one flew over the cuckoo nest film analysis

One Flew Over the Cuckoo’s Nest is a 1975 film based on the novel of the same name. The film addresses multiple themes related to the ineffectiveness of mental health treatment models and the ironies inherent in attempts to control or modify deviant behavior. Although set in a mental institution, protagonist Randle McMurphy has been processed through the criminal justice system. Therefore, the film also reveals the intersections between criminal justice and mental health. One Flew Over the Cuckoo’s Nest has also been instrumental at altering public perceptions of both mental illness and the institutionalization of psychiatric treatments. One study shows how the film increased negative attitudes towards both mental health care and mental illness (Domino, 1983). In fact, the film does effectively demonstrate some of the shortcomings of mental health treatment that have changed due to an increased interest in ethical and evidence-based care.
Multiple types of mental illness are portrayed in One Flew, although diagnoses and mental health classifications are not central to the story. The protagonist McMurphy is likely not mentally ill at all; he is simply someone who exhibits misogynistic attitudes and some forms of deviant and aggressive behavior. Because of the lack of formalized assessment and diagnostic procedures, and because McMurphy’s rights have been stripped away due to his status as a felon, the key players in the mental health system have the power to force upon him invasive—and spurious—treatment interventions like electroconvulsive (shock) therapy and lobotomy. The lobotomy leaves McMurphy in a catatonic state. Interestingly, the Chief appears to have been committed to the mental institution for a state of mind akin to catatonia given his unwillingness to talk. Only McMurphy and him form a bond that reveals the Chief is consciously choosing silence as a mode of social protest, and like McMurphy, may not be mentally ill at all but simply unwilling to conform to societal norms.
On the other hand, McMurphy might have an undiagnosed condition like antisocial personality disorder. His inability to feel remorse for the crimes he has committed in the past, his misogyny, and his eventually trying to kill Nurse Ratchett all point to a potential diagnosis of antisocial personality disorder. The Chief is a more complex character and one whose flat affect, his lack of emotional expression, may point to schizoid or schizotypal personality disorder (“Personality Disorders,” n.d.). Nurse Ratchett also demonstrates problematic behaviors, including hostility towards patients. An analysis of her character may lead to a diagnosis of paranoid personality disorder or narcissistic personality disorder. Nurse Ratchett feeds off of her own power, demonstrates manipulative behaviors, and fails to develop any empathy at all for the patients in the institution. Her fixation on rules and overall inability to accept moral ambiguity could also point to undiagnosed obsessive-compulsive disorder.
More minor characters in the movie exhibit possible diagnoses including mood disorders, personality disorders, and psychoses. Several characters, like Martini and Dale, may have symptoms of schizophrenia including paranoia and delusional thinking and yet if they were formally diagnosed by a clinical psychologist may be assessed more on the basis of DSM axes: including the possible presence of a personality disorder. For instance, Dale is paranoid and suspicious of others, consumed with fear that other people are out to get him. Dale may also have a clinical disorder on Axis I like schizophrenia or bipolar disorder, or may only be classified as having paranoid personality disorder. The film never spells out for the audience the official diagnoses given to any patient, but symptoms can point to potential conditions. One character, Billy, may have borderline personality disorder, avoidant personality disoder, or social anxiety disorder—several of which would be evident in his occasional stuttering and his fear of his mother. Charlie and Max are other minor characters with behavioral cues that relate to general impulse control disorders. The film does show audiences a cluster of symptoms that can be used during diagnoses, but fails to show how clinical psychologists assess clients. Since the film’s release, the mental health care system has changed considerably with increased awareness of ethical considerations and greater emphasis placed on formal diagnostic procedures that would prevent unwarranted treatment interventions or being institutionalized against a person’s will.




References
Domino, G. (1983). Impact of the film, One Flew Over the Cuckoo’s Nest, on attitudes towards mental illness. Psychological Reports 53(1): 179-182.
Forman, M. (Director). (1975). One Flew Over the Cuckoo’s Nest. [Motion picture]. United States: Fantasy Films.
“Personality Disorders,” (n.d.). MayoClinic. https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463