One Flew Over the Cuckoo’s Nest is a 1975 film directed by Milos Forman and based off a book of the same name written by Ken Kesey. It focuses on a criminal named Randle McMurphy who feigns mental illness in order to be administered into a mental institution in hopes of dodging a hard-labour sentence. He then becomes a liberating influence for the suppressed mental patients through standing up to the ‘Big Nurse’ Ratched. The film effectively tackles themes of order vs. chaos, oppression, freedom and most importantly, attitudes towards mental health during its context. It became a huge success during its timeframe, drawing attention to the treatment, beliefs and conditions of mental patients who were often not seen as being on the same level as those who were ‘normal’. Thus, the film became a cornerstone in the history for understanding the fine line between ‘normality’, ‘abnormality’ and all that these labels encompasses. Filmed in Oregon State Hospital in Salem, the film pursues a believability and portrayals of the mentally abnormal that are hard to recreate in an artificial setup. Forman aims for total authenticity to the degree that many actors in minor roles of the film were actual patients of the institution. Major actors were instructed to stay in the institution throughout production in order to immerse themselves into the setting and their characters. From this emerges a genuine portrayal of institutionalism and its use and effectiveness. Interestingly enough, the Oregon State Hospital was constructed under the Kirkbride Plan – a mental asylum design that intended to help mentally ill patients. However, the real hospital was actually infamous for mistreating their patients, which the movie then depicts in an effective and subtle way.Nurse Ratched is the symbol for institution and control over the entire mental ward, exercising her authority over the male patients. An example would be when McMurphy campaigns to watch the ball game, but Nurse Ratched’s intimidating presence deters most patients from agreeing with him. This is akin to how wardens in the film’s context often abused their power over patients due to a lack of understanding or ignorance to their conditions and are ineffective in helping the patients recuperate well as the hospital is meant to be used for. The film’s patients are heavily controlled under the jurisdiction of the staff, taking away their free speech and decisions. All these facets of the film contribute to an intricate representation of the historical institutionalism’s effects on psychological patients. Medical attitudes to the concept of abnormal mental health are shown through the treatment and mindsets medical staff of the hospital have towards their patients. A key example of this through Nurse Ratched – she genuinely believes that she is helping the patients through regulating their lifestyle. However the way that she approaches treatment for the patients and the control she exercises over them implies that she does not think they are fit to return into society. On a wider scale, medical attitudes shifted in the 1960’s – 1970’s with the rise of the concept of stigma, published in the book Stigma: Notes on the Management of Spoiled Identity in 1963 by sociologist Erwin Goffman. Goffman was particularly critical on mental institutions and their handling of patients because it further stigmatised and labelled the patients instead of helping them recover. The film depicts societal attitudes towards mental patients through the patients themselves in their self-confidence and beliefs about themselves. Once again, stigma is prevalent in societal views towards psychological conditions. Billy Bibbit, a patient suffering from severe stuttering, opens up to McMurphy about his insecurities regarding women and returning to society. His internalised stigma leads to a low self-confidence, which links to society’s rejection of him (through him checking himself into the institution as a form of reclusion). In a more direct example of society’s attitudes towards mental health in the context of the film, during the scene where McMurphy attempts to convince an elderly man that he and the patients chartered the boat, as soon as he mentioned the group were from a mental institution, the elderly man shows signs of further caution and wariness, before walking off, not wanting to interact with the group even when McMurphy introduced themselves as researchers. This scene shows Cuckoo’s Nest’s society in their context being deterred by even the mention of mental institutions and psychiatry. Thus, patients then would have been mostly shunned by society due to stigma and a lack of understanding of psychology.With McMurphy depicted as a man ‘fighting against the system’, it is natural for the audience to interpret psychosurgery as inhumane and oppressive to the patients of the ward. Electric shock therapy and lobotomy were the two prevalent forms of psychotherapy in the film, however it is evident that these treatments do not help patients but end up serving as threats to keep patients in check – a tool of power that the institution holds over the patients. Lobotomy goes further – the process turning especially rebellious patients’ brains into a vegetative state most of the time. It is a procedure that all patients inherently fear, making it a more powerful tool than shock therapy. Patients even refer to the procedure as ‘going upstairs’, afraid to directly speak of it. Lobotomies were notorious for inducing a lack of personality, impaired intellect and other symptoms on its receivers. The depiction of the psychosurgery and treatments as an inhumane, rigorous process may have been intended to contribute to the anti-psychosurgery wave in 1960 that swept through the US. Today, electric shock therapy and lobotomy are almost ubiquitously banned due to its proven ineffectiveness and an overall societal understanding of and empathy towards mental patients. One Flew Over the Cuckoo’s Nest portrays psychosurgery as an inherently manipulative and ultimately ineffective ‘treatment’ for mental illness, instead being used as an instrument of power by the institution. One Flew Over the Cuckoo’s Nest is a masterpiece that deconstructed the topic of psychology in a manner that can still be relevant in contemporary society. It pursues authenticity regarding the conditions of institutionalism, treatment and daily lives of mental patients in an evident manner, which in turn depicts institutionalism itself as an imbalanced and ineffective system that does nothing for mental patients. The film also explores the medical and societal attitudes towards patients through use of stigma, both internalised and from society. Finally, the film shows the use of psychosurgery methods (electric shock therapy and lobotomy) as not procedures that help patients, but as a form of power held over them to keep them in order. Thus, One Flew Over the Cuckoo’s Nest is well deserving of it’s international praise, paving a way for psychology and understanding of mental illness to reach the level of development that it is at today.
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