Modern literature's depiction of nervous ailments
Saul Bellow and Ken Kesey
by Catherine Cooper
If you don't watch it people will force you one way or the other into doing what they think you should do, or into just being mule-stubborn and doing the opposite just out of spite
(Chief Bromden, One Flew Over the Cuckoo's Nest)
It could be argued that the nature of modern living is such that people are now more prone to nervous ailments than in earlier times, whether these ailments manifest themselves in comparatively minor forms, such as mild paranoia or depression, or in more major, psychotic or psychopathic ways. Whether or not this is true, there are many instances in modern literature of characters who display some kind of nervous ailment. Minor affections such as paranoia or a feeling of oppression are perhaps most common, for example Asa Leventhal in Saul Bellow's The Victim or many of the characters in Sylvia Plath's work who display symptoms of a feeling of oppression (particularly Esther Greenwood in The Bell Jar). There are characters who appear somewhere in the middle in the 'madness scale', for example, Billy Pilgrim in Kurt Vonnegut's Slaughterhouse Five who most of the time is considered sane but is convinced that he regularly makes trips to another planet. Furthermore there are examples of work which deal with 'total madness', an example of which is Ken Kesey's One Flew Over the Cuckoo's Nest.
The theme which all these works have in common is that the character's afflictions are not perceived as being entirely their own fault but to a certain extent caused by events in their lives or the society around them. In this essay I shall look at the way in which the authors portray the ailments of their characters and the different ways which the characters have of dealing with them.
Saul Bellow. The Victim
In The Victim, Saul Bellow's character Asa Leventhal is a good example of someone suffering from paranoia. As a Jew in post-war America he is in a minority and he constantly feels that people dislike him or are even persecuting him because of his Jewishness. The situation is exacerbated by the arrival of Kirby Allbee, a figure from Leventhal's past who blames him for the loss of his job three years earlier.
The plot of the novel seems to be based on a novel by Dostoyevsky, The Eternal Husband,  although Bellow says that the parallel, now obvious to him, did not occur to him at the time of writing. The theme of Dostoyevsky's novel is the dignity of man. The protagonist, Alexey Velchaniov is unwell physically (whilst Leventhal is unwell mentally, it could be argued) and both are burdened with guilt. Into the lives of each of these men comes a 'double'; someone they have hurt in the past and onto whom they can project their guilt. The 'doubles' prey on the guilt-ridden protagonists with a combination of love and hate. In each case there is an attempted murder, and the protagonist is healed. There are many further parallels, but what is actually important is the device of the 'double'. Allbee as Leventhal's 'double' is the anti-Semite Leventhal needs to justify his guilty feelings and sense of persecution, while Allbee needs to believe Leventhal to be to blame for his downfall so that he can blame the world for his troubles rather than himself. It is through their reciprocal blaming that they manage to escape from their afflictions.
Leventhal says of Allbee that he was:
But this is equally true of Leventhal himself; he is afraid that his boss, his brother's wife, his mother-in-law and even his friend Williston are all against him because he is a Jew, even though he is never attacked on these grounds and never persecuted at all. It should also be noted that Leventhal does not seem to be a particularly pious Jew, he does not attend synagogue nor does he observed the public holiday, which seems to make his paranoia even less well-founded.
Leventhal's propensity to feel that he is the victim of persecution for no discernible reason is evident in his first meeting with Allbee. He is prepared to punch him before a word has passed between them merely because he approached looking 'suspicious'. Jonathan Wilson, however, argues that Bellow seems to be of the opinion that Leventhal has reason for being paranoid as city violence was fairly common.  This does not seem to be a particularly a viable argument as Allbee is initially only verbally abusive, but progresses because Leventhal allowed himself to be so greatly riled by Allbee's presence. This can be seen in the description of his unease at being in a restaurant with his nephew when Allbee is also there.
Another example of the his general feeling of persecution and paranoia can be seen when Leventhal is musing upon the 'strange savage things' which go on around him.
Further examples of his paranoia are evident in the fact that he believes that Allbee can have him blacklisted, even though he has been told that this is not the case, he feels that subway doors deliberately close on him and trucks 'encircle' him, he believes that his ten year old nephew bears a grudge against him and the idea that his wife might be being unfaithful to him is even put into his mind by Allbee.
Returning to the theme of Allbee as Leventhal's 'double' it can be seen that Leventhal often projects some of his feelings onto Allbee, often those of which he himself is unconscious. The most important instance of this is seen in his projection of his sexual impulses. Bellow writes that when Leventhal descends in an elevator 'amid a crowd of girls, from the commercial school upstairs' he is 'largely unconscious of the pleasure that he took in their smooth arms and smooth faces'. However when Allbee is in the same elevator with Leventhal and the same girls, Allbee comments upon them as Leventhal's double, it is his job to make manifest Leventhal's hidden feelings, particularly those which he does not even admit to himself.
