Illnesses In One Flew Over The Cuckoo's Nest

Generally, mental illnesses were treated unprofessionally during the 1960s, and conditions of institutions were inimical compared to today’s standards. Ken Kesey’s One Flew Over the Cuckoo’s Nest, despite being a fictional piece, gives appropriate insight into just how detrimental institutions at the time were. Throughout the novel, the reader follows the patients, such as the schizophrenic Chief Bromden, as they endure, and eventually overcome, Nurse Ratched’s authoritarian nature.
Aggression from the staff is common throughout One Flew Over the Cuckoo’s Nest. The first account of aggression can be witnessed in the beginning of the novel, on pages 4 and 5, when Nurse Ratched catches the aids mumbling to each other: “She knows what they

been saying, and I can see she’s furious clean out of control. She’s going to tear the black bastards limb from limb, she’s so furious. She’s swelling up, swells till her back’s splitting out the white uniform …”. Furthermore, patient fear is also common throughout the novel. For example, on page 6, Chief Bromden describes his fear of going to the electric shaver: “I hide in the mop closet and listen, my heart beating in the dark, and I try to keep from getting scared… I can feel that least black boy out there coming up the hall, smelling out for fear. He opens out his nostrils like black funnels, his outsized head bobbing this way and that as he sniffs, and he sucks in fear from all over the ward.” Unfortunately, staff aggression and patient fear were not just common in the novel. They were also common in actual institutions, which is not the ideal way mental institutions should have been at the professional level.
A real-world example is David, his name changed to ensure anonymity. Clinical psychologists, Richard S. Hallam and Michael P. Bender, recount his six years-worth of experiences of living in mental institutions through a box of letters, diaries, and official documents given to them by David’s brother. David was diagnosed with schizophrenia in 1960 and committed suicide in 1971, at the age of 27. His journal includes feelings of violence and violent treatments from nurses: “Crowley attacked me after Murphy was her usual abusive insulting self, full of self-importance. My hair was pulled very hard. Crowley put both his hands round my throat and squeezed as hard as he could.” (Hallam, Richard S., Michael P. Bender) In fact, during a visit with a psychiatric nurse who remembered David, the nurse showed Richard S. Hallam and Michael P. Bender where David resided. He then explained that one method of dealing with violent patients was to grab their arm as it “protruded through a hatch of the door in which the patient had been secluded. The patient was then fastened in an arm lock while another nurse would enter the room and administer the injection of a sedative.” (Hallam, Richard S., Michael P. Bender) Another account is from the experiences of a severely depressed woman, born in 1941, named Annemarie Randall, who stated that she “found the nurses a little bit brutish.” (Bedell, Geraldine) Overall, it can be noted that nurses at the time did not have a therapeutic role. (Hallam, Richard S., Michael P. Bender) This factor could have even contributed to the fear that existed in such institutions. Another reason could be the treatments themselves.
Common treatments, besides the various medications, included: the ECT, insulin coma therapy, narcotherapy, and leucotomy.

(Hallam, Richard S., Michael P. Bender) The ECT is talked about more prevalently compared to the others,however. The ECT, or Electroconvulsive Therapy, is a brain stimulation technique that is often used to treat major depression that hasn’t responded to standard treatments. Besides major depression, it is effective against other mental illnesses as well. With the ECT, “electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain.” (WebMD) It is considered to be one of the safest and most effective treatments used. Plus, it is the fastest way to relieve a patient’s symptoms. Despite the ECT being considered one of the safest treatments, it was dreaded among many patients in the 60s. In One Flew Over the Cuckoo’s Nest, the patients often referred to the ECT, the “shock shop” and describe it as doing the “work of the sleeping pill, the electric chair, and the torture rack.” (page 69) One patient, Dale Harding, even stated that “nobody wants another one. Ever.… Enough of these treatments and a man could turn out like Mr. Ellis… A drooling, pants wetting idiot at thirty-five.” Sadly, the ECT was feared in the real world, too. Aforementioned Annemarie Randall was given the ECT against her will and she claimed it made her “feel

worse afterwards”. (Bedell, Geraldine)
The reasoning behind why the ECT was feared is because it was misused frequently. Often times it was used “to subdue and to control patients in psychiatric hospitals. Troublesome patients received several shocks a day, many times without proper restraint or sedation.” (Sabbatini, Renato M.E., Ph.D.) Instead, the ECT should have been used to ease symptoms and help patients feel better, rather than punish them. Likewise, the risks affiliated with the ECT are correlated to “misuse of equipment, incorrect administration, or improperly trained staff.” (WebMD) Still today, it is“misunderstood by the general public.” (WebMD) More understanding could prevent further misuse, fear, and negativity in the media towards the ECT.
Other issues arose from misunderstandings of the mental illnesses themselves.

There was an anti-psychiatry movement during the 1960s, which propagated that “psychosis could actually be a positive and life-enhancing experience”. (Living with Schizophrenia) Ronald D. Laing, a Scottish psychoanalyst and the leader of the British Anti-Psychiatry Movement, believed that :schizophrenia was ‘a sane reaction to an insane world’.” (Living with Schizophrenia) Another ill-informed psychoanalyst was Professor Thomas Szaz who proposed that “schizophrenia was a myth created by psychiatrists in their own interest.” Even today the original ideas of Laing and the other doyens of the anti-psychiatry movement remain a key element in their ideology. Even some practitioners believe a diagnosis of schizophrenia is more harmful than the illness itself, and sometimes aim to deter young people with psychosis away from the mental health system. Additionally, some psychologists argue that antipsychotic medications don’t work, which is not good because “over a thousand people with schizophrenia in the UK will die by their own hand and… those people are in danger when they stop taking their antipsychotics.” (Living with Schizophrenia) With misunderstandings as such, it’s understandable why institutions were so detrimental during the 1960s, especially considering that similar misunderstandings still

exist.
As a result of the nurses’ lack of a therapeutic role, misuse of treatments, and misunderstandings of mental illnesses as a whole, mental illnesses were treated unprofessionally and conditions of institutions were inimical during the 1960s. Patients are admitted to institutions to receive help, however, during the 1960s they faced aggression from nurses like the infamous Nurse Ratched, and dreadful treatments often used to punish rather than to alleviate symptoms such as the ECT, which caused a lot of fear. Such factors are unimaginable compared to today’s standards, however, through Ken Kesey’s One Flew Over the Cuckoo’s Nest, the reader can easily grasp just how unprofessional and inimical institutions at the time actually were.