Historical Perspective

A The 1950s: Conformity and Change

The late 1950s, the time period in which the book was written and set, saw the end of a decade in which people outside the mainstream were often viewed with suspicion. The United States was engaged in a “cold war” with the Soviet Union, in which relations were tense and hostile even though no open warfare was declared. Americans feared the possibility of a nuclear conflict, and people identified as communist sympathizers-“reds”-were frequently ostracized and even persecuted for their supposed beliefs by government committees such as that headed by Senator Joseph McCarthy. But toward the end of the decade, a national rebellion against civil injustice and cultural mediocrity was in the making, and young people in particular began questioning the values and beliefs of those in power. One such group of people was the Beat Generation, who expressed their dissatisfaction with society through art, dress, and nonviolent action. Poetry readings were a common forum beatniks used to communicate their ideas, and Allen Ginsberg’s 1955 poem “Howl” articulated what many people saw as the moral and social problems of the time.

Groups such as the Beat Generation became part of a larger movement known as the counterculture. What began as a band of political protesters eventually gave rise in the 1960s to the hippies, a group dedicated to peace, love and the quest to expand one’s inner horizons through the use of mind-altering drugs such as LSD. Kesey’s experiences bridged the two groups, for he was a subject in a scientific experiment on the effects of LSD-lysergic acid diethylamide-25, one of the most potent mind-altering chemicals known. The drug had been discovered in 1938 by the Swiss chemist Dr. Albert Hofmann, and scientists determined that when carefully regulated, LSD was nonfatal and could even be used in the treatment of such psychological disorders as schizophrenia. In treating these disorders, however, successful results were often marred by the sometimes dramatic and unpleasant reactions-usually manifested in visual and/or auditory hallucinations-that would accompany them. To the rising counterculture of the 1960s, LSD served as a way to help explore their own minds and expand their horizons. However, the hallucinations could induce aggressive, even dangerous, behavior in users, who also were prone to uncontrollable “flashback” episodes. LSD has been a controlled substance-illegal to make, distribute, sell, or possess-since 1966, and Kesey himself later disavowed the use of drugs, saying that the costs far exceed the benefits.

B Mental Illness and Its Treatment

For many years in the United States, mental illness was often ignored or misinterpreted; treatment often consisted of nothing more than chaining or caging the sufferer. During the mid-1800s, attitudes regarding the mentally ill slowly began to change. Thanks to the efforts of humanitarian reformers such as Dorothea Dix, millions of dollars were raised to establish state mental institutions capable of caring for large numbers of patients. After World War II, when more soldiers were medically discharged because of neuropsychiatric disorders than for any other reason, the medical community began to more closely evaluate the conditions that existed in the mental health care system.

In the 1950s, advances in pharmaceuticals led to more methods of treatment for mental patients; in 1956, more patients were being discharged from U.S. mental institutions than admitted for the first time in over a century, many aided by prescribed drugs to manage irrational behavior. In addition to medication, the use of electroshock therapy and psychosurgery were common treatments for psychiatric disorders. Electroshock therapy, or ECT, was discovered in 1937 by two Italian psychiatrists who thought to apply an electrical charge directly to the brain. Despite the harsh stigma that has been unfairly associated with this type of treatment-in Kesey’s novel it is seen as a means of punishment rather than a cure-the use of electroshock therapy has proven immensely successful in cases involving moderate to severe bouts of depression. Others argue that its side effects make it one of the more barbaric forms of legal medical procedures in the modern age.

A third mode of treatment, and by far the most controversial, is the destruction of certain cells or fibers in the brain through surgical measures. At the onset, this technique was labeled a “lobotomy” because it required the removal of the frontal lobe of the brain. Later, with modern, more precise means of locating desired tissues, it is more commonly referred to as psychosurgery. The first lobotomy on record was performed in 1936. Although original results proved successful in calming down patients with highly energetic or exceedingly violent personalities, soon physicians began noticing undesirable effects on the patient’s mental and physical health. These effects are epitomized by Kesey’s character McMurphy after his experience in undergoing such surgery.