When the producers of One Flew over the Cuckoo's Nest secured the Oregon State Hospital (OSH) for their use in the winter of 1974–75, they were thrilled. Director Milos Forman wanted realism, and the OSH had it to spare. Cold white rooms, gray light pouring in through tall grated windows, and pale worn floors betokened a veracity rarely seen in the screen asylum. The fact that Forman had a whole wing of the institution to himself to film in also reflected the state of patient care. The OSH census had declined from a mid-century high of over a thousand residents to somewhere between two hundred and three hundred persons. New drugs and new laws, compounded by a sustained critique of inpatient regimes, had drastically reduced census numbers. By the 1970s, mental hospitals faced a crisis of existential proportions. Forman's groundbreaking film about rebelling against institutions found its moment.
America in the 1970s shuddered with internal conflict, with battles over civil rights, labor, feminist and gay liberation, and foreign policy marking these years.Footnote 1 Cuckoo's Nest tapped into this zeitgeist, offering what critic Rex Reed called “a metaphor that symbolizes the plight of the individual caught up in a computerized and inhuman system of incarceration where humans are numbers and lives are filing cabinets.”Footnote 2 The carceral system specifically addressed in Forman's film was the mental institution, and the historical context of his critique was deinstitutionalization. Broadly defined, deinstitutionalization refers to the undoing of the brick-and-mortar full-time care institutions for people suffering serious mental illness. This decline was part of a process initiated by the advent of cheap antipsychotic medicines and laws that steered patients away from long-term care. New drugs, especially Thorazine (chlorpromazine), encouraged state legislators to opt out of costly personal treatments in favor of the quick fix of sedation, while laws such as the Community Mental Health Act of 1963 and Medicare/Medicaid shifted the emphasis of care outside institutional walls.Footnote 3 The end result of these innovations, which correlated with and were reinforced by an unwinding of the government's commitment to welfare state solutions, was that people formerly treated via extended care increasingly found themselves relegated to cramped and decrepit single-residency apartments or even suffering exposure on the streets. The demise of the state hospitals, significantly, would be met not with protest but with praise. Mental institutions, commonly called “asylums,” were depicted as houses of horror.Footnote 4
In this essay, I show how Forman's film and three others told audiences a resonant message in an uncertain time. The Exorcist (1973), One Flew over the Cuckoo's Nest (1975), Halloween (1978), and When a Stranger Calls (1979) will be examined not just as artifacts of entertainment but as a kind of folklore. Specifically, I argue that these movies articulated long-standing American fears of tyranny, control, and gendered disorder using a vernacular, mythic framework. Further, all four films utilize elements of the horror genre, which reinforces this folkloric landscape.
Numerous scholars have noted that popular film can be understood as folklore. Writes Michael Atkinson, movies “are the modern equivalent of folktales, insofar as they externally dominate our consciousness the way precivilized mythologies used to, and insofar as they render the same psychosocial service, whether it be in the end actual Aristotelian katharsis or simply taking the mad dogs cornered in our blood.”Footnote 5 Mass media, notes S. Elizabeth Bird, tend to be “formularized, predictable, and sentimental, with positions on good and evil clearly defined – very much like folk narratives.”Footnote 6 Enduring American themes of individualism, self-sufficiency, and the horror of authoritarian control all make up a vernacular tradition that has long taken root in popular cinema. Viewing popular film as folklore, as Mikel J. Koven, Larry Danielson, and the above scholars indicate, helps us to see how popular entertainment can function on the level of mythic cultural transmission. Movies communicate moral messages to mass audiences, suggesting how the public discern right from wrong and good from evil. From familiar tales people are told how to react to understand problems. As Robert Darnton's reading of French peasant folktales shows, popular vernacular culture sheds light on lived worlds and everyday sentiment.Footnote 7
The films I discuss accomplished cultural work via folkloric means. They wove myths that endorsed a widespread sense of dismay at the state; demonstrated the futility of combating authoritarian social structures; and evoked long-held traditions of individualism, with heroes undertaking personal journeys of redemption in the face of steep odds. Notes Darnton, the popular desire to “outwit the system” is old and tenacious, and it is malleable enough to suit different circumstances. In the case of these films (and the two hit novels that source The Exorcist and Cuckoo's Nest), heroes battle inefficient or downright hostile institutional structures, or they wade through the quagmire residue of a failed mental hospital system. They tell us that mental hospitals do not work and that popular fears about them are justified. Additionally, they help construct a tragic landscape of state failure. New Deal-inspired promises crashing on reefs of endless war in Vietnam, an economic slowdown, and social unrest background poignant and painful, and classically folkloric, narratives.
I entwine a folklore reading with insights from the scholarship of horror. Horror relies, as theorist Noël Carroll writes in The Philosophy of Horror, on a “mirroring-effect” in which the terror the characters experience is translated to the audience.Footnote 8 Horror films take us on nightmare journeys in which we suffer with protagonists as they combat dark forces. Like folklore, horror often communicates simple moral messages by introducing fantastic elements into everyday life. The cultural resonance of “slasher” movies,Footnote 9 for example, often relies, as Larry Danielson notes, on the cultural currency of folkish “urban legends.”Footnote 10 In the 1970s, horror films often reflected (in the words of Jason Zinoman) “countercultural attacks on authority and a rejection of the frivolity of fantasy” and paralleled the “darkening tone of youth culture. They reflected the grievances of their time: paranoia about government power and mocking nihilism about the power of the American dream.”Footnote 11 In The Exorcist, the failure of psychiatry is shown graphically in the torturous treatment of young Regan by mind doctors and in the unlikely success of religious intervention. In Cuckoo's Nest, the horror of institutional control is personified in a fortress-like totalitarian landscape ruled by wicked Nurse Ratched. In Halloween, the horrors of a failed asylum are embodied in Michael Myers, whose murderous energy resides in his being at once human and inhuman, an “interstitial” being correlating to Carroll's definition of horror. In When a Stranger Calls, the horror of deinstitutionalization gone awry is captured by the homicidal suburban invasion of an escaped mental patient. In all of these cases, uncertainty and fear beget gruesome consequences.
