Turning madness into music: A former psychiatric patient’s life is now an opera

It's not often that a health organization teams with a professional music company to produce an opera, but that's what happened in July when "The Center Cannot Hold," produced by the Center for Health Services and Society at the University of California at Los Angeles, in conjunction with the Pacific Opera Project, staged the opera on the UCLA campus.

This week, the production's sponsor, Mental Health America, published a video of the event on its website, and you can watch it there now.

The opera is based on the life of legal scholar and former psychiatric patient Elyn Saks, who in 2007 chronicled her struggle with schizophrenia in a best-selling memoir. Saks co-authored the libretto with the composer Kenneth B. Wells, who is also a psychiatrist.

The idea for the opera came about several years ago after Wells invited Saks, a law professor and a MacArthur Award winner, to serve as guest speaker before a performance of his first opera, about the life of Eleanor Roosevelt. After reading Saks's memoir, Wells thought it would make a great musical subject and asked his friend if she would collaborate.

"It's a weird feeling to have an opera written about yourself," Saks said. "He really gets inside the my mind, but also inside the minds of young psychiatrists and their hopes and worries."

The opera concentrates on one of the more traumatic incidents in Saks's autobiography: her involuntary hospitalization after experiencing a psychotic break while a student at Yale Law School in the late 1970s.

In the first act, the soprano playing Saks sings "My mind's in the dark. … My head's full of noise. ... People will kill me from out of the sky."

A tenor, playing the part of the admitting psychiatrist, responds, "She's dangerous, so dangerous ... gravely disabled, suicidal, we must protect her from herself."

The experiences depicted in the opera, Saks said, are all true.

"I was scared, angry and despairing," she said. "I was in restraints and scared out of my wits."

To "bring the person behind the words into music," Wells said he met with Saks at least eight times over a period of three to four months. Because the opera's characters include the doctors who treated Saks, Wells also needed to depict, musically, their fears and frustrations.

"I was training in psychiatry about the same time as her early hospitalizations," he said. "So I used my own experiences to flesh that out."

Saks also volunteered to help out the singers, most of whom were members of the Los Angeles Opera Company or the Los Angeles Master Chorale.

"Elyn came to a rehearsal and talked about her illness and her strengths," Wells said. "And then she went around to each cast person and said, 'Let me tell you about this person.' I mean, how often do you have that when you're doing an opera?"

Still, there were moments of disagreement, according to Wells:

"At one point, she said, 'You're making the [character of the] psychiatrist too nice.' I said, 'It's not that people were trying to hurt you, they were dealing with limitations. ... That's the drama of it.' "

Schizophrenia affects approximately 70 million people around the world, including more than 3 million Americans, and is one of the top-10 causes of disability, according to the National Institute of Mental Illness.

Despite living with schizophrenia, Saks has had a distinguished career in mental-health law, patients' rights, competency, proxy consent and the right to refuse treatment. Currently she is an associate dean and the Orrin B. Evans Professor of Law, Psychology, and Psychiatry and Behavioral Sciences at the University of Southern California's Gould School of Law.

The opera, which was conducted by Stephen Karr and directed by Brendan Hartnett, has opened a new, and unexpected, avenue of dialogue for Saks.

"I hope it helps people understand the experience and decrease the stigma," she said. "The music is powerful. So really, I just hope it moves people."

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