This document analyzes the accuracy of portrayals of psychopathology in the films One Flew Over the Cuckoo's Nest (1975) and Girl, Interrupted (1999). Both films accurately depicted treatments used in the 1960s like electroshock therapy and lobotomies. Staffing levels shown were also realistic given deinstitutionalization. However, the films inaccurately suggested patients were not meant to reintegrate into society and had more attentive staff than was possible. While not completely accurate, the films provide insights into mental health treatment and institutions during that era.

1. Running head: PSYCHOPATHOLOGY AS PORTRAYED IN FILM 1
Psychopathology as Portrayed in Film
Jonathan McCormick
Messiah College

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Psychopathology as Portrayed in Film
Introduction
Psychopathology and its treatment and portrayal have been objects of curiosity for many
years. With modern technology, the easiest (and perhaps best) way to portray these is through
film. Two films in particular that show this, with some level of both accuracy and inaccuracy, are
One Flew Over the Cuckoo's Nest (1975), and Girl, Interrupted (1999).
Summary of the Movies
One Flew Over the Cuckoo's Nest (1975)
This movie was about a man (McMurphy) with a history of violent and promiscuous
sexual tendencies who was arrested and admitted to a mental institution for an evaluation of his
mental health. Once there he wondered how he was put in a place with "a bunch of crazy people".
Throughout the duration of his stay in the institution he talked and dreamed about leaving.
He even tried to convince many of the other patients to leave with him should he make good his
escape. During this time he made friends among the other patients in his ward, and these
friendships held him back from escaping when he had the chance on more than one occasion.
McMurphy continued his violent tendencies while admitted in the institution. In addition
to this he purposely instigated the head nurse (Nurse Ratched) with the intention of causing her
to lose her cool demeanor. These actions caused him to be the recipient of electric shock therapy
more than once. This ultimately had no effect on him.
The movie concluded with a final failed attempt at escape. In the process McMurphy
sneaked in several bottles of alcohol, and the entire ward got drunk. In the aftermath of the
escape night turned party, one of the other patients committed suicide when Nurse Ratched
threatened to tell this patient's mother about his sexual activity the previous night. At this point

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McMurphy attempted to choke Nurse Ratched to death, and was lobotomized as a result. His
best friend in the ward, a huge American Indian man called "Chief", after realizing what
happened to McMurphy, killed McMurphy and made his escape.
Girl, Interrupted (1999)
This movie is about a girl (Susanna) who is admitted to a mental institution following an
incident where she attempted to swallow an entire bottle of aspirin followed by vodka. This is
seen as a suicide attempt, and she is admitted to the institution for treatment and diagnosis of a
mental disorder. She is diagnosed with Borderline Personality Disorder. Throughout the film
everyone is unconvinced that Susanna is actually insane, though she herself believes it more and
more until she decides it is time to get better.
During Susanna's stay in the institution she becomes close to the other women in her
ward, but closer to one woman in particular—Lisa. It is explained that Lisa has been at the
hospital for eight years, and has attempted to escape several times. At one point in the film Lisa
convinces Susanna to escape with her. In the process they go to the apartment of one of the
women of the ward who was previously released (Daisy). Here Lisa accuses Daisy of leading the
exact same life as she had in the institution, and that nothing has really changed other than the
scenery. This results in Daisy committing suicide. Lisa escapes from Daisy's apartment, and
Susanna is taken back to the hospital.
The movie concludes as Susanna begins to seriously attempt to get better, and makes
incredible progress. Not long before Susanna's release Lisa is caught and returned to the hospital.
The night before Susanna is released Lisa steals her journal and convinces a couple of the other
women in the ward to listen as she reads it aloud. Susanna finds them, and ends up retaliating by

