Environment/Atmosphere and Mental Health

Studies have shown that the atmosphere of a mental hospital influences the likelihood of improving one with a severe mental illness. One Flew Over the Cuckoos Nest is a great example of how a negative atmosphere and authoritative behavior can have a negative impact on the patients’ treatment and improvement on their mental health. The importance of having the role of treating patients that have a history of mental health is being able to not view them as having a problem, but to treat them like the average person. Nurse Ratchet is one that uses her authoritative behavior to make the patients in the ward feel like they are not like the average person. This authoritative behavior creates a negative atmosphere for the patients and many times the patients in the ward mimic her unjust behavior. This book is a reflection of why having a positive atmosphere in a environment where there are patients struggling with a mental disorder is important. Having this role should encourage you to bring someone to a healthier state of mind and help them better themselves, not tear them down. It was bad enough that during this time, mentally ill patients were seen as a threat to society, but having people that are looking down on the patients instead of helping improve their well-being makes it worse.  

GRALNICK, A. (1989). IS THERE A CONTINUING ROLE FOR THE MENTAL HOSPITAL?: A Personal View. International Journal of Mental Health, 18(4), 3-12. Retrieved from http://www.jstor.org/stable/41344550

Morton, D., & King, J. (1975). Changes in a Mental Hospital’s Treatment Milieu. Social Science, 50(2), 94-100. Retrieved from http://www.jstor.org/stable/41959750

Dinitz, S., Lefton, M., Simpson, J., Pasamanick, B., & Patterson, R. (1958). The Ward Behavior of Psychiatric Patients. Social Problems, 6(2), 107-115. doi:10.2307/798883

Power and Sexuality

To possess power means to have the capacity or the ability to direct or influence the behaviors of others or the course of events. The power dynamics in One flew Over the Cuckoo’s Nest are, in a sense, directly related to the characters’ sexuality. The men who have no power fear the feminine form and are seen as unmasculine. The women in the novel make the inmates/patients feel insecure; Nurse Ratched partakes in this by emasculating the men in her care, pointing out their sexual inadequacies and placing the blame on their shoulders in order to maintain control in her ward. Nurse Ratched, by emasculating the patients and castrating them, has taken away their primary means of control.

McMurphy is able to use his masculinity as a weapon against Nurse Ratched. She becomes speechless when confronted by him and can do no more than make a sort of noise when he pinches her bottom. He criticizes her in a harsh way as an effort to expose her weaknesses, constantly asking questions about the size of her breasts. The confrontation between Nurse Ratched’s lack of femininity and McMurphy’s masculine presence result in a hate and power-filled sexual act that destroys them both.

Meloy, M. (2009). Fixing men: castration, impotence, and masculinity in Ken Kesey’s One Flew Over the Cuckoo’s Nest. The Journal of Men’s Studies, 17(1), 3+. Retrieved from http://link.galegroup.com/apps/doc/A197410458/GPS?u=sacred&sid=GPS&xid=cd460a8c

Packer, S. (2014, February). Altered mental state: the clue in the blue bottle. Psychiatric Times, 31(2), 6. Retrieved from http://link.galegroup.com/apps/doc/A361848232/GPS?u=sacred&sid=GPS&xid=5c2b3de9

Donaldson, E. J. (2002). The corpus of the madwoman: toward a feminist disability studies theory of embodiment and mental illness. NWSA Journal, 14(3), 99+. Retrieved from http://link.galegroup.com/apps/doc/A96953118/GPS?u=sacred&sid=GPS&xid=8e210ed8

