Thesis: Mental Illness &amp the Cuckoo's Nest

Pages: 7 (2212 words)  ·  Style: MLA  ·  Bibliography Sources: 7  ·  Level: College Senior  ·  Topic: Psychology  ·  Buy This Paper

¶ … Flew Over the Cuckoo's Nest - More than a Popular Novel

If One Flew Over the Cuckoo's Nest was written with only the strategy of revealing the missteps, incompetence, arrogance, patient abuse and general weirdness on display at say, Damasch State Hospital in Salem Oregon, or Atascadero State Hospital in Atascadero, California, it may have worked as a "white paper" report or a documentary on television. But as a novel, it has, since it's launch in 1962, captured the attention of literary critics, scholars, public servants, healthcare professionals and healthcare reformers and alert readers worldwide for reasons beyond its tangible literary value. Why? Because, as psychiatrist / professor Stanley Gold of the Department of Psychological Medicine at Monash University in Melbourne, Australia writes, the novel is "representative" of "a totalitarian state of mind" (Gold, 2003).

Indeed, it is partly that and partly just wrongheaded approaches to mental illness. The thesis of this paper is that One Flew Over the Cuckoo's Nest is in part about control, absolute control for the retention of power, and stubborn ignorance that gives no ground to legitimate challenge, innovation or visionary thinking in the mental health field. This paper alludes to the plot of the novel in terms of linking those dynamics with the arrogance and ignorance and incompetence to be found elsewhere in real world healthcare settings. In other words, what went on in Cuckoo's Nest is not that far from the reality of what goes on in some healthcare facilities even today.

All good novels of course have metaphors and applications to the world outside of literature; in this instance, it turns out that even a heavy psychedelic drug user like author Ken Kesey can tell a story that has broad social implications - and certainly not just in institutions that are supposed to treat mental illness - because Kesey himself worked at one time in an institution that was not morally viable.

Dr. Gold points out in his journal article (Australian & New Zealand Journal of Psychiatry) that of course the character Randall McMurphy is an "independent thinker" a gambler, a "possible sociopath," a "roustabout" and a guy with "more self-assertiveness and integrity that is good for him" (Gold, 2003, p. 115). And yes McMurphy was up against the wall when it came to changing hospital policies; conflict is part of literature and is always present in real and fictional life, so what's the big deal?

But Gold insists that the novel is about "...the misuse of available and legitimate knowledge to further illegitimate goals" (Gold, 115). This novel's strategy of keeping down the dissenters - albeit their dissent is based on legitimate concerns - reminds Gold of the misuse of psychiatrists and psychiatric organizations in the old Soviet Union. It also reminds him of his first job as a psychiatrist, in 1959, when he was placed "...without any prior psychiatric knowledge or experience" as a medical officer at Sunbury Mental Hospital in Australia. In that position he was "the sole medical officer" for 250 male patients. He had to totally rely on the "attitudes, reports and recommendations" of the staff of nurses that, of course, had worked there for a time and had all the "answers." If he did not totally comply with their orders, or defer to their counsel, his "life could, and sometimes was, made extremely difficult."

This narrative by Gold sounds in no small way familiar with Kesey's novel, except that of course he wasn't given "electroconvulsive therapy" as McMurphy was in the novel. In addition to the psychiatric ward that Gold had been assigned to serve in, he was expected to look after a ward of "adolescent law breakers who were admitted to the mental hospital because there was no other facility" that would have them. Psychodrama was the operative term for his interaction with these juvenile delinquents.

Meanwhile, Gold's article notes that Kesey's novel reminds him of Orwell's 1984 (the protagonist is up against a "monolithic organization") and of Upton Sinclair's the Jungle (about the brutal exploitation of non-union workers). But most damning in Gold's essay is that he believes the values in the psychiatric genre of healthcare are better, and yet too often professionals are willing to "...idealize our own goodness, technique, treatment, attitude" and believe that bad patient care is only being administered "elsewhere" (Gold, 116). The professionals who claim "moral high ground" in the field of mental health can, and do, tend to become "so obsessed with being seen as 'good' and possessing qualities of generosity, fair mindedness, integrity and strength" that, according to Gold, they become "vulnerable" to creating an "illusion...of virtue" by attributing "vice to others..."

