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Flying away from the Cuckoo's Nest

By Martha McKenzie

Story Photo

Courtesy of the Alliance Theater. Photo by Greg Mooney

When the cast began to rehearse for Atlanta’s Alliance Theater production of “One Flew Over Cuckoo’s Nest,” they received some help from the Emory Department of Psychiatry and Behavioral Sciences.

Professors met with cast members to help them understand the thoughts, feelings, and mannerisms of people with psychiatric disorders.

And after every performance, faculty experts hosted a Q&A for audience members. Most of the discussions centered on how treatments for mental illness have advanced from the barbaric practices depicted in Nurse Ratched’s ward, which included dehumanizing institutionalization and violent electroconvulsive therapy (ECT).

In fact, the depiction of R.P. McMurphy’s brutal ECT treatments in the 1975 movie adaptation of the Ken Kesey novel—treatments Nurse Ratched described as part sleeping pill, part electric chair, and part torture rack—led to a backlash against the use of large, institutional mental hospitals and ECT treatments for the mentally ill. Today, however, ECT is emerging from the shadows. For patients receiving ECT today, it is a very different procedure. They are put under with general anesthesia and given a muscle relaxant. Then a small electrical current induces a brief brain seizure, triggering a change in the brain that experts don’t totally understand but that relieves depression in many.

“Our knowledge of brain circuitry has expanded exponentially,” says Mark Rapaport, chair of psychiatry. “We have newer treatments that can actually normalize brain function. We live in a wonderful new world for patients with serious brain disorders.”

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