Folklore and horror elements combine in these movies to advance the message that psychiatric institutions are worthless, even harmful. They imply that state promises of caring for the neediest are flawed, because the “System” (the personification, in popular vernacular, of impersonal structures of control) itself has been deeply compromised and is untrustworthy. In folkloric style, these movies communicate outlandish tales that warn us of danger and hint at paths of victory through thick, duplicitous, dangerous settings. Their protagonists must overcome by waging individualist battles. In short, they pave a path to the Reagan years.Footnote 12
EXORCIZING THE ASYLUM
Two years before Cuckoo's Nest hit the screens, audiences were jolted out of their senses by a supremely graphic tale of demonic possession. Like Forman's movie, William Friedkin's 1973 horror masterpiece The Exorcist demolished box office expectations and embedded itself deeply within popular consciousness. Amazed by the size and diversity of the crowd showing up to see it on a weekday morning, film critic Vincent Canby ruminated that if it were not for its incredible popularity, this “claptrap” “wouldn't be worth writing about.” Stunningly, it had become “the biggest thing to hit the industry since Mary Pickford, popcorn, pornography and ‘The Godfather.’”Footnote 13 Canby's dismissive comment speaks to what Harold Schechter, in his analysis of folklore as popular culture, argues as the critic's likely response to non-“serious” art.Footnote 14
The Exorcist was based on a mass-market book by William Peter Blatty about a girl possessed by the Devil.Footnote 15 Starting at a dig in Northern Iraq, where Father Merrin comes across a statue of the demon Pazuzu, evil travels on to Georgetown where a young girl named Regan lives with her actress mother and the household help.Footnote 16 We follow a lengthy process that begins with Ouija board tricks and ends with full-blown telekinetic, mind-reading, blaspheming gruesomeness. In the novel, Blatty devotes considerable space to the various medical investigations of Regan's symptoms. We learn that doctors don't know much about the brain, and that psychiatry is especially useless.Footnote 17 Regan first is diagnosed with “hyperkinetic behavior disorder” and put on Ritalin. When she continues to decline, she's taken off Ritalin and put on Librium. Neurologists examine her. On come spinal taps, EEG, hypnotherapy, X-rays, and brain probes. The nonplussed doctors discourse on hysteria, neurasthenia, psychasthenia, multiple personality, split personality, thanatophobia, schizophrenia, and old-fashioned divorce guilt. Eventually Regan is sent to the “Barringer Clinic” (an apparent riff on the famed psychiatric facility the Menninger Clinic), but no succor is to be found.Footnote 18 All medical treatments fail her. The detective on the case suggests that this is due to problems beyond the scope of medicine. He says, “the world – the entire world – is having a nervous breakdown.” The Vietnam War is used as corroborating evidence. In a prefatory quote before a section of the book titled “The Abyss,” Blatty squeezes the following quote between two Biblical passages: “A [Vietnam] brigade commander once ran a contest to rack up his unit's 10,000th kill; the prize was a week of luxury in the colonel's own quarters … Newsweek, 1969.”Footnote 19
Help comes in the form of a Jesuit priest named Damien Karras. He at first wants to believe that the problem is medically treatable. He tells Regan's mother that there's no need for exorcisms, “Since we learned about mental illness; about paranoia; split personality; all those things that they taught me at Harvard.”Footnote 20 But Karras comes around as the evidence for Satan piles up. Through the priest, we travel from confidence to utter disbelief in psychiatry. As he works from secular coolness towards Catholic dogma, we follow him willingly. The power of religion trumps science in an age of psychiatric cynicism.
Director William Friedkin's The Exorcist (1973) visually elaborates Blatty's bleak worldview, including his take on institutional medicine. At Bellevue Hospital, depicted as a depressing and drab place filled with staring and self-chatting unfortunates, Father Karras has his collar torn off by a desperate inmate. He visits his mother here and finds her tied to a bed. This gestures to what the public had been used to seeing for decades, beginning with Albert Q. Maisel's photo essay, “Bedlam 1946,” in Life magazine in May of 1946, and carried on through journalistic exposés, academic treatises, and films such as The Snake Pit (1948), Suddenly, Last Summer (1959), and The Caretakers (1963), not to mention Geraldo Rivera's devastating 1972 television event Willowbrook: The Last Great Disgrace (1972).Footnote 21 Karras's mother is soon released, only to be found dead in her apartment. In Friedkin's bleak vision of the Barringer Clinic, referenced but not physically described in the book, we see Regan through a television monitor, lab-coated doctors closely observing her. Later, her mother tells this crew, “I'm not going to lock her up in some goddamn asylum,” after they try to convince her that the problem originated with “conflict or guilt.”Footnote 22 Notably, the establishing shot of the clinic is of an isolated, dreary white institution filmed through winter woods on a gray day. Once Regan returns home, the priests decide to make her bedroom into a kind of hospital room. The bedposts are covered thickly in white (or beige) sheets, the room is stark white, and drugs are pumped into her. But in Blatty's universe, priests, not doctors, supply the needed treatment. They use spiritual, not institutional, medicine to save the child.Footnote 23
The Exorcist combines folkloric and horror themes to wed mental institutions to transcendent concepts like immorality and disgust. The Barringer Clinic becomes a prison for poor Regan, its white-coated doctors peering on as the Devil does his work. The Devil himself, obviously, emblematizes a transcendent evil, an arch-nemesis whose agenda involves the doom of us all. Thanks to the special power of horror film to prod audiences, as Koven notes, to experience an intense “suspension of disbelief,” Friedkin constructs secular institutional surroundings and imbues them with supernatural dread.Footnote 24 As Nathan Abrams observes, Friedkin skillfully invokes the ultimate evil event of the twentieth century – the Holocaust. Here the Devil intrudes on the “ordinary” setting of suburban America, recalling Hannah Arendt's notion of the “banality of evil.” With ease, an ancient, mythical figure of darkness enters our supposedly enlightened age. Indeed, constant references to the helplessness of modern science in the face of pure evil echo the problem posed to the world by its inability to stop the mass genocide of European Jews. In a 2014 interview, Friedkin observed,
Now, if you look at history, there has always been an evil, destructive force that has attempted to destroy the work of the Creator. This is in every religion and it's virtually in every history. And sometimes it's not just a religious matter. You look at what Hitler and the Nazis did to the German people. A highly intelligent, skilled race of people, who wrote great music and produced great works of literature, who, as I said earlier, followed a madman into hell. And the only thing that explains the Nazis to me is demonic possession of an entire race of people.Footnote 25
In The Exorcist, Friedkin brings to life a modern morality take that speaks to ongoing memories of unexplainable evil. He continues a tradition that connects psychiatric to Nazi horrors. Though it is not explicitly referenced, Friedkin's gruesome scenes of Regan's bloody treatment at the hands of doctors and the bleak asylums he presents are part of a chain of references that properly began with Maisel's 1946 Life magazine piece, in which he calls state mental hospitals “little more than concentration camps on the Belsen pattern.”Footnote 26 The combination of concrete references with dark fantasy, in turn, speaks to Robert Darnton's argument that folklore must remain “rooted in the real world” in order to convey ethical messages in the vernacular.Footnote 27 In this case, the Devil comes to Georgetown.
