Ratched: What’s changed since 1975

2020’s Ratched serves as a prequel to the 1975 film One Flew Over the Cuckoo’s Nest by presenting the villain origin story of Nurse Mildred Ratched.  The eight-episode series takes place at Lucia State Hospital in 1947 and portrays several psychiatric disorders and treatments including lobotomies, hydrotherapy, and hypnosis.  Ratchet’s main goal is to get her murderous foster brother, Edmund Tolleson, out of the hospital which is holding him for psychiatric evaluation before going to trial for the gruesome murders of four priests.  Edmund and Ratched both suffer from PTSD after growing up in abusive foster homes with the final being sexual leading Edmund to murder them.  The relationship between Ratched and Edmund mirrors how the show approaches the topic of mental health in that there is a beacon of hope but ultimate devastation due to mistrust.

             Edmund Tolleson is initially a sympathetic character as his murder history includes sexually abusive foster parents and a priest who raped his mother and ultimately forced her into sex work resulting in her exposure to drugs and ultimate overdose.  The director of the show, Ryan Murphy, is known for his use of overt, stylized violence, however in the case of Edmund this is extremely problematic.  Over the course of the show Edmund adds seven nurses to his criminal record and countless injuries which transforms him from a tragedy of a flawed system to a homicidal maniac that resides in the genre of horror rather than reality.  Of these two descriptions, the latter reads far more like the misdiagnosis and outdated representation of what PTSD is or ever could be than a destigmatizing fresh outlook. 

            This is further exemplified through another patient of Lucia State, Charlotte Wells.  Wells also suffers from PTSD though hers manifests to dissociative identity disorder (DID).  Wells developed DID after being beaten, starved, and assaulted by multiple men for nine days before ultimately being told by a police officer who is implied to be one of the men’s fathers that she cannot press charges.  Wells develops three personalities, that of a violinist, an Olympian and a small child who all protect her fragile and severely damaged state of mind.  Wells is misdiagnosed and mistreated multiple times before ultimately finding a sense of tranquility at Lucia State under the treatment of hypnosis.  It is here that Ratched truly misses an opportunity to portray a realistic journey of someone working through therapy by instead going for shock value at the expense of mental health.  After a brief period of progress, Wells finds herself at the hospital ball smiling and dancing with, of all people, a uniformed guard.  Edmund is, at the hands of Ratched, allowed to the ball where he then slits the throat of the guard, rapidly deteriorating all of Wells’ recovery.  Well’s then escapes the hospital to accidently murder the doctor who she was finding success within a state of disassociation.

            Both Wells and Edmund are completely derailed from mental stability by the end of the series as they have escaped Lucia State and are now on the run.  It is a Hollywood depiction of mental illness both in its exaggerated violence and in its depiction of how state hospitals, even in 1947, operated.  Overall, the show is damaging for its misinformation of how trauma manifests, choosing to not show a new, more accurate representation of mental illness, but rather relies on the stereotypes of DID and PTSD.     

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