complex problems has been my best and most powerful and most reliable defense against my mental illness.

Even with all that — excellent treatment, wonderful family and friends, supportive work environment — I did not make my illness public until relatively late in life, and that's because the stigma against mental illness is so powerful that I didn't feel safe with people knowing. If you hear nothing else today, please hear this: There are not "schizophrenics." There are people with schizophrenia, and these people may be your spouse, they may be your child, they may be your neighbor, they may be your friend, they may be your coworker.

So let me share some final thoughts. We need to invest more resources into research and treatment of mental illness. The better we understand these illnesses, the better the treatments we can provide, and the better the treatments we can provide, the more we can offer people care, and not have to use force. Also, we must stop criminalizing mental illness. It's a national tragedy and scandal that the L.A. County Jail is the biggest psychiatric facility in the United States. American prisons and jails are filled with people who suffer from severe mental illness, and many of them are there because they never received adequate treatment. I could have easily ended up there or on the streets myself. A message to the entertainment industry and to the press: On the whole, you've done a wonderful job fighting stigma and prejudice of many kinds. Please, continue to let us see characters in your movies, your plays, your columns, who suffer with severe mental illness. Portray them sympathetically, and portray them in all the richness and depth of their experience as people and not as diagnoses.

Recently, a friend posed a question: If there were a pill I could take that would instantly cure me, would I take it? The poet Rainer Maria Rilke was offered psychoanalysis. He declined, saying, "Don't take my devils away, because my angels may flee too." My psychosis, on the other hand, is a waking nightmare in which my devils are so terrifying that all my angels have already fled. So would I take the pill? In an instant. That said, I don't wish to be seen as regretting the life I could have had if I'd not been mentally ill, nor am I asking anyone for their pity. What I rather wish to say is that the humanity we all share is more important than the mental illness we may not. What those of us who suffer with mental illness want is what everybody wants: in the words of Sigmund Freud, "to work and to love."

Thank you.

Thank you. Thank you. You're very kind.?