Ebert, Roger (1975). One Flew Over the Cuckoo's Nest. Retrieved April 11, 2008, from rogerebert.com Web site: http://rogerebert.suntimes.com/apps/pbcs.dll/article?AID=/19750101/REVIEWS/501010348/1023
In his 1975 film review of One Flew Over the Cuckoo's Nest, Roger Ebert lauds the film for possessing stretches of brilliance, but states that the factor which keeps the movie from being great is director Forman's insistence on trying to assign to it a broader philosophical meaning. According to Ebert, the film attempts to be more significant than its story will allow. For example, in the scene in which Billy is discovered sharing a bed with one of the women McMurphy brought to the ward, Billy talks back to Nurse Ratched, his usual stutter conspicuously missing from his voice. The intention of this message is clear: it is devised to show that Billy has been liberated to some degree by both McMurphy and his nighttime experience. However, it lacks subtlety, and takes away from the film's generally thoughtful and three-dimensional characterizations. In fact, according to Ebert, it is these characterizations that constitute the best aspects of the film. Ebert believes that Forman should have focused his efforts on examining the characters and using their interactions to develop the film, rather than trying to create an antiestablishment parable.
I agree with the review on many of its key points. The movie's strongest facet is its ability to develop its characters and portray them in a way that demonstrates their change and growth throughout the story. McMurphy's significance as a character does not lie in his crusade against the establishment; rather, it is his ability as an individual to change the patients around him, and, by interacting with them in his carefree, individualistic manner, to release them of their inhibitions. It is also interesting how each character responds differently to McMurphy based on their personality. Cheswick, easily influenced, immediately takes to him, while Harding, who is naturally suspicious and guarded, never warms up to him. The nervous Billy is cautious but open, while the wild Taber does not seem to care about McMurphy's presence at all.
Sengers, Pheobe (1995).Madness and automation: On institutionalization. Muse. 5.3
In this article, Pheobe Sengers discusses the effects and implications of institutionalization on patients. She begins by claiming that there are many who believe insanity to be a product of society. Those who fail to conform to social norms are classified as “insane,” and this condition is no more than a label imposed by those intolerant of deviance. In reality, however, according to Sengers, insanity, and mental illness in general, has a real physical manifestation. Its symptoms are not only apparent from the social point of view, but are also experienced, often painfully, by the individual involved.
Senger also goes on to compare institutionalization to imprisonment. She states that it is the coming together of the institution, with its labels and norms, and the individual, who leaves his life to become a part of the ward community. The patients, she says, are in actuality incarcerated—many are held against their will, and treated as dangerous individuals. Even those enter voluntarily aren't in control of their own care. Once they try to leave, they are often committed by the hospital and are forced to remain.
Senger also expounds on the fact that mental patients have no legal status. Once they are admitted insane, they lose legal culpability—nothing they do or say is any longer considered of their own will. With this loss of culpability comes another loss—the loss of a voice in society. They effectively lose the ability to speak, as their words are rendered meaningless by their condition. Because the very definition of insanity precludes the ability to have a voice, mental patients clearly have a difficult time getting heard by society.
In One Flew Over the Cuckoo's Nest, we can see the dramatic embodiment of the experiences Sengers describes. Though the ward attempts to deflect any negative image by focusing its attentions on community and group therapy, it is clear that under the surface, the place is as tightly and strictly run as a prison. At the first sign of dissent, Nurse Ratched wields her iron fist, politely crushing any opposition. The ward is unaccepting of any behavior that does not conform to its rules and norms. Even the voluntary patients, who turn out to make up most of the community, seem to have no realistic chance of escaping the system. They are forced by implication to stay. Perhaps most significantly of all, the attitudes that Sengers predicts of society toward to mental patients is seen come to life in the film. Even though McMurphy and other patients voice their opinions, for example to try to change the TV viewing schedule, they are unheeded by the staff. They are patronized and treated as though they cannot think for themselves or make their own decisions. Their voice, in other words, is silenced.
Murphy, M. C. (1997).Surrender of judgment and consent theory of political authority. Law and Philosophy. 16, 115-143.
