Annita Perez Sawyer, assistant clinical professor of psychology, reads the first chapter of her book "Smoking Cigarettes, Eating Glass: A Psychologist's Memoir."

For more than half of her life, Annita Perez Sawyer ’71 B.A., ’81 Ph.D. led a “double life,” keeping her troubled past a secret from all but a few people.

“The genie’s now out of the bottle,” says Sawyer, an assistant clinical professor of psychology at Yale, whose memoir, “Smoking Cigarettes: Eating Glass,” was recently published by the Santa Fe Writer’s Project.

Her memoir details Sawyer’s nearly six-year institutionalization (beginning at the age of 17) for mental illness in the 1960s, during which time she was misdiagnosed as schizophrenic and treated with electroconvulsive therapy, which resulted in extensive memory loss.

Sawyer also describes her journey from mental illness to becoming a psychotherapist herself, and how, some 40 years after her hospitalization, she learned the truth about her condition. Rather than being a chronic schizophrenic, as she was characterized in her hospital records, Sawyer actually suffered symptoms of post-traumatic stress disorder (PTSD) as a result of childhood sexual abuse.

Now in her early 70s, the psychologist is relieved to be living her life without secrets and hopes that “Smoking Cigarettes, Eating Glass” might inspire current mental health professionals to be more careful in diagnosing their patients. She begins her book with this dedication: “To all children, young or grown, who could not speak and were never known, to all healers with courage to pay attention, to all families and friends who would help if they could understand, and to everyone who has believed in me.”

Getting lost: Growing up Westchester County, New York, in what she describes as an often “silent” and “repressive” family, Sawyer was an academically accomplished but exceedingly shy teenager who became suicidal at age 17. She recalls in her memoir: “For years, I’d worried that as a human being I was despicable. I tried to be a good Catholic and go to church every week. Yet, no matter how much I prayed or confessed every bad thought, no matter how hard I worked at being kind and responsible, I couldn’t shake the conviction that I was evil at the core and didn’t deserve forgiveness. My mission was to rid the world of myself.”

In the summer of 1960, Sawyer was admitted to the Westchester Division of New York Hospital. There, her thrice-weekly shock treatment began. “Shock treatment felt like facing death again and again,” she recalls in her memoir, reflecting her understanding at the time. “Not only because the doctor caused a seizure by shooting electricity through my brain, which meant I risked dying if he miscalculated, but because it also interfered with my memory. I’d wake up terrified, not knowing who I was, the world a meaningless blank. It was as if each seizure carved me into a new jigsaw puzzle, and I had to start from the beginning to figure out how the pieces fit together. There was no guarantee they would.”

In fact, Sawyer’s condition worsened, but her doctors ordered more shock therapy. (Shock therapy treatment in the 1960s was done differently than today.) With each treatment, her memory also diminished.

Making a connection: After three years at New York Hospital, Sawyer was transferred to the New York State Psychiatric Institute in New York City. Though she had “dramatic holes” in her memory and frequently injured herself by burning herself with cigarettes, cutting, or other harmful behaviors, she eventually began to make progress in the care of Dr. Stanley Heller, whom she credits with literally saving her life.

“I was 21 and a pretty immature adolescent, and he was tall, dark, and handsome,” Sawyer says in an interview. “He was funny, and he ‘got’ me. He loved puns, and I loved puns. I spoke in metaphor, which had further convinced my previous doctors that I was schizophrenic, but Dr. Heller spoke in metaphors with me. He had a calm demeanor, and he was persistent. It took a long time for me to improve. It didn’t happen quickly. But what he did was listen and pay attention. I felt that I mattered.”

In 1966, Sawyer was finally healthy enough to be discharged, but she experienced intense embarrassment when former high school friends would greet her and she had no memory of them. She eventually began studying in the Columbia University’s General Studies program (an adult education program), determined to become a clinical psychologist. At Columbia, she met her future husband, Bill, who was taking courses there during a hiatus from Yale.