Another article in the Australian & New Zealand Journal of Psychiatry (Stagoll, 2003) explains that in 1975, when the novel was made into a film, the director, Milos Forman, linked the story with more "...to his experience of Eastern European communist oppression than to Kesey's archetypal struggles of the old West" (Stagoll, 2003, 121). And though the film was "beautifully constructed and acted" - a real "crowd-pleaser" - it departed dramatically from Kesey's "...terrifying absurdist laughter and complexity" (Stagoll, 121).

Continuing along the lines of Gold's article linking Cuckoo's Nest with heavy-handed healthcare professionals who operate with an unbending power structure, notwithstanding their wrongheaded approach and lack of training and values, there are widespread reports that Chinese healthcare professional are guilty of gross misconduct in a number of instances.

Indeed, the Associated Press reports (December 9, 2008) that some critics of China's psychiatric healthcare system are being "committed" and "locked up" for no reason other than their activism "over land corruption or land seizures" issues (AP, 2008). This sounds eerily similar to what happened to McMurphy when he protested that there were terrible things wrong at his institution. Some of the citizens who have been locked up have been "forced to take psychiatric drugs," the story continued, "and all were told they would not be released until they signed pledges to drop their complains," according to the AP's investigation, which was launched following an article that was published in the Beijing News.

These allegations result from insider information trickling out of Xintai Mental Health Hospital. The Beijing News also ran an editorial that stated: "Oppressing petitioners is no way to govern or to redress their grievances" (AP, 2008). Stories like this one don't often appear in China's newspapers; in fact this is the "first time in years that this issue has been given such a high profile," according to Robin Munro, a researcher with the University of London's School of Oriental and African Studies.

In the days past, Munro explained, China's bureaucrats would routinely use mental hospitals to "silence critics"; mental hospitals "used to put critics out of action, breaking their spirits and discrediting their complaints" (AP, 2008). And the fact that Chinese law gives authorities "wide-ranging powers to commit people without recourse to lawyers or appeal" made the system "ripe for abuse," Munro adds.

Mental health abuses are found in many places in the world, including in Turkey, according to an article in the New York Times (Smith, 2005). This research shows that Turkey's psychiatric hospitals "...are riddled with horrific abuses," Smith writes. Some of those abuses include "the use of raw electroshock as a form of punishment." A group of investigators from the Mental Disability Rights International organization found their way into a number of psychiatric wards in Turkey, and found that "the most disturbing" abuse was "the use of electroconvulsive (ECL) therapy without anesthesia." The application of ECL was used to treat "a wide range of illnesses in adults and children" (smith, 2005).

This type of ECL is what patients were given in Cuckoo's Nest, including the poor sap McMurphy. The so-called therapy includes "an electrical current" being passed through the brain, and, the article goes on, is used in "mainstream psychiatry to treat a limited number of ailments." However, it is normally given with anesthesia and muscle relaxants because without them "it can be painful, terrifying and dangerous" (Smith). In fact, patients can break their jaws and crack vertebrae during the seizures caused by the shocks.

At some hospitals in Turkey, children as young as 9 years old were given shock treatments, according to the article. Not only was it used to supposedly treat mental illness, it was being used as punishment; some patients were seen being dragged to the ECL chairs in straitjackets "and forcibly held down during the procedure." This sounds very much like the abusive behaviors that McMurphy had to deal with, along with the other patients he was trying to protect.

One of the problems with Turkey, according to Smith's article in the Times, is that there were at that time "no enforceable laws...to protect mentally ill people form arbitrary detention or forced treatment...and according to the report, thousands are institutionalized for life."

Meanwhile, an article in the journal Drugs: education, prevention and policy relates to the flaws in the education of psychiatric doctors and… [END OF PREVIEW]

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"Mental Illness &amp the Cuckoo's Nest."  Essaytown.com.  December 9, 2008.  Accessed May 26, 2019.
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