In this article, Mark C. Murphy examines practical political authority and its relationship with the surrender of personal judgment. According to Murphy, it is a widely accepted observation that under any system in which there is an authoritative figure, there will be involved some sort of surrender of judgment to that of the authority. The question, then, is whether the presence of the political authority supersedes obedience, or whether obedience leads to the emergence of an authority figure. Most believe that the existence of an authority brings about the surrender of judgment. Murphy, however, stipulates that it is the consent of the governed which leads to practical authority. In other words, by electively giving up one's judgment, one implies consent for the takeover of an authoritarian system. Murphy then cites four moral requirements for political authority: 1) If one performs an act by which they consent to obey the authority, they must obey. 2) If one's political society is mutually beneficial and socially cooperative, one must obey the authority. 3) If one owes a debt of gratitude to the governing institution, one is morally required to obey the institution. 4) If an institution's legal system applies to one, then one must obey.
Murphy's authoritarian system can be applied not only to the political realm, but also to the secluded ward of One Flew Over the Cuckoo's Nest. In Cuckoo's Nest, Nurse Ratched serves as the authoritarian figure—indeed, by distributing sedatives and stamping out dissent, the Nurse ensures that her wards have no option but to surrender their judgment to her own. Examining this article, however, one can find evidence to support the notion that perhaps, it is the result of the patients' own actions and decisions that result in Ratched's power. For instance, in a pivotal scene in the film, it is exposed that most of the patients are self-admitted: they voluntarily joined the ward. This act certainly implies consent and gives the despotic nurse license to exert her power over them. Furthermore, the inmates reside in a community setting. There is a communal source of entertainment, the television, a regular system of “group meetings,” and, as Nurse Ratched made clear, all decisions in the ward are to be made with the interests of the entire community in mind. Therefore, according to Murphy's article, as the society is mutually beneficial and socially cooperative, the patients are obligated to obey the authority. In addition, the inmates owe a debt of gratitude to the system. They have entered the system with the hope of improving their mental condition, and therefore, in exchange for the treatment and assistance they are receiving, they are morally required to obey the Nurse. Finally, by merely being a part of the ward, the patients are automatically subjected to its legal system, and as a result, must obey it. Thus, the residents fulfill the four moral requirements for authority outlined in Murphy's article, and in doing so give the nurse and the system they reside in the full right to exert their authoritarian reign.
(1976).Regulation of electroconvulsive therapy. Michigan Law Review. 75, 363-385.
This article in the Michigan Law Review describes the technique of electroconvulsive therapy, its risks, and the various legal and ethical dilemmas surrounding its use. Electroconvulsive therapy is a procedure that utilizes an electric shock to induce a grand mal seizure in the patient. It is used to treat severe depression and schizophrenia. Although it is not clear why the seizure induced has therapeutic effects, several theories have been made. Some postulate that the shock restructures a patient's personality, while others claim that it creates a chemical reaction in the brain. Still others cite the memory loss caused by the procedure, stating that it represses the stress from unpleasant experiences. Whatever the reason, there is considerable evidence supporting the treatment's efficacy. However, ECT also carries with it many substantial risks. Physical effects such as bone fractures and dislocations are common results from the violent seizures, as are cardiovascular and respiratory complications. Mental side effects, which are perhaps the most significant and worrying, include disorientation and memory loss, lasting up to six months after treatment.
The legal and ethical issues surrounding ECT are varied and complicated. According to the article, regulation of ECT is primarily focused on the issue of consent. This is a delicate matter, due to the unique nature of the context in which the treatment is generally given, and the patients most likely to receive it. Often, the patients are psychologically dependent on the doctor, and therefore may not be capable of making an informed decision about their treatment. At the time this article was written, most ECT treatments were issued by state, placing patients under the protection of the Constitution. According to the courts, since ECT alters the mind, it also affects the capacity to create speech-thus infringing upon the right to free speech. Furthermore, by denying privacy of mind, the treatment was denying the freedom of privacy.
One of the greatest impacts One Flew Over a Cuckoo's Nest had, politically, was persuading the public against electroconvulsive therapy. In a key scene in the film, the character of McMurphy is graphically shown undergoing an ECT treatment. A sense of fear is carefully built up in the sequence preceding the scene-a hysterical patient disrupts the polite silence of the ward environment with his wails, clearly dreading the procedure he is inevitably about to undergo. The film thus presents ECT as a sort of sadistic method of torture, cloaked in the familiar, white sterility of a hospital. The juxtaposition of fear and familiarity heightens the sense of horror in the audience.
