Movie Review Flying over the Cuckoo Nest - Essay Example

Running Head: ONE FLEW OVER THE CUCKOO’S NEST One Flew over the Cuckoo’s Nest Name Institution Date One Flew over the Cuckoo’s Nest Introduction One Flew over the Cuckoo’s Nest film was directed by Milos Forman in 1975. The movie was cast at Oregon State Hospital at Salem, Oregon and the movie illustrates significant mental illness as its key subject. The main character is McMurphy who apparently suffers from anti-social disorder according to his behaviour illustrated throughout the entire cast. The movie won several awards after its release (Tunstall, 2006). Synopsis of the movie’s storyline McMurphy is a convict who is serving a sentence at the prison’s farm for having raped and he is placed in a mental institution for assessment. Apparently, this is a plot by McMurphy to evade the difficult labour at prison as well as serve his remaining sentence within a more relaxed atmosphere. McMurphy is an anti-authoritian and has been violent in the past, but he does not show any symptoms of mental illness. He is in a ward which is being operated by a calm yet unproductive nurse, Mildred who suppresses her patients through employement of restrained humilation within group therapy, punishment masked as disagreeable medical treatments as well as a mind-numb daily practice. McMurphy discovers that the male patients are institutionalized and fear Mildred than they are centred on being functional within the outer world. McMurphy becomes friends with a young man named Billy who stutters and is always nervous, Charlie who throws tantrum whenever angry, Martini, a delusional young man, Dale, a high-strung, highly-educated patient and “Chief” Bromden, a quiet, tall man who patients and staff members believe is deaf and mute. In most instances, Chief” Bromden is ingnored by others but the respect him because of his size, which seems to highly attract McMurphy’s attention (Scott, 2005). At first, McMurphy teases nurse Mildred for his own amusement but aguments his efforts to reduce her control after seeing the impact she has in the ward. McMurphy gambles cigarrets but this is rapidly stopped by the nurse. To reduce monotony, he actively campaigns for policy changes within the ward: he ineffectively campaigns for a baseball game to be shown in the ward and arrages for the game agains the norm. He shows other patiens how he can escape but finally, he does not do it. To encourage other patients, McMurphy takes the group for fishing, after escaping using the asylum’s fence and taking the school bus, with a party girl known as Candy. Almost immediately, McMurphy discovers that Mildred can detain him involuntarily in the ward indefinitely and accuses other patients of intentionally refusing to inform him and discovers that all of them, except are voluntarily dedicated. Instead of Mildred transferring McMurphy’s group after escaping, she affirms her power more, trying to repress the now somehow liberated patients (Porter, 2005). After one of Mildred’s humilating session, McMurphy, “Chief as well as Cheswick get detained after a fight and they are scheduled for electroconvulsive therapy. As Chief and McMurphy are waiting for their sessions, he discovers that Chief can talk and Chief becomes his confidant. After therapy, McMurphy limps to the ward faking catatonia, before jokily animating his face and noisily greeting other patients, reassuring them that the therapy was ineffective as an attempt to suppress him (Porter, 2005). One night, McMurphy phones Candy and Rose to bring alcohol in the hospital and they get into the ward through the window after he bribes the watchman, Mr. Turkle. The patients do a party as Billy, who earlier had been mortified by Mildred for clumsiness with ladies, flirts with Candy. McMurphy and Chief choose to escape with the ladies through the window where McMurphy asks Billy to flee with them. Billy refuses, saying that he needs more time in the hospital though he is interested in Candy. McMurphy convinces Billy to sleep with Candy and all other patients pass out after heavy drinking. Nurse discovers that and instructs attendants to lock the window and carry out head count for the patients. Billy is got naked with Candy and other patients applaud him. The nurse reprimands Billy while Billy says he is not ashamed of his action without stammering. The nurse says she will inform Billy’s mother and he panics and the stutter returns and afterward he commits suicide. Mcmurphy blames Mildred for Billy’s death and nearly kills her (Porter, 2005). After sometime, patients are taught how to play cards and how to gamble cigarettes in the absence of McMurphy. Harding copies McMurphy’s illustration of the game whereas other patients guess that McMurphy radically escaped from the hospital. Nurse Mildred, who is still recuperating from the neck injury which she got after McMurphy’s attack, has to use a loudspeaker within the nurses’ station for patients to be audible. Afterwards, Chief spots McMurphy being accompanied to his bed, and at first believes he is back for them to escape jointly. Nevertheless, Chief discovers that McMurphy is unresponsive and has been lobotomized. Reluctant to see McMurphy in that condition and other patients to see him in that condition, he smothers him with a pillow. Finally, Chief executes McMurphy’s plan to escape (Kesey, 2004). Suggested axis for the main character McMurphy who is the main character is a witty, violent troublemaker and has great charisma and leadership qualities as well. He is of sound mind but he has an Antisocial Personality Disorder. After a person is above 18 years, he/she must meet four of the nine criterion of DSM III to be diagnosed with Antisocial Personality Disorder. McMurphy is suffering from Antisocial Personality Disorder since he meets four of these which include: failing to agree to social norms with respect to legalized conduct, not capable of maintaining lasting connection to a sexual partner, bad temper and aggressiveness as illustrated by his constant physical fights, and finally, unruliness. Furthermore, he is not remorseful after his callous deeds even though he is still sane (Tunstall, 2006). Despite