Human Dignity vs. Institutional Control

Human dignity is something that cannot be taken away from an individual. Every person has value, are worthy of great respect and must be free from manipulation and exploitation; each individual has an inherent value, worth and distinction. In One flew Over the Cuckoo’s nest, Nurse Ratched is known for her strong desire to have complete control over the men who are under her jurisdiction on the psych ward. Nurse Ratched has made a distinction between sanity and insanity and with that being defined, it is then used to control and categorize individuals to make them easier to control. The text explains to us that they categorize the patients in order to treat and rehabilitate them, but it becomes clear that this process is more punitive and controlling than it is helpful for any mental ailment. There are daily meetings that occur and it tends to always pit the men against each other and the list on Nurse Ratched’s desk to record and reward the men for betraying each other’s secrets are all ways to force people to obey, not to make them well, are just a few examples. As the novel opens, the men do not have names, instead they have more broad labels. The categorization of these men shows the inherent loss of human dignity; it does not show or tell us who they are and/or what they may be interested in. The patients have very little freedom of expression and access to the actual outside world. All therapy sessions are scheduled with precision, and are to be with Nurse Ratched. This is exactly as she prefers it to be because she can then strip the humanity of her patients in order to be in complete control and run her ward.

Munoz, M. (2013). “A Veritable Angel of Mercy”: The Problem of Nurse Ratched in Ken Kesey’s One Flew Over the Cuckoo’s Nest. The Southern Review, 49(4), 668+. Retrieved from http://link.galegroup.com/apps/doc/A350339179/GPS?u=sacred&sid=GPS&xid=e26709f9

Ozsu, U. (2018, Fall). NEOLIBERALISM AND HUMAN RIGHTS: THE BRANDT COMMISSION AND THE STRUGGLE FOR A NEW WORLD. Law and Contemporary Problems, 81(4), 139+. Retrieved from http://link.galegroup.com/apps/doc/A570819078/GPS?u=sacred&sid=GPS&xid=9190e1ed

Jo, H., & Niehaus, J. (2018, Fall). THROUGH REBEL EYES: REBEL GROUPS, HUMAN RIGHTS, AND HUMANITARIAN LAW. Law and Contemporary Problems, 81(4), 101+. Retrieved from http://link.galegroup.com/apps/doc/A570819076/GPS?u=sacred&sid=GPS&xid=75317395

Power vs. Patients

One recurring theme in Ken Kesey’s novel, One Flew Over the Cuckoo’s Nest, is dehumanization. The inmates, not matter their psychological disorders, are treated unfairly and are not viewed equally to the ‘average person:’ “the inmates are typical of disturbed men whose already distorted world is being further systematically dehuman-ized by the ward nurse” (Sutherland, 1992, p. 28). This is obvious because of the way Nurse Ratched acts towards the patients. Her negative, authoritative, and unjust behavior enlightens the reader on the atmosphere of the ward, giving a sense that the environment is somewhat similar to society. The nurses in the ward make the patients feel like they are different from everyone else and that something is wrong with them: “All I know is this: nobody’s very big in the first place, and it looks to me like everybody spends their whole life tearing everybody else down” (Kesey, 1996, p. 174). This dehumanizing behavior of “tearing everybody else down” makes the patients feel like they are lesser than, therefore destroying their sense of self and confidence, “This process of transforming the patients into obedient automatons involves the loss of their sexuality, their masculinity, and their individuality” (Vitkus, 1994, p. 65). Those who’s disorders are more severe than others have a tendency to grasp what is truly going on, in terms of the way they are being treated and the nurse’s attitude towards the patients. The one who truly knows what is going on is Chief, the narrator of the novel.  Although there is a lot of tension in this ward, Randle Patrick McMurphy is one patient that has humor like no other. Different from other patients, McMurphy sees the abuse done to the patients and in a way, takes control of the situation. One could say that he is the ring leader of the patients due to the fact that he isn’t afraid to defend, but also teach the patients that they shouldn’t stand back while the Nurse Ratched uses her power to take advantage of the patients and make them feel like they are worthless.

Kesey, Ken.Pratt, John Clark. (1996) One flew over the cuckoo’s nest /New York : Penguin Books,

Sutherland, J. (1972). A Defense of Ken Kesey’s “One Flew over the Cuckoo’s Nest”. The English Journal, 61(1), 28-31. doi:10.2307/812889

Vitkus, D. (1994). Madness and Misogyny in Ken Kesey’s One Flew over the Cuckoo’s Nest. Alif: Journal of Comparative Poetics,(14), 64-90. doi:10.2307/521766

Ken Kesey and his Experience with Drugs

(Cobra, 2014)

“One Flew Over the Cuckoo’s Nest would have never seen the light of the day” (Andrews, 2016).

