Novels on Psychiatry

Novels on Psychiatry: The Bell Jarand One Flew over the Cuckoo's Nest are two of the most popular novels of the last fifty years. Their popularity has quite a bit to do with the quality of writing in each novel as well as the verve and sincerity that come across through the prose.

However, these novels present us with something more than good writing and access to sharp and generous minds. The Bell Jar and One Flew over the Cuckoo's Nest each give us a glimpse into a dark era of American behavioral science and psychiatry. They take us inside the psychiatric wards that existed in our country until the 1960's where lobotomies and shock therapy were common place.

Both novels begin with starkly negative views of the methods of psychiatric treatments in use at the time, giving us a frightful view of life in the asylum circa 1950. In the end however, one novel comes around to a changed view of the usefulness and the (compassionate) humanity of shock therapy specifically and of psychiatry in general.

The other novel continues in its condemnatory view of American psychiatry as it plunges deeper into the dark side of the psychiatric ward, emphasizing the uneven power relationships of nurses and doctors to patients in psychiatric hospitals, the abuses arising from those relationships, and the ultimately de-humanizing effects of lobotomy and shock therapy.

Though The Bell Jar has a reputation for being a dark and depressing novel, it does not deserve such a reputation. In fact, Sylvia Plath's book ends happily. It is her real life that ended with suicide and it seems that the author's history has seeped into the reputation of her lone novel. The book is a gem of wit and honesty.

The Bell Jar takes us through some rather trying times in a young woman's life and brings us out again. Surprisingly, Plath's novel comes to take a positive view on shock therapy.

Sent to a psychiatric hospital after a suicide attempt, the young lady protagonist is mortally afraid of shock treatment. She looks with horror on the prospect of being strapped down and shocked.

Her mental state is fragile and rather broken really. She is like a mirror with cracks all along the back side and she knows she is already undone. Though she tries to hold herself together for the world to see, the cracks keep growing in the dark.

Yet she resists the prospect of being electrocuted. Somehow this does not seem therapeutic to her, but rather like a medieval torture.

When the young lady has begun to think that she is no longer in danger of the shock therapy, it is sprung on her. She feels betrayed and angry and afraid.

They attach her to the apparatus and she floats away on the electric current.

When she comes back to herself in the psychiatric ward, the young woman is serene. "All the heat and fear had purged itself," she writes, "I felt surprisingly at peace."

Plath's take on shock therapy in the psychiatry of the day was positive then, quite contrary to the brutal use of shock treatment and anti-psychotic drugs in Ken Kesey's One Flew over the Cuckoo's Nest.

In Kesey's book patients on the psychiatric ward are dominated by the head nurse. They are drugged into submission and if that doesn't work they are given shock treatments until they are rendered docile and quiet.

The view put forth in Ken Kesey's novel of mental health is one of psychiatry as punitive instead of curative. The "treatments" given to the patients are not meant to rehabilitate them, as they are in The Bell Jar. Instead, the treatments are meant to shut the patients up, shut them down, and simply keep them quietly sitting in their chairs.

In Kesey's book, the psychiatry of the day really was a medieval torture, diminishing the people undergoing treatment until they broke down to such a low point that there was no getting back up again, no re-fitting the pieces of the mind back together into a coherent identity.

Fear of treatment and the reality of psychosis are both prevalent elements in The Bell Jar and One Flew over the Cuckoo's Nest. The need for care, despite the questionable execution of that care, is unequivocally presented. People need help sometimes. This is a fact at the heart of each novel.

Mental health is a precious thing and nowhere is that clearer than in a psychiatric ward.

Reading these novels, each anchored in the subject of psychiatry, and each drawing very different conclusions as to the effectiveness of shock therapy and other treatments, we get an interesting and complex picture of an interesting and complex practice as it once was.

Psychiatry has changed profoundly in the last fifty years. Yet the fundamental issues still remain. Questions raised in One Flew over the Cuckoo's Nest as to the intentions, dedication to health, and morality of medical authorities still fester as we struggle toward a better diagnostic understanding of mental illnesses.

Young men and women, like Plath's protagonist, still struggle mightily to understand themselves and to admit that they might need psychiatric help. However, it is on this point perhaps that we have made our most significant changes as a culture. No longer is it taboo to take prescription drugs for a "chemical imbalance" in the brain.

Disorders and conditions are commonplace. Perhaps Sylvia Plath is to be thanked for showing us that, with the acceptance of aid, we can breathe more easily and live in the world, as her character learns to do in the psychiatric hospital.

There is something uncomfortable about this conclusion though, because the sinister idea of being electrocuted into health and being subdued and de-humanized by psychiatry looms as a monster in the background. One Flew over the Cuckoo's Nest and The Bell Jar show us that there are people who definitely need help. They also hint that there are some who are damaged by treatment more than they are helped.

Reference:

The Bell Jar, Sylvia Plath. 1971.

One Flew over the Cuckoo's Nest, Ken Kesey. 1962.