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forcing Lisa to face herself and come to terms with who she is. Susanna is released the next day,
and becomes a "recovered borderline".
Reflection
Accuracies
Both of these movies had some points that were portrayed correctly given the times they
were set in. One Flew Over the Cuckoo's Nest was set in 1963, and Girl, Interrupted took place
in 1967. In Cuckoo's Nest, for example, we saw the use of both electric shock therapy and frontal
lobotomy, both of which were still used during the 1960's (Jantzi, 2014). While both of these
were quickly losing popularity due to brutality issues, they were still used in many institutions in
the 1960's. To the contrary, neither of these was seen in Girl, Interrupted, which reflects the fact
that they were both losing popularity.
The next accurate assumption was the lack of staff seen in both films. This was due to
deinstitutionalization, which was in the early stages of hospital reform during this time period
(Jantzi, 2014). During the 1960's, there were so many patients in mental institutions that it was
extremely difficult to have enough staff to care for the number of patients. This is seen in
Cuckoo's Nest in that there were approximately two nurses and three orderlies to care for
eighteen patients. In Girl, Interrupted, there was one nurse and two orderlies to care for several
patients.
One idea which was only present in Girl, Interrupted was that of a "halfway house". This
was a place where people who were ready to be released from the institution could go to live
while they began the adjustment back into society (Jantzi, 2014). This was something that was
attempted during the 1960's, although it was not very successful, which was also shown when
Daisy committed suicide in her halfway home.

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Finally, the treatment of patients, while different in both movies, was still accurate for the
time these films are depicting. In Cuckoo's Nest, therapy included group therapy, group exercise,
and medication. Medication in particular was becoming increasingly popular in this era (Jantzi,
2014). In Girl, Interrupted, therapy was done in an individual setting—i.e. one patient with one
therapist. This was mostly Freudian in nature, in that the patient was laid down on a couch and
talked while the therapist sat in a chair and listened, but it also had hints of humanism in it in that
the therapist related to the patient on a much more personal level than was common with
Freudian psychotherapy, and the ultimate goal of therapy was to help the patient to better
themselves for the purpose of reintegration with society (Barlow & Durand, 2012). Furthermore,
Girl, Interrupted also portrayed a heavy reliance on medication, which would have been even
more popular in 1967 than it was even a mere four years earlier in 1963.
Inaccuracies
In Cuckoo's Nest, there was this idea that releasing the patients back into society was not
the goal of the therapeutic process. This is in contrast with the reality of the times in which some
institutions would even close down regardless of whether or not the patients were ready to be
reintegrated with society (Jantzi, 2014). Instead, we see patients who are clearly not insane being
kept in the mental hospital simply because the head nurse does not believe them ready to be
reintegrated with society. Furthermore, there were a significant number of patients who were in
the hospital voluntarily. Considering the trend towards deinstitutionalization, this is something
that would most likely not have occurred in reality.
In both Cuckoo's Nest and Girl, Interrupted the hospital staff was far more in control and
far more attentive to the needs of the patients than was actually possible for the times. This is
seen more in Girl, Interrupted than in Cuckoo's Nest. In the 1960's, there were so many patients

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in the hospitals that there were simply not enough staff members to care for the colossal number
of patients admitted (Jantzi, 2014). It was this that sparked the idea of deinstitutionalization. In
both of these films the number of patients was limited enough that the staff was capable of caring
for them (in the case of Girl, Interrupted) individually.
Conclusion
Both of these films have some accurate and some inaccurate themes in them. Both
included wide use of medication and therapy, and both failed to accurately, fully represent
deinstitutionalization. However, regardless of their failing, and perhaps because of their
successes both of these films are, on the whole, fairly accomplished at providing an insight into
the world of mental disorders and mental institutions.
These films both present the changes between the 1960's and present day, and even
within the 1960's, that treatment of mental health has seen. This includes the changes that
hospitals and therapy have both seen since the 1960's. Even so, they must be watched with a
certain level of caution as to what is accurate to the times, and what is not.

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Works Cited
Barlow, D. H., & Durand, V. M. (2012). Abnormal Psychology, 6th Edition. Belmont, CA:
Wadsworth.
Jantzi, Charles, Personal Communication, February 4, 2014.