The Exorcist tells us that institutions are worthless when it comes to addressing the problem of evil. Vincent Canby reflected on the power of the film as having to do with the audience's delight at “the various systems of diagnosis, treatment, quarantine, etc. that legend and imaginative writers have imposed on such things as vampirism.”Footnote 28 To take this a step further, I would argue that audiences delighted in the failure of one kind of system, that of institutional medicine. As mental hospitals declined and underwent massive criticism, the classic folkloric monster, the Devil, entered with impunity. His defeat comes thanks to a theological, not psychiatric, diagnosis. The film's huge success suggests that the folkloric concept of beating the Devil, in this case by disregarding institutional care, resonated.
One might further note that the young girl at the story's center marked an unsubtle reference to the classic, enduring folkloric figure of innocence imperiled. Like Little Red Riding Hood, Regan faced a “disguised” beast, only to be saved by brave men equipped to battle it. The priests are the woodsmen here, setting off to battle a foe using the power of a sacred book and special incantations. Only they can do this, because their adversary is impervious to the ineffective slings and arrows of the welfare state.
THE WELL-RUN HELL
In 1975 Milos Forman logged a new kind of horror into the cinematic register – the well-run hell. In Forman's asylum, an Orwellian, not satanic, menace stands at the threshold, overpowering the minds and bodies of those who attempt to confront it.Footnote 29 Unlike in The Exorcist, where psychiatric authority is merely worthless, here it is downright malevolent. Yet Forman's film communicates a similar message in a similar way. He uses folkloric and horror themes to invoke an epic battle between good and evil, summoning evil's “banal” entrance into the everyday world, and crafting a struggle in which a wily protagonist enters the “woods” to find a special sort of monster lying in wait. Forman's updating of the classic “trickster” and “witch” archetypes does what folklore has often done – communicate moral lessons via a popular vernacular style.
The voyage from page to screen began in 1962, when actor Kirk Douglas purchased the rights to Ken Kesey's book for $47,000. After the play he commissioned stalled out on Broadway (the New York Times sarcastically wrote, “Do you find the quips, pranks and wiles of the inmates of a mental hospital amusing? If you do, you should have a merry old time at One Flew Over the Cuckoo's Nest”Footnote 30), and production attempts fell through, he turned the property over to his son.Footnote 31 A young Hollywood player who had already made a few films and was currently starring a hit television show, Michael Douglas was excited about his new acquisition, feeling that it spoke urgently to the times. Kesey's work, he believed, was about “an individual man fighting the system … trying to overpower the establishment.” With money from coproducer Saul Zaentz, Michael set about finding a director.Footnote 32 After seeing the work of Czechoslovakian Milos Forman, he knew he'd found his champion. For his part, Forman realized that he'd be making “a Czech movie. This is a movie about society I just lived twenty years of my life. You know, it's about everything I know. And I know how these people feel.” Forman had grown up under oppressive circumstances. His parents had died in Nazi concentration camps and he'd been raised in an environment he nicknamed “Kafkarna.” His was a gray world of “surveillance” so pervasive that it became “boring.” In the wake of the failed 1968 Prague Spring revolt, Forman relocated to the United States. One Flew over the Cuckoo's Nest would be his second American film.Footnote 33
Unlike previous asylum films, Cuckoo's Nest was shot almost entirely within a real institution. The actors lived on the campus and absorbed their surroundings. They were also assigned to watch Titicut Follies, an infamous mental hospital documentary.Footnote 34 What most struck Forman was the difference between reality and his expectations. He thought he would see people doing “all kinds of crazy things” like “hanging from the chandeliers” and calling themselves “Jesus Christ.” Instead, he witnessed patients “desperately trying to look normal.” In his memoir, Forman writes that he had been voluntarily institutionalized for a nervous breakdown as a young man. At that time, he “had expected the mental patients to act out all kinds of bizarre conceits, but in reality they strove only to be absolutely normal. They just somehow didn't make it. The banality that permeates everything extends even to madness.” His recurrent “discovery” of institutionalized dullness is telling. The true horror of the asylum, in an echo of Arendt's observation about Nazis, is in its banality. This might be film's first postmodern asylum, the banal hell.Footnote 35
The movie begins by telling us that we are in the middle of nowhere – a desolate road in the early morning, with some mountains in the distance. A car makes its way across the screen. The next scene tells us where the car is heading. Sleeping on cheap iron beds, patients lie in the morning gloom as a clock loudly ticks. The camera pans and we briefly see a drawing of a face contorted in agony. Next enters Big Nurse. Played by Louise Fletcher, Nurse Ratched comes in through a clanking metal door, coolly greeting a group of smartly dressed African American attendants mopping the floors. One attendant unlatches a patient from his bed, and a nurse announces, “medication time.” A pabulum orchestral recording comes on and the patients obediently line up for their meds. All of this tells us we are in a dreary, dead, and yet medicalized space. In folkloric style, we are in an isolated stronghold, in a forbidding landscape. Once the evil nurse (witch) sets its infernal works in motion, the hospital becomes an infantilizing, soul-killing machine, the “total institution” that sociologist Erving Goffman had famously analyzed in his 1961 treatise Asylums.Footnote 36 Then comes Jack.
Legendarily, Jack Nicholson was nobody's first choice for R. P. McMurphy, who in the book is described as a big, wild, red-haired Irish American, “broad across the jaw and shoulders and chest,” with stitches across his nose from a recent fight.Footnote 37 Kesey had in mind a gruff western underdog hero, with the Native American patient Bromden as his allegorical sidekick.Footnote 38 Nicholson, on the other hand, represented a different sort of hero. He'd had a recent hit in Chinatown, and in Five Easy Pieces and The Last Detail he showcased what one writer dubbed “that Nicholson energy and hatred of authority.” He played McMurphy as a joking roustabout, a young man gleefully bucking the System as the 1970s audience might have liked to do. Even his unintimidating size helped; the little guy was tweaking the monster's tail. The small budget helped as well. As Forman explained, because Nicholson was “known to us,” we identified with him as he entered “a world unknown to us” peopled by unfamiliar, low-paid actors.Footnote 39 One important aspect of folklore is the manner in which its protagonists often parallel the everyman/-woman, allowing the reader/listener/viewer to comfortably insert themselves into bizarre situations.