having four different chances to escape, he still remains in the hospital and this is because not like he fears being caught but because of the following reasons; during the initial expedition, the fishing trip, he wants his group members to have something new and experience some freedom. He informs them, they are fishermen and not patients and over the trip and shows them fishing and they all enjoy the trip. His other chance was when he organised a party as a farewell. He could have escaped but was enjoying the party and when he eventually decided to leave, Billy did not want. Therefore, he decided to convince Candy to sleep with Billy and afterward he slept until when nurse came. His third chance was when he was almost jumping out and a nurse screamed. Instead of escaping, McMurphy followed the orderlies after Billy committed suicide. The forth chance was after the incident whereby instead of escaping immediately, he started strangling the nurse where he was lobotomised afterward (Scott, 2005). Throughout the movies, his behaviour is normal. He is regarded as a social deviant on the outside world, and is hence suffering from Antisocial Personality Disorder, but a normal person on the inside. Just like anyone, he bonds with the people he spends time with and he is caring towards them. Consequently, the main question is whether McMurphy is sane. He is sane but all the same, he never escaped when he had several chances. Friendship and its ties with the people in the ward is what kept him there. The normal scientific reaction towards any dangerous situation is either fighting or escaping. Finally, McMurphy decided to remain and fight (Scott, 2005). Apparently he is experiencing axis 1. Signs and symptoms In antisocial personality disorder, the indivindual normally has constant disregand for other people’s rights and usually violates their rights. This starts during childhood and carries on into adulthood. The person is normally dishonest and tries to manipulate other people always. For a person to be diagonised with this disorder, he or she is suppossed to be at least 18 years old and should have had some symptoms of delinquecy before he/she 15 years. Antisocial personality disorder is only diagnosed when such behaviours become constant as well as very disabling or distressful (Stan, 2005). For a person to be diagnosed with this disorder, he or she must fulfil the some diagnostic criteria and the following symptoms are required to be demonstrated; the person fails to obey the rules to social norms with respect to lawful behaviours as illustrated by constant doing actions that can lead to arrest, deceit, as illustrated by constant lying, the person uses aliases and cons others for his own benefit or pleasure, impulsivity and also the person always fails to plan ahead, reckless disregard for his or her safety and the person does not also care about other people’s safety, regular irresponsibility, as illustrated by constant failure to maintain steady work behaviour, relationships or honour financial responsibilities. Such an individual also has a tendency to irritability, anger as well as aggression, as illustrated by constant assaults to other people or the person always getting into physical fights and the person also does not feel guilty regarding any wrong doing he or she commits. Finally, the person is never remorseful and this is illustrated by being uncaring to or rationalising having harmed, mistreated or stolen from another person (Stan, 2005). The current prevalence of antisocial personality disorder is about 10% to 15% of the population within the United Kingdom. Gender has an effect on the disorder; for instance, antisocial personality disorder is more prevalent in men than in women. Approximately, one in 47 people within United States has the disorder. This means that about 10% or 5.7 million people have it (Bienenfeld, 2008). Different theories try to explain the origin of the antisocial personality disorder. For example, genetic factors have an effect on the biological basis of the brain in addition to the basic personality system. As a result, personality structure have an influence on how an individual respond to life experiences and how a peson interacts with the social enviroment. With time, every individual develops distinguishing ways of perceiving the world of feeling, thinking as well as behaving (Spitznagel, 2003). According to research, poor regulation of the areas that control emotion in the brain raises the risk of a person getting antisocial personality disorder, more so when combined with factors like abuse, disregard or separation. For a biologically, predisposed individual, the main developmental challenges of adolescence and early adulthood can prompt an antisocial personality disorder. Social theories suggest that antisocial personality disorder indicate learned responses, and has more to do with fortification, modeling as well as aversive spurs as contributing aspects. From psychodynamic theories, antisocial personality disorder indicates deficiencies in ego as well as superego development and it is connected to poor child relationships with others exemplified by unresponsiveness, over protectiveness or even early separation from someone the child was deeply attached to (Barnow, 2007). Antisocial personality disorder can be treated through combination of both drug therapy as well as psychotherapy, which are supposed to correct the behavior and mood disturbances that come as a result of the patient’s mistaken beliefs. Treatment can also involve mobilization of a support system for the isolated patient. Drug treatment with a antipsychotic work through blocking postsynaptic dopamine receptors. The drugs decrease the incidence of psychotic symptoms, for instance, hallucinations, delusions and also relive both anxiety and agitation. There are other psychiatric drugs that can be used in treating antisocial personality disorder and they include antidepressants and anxiolytics. These drugs can be prescribed for the patient in order to control the symptoms that are associated with this disorder (Rubroek, 2006). The history of the patient’s response to medication is the most effective guide