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  • 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.