There is a further example of this when Leventhal returns to his flat to find Allbee in bed with a woman, whom he immediately thinks Mrs Nunez, a woman from whom, throughout the novel Leventhal has felt a certain sexual suggestiveness emanating. Here Allbee is living what Leventhal desires, (even though it turns out that the woman is not Mrs Nunez) and so alleviates some of his guilt.
By the end of the novel Leventhal is much more at ease with himself. Allbee has provided him with the means of justifying his paranoia and guilty feelings and so he now no longer feels that he is being blamed for everything, (after having begun to believe at one point that he really was to blame for Allbee's job loss), and is not so ready to blame others for his misfortunes. Bellow writes:
In the final chapter of the novel both men seem much more confident and at ease with themselves. Having had the opportunity to justify their feelings of guilt and persecution by projecting them onto each other, Leventhal and Allbee seen to have been able to overcome their respective feelings of paranoia and accept themselves.
Ken Kesey. One Flew Over the Cuckoo's Nest
The nervous ailments dealt with in Ken Kesey's One Flew Over the Cuckoo's Nest are of a very different order to the paranoia felt by the protagonists in The Victim. The characters in One Flew Over the Cuckoo's Nest are actually considered mad, and so the novelist deals with their problems in a different way and also has a considerably different view as to how their ailments were caused. While Bellow seems to suggest that the reasons for Leventhal's and Allbee's paranoid feelings came from within themselves rather than being caused by society, Kesey strongly suggests that the residents of the ward in his novel are there because they could not cope with the pressures put on them by society to conform, and that their madness is caused by others, rather than originating within the men themselves.
Kesey also deals with the ineffective way in which these men are 'treated' for their various aliments. He constantly alludes to the way that the institution, in particular 'Big Nurse' attempts to dehumanise these men, illustrating the fact that it is deemed better that these men have no signs of individuality so that they will fit into society more easily. The author does not portray them then in a derogatory light or laugh at them, but rather seems to look on them as victims of society's oppression, and sees society as the root of their problems.
The author also seems to be attacking society's view of madness, in that these men are merely dehumanised, ill-treated by the staff, and appear to be on the ward just so that they are kept out of the way, rather than to be treated.
The novel is based on Kesey's experience of working in such an institution. He noticed that the system worked by disallowing freedom of any kind; freedom of movement, freedom of speech, and even freedom of thought.
The men on the ward are resigned to their regime until McMurphy arrives to disrupt it. Randall McMurphy makes the men realise that it is possible to think for themselves, which results in a complete destruction of the system as it was.
Fred Madden wrote: 'For Kesey, any sort of conformity means a loss of individual sanity.'  and this view is clearly illustrated throughout the book.
The action is seen through the eyes of Chief Bromden, a huge red Indian who everyone believes to be deaf and dumb. He comments that it was not he who originally decided to adopt this act but others who treated him as if he were deaf and dumb, which illustrates that the way a person is depends upon the society around him. Indeed, Chief Bromden's father told him:
In a way the Chief has done both: he acts deaf and dumb because that is the role imposed upon him, but also gains the upper hand by pretending to be what he is not. However, his lack of communication also works against him, he often feels alienated, lost in the 'fog' which he believes is created by a machine from time to time. As well as being indicative of his mute state, this is also an indication of his state in society, he feels he is an outsider.
There are other men on the ward whose problems have clearly been caused by other people, for example, Billy Bibbitt whose problems, which are clearly rooted in his mother's oppressive treatment of him, cause him to stutter, and Harding who suffers from excessive sexual jealousy caused merely by the attractiveness of his wife. For these two men the atmosphere of the ward is particularly unhelpful. Nurse Ratched is often referred to as the 'mother' of the ward and continues the female oppressiveness from which the two men are already suffering. This is particularly true for Billy, as the nurse frequently threatens to report his behaviour to his mother when he steps out of line, which is in fact what causes his eventual suicide.
The men are all dehumanised and even emasculated, a fact which is emphasised by the first of three suicides in the novel, Old Rawlet's death by castration. It is the arrival of McMurphy which makes the men begin to question the system. McMurphy begins challenging the system in small ways, such as asking that 'ward policy' be changed so that they can watch the world series, and is shocked to find the men so unwilling to vote. Another more symbolic example is his attempt to lift the control panel, a feat which he will clearly be unable to achieve; but he makes the point that he tried, which is more than any of the other men would think to do. The control panel is a representation of the 'Combine', the Chief believes that it mechanically controls the men via the devices which he momentarily sees inside the tranquilliser pills which they are given. Whilst it is true that his hallucinations are mere hallucinations, they are in fact representative of what is happening on the ward; even though the men are not being controlled by electronic devices, they may as well be because they have been deprived of the ability to think for themselves to such an extent.