when choosing treatment for a patient. The type of medication is also dependant on the patient’s symptoms. Even if drug therapy may not be effective when treating the patient, it assists in reducing stress and anxiety as well. Family therapy and group therapy are the best treatment for anyone suffering from antisocial personality disorder. Effective therapy for the patient suffering from personality disorder requires a trusting relation with the nurses as well as the therapist since the therapist will be able to make use of a direct approach when treating the patient. Hospital inpatient setting therapy can be successful in emergency situations and probably for long-term treatment for intermediate antisocial personality disorder. Inpatient treatment is contentious, nevertheless, since most patients with antisocial personality disorder don’t conform to extensive therapeutic regimens; for such patients, outpatient treatment can be more helpful (Lee-Evans, 2005). In the movie, the nurse Mildred Ratched did not provide ample and calm environment for the patients. She was basically argumentative and at times was rough while administering the treatment. This is what perhaps raised agitation in the patients especially McMurphy who did not like the way the nurse was being authoritative with the patients. For example, it is apparently clear that the violent and unmerciful environment is what was delaying Billy’s treatment (Westen, 2007). This is illustrated by the incident where he had slept with Candy and when asked about it he answered without stuttering. But when the nurse became forceful and argumentative with him, he immediately began stuttering. The nurse was purely not effectivesince instead of dealing with Billy calmly; she started threatening that she would inform his parents. This is what eventually led to Billy’s suicide. The main ethical issue in this movie is the way the nurse was treating the patients. She was very inhuman with them and often arguing with them which obviously worked against the purpose of the patients being in the hospital. The nurse was also regularly implementing restraints to the patients whenever they acted against her, even when McMurphy won the campaign for the baseball to be cast, the nurse vehemently refused. It seems that the nurse aimed more at satisfying her ego, rather than instilling effective treatment for the patients (Taylor, 2006). Since agitation can be an early sign of several varying disorders, it is important for the therapist to first monitor the patient’s fundamental symptoms and neurologic condition while the cause of the disorder is being established. For a patient who is suffering from antisocial personality disorder; the therapist should avoid any stressors to the patient since such stressors are likely to increase agitation for the patient. The therapist should also offer enough lighting in the patient’s ward, maintain a calm environment for the patients suffering from this disorder and should also give the patients enough and ample time to sleep (Davies, 2003). The therapists taking care of such patients should also make sure that the patients are provided with balanced diet and also should provide them with vitamin supplements as well as hydration. Moreover, the therapist or the nurse should not be judgmental or argumentative with such patients but should always remain calm for the best treatment for them. Finally, the therapist should at all cost avoid impacting restraints to the patients unless it is utterly necessary since such restraints tend to increase agitation in them and is appropriate the therapist or the nurse should make preparations for the patient in order to carry out diagnostic tests, like computed scan, blood studies in addition to magnetic resonance imaging (Armelius, 2007). While teaching the patients with antisocial personality disorder, it is important for the therapist to orient the patients to the unit and its processes and routine. It is also equally important for the therapist to explain stress-reduction measures as well as provide reassurance and emotional support to the patients. It is also necessary to explain all the medical tests and procedures, the primary cause as well as the treatment plan for the patient (Blair, 2006). References Armelius, B. (2007). Cognitive-Behavioral Treatment for Antisocial Behavior in Youth in Residential Treatment." Cochrane Database Systems Review. Vol.17/4. Barnow, S. (2007). The Influence of Parental Drinking Behavior and Antisocial Personality Disorder on Adolescent Behavioral Problems. London: Oxford University Press. Bienenfeld, D. (2008). Personality Disorders." eMedicine.com. . Lee-Evans, J. (2005). "Reactions of Primary and Secondary Psychopaths to Anger-Evoking Situations." British Journal of Clinical Psychology. Vol. 24/2. Blair, RJR. (2006). "Neurobiological Basis of Psychopathy." The British Journal of Psychiatry. Vol.182/ 5-7. Kesey, K. (2004). One Flew Over the Cuckoo's Nest. New York: Penguin Classics. Rubroek, P. (2006). "Treatment Response of Adolescent Offenders with Psychopathic Features." Criminal Justice and Behaviour. Vol. 33/5. Scott, J. (2005). One flew over the cuckoo's nest. London: Macmillan. Taylor, M. (2006). Role of Genotype in the Cycle of Violence in Maltreated Children. Science. Vol. 2/3. Spitznagel, M. (2003). The Role of Psychiatric Disorders in Predicting Drug Dependence Treatment Outcomes." American Journal of Psychiatry. Vol. 2/5. Tunstall, G. (2006). "Facial Emotion Processing in Criminal Psychopathy. Preliminary Functional Magnetic Resonance Imaging Study." British Journal of Psychiatry. Vol.5/12. Stan, E. (2005). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Treatment Revision. Washington, D.C.: American Psychiatric Association. Porter, G. (2005). One flew over the cuckoo's nest: rising to heroism. California: University of California. Davies, A. (2003). "Psychopathy and Institutional Outcome in Patients with Schizophrenia in Forensic Settings n the U.K." Schizophrenia Research. Vol. 2/5. Westen, D. (2007). "Personality Profiles in Eating Disorders: Rethinking the Distinction between Axis I and Axis II." American Journal of Psychiatry. Vol.5/12. Read More