This article is interesting because it describes the reality behind the sequence depicted in the film. According to the article, ECT is only prescribed for a limited number of situations, and the way it is used in the movie are not in compliance with any of these. In Cuckoo's Nest, Nurse Ratched forced McMurphy and his fellow patient to undergo the treatment as a punishment, or perhaps a sedative, for unruliness during a group meeting. Not only did this go against the procedure's indications, but it also completely ignored the issue of consent. Clearly, neither McMurphy nor Cheswick agreed to the therapy; in fact, Cheswick is physically forced against his will to comply. It raises the question of who, if anyone, undertook legal responsibility for the decisions made, and also adds a layer of depth to the depravity of the Nurse, and the system in general.
Mechanic, D. & Rochefort, D. A. (1990). Deinstitutionalization: An appraisal of reform. Annual Review of Sociology. 16, 301-327.
In 1963, President Kennedy introduced the Community Mental Health Centers Act. It was met with great enthusiasm by professionals and the public, and surpassed its goals of deinstitutionalization of mental health care by leaps and bounds. Little did Kennedy know that his piece of legislation would have significant negative effects on the mentally ill community. In their article “Deinstitutionalization: An Appraisal of Reform,” Mechanic and Rochefort examine these effects and their possible causes.
As Mechanic and Rochefort state, deinstitutionalization initially achieved what few public policy initiatives have—rousing support and unexpected success. As time went on, however, it became clear that the measure was, in fact a failure. Because of the incomplete and inadequate performance of supportive services that were intended to accompany the release of patients from inpatient facilities, many severely and persistently mentally ill patients did not receive the essential care that they needed. This led to a growing number of mentally ill homeless, who, having been released from their inpatient hospitals, had no sufficiently supportive community-based system to turn to. The undersupply of community mental health centers was due in part to significant financial cuts in social programs. These cuts particularly affected those who were both young and severely mentally ill.
One Flew Over the Cuckoo's Nest presents to the audience an example of the negative facets of institutional mental health care. This article is interesting because it argues the opposite side of the matter. It presents deinstitutionalization as a well-intentioned but misguided alternative to inpatient facilities. Even if conditions in a mental hospital are not ideal, some patients may require such a system in order to function. The movie seems to argue that the institutional mental health care system crushes individuality and human expression, and portrays such atrocities as ECT and lobotomies as characteristic of such a system. However, in order to truly appreciate the issue, one must also be exposed to the other side of the coin—the argument that the rigidly controlled hospital system is the only system in which the most severely ill can thrive, and that giving free reign to those who cannot live independently is disastrous and counterproductive.
Bialostocki, J. (1981).Forman's Cuckoo's Nest, its composition and symbolism. Artibus et Historiae. 2, 159-162.
In “Composition and Symbolism,” Jan Bialostocki describes the technique and imagery that Forman uses in One Flew Over the Cuckoo's Nest to comment on the social dynamics of groups, and the constant struggle of individual expression versus normative stability. The article begins by invoking the imagery in Cuckoo's Nest's opening and closing sequences. The vast landscape that the mental hospital in the film resides in plays an important symbolic role—in the beginning of the film, it is a visual representation of the isolation and confinement of the inmates, while at the end of the film, the image of the Chief running into the distance of the landscape signifies the escape from such a closed world. Bialostocki also asserts that the isolated psychiatric ward is a metaphor for the human world in general. Within the confines of this environment, we can observe the facets and problems of human nature, such as the dependence of the inmates on one another and their need to participate in community life. McMurphy, as a rogue figure, acts as a catalyst for this human nature. Before his arrival, the inmates are meek and mellowed by the drugs they are taking, and the strictly regulated system they are forced to abide by. Once he arrives, however, he liberates them from this rigidity, allowing them to release their inhibitions and inciting in them real, human emotions and reactions. Although freeing, this also introduces conflict to their previously uncomplicated existence. By pursuing their individual needs and impulses, they in turn sacrifice the order and comfort of the community. McMurphy's individuality walks the thin line between freedom and anarchy, and eventually results in a tragic finish. In the end, McMurphy is defeated by the system which beats down dissent, and treats individuals as though they cannot make their own decisions. Only the Chief is affected and liberated by McMurphy's actions as he makes his escape. The other inmates return to their formerly grey lives. Having seen the destruction that human emotion and freedom can bring about, they revert back to the passionless, vegetative comfort of their old system of norms, thus letting go of the of innovation and expression they enjoyed for that short period of time.
This article is interesting because it brings to light the meaning and symbolism behind this story. It is not merely a critique of the institution-based mental health system, but a commentary on human society in general. According to the article, illuminates the problems inherent in society, and the difficult trade-off between group safety and security and individual expression.