Another folkloric reference is what we might call McMurphy's character type – the trickster. Like Carroll's argument about the unnerving noticeability of “interstiality” (i.e. in-between-ness), folklore theorist Barbara Babcock-Abrahams notes that the appeal of the trickster archetype resides in “his ability to live interstitially, to confuse and to escape the structures of society and the order of culture.”Footnote 40 McMurphy is a sane criminal who tricks his way into an asylum, believing his time in the institution will be easier than prison. He is devastated to discover that the powerful, evil woman ruling the institution (or witch's castle, to continue the analogy) can keep him here forever. He must use his wiles to subvert Ratched's order. He undermines her at every step, “playing” at madness. He does not fit into this world, nor does he completely fit into our own. His trickster appeal resides in his refusal to play by the rules.Footnote 41
The electroconvulsive therapy (ECT) scene reflects Forman's approach to representing the monstrous System as wielded by Ratched. The ECT is realistic yet highly symbolic. After brawling on the floor with attendants, McMurphy, along with two other patients, Cheswick and Bromden, are made to wait on a bench outside the ECT room like misbehaved children outside the principal's office. Cheswick is taken in first, screaming as he gets dragged off. In a touching scene where McMurphy learns that Chief Bromden can talk, he suggests breaking out and fleeing to Canada together. “What are we doing in here, Chief?” he asks. “Huh? What's us two guys doin’ in this fucking place?” Next, we see Cheswick wheeled off on a gurney, incoherent. Cut to McMurphy and the Chief watching. Out comes a nurse with two big attendants. “Mr. McMurphy? Please follow me.” We can see fear in McMurphy's mien and demeanor now. Into the ECT room he goes, an attendant on each arm. What is most effective about this moment is Nicholson's brilliant performance. He's clearly terrified, yet he forces a nonchalance and whimsicality. He flashes a big, cheesy smile, and gives two thumbs up to Bromden before going in. The medical team consists of attendants, the nurse, and Dr. Spivey. McMurphy visibly shudders at the sight of it all, but again reverts to his carefree stance. As they lay him down and take off his boots, he jokes, “Light shine, boys.” He startles when the nurse puts conductant on his temples. “A little dab'll do ya,” he says. Then comes the mouth guard. The nurse explains that it will keep him from biting his tongue. He struggles with the mass in his mouth, coughs. Next up, the white headphones. The familiarity the staff have with the apparatus, the lack of a soundtrack, the firm hands holding down his shoulders, and the group's businesslike dismissal of McMurphy's antics make clear the bureaucratic realism Forman is going for, and the effect is excruciating. McMurphy still resists in his small way, humming a song after he can no longer speak. Then comes a clicking sound; no Hollywood-style blaring horns. He goes into a massive convulsion, back arching as the attendants struggle to hold him down. An extreme close-up of his face shows unbearable agony.Footnote 42
The ECT event tells us that rebelling against the System can result in devastating punishment. Its machinery is powerful, its bureaucrats resolute, its psychiatric authorities diabolically accomplished. Not even a trickster can escape it. While Forman builds upon past cinema ECT moments, such as Olivia DeHaviland's hallway wait in The Snake Pit (1948) and the jolting scares in Shock Corridor (1962) and Shock Treatment (1964), this scene breaks new ground. Instead of the melodramatic sensibility of past ECTs, Forman develops a documentary feel, without screeching horns and leering looks.Footnote 43 This is a scenario of unalloyed terror, the kind one encounters when one knows that something bad is coming and cannot prevent it. It is the terror resulting from the inevitable and catastrophic institutional response to McMurphy's brash independence. One Flew over the Cuckoo's Nest elaborates prior cinematic language but firmly places it in the context of realism. It feels genuine. As Forman told Douglas and Zaentz, “It must be real.” The ECT “reality” we get, however, is dated. It is consistent with pre-sedation treatments of the 1950s, but less so for the ostensible 1960s date of the film (based on the 1963 World Series footage used in the movie). Realism, though, is mainly vehicle for a larger, metaphoric ambition. This is an allegorical folktale.Footnote 44
Even more notorious is the lobotomy scene. Lobotomy had been scarcely treated in film prior to Cuckoo's Nest. It was used as a threat to silence Elizabeth Taylor's character in Suddenly, Last Summer (1959). In A Fine Madness (1966) we get an explanation (if comedic) of the procedure and later a post-op moment when we are not sure if Sean Connery's character is a goner (he isn't). There's also the scene in Planet of the Apes (1968), wherein a human is lobotomized and made into a zombie by the apes. One might add 1973's Don't Look in the Basement, in which a lobotomized man is left “harmless but with the mentality of an eight-year-old.” When the evil psychiatrist tells him to help her lobotomize the heroine (“Go in and cut out the sickness and return her to innocence”), he has a lobotomy flashback and rescues the woman instead. Shot by the director who would go on to make Don't Open the Door! and Keep My Grave Open, this movie makes lobotomy a silly plot mover, warning us that both psychosurgery and Aquarian mind-healing methods are equally suspect.Footnote 45
In One Flew over the Cuckoo's Nest, we don't see the procedure at all, nor do we get any description. After nearly strangling Nurse Ratched and getting struck down by an attendant (the film does without Kesey's tearing open of Ratched's blouse), we fade to a scene of the patients playing cards. They start talking about McMurphy's whereabouts. Has he escaped? asks one. No, says another, he is upstairs, “meek as a lamb.” We learn the horrible truth when Bromden watches as a pair of attendants bring in a zombie McMurphy into the dorm late at night. Bromden unties himself from his bed and walks over. He tells McMurphy, “now we can make it,” and “I feel as big as a damn mountain.” He lifts Nicholson's head and we can see two small scars in the moonlight, one on each side of his forehead. The scar symmetry and blank stare evoke Frankenstein's monster. Chief Bromden smothers the sad monster with a pillow, and then smashes his way out of the hospital with a water pump.Footnote 46
The media's celebratory reception of Cuckoo's Nest reflected the jaded temper of the times. Vincent Canby stated that the film's success lay in its resistance to the old madness clichés evident in The King of Hearts (1966), which was still “playing almost continually around the country.” In that film, patients learn to create a society for themselves after their doctors flee in the face of World War I armies. While Forman's picture is “one more epic battle between a free spirit and a society that cannot tolerate him,” its realistic style resonated with the prevailing sentiment that mental hospitals destroyed healthy minds. Wrote Ruth McCormick, thanks to the revelations of abuses and “the work of such leftist psychologists as Reich, Laing, Cooper, Szasz, Fromm and others,” we now have a film that tells it straight. But even more importantly, she grasped that the movie transcended mere literal representation. McCormick asserts, “neither the novel or the film are really about mental illness.” They are about battling the System. This is a message of good versus evil, of a lone rebel going up against the power of bad institutions.Footnote 47
The degree of drift from Kesey's source novel provided fodder for consideration and space for rumination about the System. Elaine B. Safer would note in Literature Film Quarterly a few years later, “the movie emphasizes only one major part of the book: McMurphy's challenge of the establishment.” We don't get the surreal-ness of Bromden's perspective, nor is Nurse Ratched a “huge machine or a witch or a Circean figure.” Rather, Big Nurse is simply “an authoritative nurse called Mildred.”Footnote 48 Variety found the film a bit dated. While it is “theatrically powerful,” Variety noted, “Sadly, the ideas herein are as earth-shattering as The Pill, as revolutionary as pot, as relevant as the Cold War.”Footnote 49 The idea that insane asylums are bad and that society is a bureaucratic nightmare was not particularly revolutionary in 1975. Yet this is precisely what accounted for its impact. Folklore does not so much create novel plots as it reaffirms traditional values.
