Opera raises curtain on living with schizophrenia

A scene from

A scene from "The Center Cannot Hold: Addressing the Stigma of Serious Mental Illness through Opera." (Joseph Mango)

What’s it like to have psychosis? The Mütter Museum has a live opera performance and discussion Thursday to address that question.

Dr. Kenneth Wells, a psychiatrist at the University of California Los Angeles, has been an opera fan since he was 12.

He finally started writing one several decades later, to distract a high school friend and fellow opera fan, who was ill with cancer. The first song took four years to write.

“By that time, my friend had been declared cured, so I said, ‘Listen, if you can survive this cancer, I can write an opera.’”

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He finished that first one — about the life of first lady Eleanor Roosevelt after her husband died — and saw it performed on stage in 2010.

At one of those performances, he invited law and psychiatry professor Elyn Saks to speak; afterwards, she said wanted to collaborate with him. So Wells adapted Saks’ memoir about living with schizophrenia, “The Center Cannot Hold,” into an opera. Thursday night, the Mütter Museum will present parts of the opera, as well as a discussion about using music to address the stigma of mental health, and a conversation with Saks.

Offering, gaining insights

Saks has suffered a lot during the course of her illness. While in a psychiatric hospital, she was held in restraints for 24 hours, and she thought the staff were demons threatening her.

“The way she coped with that was by screaming Beethoven’s Fifth Symphony, his primary theme, over and over and over again all night long,” Well said. “So I took Beethoven’s Fifth Symphony and kind of distorted it and portrayed the staff becoming demons.”

Wells also added a bit of his perspective to the opera, because he was a psychiatrist in training at the same time that Saks was a patient.

For instance, Saks’ attending psychiatrist has a solo to reflect on hearing her screams. He laments that, even though he had a dream to cure schizophrenia, there is nothing he can do.

Wells said the idea is to show people what severe mental illness is like, and that recovery is possible.

Saks went on to win an MacArthur genius fellowship. In a 2013 opinion piece for the New York Times, she recalled that, when she was diagnosed, she was told that she would never live independently, hold a job, or get married. The rest of her days, she was told, would be spent  watching TV with other people with mental illness.

Even though it’s important to not romanticize mental illness and the real limitations it imposes, she wrote that work is her best defense because it keeps her demons at bay.

“That is why it is so distressing when doctors tell their patients not to expect or pursue fulfilling careers,” Saks wrote.

Positive reception

The opera was first performed in 2016, and Wells said people really connect with it.

“The audience reaction for a number of people was to come up to me at intermission right after the Beethoven scene and kind of say, ‘I never knew what psychosis was really like inside, and this gave me some insight.’ ”

He’s now working on a second opera, adapting a different part of Saks’ memoir, but expects it will be another few years before he finishes it. Another opera in the works will tell the stories of people who live with depression.

Other therapists and mental health professionals are interested in this program as well.

The Journal of the American Medical Association published a review of “The Center Cannot Hold” in 2017, remarking that “opera features medicine more than many may recognize.” The Behavior Therapist, another journal, asked Saks, Wells, and their collaborators to write a commentary — published in April — about the process behind their opera and other cooperative art programs.

Wells said he’s hoping more mental health professionals will work with patients and other groups to produce such projects. People with mental health don’t always get help, he said, but “art can play an important role in facilitating feeling it’s OK.”

The full opera adaption of “The Center Cannot Hold” is available on the Mental Health America website, along with remarks from Wells and Saks and information about psychosis and schizophrenia.

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