Ken Kesey, the author of One Flew Over the Cuckoo’s Nest, was a very interesting man. He considered himself a great leader “of the counterculture and beat generation” (Cobra, 2014). He was born September 17, 1935, and he, from a young age, loved reading and boxing/wrestling. He went to further his education at Standford University, and later he married Faye Haxby (Cobra, 2014); (“Ken Kesey Biography,” 2019).

https://nancysyogurt.com/our-creamery/history/

As Kesey grew older, he “experienced a dramatic life change,” where he took place in experiments (“Ken Kesey Biography,” 2019). These experiments where Psychedelic drug experiments known as “Project MKUlta” (Andrews, 2016). Kesey took many different psychedelic drugs including but not limited to LSD, cocaine, and mushrooms. These drugs are have said to played a major role in his life, altering who he was and what he wrote about (Andrews, 2016); (Cobra, 2014); (“Ken Kesey Biography,” 2019).

(Andrews, 2016).

After being a “medical guinea pig,” and sometimes participating in the sometimes illegal “Project MKUlta,” the author produced his first and most well-known work, One Flew Over the Cuckoo’s, (Andrews, 2016). Many of the ideas from the story came from parts on the MKUlta Project. Kesey continued these experiments later into his life, even after completing the writing of OFOCN (Andrews, 2016).

Works Cited

Andrews, S. (2016, December 20). Ken Kesey was Part of Psychedelic Drug Experiment. Retrieved January 28, 2019, from https://www.thevintagenews.com/2016/12/20/ken-kesey-was-part-of-psychedelic-drugs-experiments-before-he-wrote-one-flew-over-the-cuckoos-nest/

Corba, L. (2014, September 15). Ken Kesey, Writer of the Counterculture and Beat Generation. Retrieved January 28, 2019, from https://blog.bookstellyouwhy.com/ken-kesey

Ken Kesey Biography. (2019). Retrieved January 28, 2019, from https://www.notablebiographies.com/supp/Supplement-Ka-M/Kesey-Ken.html

Shock Therapy as Positive Punishment

When learning operant conditioning, it is easy to confuse the difference between punishment and reinforcement as well as if the punishment or reinforcement is positive or negative. Reinforcement is when a stimulus, “increases the frequency of the,” desired behavior (T.S.). Punishment is when a stimulus is added or removed which would result in the behavior to decrease in frequency. Reinforcement and punishment both can be either positive or negative. Despite what it may seem to mean, positive in this sense, does not mean that it is good. When a reinforcement or punishment is positive it means that a stimulus is being added. In contrast, when a reinforcement or punishment is negative it means that a stimulus is removed. Shock therapy is a medical treatment to relieve patients suffering from a mental disorder by sending a small amount of electricity to the brain. Knowing this, we can deduce that shock therapy is an example of positive punishment. Shock therapy is positive because a stimulus, the shock, is being added. Shock therapy is also punishment because this treatment is given in order to decrease the patients the frequency of the patient’s behavior. For example, If someone who was depressed received shock therapy, they would do so to become less depressed. In the book, One Flew Over the Cuckoo’s Nest, by Ken Kesey Nurse Ratched uses shock therapy as punishment when she believes one of her patients has done something bad and does not want them to act that way again.

Electroconvulsive therapy. (2007). In World of Health. Detroit, MI: Gale. Retrieved from https://link.galegroup.com/apps/doc/CV2191500419/SCIC?u=sacred&sid=SCIC&xid=447d5b37

T., S. (n.d.). What is the difference between reinforcement and punishment in operant conditioning? Retrieved January 28, 2019, from https://www.mytutor.co.uk/answers/8603/A-Level/Psychology/What-is-the-difference-between-reinforcement-and-punishment-in-operant-conditioning/

Cheeking Pills

“I got away once holding one of those same red capsules under my tongue, played like I’d swallowed it, and crushed it open later in the broom closet” (Kesey, 1962, p. 35).