Perhaps the most often heard accusation of the film (beyond how it created the anti-woman Nurse Ratched stereotype) is the role it played in advancing anti-psychiatry laws. Not since The Snake Pit had an asylum movie created such a negative stir. Cuckoo's Nest even got blamed for the decline of ECT. One psychiatrist confirmed that it had “a major impact on the lack of availability of ECT, despite the development of much safer delivery systems and its potential for lifesaving quick benefits.”Footnote 50 A spokeswoman for the Royal College of Psychiatrists would comment that it (and similar films) “did for ECT what Jaws did for sharks – the depiction of treatment in that film is completely over the top, with the patient being held down, writhing in pain, as he is electrocuted.”Footnote 51 There is truth to this, but it also without a doubt overstates the case. As the authors of Pushbutton Psychiatry: A History of Electroshock in America explain, “the context of legislative and bureaucratic restrictions, unfavorable media publicity, scholarly critiques, the deinstitutionalization movement, psychopharmacology and insurance issues” had already begun a “steady decline in the use of electroshock in America during the 1960s and early 1970s.”Footnote 52 Negative portrayal of ECT on film was at least as old as The Snake Pit, and according to Edward Shorter and David Healy, it was Kesey's 1962 novel that was “the primary source of information on ECT for most of the liberal intelligentsia.”Footnote 53 Ernest Hemingway's and Sylvia Plath's suicides were imaginatively wedded to their ECT experiences before Forman's film existed, and writings by Thomas Szasz, Phyllis Chesler, and Doris Lessing, not to mention articles in major newspapers and magazines, had been bashing away at the treatment for years.Footnote 54 De rigueur is the description of ECT in Millen Brand's hit 1968 novel Savage Sleep, where it is decried as something that physically damages the structure of the brain.Footnote 55
Yet the comparison to Jaws (which also came out in 1975) is telling and important. Jaws, notes Carroll, operates effectively as a horror film in which the hidden monster is not initially acknowledged by the authorities. Similarly, Forman treats ECT as a legitimate medical treatment; only the rebel and the outcast patients see it as the “monster” it truly is. Like the shark in Jaws, ECT is a mindless engine of destruction, a beast hidden beneath the “surface” of modern society, revealing itself only when its victims stray into its “territory.” McMurphy is “ambushed” by an unthinking, unfeeling thing, something nearly unstoppable by its very nature. Viewers were led to believe that real ECT looked like what Forman depicted, and that it served the purposes of, to crib from Michel Foucault, discipline and punishment. That is, it was both dangerous to their brains and a chastisement for behaviors deemed unacceptable.Footnote 56 According to Michael Douglas, thanks to the film, the citizens of Florida were outraged enough to inspire the state to revise its enforced-commitment laws for the better. And one study (of a hundred Dublin factory workers) found that 66 percent of respondents were “put off” by ECT after watching the movie.Footnote 57 More colorfully, actress Carrie Fisher, in her 2008 memoir Wishful Drinking, would frame her decision to receive electroconvulsive therapy, it was either “ECT or DOA.” Though a number of psychiatrists had recommended it to her, Fisher writes,
I couldn't bring myself to consider it as it seemed too barbaric. My only exposure to it was Jack Nicholson in One Flew Over the Cuckoo's Nest, which wasn't exactly an enticing example. From the seizures to the biting down on a stick to the convulsions, it looked traumatic, dangerous, and humiliating. I mean what do we know for certain about it? Aren't there a bunch of risks? What if something goes wrong and my brain blows up?” Ultimately Fisher decided chance it and “ride the lightning.”Footnote 58
Interestingly, psychiatrists did not uniformly condemn Forman's movie. The 1976 American Psychiatric Association's annual meeting praised it for its “timely relevance” and expressed “hope that it will break down some of the barriers that have made mental illness a hidden quality [sic] in American culture.” The staid medical journal The Lancet even asked psychiatrists to give the movie a chance. Cuckoo's Nest, they assure us, is more than a mental hospital movie. It may have all the old trappings, such as the “watchtowers, high fencing, and straight-jackets.” But it offers an important lesson for psychiatrists who have an erroneous yet “absolute” certainty that their “authority is self-evidently and unquestionably incorruptible.” In other words, it can teach the moral of humility.Footnote 59
One Flew over the Cuckoo's Nest communicated the message that institutional medicine was dangerous to healthy minds. Forman's effective use of folkloric and horror motifs framed a morality tale in which the fantastic – a medical prison that obliterates sane minds – becomes the prosaic. The doctors, nurses, and staff of this Oregon institution all operate with professionalism and efficiency. Yet they create a banal fascist state, and they do this by summoning classic tropes of evil. The hospital is an isolated fortress in the desolate wastes, as the first scene establishes. Into this setting we observe a trickster do battle with a witch. Nurse Ratched might not look scary, and critics did highlight her humanity as compared to the monster of Kesey's novel, but this difference, I'd argue, is far less than might be apparent. The movie Ratched is clearly a villain – her behaviors summon the impersonal, bureaucratic evil at the source of 1970s resistance culture, i.e. the System. She might not be the “precision-made” thing of the book, but she has absolute power over McMurphy's life.Footnote 60 Her very regular-ness, in fact, creates a disturbing juxtaposition. Here is a professional health care worker who can destroy the soul of a man. She does this not with magic but rather with the machinery of psychiatric medicine. Like many folktales, the contemporary setting yields a resonant moral message. Writes Darnton, “The modern trickster follows new scenarios … but every move he makes is a tribute to his ancestors.”Footnote 61 In this case, horror prevails – this trickster, unlike forebears such as Hansel and Gretel, will lose his life. Though, one might argue, he succeeds too, metaphorically defeating the witch by inspiring rebellious individualism among the ranks of formerly slavish patients.
