Summary 4 - Saks - Voices from the Inside: Readings on the Experiences of Mental Illness PDF

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Summary of chapter 4 plus answer to one of the questions. Graded 10/10 by the professor....

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Summary 4 In this fourth chapter entitled “The Center Cannot Hold”, Elyn R. Saks shares her experience dealing with schizophrenia while talking about her therapeutic relationship with her therapist Mrs. Jones. With her, she started a Kleinian analysis (a form a therapy that comes from Freud), involving the concept of the unconsciousness. Saks explains that, during the sessions, the therapist, that she calls an analyst, uses the same type of language and words the patients do and they are never face to face. The author writes that Mrs. Jones was patient and understanding, and was never shocked by what she confided in her. Saks was delusional and paranoid, and was ashamed of it but Mrs. Jones’ rule implied that she had to tell her everything. Contrary to the doctors she had encountered before at the hospital, Mrs. Jones didn’t try to give her advice but rather listened and helped while never weighing her words in the process, which Saks seemed to appreciate (her calm presence helped her, more so than her words). While dealing with her illness, Saks was still a brilliant student: indeed, the Oxford examiners judged her thesis as excellent and she got accepted into all the prestige American schools she had applied to afterwards. In the meantime, as she continued her therapy, she began to become paranoid towards Mrs. Jones too as she grew closer to her. She thought of ways to defend herself since she was convinced her therapist wanted to hurt her but she was as terrified to lose her and she would tell her everything during the next session. Her analyst was as understanding as she had been before. Saks saw her as the glue holding her together: when she wasn’t with her, she hallucinated and became paranoid but she still met her obligations. Since Mrs. Jones helped her so much, Saks decided to stay in England one more year to continue her sessions

with her. She was still psychotic and couldn’t always distinguish her fantasies and reality. She continued her therapy since she had to stay in England after an accident that broke her collarbone and things turned worse: she had become completely dependent on her therapist and couldn’t imagine leaving England and living without her. On her final session, she refused to go, begged Mrs. Jones to keep seeing her and only when she saw she had no other choice did she actually leave, devastated.

Q2: In my opinion, therapists should remain relatively remote, anonymous and distant from their clients for multiple reasons. First, to me, the therapist has to know where to place the boundaries in the therapeutic relationship, otherwise an unhealthy dependence can be created like with Elyn Saks and Mrs. Jones. Indeed, we see in her story that she thought of her therapist as the glue holding her together, without whom she couldn’t function anymore. Reading her reaction to having to leave her, we see she developed a strong dependence on her therapist, which I think isn’t a good thing. I believe therapy has to help the patient but it can’t be the only thing holding the person together. The therapist can’t be the only one who understands the patient. To me, he/she should seek out ways to encourage the patient to create ties with other people in spite of his/her illness. Otherwise what happens if the therapist retires or moves away or the patient has to move? The dependence will make it very hard, as we saw with Elyn Saks and Mrs. Jones. Moreover, it is known that when there is a deep loving connection between the patient and the therapist, boundaries can be crossed, which can lead to many problems - the patient can fall in love with the therapist for example, or see him/her as their friend instead of their

doctor. I reckon the therapist has to take a step back and create a sort of separation to protect the client (from false hopes and false ideas of what the nature of the relationship between them is) but also to protect himself. Otherwise, the therapist can get very affected by what the client confides in him/her and if the client’s state becomes worse (or, worse, he/she dies), the therapist will have even more of a hard time dealing with it. Moreover, if the relationship goes beyond a distant professional one, the patient can feel as if the therapist is just another person in their direct surroundings, such as their sibling or great friend. While I believe the great thing about therapy is that you get to talk and confide in an anonymous person that isn’t apart of your direct entourage. Besides, I personally would be more comfortable to really say what I thought if the person were anonymous and relatively distant because it gives more room for honest answers and shameless confessions that you would normally refrain from sharing....