On ECT, Jack Nicholson and One Flew Over the Cuckoo’s Nest

David Laing DawsonBy Dr David Laing Dawson

In my addendum to Marvin’s blog last week I referenced Jack Nicholson in One Flew Over the Cuckoo’s Nest. I’m sure everybody got the reference. Some of those scenes are burned into the collective imagination. And I was a fan of both Ken Kesey’s novel and the movie. I say ‘was’, because as great as Nicholson’s performance, as great as Milos Forman’s direction, and Louise Fletcher’s acting, the movie may have played a minor role in the demise of the Mental Illness treatment system of North America and a return to incarceration in jails and prisons for thousands of the mentally ill, to say nothing of an unwarranted negative public reaction to ECT.  At least unwarranted since it has become more selectively and carefully used to treat only patients with severe illness not responding to medication.

The novel rose out of Mr. Kesey’s part time work as an attendant on the night shift of a Veteran’s Hospital, while taking part in a CIA sponsored experiment with psychedelic, hallucinogenic drugs, in the late 1950’s.

Movies are magic, and they play fast and loose with the truth. In the sound and fury of them, in our vicarious pleasure of escaping our bonds, seeking revenge, getting back the man or woman of our dreams, and saving the world, we often miss a few nuances and incongruities.

Randle McMurphy does embody the free rebellious rule-breaking individual confronting oppressive institutional authority as personified by Nurse Rached. And the movie makes us root for him and hate Nurse Rached. Her ultimate weapons being ECT and Lobotomy.

Now there certainly is some truth to those big overcrowded wards of large mental hospitals being run by nurses whose prime directive was to keep everything peaceful, under control, with a modicum of care and nurturing on the side. And the doctor often was, as described by sociologists, the absent father whose power could be invoked by the nurses, as in “You just wait until your father gets home.”

But here are some of the nuances in that film that slip by us: All but a couple of the patients on that ward are voluntary and could leave any time they wanted. And McMurphy, well, he is a charming psychopath, and he has faked insanity so he could be transferred to that hospital from a prison. His most recent conviction is for statutory rape with his defense being, “She came on to me.” That would imply that McMurphy had sex with a 13 or 14 year-old child at the time the book was written.

Our attitudes have shifted a little since that film was made. Today McMurphy might be charged with “sexual assault” “rape of a minor” “sexual molestation of a minor”. He would be placed on a sexual offense registry, and the public and our courts would show him little sympathy. And, I suspect, that if I were asked to provide a psychiatric evaluation of McMurphy, I would be telling the court that he is high risk to re-offend.

On the other hand, if any actor could make us root for a pedophile it would be Jack Nicholson in his prime.

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6 thoughts on “On ECT, Jack Nicholson and One Flew Over the Cuckoo’s Nest

  1. The prostitute was portrayed as a person who willingly collaborated with Jack Nicholson. Yet in reality it was probably poverty and necessity that drove her into a role of oppression. When we look back, we are judging behavior by today’s standards. I saw Jack Nicholson as someone who looked out for his fellow patients, questioned authority, and did not take any BS, for which he paid an awful price.

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  2. This is a good start on a critique of the movie but hardly complete. A couple nuances that bother me are the underlying theme that the problem was the hospitalization itself rather than the diseases that typically put people there as well as no main patient characters displaying symptoms of serious mental illnesses.

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  3. I could think of so many other instances when we throw ourselves on the side of the underdog without asking ourselves how the underdog got into the mess he or she is in..Most of the time it wasn’t their fault, but sometimes it was..
    Charlie Hebdo ?
    Bonnie and Clyde ?

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  4. There is a current TV series “Criminal Minds” which perpetuates the false mother-blaming theory of serious mental illnesses(SMI) and exaggerates the violence of mentally ill people.

    It is a cruel untruthful version of the reality of SMI. It is fiction that spreads a pack of lies and leaves uninformed viewers with no understanding that these diseases are medical illnesses.

    I doubt if we would allow any other deadly disease to be given such a false depiction for public entertainment.

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  5. Hi— thanks again for perspective. A request: Please send copy of earlier post. I am subscriber, but cannot find blog. Would like another copy of your recent Post on “suicide prevention.” I posted this to Mental Illness FACTS —Facebook page–a grass roots organization I co-founded in 2010. BUT I didnt save your commentary. Would like to repost on our website http://www.right2treatment.org Thanks, Rose King

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