MONSTERS ON THE LOOSE
By the end of the 1970s, deinstitutionalization produced not only a quantity of empty and rotting state hospitals but also a rising number of ex-patients with nowhere to go. Community mental health never fully replaced the old system. America proved more effective in dismantling and cutting funds than in inventing successful replacements. The ending of the welfare state's promise to help those benighted by mental suffering led not to a bold rush to replace the hospital system but rather to mounting numbers of suffering homeless. By 1981, the New York Times would editorialize, “The vogue word ‘deinstitutionalization’ once signified the most humane reform in caring for the mentally ill … [It] has become a cruel embarrassment, a reform gone terribly wrong, threatening not only the former mental inmates but also the quality of life for all New Yorkers.”Footnote 62 Fear percolated. People wanted to stop paying for mental hospitals, but they were not especially interested in what happened to those people who might have lived out their lives within their walls. Only when homeless sufferers of mental illness became a perceived threat did people's ears prick up. A new cultural response to the acceleration of deinstitutionalization arose: the celluloid psychotic killer, breaking out of places that could not fix him or hold him.
Folklorist Mikel J. Koven writes that the “movie monster” can be understood as “a metaphor for some form of social anxiety.”Footnote 63 In Halloween and When a Stranger Calls, the monsters are escaped mental patients. Invoking urban legends like “The Hook,” in which an escaped mental patient with a hook for a hand nearly kills teens making out in their car on a lonely road, these films target youthful audiences and scare them with unhinged killers who cannot be contained by institutional medicine. Folk messages warning against premarital sex and irresponsible behaviors resonate in these films. I will add to this an additional message – asylums do not work, but rather “manufacture” monsters and speak to the failure of state welfare.Footnote 64
Halloween, a small-budget slasher directed by John Carpenter for about $300,000, premiered in October 1978. It has an unforgettable opening scene. It is Halloween night, 1963, in the town of Haddonfield, Illinois. A four-minute-long subjective tracking shot takes the audience on a rampage through the eyes of a killer. First, he stalks a house from the bushes, watching as two teens make out and then go upstairs for sex. He then comes in through the kitchen, and we joltingly see a small costumed arm grabbing a big knife. He waits for the boyfriend to leave before going upstairs to the girl's room. We see the arm reach out to put on a clown mask, and then, through the restricted vision of the eye slits, we watch as he stabs the girl to death and then exits. Out front, a car pulls up. The tracking shot ends and we finally see the killer for ourselves – it is a young boy in a clown costume. Flash forward to 30 October 1978. On a dark and stormy night on a country road in Smith's Grove, Illinois, psychiatrist Dr. Loomis rides in a car with a nurse. Loomis asks, “You ever done anything like this before?” She replies, nervously smoking, “Only minimum-security.” The headlights illuminate a sign on a chain-link fence up ahead: “The Illinois State Hospital.”Footnote 65
These two are on their way to retrieve a patient whom Loomis refers to as “it.” The nurse scolds him, “Don't you think we could refer to it, as him?” Yet her voice is devoid of compassion. She has already commented on how she is bothered by patients’ “gibberish” and how “they start raving on and on.” Loomis intends to put this patient on Thorazine prior to seeing the judge. The nurse says that this will make him incoherent. For Loomis, that is the idea. This patient must never get out. The nurse wonders why they are even going through with the charade. “Because,” replies Loomis, his voice tinged with frustration, “that is the law.” Bureaucratic legalities and misplaced notions of patients’ rights have forced him to parade a monster before a judge in order to keep him confined. As they pull up to the hospital, we see in the headlights a group of white-gowned patients aimlessly milling about on the lawn. Though it is pitch dark and raining, the nurse absurdly wonders, “Since when did they let them wander around?”Footnote 66
The asylum breakout scene in Halloween is telling of the age of deinstitutionalization. Carpenter does not show us Michael Myers forcing himself out of the institution, nor does he show Myers being brutalized or mistreated there. In fact, in this scene, we don't see the asylum at all, and we never get a glimpse of its interior. What we see is a field full of zombies. As the headlights illuminate the mad on the lawn, one is reminded of the “Thorazine shuffling” cannibals in George Romero's 1968 Night of the Living Dead. That movie introduced a new cinema monster – the pale, flesh-eating, vacant-eyed undead who move inexorably into civilization to rend the living. Though he was not meaning to do it, Romero created the perfect model for the horror-film deinstitutionalized, the escaped mad incapable of participating in society yet deadly by virtue of their Other-ness. Later, institutionalized adolescents would refer to Thorazine as “zombie juice.”Footnote 67 In the case of Halloween, Myers is at once a released patient – he too wanders in a gown – and something more. Unlike the zombies on the lawn, he is, at first at least, fast, leaping on the nurse's car and smashing his way in. He steals the car and spares the nurse. Dr. Loomis immediately recognizes the momentousness of the event, lamenting, “the evil is gone.”Footnote 68
Michael Myers is, as Loomis says, “the Boogeyman.” He is a folkloric monster. With his blank mask and mechanical movements, we understand that he is not a real person but rather a symbol of evil, a thing (or “The Shape,” as the credits call him) that stalks the “woods” of modern suburbia. His alienation from humanity is reinforced during an acrimonious conversation between Loomis and the superintendent in front of a nondescript mental hospital that looks like a public office building.Footnote 69 The superintendent, who resembles an officious business-suited manager, tells Loomis, “I'm not responsible, Sam.” He even blames the psychiatrist for not making Myers's meds “strong enough.” Loomis yells back, “I told everybody! Nobody listened.” We gather that the primary function of institutional medicine is to dope monsters into submission in order to contain them. Loomis even says that Myers isn't “a man.” Dr. Loomis is not here to heal, but rather functions more akin to his literary forebear, Dr. Abraham van Helsing. Van Helsing also recognized the limits of medicine; destroying Dracula required him going beyond Western science and into vigilantism.Footnote 70