Cheeking, “concealing a medication in the mouth,” is a way for not taking a pill while still going unnoticed (“Cheeking,” 2009). There are many reasons a patient would “cheek” their medicine. Often times, especially in Psychiatric Wards, patients may have great anxiety as to what the pills they are taking and what they might do. They will sometimes try to avoid taking the drug out of fear, misunderstanding, mistrust, worry, depression, or even out of curiosity (“8 Reasons Patients Don’t Take Their Medications,” 2015).

http://nursing-skills.blogspot.com/2013/12/procedure-of-administering-oral.html

In One Flew Over the Cuckoo’s Nest, there are many patients that show they do not want to take the medicine they are being asked to take. Chief Bromden cheeks his red pill once to see it later, but he is still unable to find out what it is, and why he must take it. He also tries to avoid taking the red pill in other ways such as pretending to be asleep when the nurses come to give it to him.

https://www.flickr.com/photos/148389033@N02/30150887170

In Kesey’s novel, the Psychiatric Ward Chief Bromden was in was very corrupted and messed up. Many patients had good reasoning as to why they would not want to take the medicines they were being given. It is actually an ethical issue according to Dr. Clarance Braddock, who wrote about the ethics behind giving information about the medicine being administered in “Truth-telling and Withholding Information.” “There are two main situations in which it is justified to withhold the truth from a patient:” “compelling evidence that disclosure will cause real and predictable harm” or “the patient him- or herself states an informed preference not to be told the truth” (Braddock, 2011). Neither of those were the reason for the nurses not telling the patients truely what medicine they were taking. So, they had every right to try and avoid taking those drugs.

https://www.ausmed.com/articles/when-a-patient-refuses-assistance/

Works Cited

Braddock, C. H. (2011, April 11). Truth-telling and Withholding Information. Retrieved January 28, 2019, from https://depts.washington.edu/bioethx/topics/truth.html

Cheeking. (n.d.) Medical Dictionary. (2009). Retrieved January 28, 2019, from https://medical-dictionary.thefreedictionary.com/cheeking

8 Reasons Patients Don’t Take their Medications. (2015, October 16). Retrieved January 28, 2019, from https://www.ama-assn.org/delivering-care/patient-support-advocacy/8-reasons-patients-dont-take-their-medications

Acutes and Operant Conditioning

• 

In The One Flew Over the Cuckoo’s Nest, it is made clear that the only way you are getting out alive is if you are an Acute and you conform to Big Nurse’s rules and standards. Once you become a Chronic, you’re there for life. Because of operant conditioning, Nurse Ratched was able to wrap the boys around her finger to make them conform. Operant conditioning is when behavior choices change in response to consequences. So the Acutes would conform to avoid lobotomies, shock therapy, and the high risk of becoming a Chronic and never escaping her grasp. One man who really fleshed out our definition of operant conditioning was B.F. Skinner. He did multiple experiments where he taught pigeons to read and rats to recognize different types of music just by classical conditioning. Nurse Ratched conditions the Acutes to behave by making an example of the Chronics, knowing none of them to want to end up like them, unable to ever escape. For this reason, they conform and act in line like Big Nurse wants them to. Similar to Skinner and his box, Nurse Ratched had her dayroom and the glass to watch the patients through, controlling and modifying their behavior.

Citations

McLeod, S. (2007). B.F. Skinner. Retrieved January 28, 2019, from https://s3.amazonaws.com/academia.edu.documents/44186702/Skinner.pdf? AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1548739124&Signature=zQdJM7O2Nu2odAfTSvSDu0c9jRQ=&response-content-disposition=inline; filename=Skinner_-_Operant_Conditioning.pdf Source updated in 2015

Myers, D. G. (2001). Psychology: David G. Myers(10th ed.). New York: Worth.

Sexual Identity

An image from One Flew Over the Cuckoos Nest movie, showing the relationship of the patients and women

A healthy expression of one’s sexuality is an important aspect of their individuality. Throughout One Flew Over the Cuckoo’s Nest, it is implied that in order to be considered sane, one must exhibit a clear sexual identity. It was extremely hard for patients to express their sexual identity due to their damaging relationships with women and how many supposed sex acts that would take place in the ward such as cases of rape patients.