Canby, V. (1975, November 23). 'Cuckoo's nest': A sane comedy about psychotics. New York Times,
This article from the New York Times is a review of One Flew Over the Cuckoo's Nest. The review makes many key observations. It claims that most films dealing with the subject of mentally ill patients treat them as innocent observers removed from our cruel world. They present lunacy as a sort of escape. Cuckoo's Nest resists taking this sentimental point of view, however, and presents mental illness as it really is—disturbing and terrifying, and, at times, even funny. The article considers Cuckoo's Nest to be primarily a comedy, and therefore many of its points of praise address Forman's light, subtle comedic touch. The review points out the irony of society's view of dissenters that Forman's film brings to light: Society admires non-conformists as long as they are either fictional or dead. In life, people expend all their effort to be exactly like everyone else. The review implies that Nicholson's McMurphy is an important and admirable figure because he is a fictional non-conformist.
Although the article does concede that if one views the film as though it were trying to invoke a message, it will become cheesy and sentimental, it also states that if one avoids giving it ulterior meanings, Cuckoo's Nest is a humane comedy with good performances. I agree—the movie is subtle and elegant in making its point, and taken simply as a piece of film, it is an honest and well-made specimen.
According to the review, though the film is flawed with the occasional misrepresentation of factual information, it emerges as a strong and significant comedy. It creates out of its psychotic characters individuals who are important and identifiable, when the mentally ill are usually portrayed as exotic, unfamiliar enigmas.
This review is significant because it not only addresses the issue of individuality and McMurphy's role as a catalyst for individualism, but it also rejects the idea of the film as social commentary. The review views the movie not as an allegory for human life, but rather as an isolated, well-developed section of humanity that is portrayed honestly and candidly. To the writer, Cuckoo's Nest is an example of good film-making and acting, and though it raises and investigates powerful and important issues, it does so simply and with humor.
Palmer, A. (2000). 20th century treatment of mental illness. Mental Health World, 2, Retrieved April 8, 2008, from http://www.mentalhealthworld.org/29ap.html
This article by Ann Palmer investigates the history of the treatment of mental illness. It begins by looking at the view of mental illness in the 19th century. In those times, the insane were viewed as incurable and subhuman, condemned to life in jail cells or almshouses. As time went on, however, professionals dealing with the mentally ill were expected to treat them with respect and compassion. This led to the rise of the asylum system, whose main goal was to isolate “lunatics” in hopes that this would be therapeutic and enable them to return to the “normal” community. These asylums employed such techniques as wrist and ankle restraints, and stupor-inducing drugs, to force the mentally ill into docility. After the conditions of asylums were made known, responsibility for the mentally ill moved to the state. It was hoped that this would ensure better conditions for the inmates. Even so, these new state mental hospitals were far from ideal. Misguided treatments included untested drugs, electroconvulsive therapy, induced seizures, and, perhaps more horrifying of all, lobotomies.
In the 50s and 60s, and most notably with President Kennedy's Community Mental Health Centers Act, there began a movement towards shifting the treatment of the mentally ill from an asylum system to a community-based mental health system. Though this tended to ignore the more severely and chronically ill patients, it did enable many patients to live independently within a community, and was a vast improvement to the mental hospitals of before. Films such as Cuckoo's Nest also served to persuade the public against the use of electroconvulsive shock therapy, and led to the focus of the medical community on antipsychotic drugs instead.
This article is significant to the film because it describes the difficulties in mental health care that the movie illuminates. One of the most powerful aspects of the film is its portrayal of a psychiatric ward. Though on the surface the ward is clean, well-kept, and tightly run, there is an undercurrent of repression and cruelty. Cuckoo's Nest serves just as well as an eye-opener as it does a critique of mental hospital conditions. The film takes place in the 60s, after the archaic asylum system was demolished, but before the community-based system firmly took hold. We can see evidence of this transition phase in the film. The laughable “group therapy” sessions, and Nurse Ratched's tireless insistence that the inmates behave in a manner compliant with the entire ward's desires are signs of the effort to move toward community mental health care. This system is even parodied in the film. When McMurphy attempts to change the TV schedule for a day in order to watch the World Series, Nurse Ratched demands a majority vote. She claims that schedule changes are to be made only if they are accepted by the whole community, even though only one more vote would enable McMurphy to win. This mocks the idea that there is even such a thing as a communally beneficial system.