McMurphy symbolically challenges the system by attempting to lift the control panel and continues to do so in more rebellious ways, by organising the fishing trip and eventually the party. Kesey says that McMurphy is a fictional character but was inspired by 'the tragic longing' for such a character that he saw in the men he worked with on the ward.
McMurphy's influence, however, is not wholly positive. McMurphy is not wholly above conformity: when he realises that nurse Ratched can decide to whether he should be relocated or kept institutionalised he falters in his striving for non-conformity and personal identity. This causes Cheswick, who was beginning to learn to become less dehumanised, to lose hope and commit suicide. His increasing despair can clearly be seen when, given the chance to escape, he 'accidentally' oversleeps after the party. Having been in the institution for a length of time, he too has become dehumanised. This dehumanisation becomes total when McMurphy is lobotomised, and in the final section of the book, when the Chief kills him, he is completely depersonalised, being referred to as 'it' or a 'body'. 'It' is no longer a person, but it should be noted that in this instance the dehumanisation is particularly severe; McMurphy is now practically a vegetable, although this fact could be seen to be making the point that the other men on the ward are in almost the same state, the only difference being that they can move about.
The Chief's account of killing McMurphy shows that McMurphy was now a non-person:
At no point in this final section is 'the body', McMurphy, a person; it is just a body, showing the damaging effects of the depersonalisation caused by such an institution in an extremely striking way.
Madden argues that the Chief's killing of McMurphy is not a mercy killing as it is often seen to be. He sees it as being the Chief's final act as part of the oppressed group of the men on the ward and through it he sees how much McMurphy was manipulated by group pressure, in the same way as the other men in ward, but pressure of a different kind. While the other men were pressed into submission by the 'Combine', McMurphy was forced to act as the rebellious hero bringing reform by the rest of the group, but was forced to take things too far and consequently sacrifice himself. The Chief, through this awareness, becomes able to free himself and shows this symbolically by throwing the control panel through the window and escaping. McMurphy's influence also encourages a lot of the men on the ward to find the courage to discharge themselves, realising that they too have been depersonalised and their state is not going to improve unless they escape.
It should be noted that although Kesey's main idea in the novel is that the pressure of society has caused the ailments of these men, their recovery must come from within themselves, in the same way in which Leventhal and Allbee had to find it within themselves, through each other, to overcome their paranoia and guilt. McMurphy was a mere catalyst in the Chief's recovery; if he had been the sole cause, surely all the men on the ward would have been cured. McMurphy merely inspired the Chief to find it within himself to rediscover his identity and escape from the dehumanising atmosphere of the institution. So the message of the novel appears to be that while society causes nervous ailments, rather than them coming from the individuals themselves, to achieve recovery a person has to find it within himself to challenge the rules being laid down. It also makes the point that mental institutions are unhelpful and oppressive.
The two novels discussed in this essay are to an extent different in their analysis of nervous ailments. In One Flew Over the Cuckoo's Nest it is implied that the men's ailments are caused and exacerbated mainly by the oppression of society, whilst in The Victim the ailments come mainly from within the protagonists. What they have in common is the message that society is generally unhelpful in helping people to overcome their ailments and that the will to recover must come from within.
Taking modern literature as a whole, Kesey's view that society is at fault appears to be more common. Examples are Salinger's Catcher in the Rye, in which Holden Caulfield's unease is caused by the 'phoniness' of society, Sylvia Plath's The Bell Jar where Esther's breakdown is caused by the imposition of roles by society, and Vonnegut's Slaughterhouse Five where Billy Pilgrim's hallucinations are caused by trauma suffered in the war. On the whole, modern literature treats nervous ailments as something which is not shameful, not the fault of the individual, but also makes the point that the individual must generally find it within himself to gain recovery, and not look to society for help.
Clayton. Saul Bellow in Defence of Man
Saul Bellow. The Victim
Kesey. One Flew Over the Cuckoo's Nest
Leeds. Ken Kesey
Wilson. On Bellow's Planet
Madden. Sanity and Responsibility: Big Chief as Narrator and Executioner. In 'Modern Fiction Studies' volume 32 1986
Kesey. Kesey's Garage Sale
 Clayton p 141
 Wilson p 59
 Madden p 206
© Catherine Cooper, April 2001