In "One Flew Over The Cuckoos Nest," what form of therapy did the hospital use on the mentally ill? Did it work? Describe the common routine that all patients had to follow.

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mwestwood eNotes educator| Certified Educator

Ken Kesey's novel One Flew Over the Cuckoo's Nest is based on some of his personal experiences as a volunteer as a medical guinea pig at the Menlo Park veterans hospital in Oregon, where he worked as a night aide in what turned out to be a CIA-financed secret study of the effects of psychoactive drugs on people.

The inmates of the hospital where the main character McMurphy is transferred is a psychiatric ward. After lining up to be given their medications each day, the men attend a session of group therapy, but the Nurse controls the discussions too much and few benefits are derived from the sessions.

The dangerous patients--both to themselves and to others--are given various tablets. One such tablet is probably Thorazine, a drug used to reduce schizophrenia and other psychotic disorders. Many men are put into stupors so that they will not be violent or disruptive and they can be controlled. In Chapter 6, the narrator describes the "time control" and the "fog" that are created in the ward.

The Big Nurse is able to set the wall clock at whatever speed she wants by turning one of those dials in the steel door...and everybody is driven like mad to keep up with that passing of fake time; awful scramble of shaves and breakfasts and appointments and lunches and medications and ten minutes of night....

About the only time we get any let-up from this time control is in the fog; then time doesn't mean anything. It's lost in the fog.

Those inmates who become uncontrollable are given shock therapy. If this does not make the patients more tractable and no medication works, these men are reduced to human vegetables by being given pre-frontal lobotomies, a neurosurgical operation in which connections in the brain's pre-frontal lobe are severed. 

Because the "Big Nurse" is so domineering, the group therapy is nothing more than her manipulation of the men so that they will be docile and submissive to her rules. The psychiatric doctor is not assertive enough with this nurse, and so he has little impact upon the men. When the rebellious McMurphy, who greatly influences the behavior of the other inmates, realizes that no one can be released unless the staff decides that he is cured, he backs away from his leadership. Afterwards, no amount of therapy and medication seems to help the men in the absence of McMurphy's influence.

ms-mcgregor eNotes educator| Certified Educator

The hospital employed several kinds of therapy. The first kind was drug therapy which was one routine that all patients on McMurphy's ward followed. The hospital also employed group therapy. In the novel, the group atmosphere, McMurphy is able to challenge Nurse Ratched's contol of the ward. If patients became agitated or the hospital doctors felt it was necessary, patients were given electric shock therapy. Electrodes were attached to the patients and they were given a sharp electric shock which seemed to have a calming effect. This was given to McMurphy, Cheswick and the Chief after an incident during group therapy. The final solution seems to be frontal lobotomy in which part of the frontal lobe of the brain is removed. It was also thought to have a calming effect, although it left people with almost no personality. This is what occurs to McMurphy and is the catalyst for the Chief's escape from the hospital. If the novel is to be used as a guide, most of the time the therapy was ineffective because after McMurphy's death, most patients check themselves out.

Nurse Ratched was obsessed with the daily routine which included getting the men up at a certain time, having them clean up and take their medication, group therapy, field trips and individual for patients to interact. Then, they all went to bed at the same time.

Read the study guide:
One Flew Over the Cuckoo's Nest

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