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The Methods of Madness: Representations of Inmates, Authorities and the Asylum in One Flew Over the Cuckoo’s Nest and Awakenings [Page 1]

    This paper focuses on the concepts and representations of the institution and the inmate, and how films, even when presenting in a seemingly sympathetic tone, have often served only to further stigmatize both entities.

    "Madness need not be all breakdown-it may be also breakthrough." - R. D. Laing
Perception of the mentally ill, the environments in which they are housed and those who care for them has been largely determined and influenced by filmic representation. In American cinema, representation of the asylum in film has been a recurrent theme. There were 34 feature length US productions featuring scenes of psychiatric hospitalization between 1935 and 1990 alone (Levers). The institution has traditionally been vilified in these representations, both in the space itself, as well as the inhabitants-the inmates and employees. The asylum, by its detachment from mainstream society is a place that has been otherized. Two films that offer distinct manifestations of this realm are One Flew Over the Cuckoo's Nest and Awakenings. The first film represents the institution in the more routine negative manner. The second attempts to reveal the place as a potential site of healing, renewal and love, offering the possibility for rehabilitation if headed by the proper individuals. Cruel Nurse Ratched is juxtaposed with selfless Dr. Sayer, increasingly inflammatory inmates contrasted with catatonic patients. Regardless of these differences however, there are discriminatory elements in both films that must be addressed.

Mental illness or instability has been a traditionally mis-conceived and demonized phenomenon. Stereotypes of 'madness' are powerful and deeply rooted within Western culture. The mass audience has tended to view such individuals and institutions in a particularly negative manner because of representations proffered by the foremost purveyor of mass culture, Hollywood film. Due to the powerful position of film and its ability to affect audience perception and the narrow range of diversity in terms of representations of the mentally ill and the space of the asylum itself presented to audiences, widely held stereotypes abound in the public sphere. Subsequently, discrimination and misunderstanding are as commonplace as ignorance and hostility. Historically, Hollywood has presented one mode of representation of the hospital and the inmate-as dangerous, incapable, burdensome, pitiable and pathetic, asexual or sexually deviant, as an object of violence or a comic character (Levers). In more recent years however, directors have attempted to topple these constructed prejudices surrounding the figures of the inmate, the medical worker and the institution. Despite some changes in representation, these stereotypes have persisted in film-substantially in One Flew Over the Cuckoo's Nest and to a lesser, but still significant degree in Awakenings.

The film adaptation of Ken Kesey's One Flew Over the Cuckoo's Nest is looked to as one of the primary documents representing the asylum. The film launched hundreds of imitations and every film about a hospital seemingly contains a reference to it. In fact, since its release in 1975, there have been over thirty films that have made allusions to One Flew Over the Cuckoo's Nest ( Every film involving mental illness or institutions has their own Nurse Ratched and Randle Patrick McMurphy. The film lay the foundation for representing all facets of the asylum. The nurse was overtly professional, so serious about her job that any semblance of compassion was replaced with mild sadism. The inmate was sexualized, rebellious, yet eventually fallible and broken by the system. The asylum was a menacing, monolithic place governed by unfeeling drones and concerned with confinement instead of rehabilitation.

With films of the late 80s and early 90s, attempts to reform perceptions and representations of the key players in the asylum gained popularity. One of the major films to do this was Penny Marshall's Awakenings. Here, the doctor is presented as benevolent and good, sincerely concerned with the task of healing his patients. The inmates have been somewhat neutralized and emasculated. The institution has not necessarily been reformed, but the new figure of the alternative method style doctor helps the asylum begin to function as a loving, albeit sometimes misguided caretaker. In spite of these changes, the institution has remained an elusive, sinister and inaccessible place.

The asylum in both representation and reality, is a space that is always, to some degree, isolated and distanced from the 'real' outside world. One Flew Over the Cuckoo's Nest emphasizes this separation in its opening sequence.
    We survey with McMurphy-Nicholson the wide-eyed faces of the patients, the malevolent orderlies, the expressionless Native American and all the rest. We may be uneasy, but we know where we are, because the beginning of the movie is a cliché, another version of the stranger riding into Dodge City to clean it up. As viewers we find the familiar beginning as comfortable as our favorite armchair. Although we laugh at McMurphy's exploits and sorrow when Billy Bibbit kills himself and when, after McMurphy is wheeled back into the ward in a gurney, we realize that he has been lobotomized, we are not wrenched from our armchair, we are 'safe,' because even in the hospital we feel ourselves to be 'outside.' (Sodowsky and Sodowsky 36)
Often there is encroachment from this 'outside' world, but in general, this sense of removal creates separation for the inmates and distance for the viewer. When encroachment does occur, the resulting effect is typically some kind of mayhem, hi-jinks or hilarity. In One Flew Over the Cuckoo's Nest, these intrusions include the fishing 'field trip,' the hookers at the illicit and eventually disastrous holiday gala and the very presence of McMurphy himself as an outsider entering the space of the inside. He trespasses in that space on all levels, through disruption of routines, relationships and existing power structures.

Its limitations and barriers, both physical and psychological characterize the institutional space. The asylum seems unable to reach and effectively treat its patients and at the same time, the space is defined by its boundaries. In One Flew Over the Cuckoo's Nest especially, the hospital is represented as a labyrinthine prison of doors and locks and cage-like structures. With a focus on the patients strapped down in the beds, an overarching sense of repression pervades the scene. Even the music, operating under the guise of calming the patients, operates as a means of insidious domination. The sound is ever present and controlling. The music, like the staff, function as unceasing surveillance, and the inmates cannot ever escape this sense of constant regulation and confinement.

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