As Danielson argues, Halloween fairly resonates with folkloric elements. As in “The Hook,” here an “escaped lunatic preys on adolescents more concerned about their sex lives than about their personal safety.” But there is more than this here, and as Danielson explains, the film is in fact “a composite of themes familiar to any folklorist” who studies urban legends, including “lovers’ lane” stories and “caller-in-the house” tales. I will add that the confluence of horror and folklore in this film speaks to the worries of deinstitutionalization in unnerving and specific ways.Footnote 71
Contextually, the year Halloween hit theaters, stories of released mental patients wreaking havoc were already making their way through the popular press. In the New York Times, one might have read a March 1978 article about “smoldering community resentment” towards the recently released, and how deinstitutionalization was turning formerly safe neighborhoods into “bedlams.” Another Times piece tells how some New Yorkers lived in a state of terror, confusing “their fear of crime with their fear of insanity.”Footnote 72 The tagline of Halloween, “The Night HE Came Home,” brings to mind the purported threat of the ex-patients returning to communities. Myers escapes a hospital that cannot fix him, and is pursued by a doctor who knows that there is no cure aside from a bullet. Regardless of the directorial agenda of the film, which Carpenter acknowledged as a purely “stylistic exercise,” we are presented with an unfixable homicidal monster unleashed from an ineffective institution who goes home to terrorize his community.Footnote 73
Folkloric and horror elements drove this message home to mass audiences. The heroine, Lauri Strode, is a virtuous girl, a Red Riding Hood encountering a wolf. Like the beast in that folktale, this is an “it” that looks like a human, but with telling, unnerving differences. Rather than big teeth and fur, this thing has a pasty “human face” mask. Scholars have noted that what saves Strode is her virtue. By focussing on babysitting and not engaging in sexual relations like the other female babysitters, she is able to avoid being butchered.Footnote 74 The asylum which Myers escapes from might also be viewed as a kind of fortress, a place in which the villain enters as a child and exits as a powerful adult. When Myers later takes up residence in his old childhood home, now rotting and abandoned, we find another folkloric element, the dark house in the woods possessed by a haunt. Haunted houses, notes Dale Bailey, remind us of past sins and contemporary shortcomings, and, being real estate, can easily summon the nightmare of unfulfilled American dreams.Footnote 75 Carpenter expertly weaves these folkloric “urban-legend” elements into a horror dream of evil penetrating erstwhile “safe” suburban spaces.
Like The Exorcist, Halloween serves up a fairy tale in which institutional medicine proves incapable of dealing with dark problems facing our country. In both stories, a monster breaks into quiet middle-class neighborhoods after hospitals fail utterly to cure or even quarantine the problem. Like traditional folkloric stories of innocence imperiled, these films communicate moral messages. In this case, that moral is that the state, symbolized by institutional medicine, does not work.
Perhaps an even more obvious folk response to deinstitutionalization is 1979's When a Stranger Calls. Like Halloween, this movie also features a babysitter under siege by a maniac. Inspired by urban legends (and by “caller-in-the-house” films like the 1972 short Foster's Release and the 1974 slasher Black Christmas, not to mention director Fred Walton's earlier 1977 short The Sitter), it is about a murderer who phones a babysitter from upstairs in the same house. In the tense twenty-one-minute opening sequence, the young sitter (Carol Kane) gets repeated crank calls from a man asking, “Have you checked the children?” As the night wears on, he makes increasingly vile comments. Eventually, the cops trace the call and tell the sitter it is coming from inside. The killer, who has butchered the children, is found upstairs covered in their blood. We fast-forward seven years. Detective Clifford, who was at the original crime scene, is now a private investigator. The murdered children's father is telling him that the killer, Curt Duncan, has just escaped from “a state mental institution where the security is less than perfect.” The father hires Clifford to track down the monster. Clifford's first stop is the mental hospital, a prison-like place where a prim and dismissive female psychiatrist explains that Duncan is not going to “run right out and kill more children.” She explains that he has been under “continuous therapy, some of it rather forceful,” including “drugs, tranquilizers, depressants, lithium.” Duncan received ECT thirty-eight times, he learns, and this fact clearly unnerves the detective. In later flashbacks, we see Duncan strapped into a straitjacket, huddled in the corner of a padded call. “Eventually,” the psychiatrist confidently explains, “anyone will respond to the treatment here.” When Clifford tells her that Duncan would still be here if “you'd done your job right,” she admonishes, “this is a hospital, Mr. Clifford, not a penitentiary.” She then concedes that doctors know little about “the human mind.” The escape, we understand, is merely a sad event in the life of an essentially worthless institution that can neither hold nor understand its charges.Footnote 76
The movie then takes an unusual tack for a horror film. Following Duncan as he tries to survive outside, we watch as he pathetically hits on a woman in a bar, gets beaten by a customer, and, after following the woman home and being rejected, spends the night in a flophouse. He is on his way to becoming another homeless chronic living amongst social castoffs in a trash-strewn alley, panhandling and getting progressively filthier. He is nicknamed “Crazy Curt” by another homeless man. Scenes of Duncan talking to himself, muttering nude in front of a public restroom mirror, sweating, and nervously looking about, make for a pathetic sight.
The remainder of the film mainly involves detective Clifford tracking Duncan down, chasing him through the streets and the flophouse, while Duncan becomes more unhinged. Eventually we arrive back with the original babysitter, now married with kids of her own. She's living in a cozy suburb and preparing to go out to dinner with her husband. She puts the kids to bed, and then the babysitter arrives. As might be expected, Duncan is on his way, having found her by reading an article about her in a newspaper he picks up in the gutter. At dinner, a waiter comes by and tells the woman she has a phone call. She hears the familiar old voice: “Have you checked the children?” The parents dash home and find everyone safe. But Duncan is already here, hiding. He later jumps out of bed right next to her, playing the role of her husband (whom he has beaten and stuffed in the closet). The detective shows up in the nick of time and shoots Duncan repeatedly in the chest, killing him.