There are signs, too, of the older, more barbaric mental health care facilities. When a few of the inmates cause an uproar during one of the group meetings, they are all sentenced to a round of electroconvulsive therapy. The procedure is shown with dramatic realism, and presents it as a form of brutality. In the powerful ending, McMurphy is shown after having undergone a lobotomy: a blank, mindless drone devoid of any of the human nature and individuality he came in with.
Allen, V. L., & Levine, J. M. (1968). Social support, dissent, and conformity. Sociometry. 31, 138-149.
This study, conducted by Vernon L. Allen and John M. Levine of the University of Wisconsin, investigates the influence that the presence of a dissenter in a group has on the conformity of a individual to the group's beliefs. It was devised in response to an earlier study by Solomon Asch's famous 1951 study examining the same thing. That study found that in conditions of pure conformity, a subject has a high likelihood of agreeing with a group, even if the group is clearly incorrect. However, the presence of a dissenter, whether the dissenter agrees or disagrees with the subject, significantly decreases conformity. Allen and Levine, questioning the methodology of the Asch study, conducted their own. They devised four scenarios: pure conformity, one agreeing dissenter, one disagreeing dissenter, one slightly agreeing dissenter, and one slightly disagreeing dissenter. Their results were similar to those of the previous study. They found that a dissenter agreeing with the subject's viewpoint will significantly reduce the subject's conformity. A dissenter who disagrees will also reduce conformity, but to a lesser extent. In general, the study shows that the very presence of a dissenter is enough to decrease conformity be an appreciable extent.
The findings of the Allen and Levine study are especially pertinent to the theme of One Flew Over the Cuckoo's Nest. In the film, Randall McMurphy is a rogue who disrupts the strictly regimented system of a psychiatric ward run by the tyrannical Nurse Ratched. His role in the community of mentally is of the dissenter. Before his arrival, the ward inmates contently conform to their drab, expressionless surroundings. After he enters the scene, however, he rouses them into a fit of individuality and uprising. The film suggests throughout that, in fact, the patients in the ward inherently possess this seed of revolt, and McMurphy is merely a catalyst. He states at various points in the film, “You guys aren't so crazy,” implying that it is the system, and not their nature, that results in their conformity. The film virtually embodies the findings of the Allen and Levine study. McMurphy is the only factor necessary to shake the patients from their blind conformity. The presence of a single dissenter does, indeed, result in a decrease in conformity—with one dissenter among them, the inmates feel free to release their inhibitions and express their differing viewpoints, giving them sense of freedom that the pure conformity of the past had ironed out.
Levine, Richard (1975, April 13). A real mental ward becomes a movie 'Cuckoo's Nest'. New York Times.
This newspaper article published in the New York Times in 1975, describes the experience of the reporter on the movie set while filming of One Flew Over the Cuckoo's Nest was in progress. The movie was filmed on location in an abandoned ward of the Oregan State Hospital. Not only was the film shot in a real ward, but many of the actors and crew members were actual patients of the hospital. One patient, named Gordon, who had been admitted twice for rape, was a full-time employee of the filming company. Some of the hospital staff were concerned that audiences may draw the wrong conclusions from the film due to its location. They worried that the Oregon State Hospital would garner a bad reputation. However, the hospital director, who also has a role in the movie, believed that it would be a benefit both as an experience and financially for the patients to be involved in the filming. He did, however, ask that a disclaimer be placed on the film denying its factual portrayal of a real mental institution.
This article is interesting because it compares and contrasts life on a real ward with the events being portrayed in the film. The reporter's experience is nicely weaved within his observations of the filming, and they illuminate many of the similarities, as well as differences, between real life and the fictional ward. For example, the reporter describes an incident in which he witnesses a woman in the high-security wing being given oxygen by hospital aides. A nurse explained that the woman was an uncooperative patient who had been given an electroconvulsive shock treatment. This strongly mirrors the scene in Cuckoo's Nest where McMurphy and other patients, after creating havoc at a group meeting, are subjected to ECT treatments. It reminds one that these treatments do, in fact, exist, and are given out for similar reasons as in the film. It also shows the remnants from the older asylum system of mental health that still existed in the 70s. Another incident that the reporter described that bore resemblance to the film was a patient basketball team. The team had just played at a local high school, and although it had lost by 40 points, the existence of the team brings to mind the basketball match in Cuckoo's Nest between the staff and the patients. It also is an example of the beginning of the transition from institution-based to community-based mental health care. The basketball team was a form of community that would have fit in well with the reform efforts of the time.