“Along that road to crazy”

    “Along that road to crazy”: Healing the Mentally Ill and Changing Our Attitudes

      In Ken Kesey’s One Flew Over the Cuckoo’s Nest

Institutionalized, marginalized patients are the center of Ken Kesey’s novel, which deals with malicious Nurse Ratchet’s immoral asylum that is changed irrevocably by the loud, boisterous, hero Randle McMurphy; his commitment to the ward leads to events that shed light on the horrendous treatment these men face daily. The novel One Flew Over the Cuckoo’s Nest is told through the eyes of Chief Bromden, a “chronic” who tells what life was like in the ward and shares the rise and fall of the hero McMurphy. From the beginning, McMurphy is clearly shown as different from the other patients, as he is not clinically insane. McMurphy does not truly see himself as ill but rather wants to take a break from his work and take charge of the ward. Rather than keep himself separated from the other patients he becomes the catalyst for change in the ward and sparks a change in his fellow ward mates. Through McMurphy the other patients of the asylum find their voices and become more like humans rather than numbers on their hospital wristbands.

Previously, psychiatric wards since the nineteenth century have suffered from small medical staffs, overcrowded institutions, and inhumane therapeutic treatments that only considered the patients in a behavioral mindset. Anyone considered deviant from the norm were put into hospitals under the notion of treating them for their illness. Electro-shock therapy, lobotomy, and over-medication were common in these types of places, and the novel critiques these types of treatments for patients. Robert Rosenwein is a professor who focuses on social psychology, evident in his essay “ A Place Apart: The Historical Context of Kesey’s Asylum” that appears in the book A Casebook On Ken Kesey’s One Flew Over The Cuckoo’s Nest. In this essay Rosenwein offers a historical perspective on the social constraint that labeling and institutionalizing the mentally ill had. Mental illness was seen as a social phenomenon and the essay deals with the way mentally ill patients were incarcerated, and later “hospitalized”, in Europe and America. Rosenwein also rationalizes the reason why historically those considered insane were incarcerated and uses these examples in relation to the action of Kasey’s novel. He also points out the lasting effect of the novel on the way people view institutionalization. Asylums may seem like an outdated concept but the effects of incarceration of the mentally ill are still felt years later. Rosenwein gives the history of asylums and the medical staff that worked in these institutions, and also offers three reasons why society adopted the stance of “out of sight, out of mind” in the past and now. Moral re-socialization, relearning social positions, and protecting society from the insane were the justifications for keeping those considered deviant from society in these wards, just like the one described in Kesey’s novel. Even today our society faces problems with stigmas surrounding the mentally ill. This leads to the question, then, what would help? Cognitive-based therapies, medicine, and talking about the stigmas surrounding those considered insane could become the building blocks towards change. We also know now that humanistic psychology principles help; this is the school of psychology that developed in direct response to that of behavioral psychology, which previously only regarded patients as observable behaviors and actions. Yet the question of treating the mentally ill as more than just a disorder is still being asked because although we have made strides, we have not yet reached the finish line. As a society we have a long way to go before we can truly start eradicating the stigmas that surround the mentally ill.

These stigmas are the underlying layer that drives the novel and pushes its ideas from fiction to reality. Ken Kesey’s novel One Flew Over The Cuckoo’s Nest provides insight into the effects that behavioral psychology and hospitalization has on the mentally ill. Though critics have noted the benefits that humane methods have on patients, I would like to further explore how this shift helps eradicate stigmas and heal the mentally ill. Some critics have argued against the act of deinstitutionalization, stating that it hurts patients who cannot function in normal society. Those for the movement argue that it helps with actual treatment of the mentally ill and closes the boundaries between those who are considered deviant and not. This boundary is not easy to cross however, as the research in the article “An Attributional Analysis of Reactions to Stigmas” points out. Experiments from the minds of psychologists found that people believed those with mental disorders were responsible for their condition, along with evoking anger and little pity. However, I believe that if we as a society educate others about the truths of mental illness, change can happen. Thus, closer attention to Bromden’s narration and his character development because of McMurphy reveal that the author suggests that these patients have been wrapped in these hurtful stigmas and should try to break free of them. McMurphy, as the center of the novel, also deserves to be the center of discussion; his character is used to illuminate the wrongs that society has done to those considered mentally ill. This novel urges readers to look at the way this society functions, and by turn the real world we live in, and hope for a change in these institutions and in the ways people think about the mentally ill.

The stigmas surrounding the mentally ill are part of the focus of my close reading capstone, which deals with aspects of the novel that are pertinent to the kind of conversation I wanted to have about the mentally ill. My close reading focuses on both Bromden’s “growth” in size and this conversation between McMurphy and Harding:

“Though I used to think at one time…that society’s chastising was the sole force that drove one along that road to crazy, but you’ve caused me to re-appraise my theory.”

“Yeah? Not that I’m admitting I’m down that road, but what is this something

else?”

“It is us.” He swept his hand about him in a soft white circle and repeated,

“Us.”

McMurphy halfheartedly said, “Bull.” (257-258).

It’s very interesting here to see that Harding blames not only society, which is clearly marginalizing him and the other patients, but also themselves. Harding and many of the other patients, especially Bromden, have a self-stigma against themselves that makes them believe they are less. Nurse Ratchet, who to me embodies society and its cruelties towards the mentally ill, reinforces this. McMurphy then, despite his response, is the one who saves the patients from themselves and society embodied by the Big Nurse. Even though he is sacrificed in the process, McMurphy is the driving force that causes the characters to reappraise their lives and try to start over.

Bromden’s growth is also very important when talking about stigmas surrounding the mentally ill. Although consumed by the idea of his self being demolished by his time in the ward, Chief Bromden begins to grow, literally and figuratively, into a person who is free of restraints. Bromden is the narrator of the story, and although his telling of the story includes descriptions of events that could never be true, we become invested in his own truth that leads to his healing. Nurse Ratchet and the environment of the ward have clearly taken its toll on Bromden, who would rather stay in the not-really-there fog that distorts his reality. McMurphy is the one who ends the fog and pulls Bromden out of this label and promises to help him grow back to his normal size, and as Hunt points out in his essay, will make Bromden into a healed person.

Change, however, is a long road with detours and obstacles in the way that make it harder to reach the final destination. Of course, in this instance, the final destination is unknown: Does the novel push the need for deinstitutionalization of does it ask even more of society? Should we eradicate labels that are possibly harmful and instead try to heal in different ways? But which way is best? These questions that the novel raises needs more support from psychologists and psychiatrists, but also from normal people who have to live with people who suffer from mental illness. We can’t leave change up to only a few and presume that they speak for the whole; we need a change in the way of thinking of everyone, not just the people who make laws and regulations. Can there be a world where the normal and the abnormal can coexist without harming each other? Or does the novel reach too far in assuming we can? Given the ambiguous ending, in which we see Bromden escaping the ward into a world that might not accept him, the change in our way of viewing the mentally ill might take a long time.