Compare the ways in which psychiatric institutions and mental illness are presented in Barker's 'Regeneration' and Kesey's 'One Flew Over The Cuckoo's Nest'.

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Compare the ways in which psychiatric institutions and mental illness are presented in Barker's 'Regeneration' and Kesey's 'One Flew Over The Cuckoo's Nest'

The novels 'Regeneration' by Pat Barker and 'One Flew Over The Cuckoo's Nest' by Ken Kesey are both centred on events that take place within psychiatric institutions. The protagonist of 'Regeneration' is Siegfried Sassoon, a soldier protesting against war who is sent to Craiglockhart psychiatric institution for assessment because of his views. In comparison, 'One Flew Over The Cuckoo's Nest' focuses predominantly on Randle McMurphy, a character who seems to have contrived to get himself admitted to a mental hospital in Oregon to escape the rigours and hardships of prison life.

An immediate similarity between both these characters is that neither Sassoon nor McMurphy appears to be truly insane, and consequently one might say that they do not belong in a mental hospital. In 'Regeneration' Sassoon presents the British government with his Soldier's Declaration, an act of 'wilful defiance' signalling his refusal to fight. The Soldier's Declaration is a document that proclaims that it is wrong for soldiers to keep fighting when the war could be ended on diplomatic terms. This poses a problem for the government. One course of action for them would be to shoot Sassoon for desertion. However, this would be unwise, since shooting a high profile poet who had previously fought in the war would not earn them good publicity. That leaves the option of declaring that Sassoon must be suffering because of psychological strain, and sending him to Craiglockhart institution where further analysis can take place. Interestingly McMurphy is also sent to a psychiatric institution for assessment of his mental state since it suspected that he might be feigning mental illness. McMurphy seems to have entered the mental hospital in order to make easy money by gambling with the other patients of the hospital who truly belong there. McMurphy seems to suppose that the staff in a mental institution will be a soft touch when set against those whom he encountered in his former prison regime, and he also supposes that they hospital ward will be more to his liking. This assumption drives McMurphy to rebel against the figurehead of power in the novel, Nurse Ratched, for the sheer enjoyment acquired from belittling a feared authoritarian. 'Sometimes he slept till eight o'clock. She would reprimand him without heat at all, and he would stand and listen until she was finished and then destroy her whole effect by asking something like did she wear a B cup, he wondered, or a C cup, of any ol' cup at all.' McMurphy's behaviour can be compared with that of a schoolchild who seeks the attention of his classmates by provoking the teacher. In this case, the authority figure exists in the form of nurse Ratched, seen as a formidable disciplinarian on the ward.

A fundamental difference between the setting of the two novels is that Barker's 'Regeneration' is set in Craiglockhart, which is a Psychiatric institution that really existed, so Barker tries to recreate through fiction, actual conversations that may have taken place between real personages. 'One Flew Over The Cuckoo's Nest' on the other hand is a fictionalized account of a 'mental institution' in Oregon, although Kesey may have been partially inspired by his own experiences of working in psychiatric institutions. Indeed prior to writing 'One Flew Over The Cuckoo's Nest' Kesey had submitted himself to electro shock therapy and took psycho active drugs such as LSD as he was interested in altered states of consciousness.

In 'Regeneration' Dr Rivers is a well-respected psychiatrist at Craiglockhart castle, and it is precisely for this reason as a man at the pinnacle of his profession, that he is chosen to assess Sassoon. When interacting with his patients he displays patience and will power holistically by drawing patients out of themselves through a careful and painstaking process and listens to what the patients tell him, rather than telling the patients what their problem is and neglecting their opinions. His form of treatment is to cure the problem, rather than merely address the symptoms. Rivers allows patients to decide the way the therapy sessions are run, which is an effective approach as he usually gets the information he needs to make a diagnosis without putting much pressure on the patient. Nurse Ratched, the head nurse on the psychiatric ward In 'One Flew Over The Cuckoo's Nest' has a very different method to Dr Rivers when it comes to handling patients. She occasionally resorts to Electro Shock Therapy to treat patients who fall out of line, claiming that it has therapeutic value, as patients seem to calm down after the treatment. This is evident from a quotation from Chief Bromden after he had received his last administration of Electro Shock Therapy. 'There had been times when I'd wandered around in a daze for as long as two weeks after a shock treatment...for two weeks'
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In 'One Flew Over The Cuckoo's Nest' we see the patients take part in group therapy, which involves all the patients sitting together and discussing and problems they would like to share or any progress they have made. Nurse Ratched claims that this has therapeutic value, however early on in the book we can see that it is a means of control for the nurse, as she has the chance to humiliate patients in front of each other. For example, in the first group meeting we witness the nurse is able to make each patient reveal a secret ...

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