Sustaining secrets: During her time at Columbia, Sawyer continued to see Dr. Heller, who told her his office was one place where no secrets needed to be kept. However, says Sawyer, she felt she had to keep the fact that she was in therapy a secret.

“It was a very different time,” she remembers, “and there was more stigma about mental illness than there is today, though there is still considerable stigma today.”

She and Bill married right after he graduated from Yale, and Sawyer was accepted as a special student on the campus. It was the early years of coeducation at the university, and Sawyer was eventually able to apply for regular admission when Yale began to accept transfer students. “I had just one semester as a real undergraduate, and I was seven years older than other seniors, although no one really knew that,” says the psychologist, who graduated summa cum laude and Phi Beta Kappa, with highest honors in sociology. She then went on to earn her Yale graduate degree in sociology, with a focus on mental illness.

A forgotten time: After an internship, Sawyer began working as a clinical psychologist. While she enjoyed her work and had a happy family life raising two children with her husband, she had a feeling of “incompleteness,” she says, mostly because so much of her childhood and adolescence was a blank. In 2001, with the encouragement of the therapist she was then seeing, she decided to request her hospital records from the New York Hospital and the New York Psychiatric Institute. What she read in them filled her with grief, including notes that described her as being “resistant” to shock treatment.

“When I read the records I felt such dismay to see the contempt that they had for me at the first hospital, and it filled me rage to see how, when the shock treatment wasn’t working, they simply decided to give me more.”

The records, along with her own professional training, jostled her memory and allowed her to understand the cause of her PTSD.

The whole person: Her recovered memories, along with the knowledge of her misdiagnosis, deeply saddened Sawyer, who realized that her detest and fear of her shock treatments mimicked the feelings caused by the sexual abuse she had experienced.

Her own psychotherapy practice was an oasis for her at the time, says Sawyer. Working with clients who also suffered traumas, often worse than her own, she says, made her “summon the energy” to carry on in her own journey of recovery. She began writing about her experience while taking part in writing conferences and workshops, including the Wesleyan and Bread Loaf Writers Conferences. She also was a fellow at the MacDowell Colony, the Millay Colony, Vermont Studio Center, Ragdale, VCCA, and Hambridge.

Sawyer wrote her doctoral dissertation about psychiatric diagnosis, and connecting with her own past made her feel even more urgent about the issue, Sawyer says. She now shares her own story of misdiagnosis in talks before mental health professionals around the country.

“So much is expected of clinicians, and wrong diagnoses still happen,” says Sawyer. “It often happens that if you go to a conference on borderline personality disorder, then suddenly [you think] everybody has borderline personality disorder. There are fads in the diagnosis of mental illness, and I think my experience is also a reflection of that. PTSD hadn’t been described yet when I was in the hospital. But the thing is, real people are so complex, especially patients who are seriously in trouble. If you are only looking at symptoms, you are often only going to see the diagnosis and treatment du jour, not the whole person.”

Offering inspiration: Sawyer hopes that mental health clinicians will read and learn from her book, which, she notes, carries this message: Pay attention.

“That means sometimes living with uncertainty [about a diagnosis], which is very hard to ask people to do, especially medical professionals and clinicians who want to have answers and do something to help,” Sawyer says. “I look at myself and say, ‘I could have been dead, but somebody believed in me and didn’t just go along with the popular diagnosis and picture.’ And here I am. I want to inspire other clinicians to think, ‘Okay, I could be that person who pays attention, who doesn’t just take the easy way out.’”

The psychologist also hopes her story will help free others of the shame that so often accompanies sexual abuse and mental illness.

“Shame causes so much harm, and adds to the trauma,” says Sawyer. “Instead of being shunned as I feared, so many of my colleagues have endorsed me and supported me since I’ve shared my story. I re-connected with old friends whom I had cut off during my hospitalizations, and discovered that they still cared about me. Telling my story has opened up a new world for me.”