In an American History article, it states, “Sexuality, along with race and gender, is an aspect of identity that… has demonstrated the centrality of sexuality to definitions of American national identity” (Turner). This means that sexuality is a key part of defining who we are as individuals. In the novel, Kesey constantly comes back to this idea of expressing one’s sexuality, especially through McMurphy who clearly has expressed his sexuality. For example, he had even brought a very sexual deck of playing cards. If this idea of sexuality being an alignment of one’s individuality, then it was clear that McMurphy had his own identity and was sane.

In an article on sexual orientation, it states, “Although frank discussions of sexual behavior still often inhabit the realm of low humor, the general public has become increasingly tolerant of serious discussion regarding the issue of sexual orientation, especially as it relates to individual rights and attempts to forge identity” (“Sexual Orientation”). Throughout the novel, Ratched continuously tried numerous methods to try to make her patients conform to her societies identity: straight, sane man. The Catch-22 was that whether or not you showed evidence of sanity, for example, through your expression of your sexuality, Nurse Ratched would just label “Acute”, and she would use shock therapy and other methods to make a perfectly normal or increasingly better patient into a type of vegetative state.

Sexual identity is a major aspect of one’s individuality and how sane they are, but the novel shows that even with this, one’s individuality was never going to be truly free unless it conformed to Nurse Ratched’s idea of a perfect, sane individual.

Citations

Sexual Orientation. (2006). In A. M. Hacht (Ed.), Literary Themes for Students. Literary Themes for Students: Race and Prejudice (Vol. 2, pp. 565-568). Detroit, MI: Gale. Retrieved from https://link.galegroup.com/apps/doc/CX2661800062/SUIC?u=sacred&sid=SUIC&xid=14ec908d

Turner, W. B. (2003). Sexuality. In S. I. Kutler (Ed.), Dictionary of American History (3rd ed., Vol. 7, pp. 328-332). New York, NY: Charles Scribner’s Sons. Retrieved from https://link.galegroup.com/apps/doc/CX3401803823/SUIC?u=sacred&sid=SUIC&xid=b1d677fd

Effect of One Flew Over the Cuckoo’s Nest on Shock Therapy

The history of shock therapy, or electroconvulsive therapy, is long and complicated. Although initially proposed as a humane treatment for depression and other mental disorders, shock therapy eventually earned a much darker reputation thanks to its misuse and adverse effects. The rapid decline of shock therapy’s reputation throughout the 60s and 70s is also thanks in part to the movie adaptation of One Flew Over the Cuckoo’s Nest released in 1975, which features a particularly graphic scene depicting the practice. During this scene, McMurphy is administered shock therapy as a punishment and it induces a seizure as his body violently convulses. This scene was extremely detrimental to the practice of shock therapy, though it did shed some light on the reality of the time. Although professional shock therapy did not cause the patient to violently convulse, it was proved to be used as a punishment for unruly patients. This was a big factor in the diminishment of its use. Protests were held for nearly a decade after news emerged of psychiatric hospitals abusing their powers and intentionally harming patients with the use of shock therapy. However, it can be argued that the unrealistic scene of shock therapy depicted in the movie did more harm than good. Shock therapy has proved to be highly effective time after time and if used correctly and professionally, it can greatly benefit patients suffering from severe mental disorders.

Fields, R. D. (2017, November 27). Beyond the Cuckoo’s Nest: The Quest for Why Shock Therapy Can Work. Retrieved January 28, 2019, from https://www.scientificamerican.com/article/beyond-the-cuckoos-nest-the-quest-for-why-shock-therapy-can-work/

Sadowsky, J. (2017, January 13). Electroconvulsive Therapy: A History of Controversy, but Also of Help. Retrieved January 19, 2019, from https://www.scientificamerican.com/article/electroconvulsive-therapy-a-history-of-controversy-but-also-of-help/