1. One Flew Over the Cuckoo’s Nest Ken Kesey

2. Published in 1962 What was going on in the U.S.? – Vietnam War – Protests – JFK is president – Hippies, psychedelic drugs

3. What inspired Kesey to write this novel and why in a freaky, messed up way? Kesey actually worked as a night warden on a ward in a mental hospital. He was so determined to get the feel of a patient that he underwent ECT (electroconvulsive therapy) While at Stanford, Kesey volunteered for medical studies on the effects of psychoactive drugs (hallucinogens).

4. Narration Be patient with your narrator, Chief Bromden or “Chief Broom.” He has had too much electroshock therapy and too many drugs. Keep in mind that a narrator is not necessarily the same as a protagonist.

5. What is this?

6. Combine Harvester An agricultural machine that harvests all types of cereals, oils, seeds and legumes. All parts work together to harvest the crops. The combine as the “machine” is a major motif to watch out for. Conflict - Man vs. machine

7. Other motifs to keep an eye on Fog Hands Nature/purity Christ/savior Sanity/insanity Laughter Combine/machine

8. Images from a ward

10. Similarities to One Flew Over the Cuckoo’s Nest Guests had to check in Most were admitted by family members Many patients had the power to leave on their own but were “controlled” by staff and manipulated to believe they needed to stay.

11. Mental Hospitals in the 1930s-1960s

12. Conditions at hospitals could be atrocious Over crowded Dirty Not nurturing No privacy Similar to, or in some cases worse than, prison

13. Inside the Institutions Patients were provided with “adequate care.” Many times this meant minimal care, poor facilities and loss of dignity. They were given uniforms and chores. Families were often ashamed and would deny their existence. Many patients stayed for their entire lives.

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16. Mental Disorders Germaphobia (OCD) – fear of dirt or germs Epilepsy – seizures Schizophrenia –hallucinations, bizarre delusions and muddled speech/thinking Neurotic Disorder – distress Dissociative Personality Disorder – multiple personalities Speech Disorder – stuttering/stammering

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19. Medical Care in Mental Hospitals Injury and death sometimes resulted from treatments Patients were treated with medically approved procedures: being put in tanks of ice-cold water, spun in chairs for hours and forced “medications” (psychoactive drugs). Patients were treated with non-medically approved procedures: shackled to walls, placed in seclusion or put in restraints.

21. Types of Treatment for the Mentally Ill Group Therapy Drug Therapy Electroshock Therapy Lobotomy

22. Drug Therapy Thorazine – First psychotropic drug – Was a milestone in treatment therapy – Calmed unruly behavior without restraints

23. Drug Therapy Chlorpromazine – Treats schizophrenic psychosis – Treats manic-depressive disorders

24. Electroshock Therapy Became very popular in 1930s-40s Originated to control negative behavior in animals A doctor noticed that during seizures, schizophrenics were more “normal.” Used to alter the chemistry in the brain Cruelly, it was used as a control device

25. Electroshock Therapy

26. Still used today Used to treat some forms of severe depression Used to “control” the elderly Used on children in an attempt to correct wild and/or unwanted behaviors

27. Lobotomy Surgical procedure for cutting nerve pathways in the frontal lobes of the brain. This procedure was supposed to be a last resort for patients that did not improve. If performed correctly, disconnecting the frontal lobes should cause no loss of intellect, memory and no problems with speech.

28. How a lobotomy was performed Leucotomy – drill two holes on either side of the forehead, insert a surgical knife and sever the prefrontal cortex from the rest of the brain Ice-pick Lobotomy – Insert an ordinary ice pick above each eye using only a local anesthetic, drive through the thin bone with the tap of a mallet, swish the pick back and forth and remove

29. Lobotomy Results A formerly difficult patient is now calm and passive!

30. Abuse of Lobotomy Walter Freeman, inventor of the ice- pick lobotomy, also developed “assembly line lobotomies.” He would go from one patient to another with his gold-plated ice pick to see if he could break his speed record.

31. Abuse of lobotomy Doctors would recommend the procedure for everything from psychosis to depression to neurosis to criminality.

32. Lobotomy images