Ken Kesey One Flew Over the Cuckoo's Nest by Ken Kesey was written after its author worked as an orderly in a psychiatric ward. Yet the novel also demonstrates significant research that manages to elevate it to the level of a serious critique. Published in 1962, One Flew Over the Cuckoo's Nest is thus an artistic contribution to that decade's emerging critique of societal handling of mental illness, a loose affiliation of scholarly critics that would include the British psychiatrist R.D. Laing and Canadian sociologist Erving Goffmann and would in 1967 be collectively nicknamed the "anti-psychiatry movement." I think we can understand Kesey's role in this movement by focusing on the narrator of his novel, Chief Bromden. By examining Kesey's handling of Bromden's mental state, both as medical fact and as metaphorical device, the novel's criticism of psychiatry in its year of publication may be seen as part of a larger critical movement emerging at precisely the same moment.

Kesey's Chief Bromden is the half Native American narrator of Kesey's novel. The Chief is represented as a long-term inmate of the ward: he dates his confinement to the end of the Second World War, which is presumably well over a decade by the time the novel begins. But the opening sentence of the novel reveals that Kesey has an unusual vantage for the depiction of mental illness -- the novel will be told by a mentally ill patient. We are meant to note this from the novels opening sentences: "They're out there. Black boys in white suits up before me to commit sex acts in the hall and get it mopped up before I can catch them." (9). Of course the "black boys in white suits" are no hallucinations but a straightforward reference to hospital orderlies (likely to be African-American in 1962) -- yet the delusion of conspiratorial activity, together with the blanket suspicion that "they're out there," is meant to identify Chief Bromden as paranoid. This is well in keeping with the spirit of the early 1960s -- the year after the novel's publication, 1963, would witness Columbia University historian Richard Hofstadter deliver the original version of his legendary essay "The Paranoid Style in American Politics," which would note that "in fact the paranoid mind is far more coherent than the real world" (Hofstadter 85).By 1964 General Jack D. Ripper would be showing classic symptoms of paranoid schizophrenia in Kubrick's film satire "Dr. Strangelove." If we wish to extent our definition of politics and paranoia, we might note that 1964 also saw the publication of the Warren Commission report on the Kennedy assassination, which over two-thirds of Americans believed to be a conspiratorial cover-up. By 1966, Thomas Pynchon's novel The Crying of Lot 49 would depict paranoia as being the central metaphor of post-war American life: Pynchon's invocation of "The saint whose water can light lamps, the clairvoyant whose lapse in recall is the breath of God, the true paranoid for whom all is organized in spheres joyful or threatening about the central pulse of himself" (Pynchon 104) seems to define paranoia as America's default religious vision.

If Kesey's selection of paranoia, though, seems part of a larger trend, it is worth noting that Kesey has given the Chief a particularly unusual sub-variety of paranoia. The Chief believes that his persecution is being accomplished by means of machinery, employed by a human conspiracy -- yet he gives the conspiracy the same name as a piece of farming machinery, "The Combine." Defining Nurse Ratched's role in his persecution, the Chief says:

Working alongside others like her who I call the "Combine," which is a huge organization that aims to adjust the Outside as well as she has the Inside, has made her a real veteran at adjusting things. She was already the Big Nurse in the old place when I came in from the Outside so long back, and she'd been dedicating herself to adjustment for God knows how long. (30)

In other words, the psychodynamics of paranoia in which an internal mental state is projected outwards, and malevolent forces are assumed...

The Chief sees Ratched's role within the ward as being equivalent to what the "Combine" does outside it -- but to some degree, it seems like a justification for the Chief's having been locked up in this ward for so long. But he defines the processes as exactly parallel, and putting it into a parody version of American business capitalism, the Chief defines their relation bluntly:
The ward is a factory for the Combine. It's for fixing up mistakes made in the neighborhoods and in the schools and in the churches, the hospital is. When a completed product goes back out into society, all fixed up good as new…something that came in all twisted different is now functioning, adjusted component, a credit to the whole outfit and a marvel to behold. Watch him sliding across the land with a welded grin, fitting into some nice little neighborhood…And the light is on in his basement window way past midnight every night as the Delayed Reaction Elements the technicians installed lend nimble skills to his fingers as he bends over the doped figure of his wife, his two little girls just four and six, the neighbor he goes bowling with Mondays; he adjusts them like he was adjusted. This is the way they spread it. (38).

In other words, a society conceived upon industrial and capitalistic lines is naturally going to require some kind of industrial repair policy for practice on the human products of society. The Chief is afflicted to a certain degree by machinery: within the ward, Ratched "is able to set the wall clock at whatever speed she wants" (73) implying a control over time itself (which may merely represent a way of talking about the kind of boredom entailed in this sort of ward, at least before McMurphy arrives). But the Chief also will talk about "a big machine room down in the bowels of a dam where people get cut up by robot workers" (87). And overall he defines the hospital itself as "like the inside of a tremendous dam. Huge brass tubes disappear upward in the dark. Wires run to transformers out of sight. Grease and cinders catch on everything, staining the couplings and motors and dynamos red and coal black" (83-4).

These final details in the Chief's delusion reveal that Kesey has something very specific in mind -- what psychiatry refers to as the "influencing machine" delusion. Neyraut-Sutterman relates the first clinical description by the Freudian doctor Viktor Tausk in the 1920s:

Viktor Tausk completed his medical studies in 1919 and went on to work as a psychiatrist with an interest in the psychoses. After three consultations with Tausk, a Miss Natalija A. consented to describe for him the influencing machine which she felt was being operated in an obscure fashion by a rejected suitor of hers who had previously sought to influence her, to make her agree to marry him. Though in Tausk's view this case was unique, the machine described was analogous, if atypically, to a number of such machines alluded to but not interpreted in the psychiatric manuals. In "On the Origin of the 'Influencing Machine' in Schizophrenia," Tausk developed several psychoanalytical hypotheses. Influencing machines were of a "mystical nature," described by patients at once in would-be technical terms and allusively with respect to their persecutory effects, namely images, thoughts, feelings, motor phenomena, sensations, and various bodily manifestations. (Neyraut-Sutterman)

Dr Ronald K. Siegel, in his book of case studies and observations Whispers: The Voices of Paranoia, defines this particular sub-variety of paranoia as follows:

Throughout history, many paranoids have imagined that these enemies used state-of-the-art technology to exert their influence. In the nineteenth century, such "influencing machines" operated via hydraulic pumps and invisible chemical forces. Since that time, the machines have kept pace with advancements in science, using radio waves, then microwaves, and finally lasers. (Siegel 15)

Siegel goes on to reveal that we actually have an extremely early record of a patient with precisely these delusions from the late eighteenth century, suggesting that unlike certain phenomena of mental illness (such as the late nineteenth century forms of "hysteria" which have ceased to exist), the "influencing machine" delusion is particularly durable over time. As Siegel defines the original case:

James Tilly Matthews was an eighteenth-century London architect who followed the revolutionary ideas of Franz Mesmer, the father of hypnotism. Mesmer claimed that people could influence one another by the power of magnetic fields passing between them. Mesmer even built a machine, the "baquet," a type of electrical condenser that actually produced physical sensations at relatively short distances. It was…