When a Stranger Calls allegorizes late 1970s deinstitutionalization. A maniac without rational motive murders children, gets committed to an ineffective institution, and then breaks out to kill again. On the streets, he becomes an anonymous homeless person, one of the untreated disturbed haunting urban spaces. Though we begin to sympathize with him, Duncan cannot escape his folkloric function. He returns to the suburban community to kill. Tracked by a detective who understands that death is the only “cure,” Duncan is executed before he can murder yet more children. Like Dr. Loomis, detective Clifford is a wise Van Helsing character filled with experientially earned pathos, a person present at the origin of the evil and the only one who understands that the monster must be destroyed. Duncan is, incidentally, killed in virtually the same manner as Michael Myers – a revolver round to the chest at close range. This kind of gun is a weapon of home defense, a nod to the save-yourself individualist backlash of the increasingly conservative times. While Duncan's body does not vanish, the closing shot features the superimposition of his eyes over the house, implying that his spirit is still alive. As John Carpenter would say about Halloween, “Your house is supposed to be a sanctuary. Nowadays, maybe because of conditions beyond our control, there is no sanctuary.”Footnote 77
CONCLUSION
In American Folklore and the Mass Media, Linda Dégh writes, “The mass media liberate folklore from its earlier confinement to the so-called lower layers of society … It is common cultural property characterizing our ways of thinking, believing, dreaming, and our modes of defining our identity.”Footnote 78 By accessing folkloric elements and using horror-genre tropes, the films discussed here speak to contemporary fears of mental institutions, a diabolical System, and anxieties of a society becoming unmoored. The enduring success of these films, especially One Flew over the Cuckoo's Nest, The Exorcist, and Halloween (though When a Stranger Calls was successful enough to spawn a sequel and a remake), relates to their effectiveness in relating vernacular moral messages. These movies, to various extents, became “common cultural property.” Deinstitutionalization informed their contextual framework.
The demise of the state mental hospital was the result of a confluence of factors involving the creation of new medical and legal interventions and a growing wave of critiques as to the efficacy of inpatient treatments. As the numbers of state hospital patients plummeted, the imagined (and occasionally real) threat of untreated patients percolated in the popular imagination. The films above accessed this fear, providing stories utilizing long-standing folklore motifs such as isolated fortresses, superhuman evil, trickster heroes, and imperiled female virtue. The Exorcist related a story of a waif besieged by a monster who could not be comprehended by psychiatry or institutions. One Flew over the Cuckoo's Nest presented a trickster battling the forces of the institutional state as wielded by a brutal female nurse. Halloween offered a bloody antihero erupting from a worthless asylum and into the community in a “Hook”-inspired allegory of disastrous deinstitutionalization. Finally, When a Stranger Calls provided a warning about the danger of the unbound psychotic on the unprotected female, in both virgin and matron archetypal forms, using the “caller-in-the-house” urban legend as fodder.
All of these films expertly combined folkloric and horror elements. There is the classic theme of pure evil attacking white girlhood, the trickster facing off with the beast, the monster lurking and hunting the unaware or sinful, and the punishment of inverting or contradicting gender norms. These films are particularly ripe in this final category. In The Exorcist, Regan's raspy-voiced cursing and masturbating with a crucifix make a twelve-year-old girl into a middle-aged sexualized monster. In One Flew over the Cuckoo's Nest, female Nurse Ratched throttles manhood with her bureaucratic power. In Halloween, sexualized babysitters meet bloody ends. More subtly, in When a Stranger Calls, a young babysitter playing house in a suburb is unable to handle a male upstairs demolishing unprotected children while their father is away.Footnote 79 That film also has a callous female doctor who is unhelpful at best.
Another folklore/horror marker of these films has to do with the “banality” of modern evil, particularly of the fascist sort. Folklore often places fantastical evil in prosaic settings. The shock of finding the Devil in Georgetown, for example, helps set off the unnerving terror of The Exorcist. Similarly, Nurse Ratched rules not by magic or even her own violence, but rather via the violence of the bureaucratic institution itself. Nazi references haunt both of these films. In both we are made to wonder how such evil can penetrate our modern world of “progress” and safety. Nurse Ratched, like Arendt's portrait of Eichmann, is the kind of person who calmly carries out atrocity, and who would say, as did Eichmann, that they were “unable to change anything.”Footnote 80 Forman's own family experience with the Holocaust and with the oppressive “Kafka-esque” state structures of Czechoslovakia undoubtedly shaped his vision. Likewise, Friedkin's Jewish parents fled murderous anti-Semitic pogroms in Ukraine in the early twentieth century, and his above-quoted comments about “demonic” Nazis surely intersected with the horrors he portrays inflicted upon young Regan.
Employing folklore motifs and the tools of the horror genre, the makers of these four films crafted powerful messages for the age of deinstitutionalization. They worked in the vernacular, referenced contemporary fears, and built narratives that evoked classic morality tales while echoing worries about a failing, even insidious, System. Their productions came at a critical moment. Not only was the press freely alleging that mental institutions employed barbaric and inhumane treatments, but state legislators facing fiscal crises were intentionally emptying them out. Once released, people suffering from mental illness could find themselves in positions of social abandonment with nowhere safe to go. Their plight triggered popular fears of dangerous “maniacs” running the streets and invading neighborhoods.
From The Exorcist to When a Stranger Calls, we can trace the trip from distrust to institutional annihilation during the 1970s. In this period, state legislations released patients at higher rates and states like California were considering banning ECT. Once patients started hitting the streets, fears of freed “psychos” resonated in cultural productions. The four movies discussed above folklorically confirmed popular horrors of mental hospitals and the people trapped inside them. At the root of their critique is not the argument that state funding must be restored; rather, it is simply an acknowledgment of state failure. There is no statist way to solve the crisis of mental health care, because the System itself is not to be trusted. The resolution, in the 1980s, would be a rejuvenated dream of the mythic individual, and a climate that would produce Gordon Gekko and John Rambo. Standing one's ground, armed if necessary, without reliance upon the government, would be the reigning folk myth of the Age of Reagan.
