One Flew Over the Cuckoo’s Nest

1. One Flew Over the Cuckoo’s Nest By Ken Kesey

2. Ken Kesey Born in LaJunta, Colorado in 1935 Raised in a religious household and voted “most likely to succeed” in high school. Became one of the most controversial figures of his age. Was a leading figure in the counterculture movement of the 1960s – a quintessential “hippie”.

3. The Electric Kool-aid Acid Test • Written by Tom Wolfe in 1968, The Electric Kool-aid Acid Test detailed Kesey’s real-life adventures with his “Merry Pranksters”. • Kesey and the Merry Pranksters drove across the country in a psychedelic bus, reaching collective and personal revelations through the use of LSD and other psychoactive drugs. • Their philosophy revolved around breaking the boundaries of spiritual awareness through experimentation and communal living (and, of course, drug use). • As they drove across America, they gave LSD to anyone willing to try it, hoping to expand their banal existences.

4. What inspired Kesey to write this noveland why in this freaky, messed up way? • While at Stanford, Kesey volunteered for medical studies on the effects of psychoactive drugs (often hallucinogens). He used these experiences to inform how Chief would see the world. • Kesey actually worked as a night warden on a ward in a mental hospital. He was so determined to get the feel of a patient that he underwent ECT.

5. Adaptations • Cuckoo’s Nest was adapted for both stage and screen. • The 1975 film won the “big five” Oscars: best film, best adapted screenplay, best actress, best actor and best director. • Kesey unsuccessfully sued film producers in 1975 because they changed the point of view from the original story.

6. Narration • Be patient with your narrator, Chief Bromden. • He has had too much electroshock therapy and is suffering from mental illness. • Keep in mind that our narrator is not the same as our protagonist. Likewise, the narrator is a separate personality from the author.

7. What is this?

8. Combine Harvester • A combine harvester is an agricultural machine that harvests all types of cereals, oil seeds, and legumes through four main steps: • The crop is cut and directed into a rotating chamber with a series of beaters going the opposite direction. The grain is dislodged, falls to the bottom, separated from debris by sieves and wind. The grain is transferred to a hopper and the debris falls out of the rear. • Chief Bromden often makes references to “the Combine”. What might a combine harvester symbolize?

9. Motifs to Keep an Eye On: • Fog • Hands • Nature/Purity • Machine/Combine • Christ/Saviour • Sanity/ Insanity • Laughter

10. Check out some images that McMurphy would have seen on his ward:

14. Connections to One Flew Over the Cuckoo’s Nest • Guests had to check in • Most patients were admitted by family members • Many patients had the power to leave on their own but were “controlled” by staff members and manipulated to believe that they needed to stay.

15. Mental Hospitals1930s – 1960s

16. Conditions at these hospitals could be atrocious... • Overcrowded • Dirty • Not nurturing • No privacy • Similar to – or in some cases worse than - prison

17. Inside the Institutions • Patients were provided with “adequate care” (and segregated), which often times led to inadequate care, poor facilities, and loss of dignity. • They were usually given uniforms and “daily chores”. In fact, it wasn’t until 1973 that New York state banned public hospitals from requiring patients to work in exchange for their room and board. • Families were often ashamed of patients and would deny their existence. • Ultimately some of these hospitals became holding areas for a person’s entire life.

18. Some More Images:

22. Medical Care in Mental Hospitals • Deaths and injuries sometimes resulted from treatment. • Patients were treated with medically approved procedures like: being put in tanks of ice-cold water, spun in chairs for hours, and forced “medications” (powerful psychoactive drugs). • Patients were also treated with non-medically approved procedures, which were simply designed to control them. For example, patients could be shackled to walls, placed in seclusion (most often without clothing) or placed in restraints (strapped to a bed with leather restraints, often spread-eagled).

23. Types of Treatments for the Mentally Ill • Group Therapy • Drug Therapy • Electroshock Therapy • Lobotomy

24. Drug Therapy • Thorazine • The first psychotropic drug, thorazine was a milestone in treatment therapy, making it possible to calm unruly behaviour, anxiety, agitation and confusion without using physical restraints. • Chlorpromazine • Prescribed for schizophrenic psychosis or manic-depressive disorder. • Worked as an anti-psychotic agent.

25. Electroshock/Electroconvulsive Therapy • Became very popular in the 1930s-1940s. • Originated to control negative behaviours in animals. • A doctor had noticed that schizophrenic epileptics who had a seizure were often more “normal” after the seizure – which led to chemical convulsives and ultimately electroconvulsive treatment. • Used to alter the chemistry in the human brain to produce desired behaviours. • Cruelly, it was used as a control device within most wards.

26. Electroshock therapy is very controversial, but is still used today. • Used to treat some forms of severe depression. • Used to “control” the elderly. • Used on children in an attempt to correct their wild and/or unwanted behaviours.

27. Lobotomy • Surgical procedure for cutting nerve pathways in the frontal lobes of the brain. The operation had been performed on mentally ill patients whose behavioural patterns were not improved by other forms of treatment • It was supposed to be a last resort. • The procedure was pioneered by Nobel laureate Egas Moniz in the 1930s. • Between 1939 and 1955 over 100,000 lobotomies were performed in the United States. • If performed correctly, disconnecting the frontal lobes caused no loss of intellect, no impairment of memory, and no problems with speech or gait.

28. How a Lobotomy Was Performed • Leucotomy • The goal was to cut the nerves that run from the front of the brain to the rear. A technique was devised that involved drilling two holes on either side of the forehead, inserting a surgical knife, and severing the prefrontal cortex from the rest of the brain. • Ice Pick Lobotomy • Invented in 1936 by Walter Freeman • Insert an ordinary ice pick above each eye of a patient with only local anaesthetic, drive it through the thin bone with a light tap of a mallet, swish the pick back and forth, then remove. • A formerly difficult patient is now passive.

29. Abuse of Lobotomy • Freeman developed what others called “assembly-line lobotomies”, going from one patient to the next with his gold-plated ice pick, even having his assistants time him to see if he could break the lobotomy speed record. It is said that even some seasoned surgeons fainted at the sight. • Doctors would recommend the procedure for everything from psychosis to depression to neurosis to criminality.

30. Lobotomy • “Every patient probably loses something by this operation, some spontaneity, some sparkle, some flavour of the personality”. • The aim was that “the patient might be transformed from a disturbed to a quiet clement (insane person).” There was no intention to “help” the patient. The goal was only to eradicate the behaviour which others found undesirable. • “Mercy killing of the psyche”. • The frontal lobe is the seat of higher functions such as love, concern for others, empathy, self-insight, creativity, initiative, autonomy, rationality, abstract reasoning, judgement, future planning, foresight, will-power, determination and concentration.

31. “Deinstitutionalization Revolution”mid 1960s • A radical deinstitutionalization revolution began. • It was supposed to end the cruel and inadequate care of institutions. • Individuals would live in their communities and have a “normalized” life. • Group homes, residential care facilities, and rooming houses were developed. • The movement helped break up the control that was happening in the hospitals.

32. So, let’s think about some major issues that occur in the novel: Decide where you fall on the spectrum.

33. Discipline Discipline is absolutely necessary in most situations.

34. You’re Crazy All people are “crazy” to some extent.

35. One Person One person can change an established, stable environment.

36. Institutions The best place for those with mental illness is in an institution and/or hospital.

37. Men Our society forces men to act like stereotypical men.

38. Hatred Hatred is inherent to human nature.

39. Rules The more rules the better.

40. Self-Esteem Self-esteem is vital to living a happy life.