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Asylums for the insane in the cinema: the representation of mental institutions and their procedures on the wide screen

Beatriz Vera Poseck

Psicología Clínica. Universidad Complutense de Madrid (Spain).

Correspondence: Beatriz Vera Poseck. Psicología Clínica. Universidad complutense de Madrid (Spain).

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Received 9 March 2006; accepted 23 March 2007


Mental institutions have always attracted the cinema as scenarios and they have nearly always appeared in a very negative and pessimistic light. Proof of this is that in horror movies they have often been used to represent ghastly, spooky places, possessed by terrible occult forces.

The view offered by the cinema of mental institutions has undoubtedly influenced the perception of the public at large of these places, considered centres of reclusion where not only do the staff fail to cure the patients but these are further damaged and alienated. Although it is true that for centuries this was the reality of psychiatric hospitals, it is also true that the situation began to change –quite radically in fact- several decades ago. Nevertheless, the cinema continues to offer the image typical of asylums for the insane a hundred years ago.

Here we offer an overview of the reality of mental institutions, together with an exploration of how movie directors, since the dawn of the cinema, depict them as a basis for their work.

Keywords: Mental Institution, Asylums for the Insane, Mental Patients, Horror Movies, Electroshock Treatment, Lobotomy.

A brief history of mental institutions

In Europe, towards the end of the Middle Ages and during the Renaissance those considered mad were often left to their own devices, and were confined to a tiny ship that sailed the rivers with no fixed direction. The Ship of Fools, as it was known as, was responsible for keeping such people out of the towns and cities and for liberating society of what was considered a millstone.

It would appear to have been the Arabs who around the fifth century first created hospitals for mental patients. However, it was not until the beginning of the fifteenth century (1409) that the first mental institution was opened in Europe. This was the Hospital de Ignoscents, Folles e Orats, created by Joan Gilbert Jofré in Valencia (Spain). It was a comfortable enough place and suitable for treating such patients: the leitmotif was to eliminate bindings and chains, and offer the patients different activities and a chance to work…. In this sense, Spain may be considered pioneer in institutionalised treatment. The hospital in Valencia was later imitated by others in Saragossa, Seville, Valladolid, Toledo, Granada…

In and around the seventeenth century Europe saw the creation of huge internment centres, whose main aim was to lock up the patients and isolate them from society. Within the cold, dark walls of these first asylums, mental patients, people with physical disabilities, beggars, drunks, prostitutes and homosexuals were all somehow packed in together. These institutions were little interested in cure or therapy; they were designed merely to hold the inmates at bay and thereby defend, as far as possible, law and order.

The first of such centres was the General Hospital in Paris, opened in 1656, although such institutions were soon extended across the whole of Europe. In London, mental patients were shut up in the Bethlehem Hospital (Bedlam), where those able to survive the deplorable conditions, the rotten food, the isolation, the darkness and the brutality of the wardens were subjected to the most frightful of abuses: emetics, purges, bleedings, and torture. Bedlam even became a Sunday spectacle for Londoners, who would pay to look at the unfortunate inmates behind their iron bars. Similar situations occurred at La Salpêtrière and Bicêtre (Paris) at Saint Luke’s Hospital (London), the Pennsylvania Hospital (Philadelphia), The Hospital for the Mad (Moscow) and Narrenthurm (Vienna).

At the end of the nineteenth century and start of the twentieth, the situation of such institutions continued to be abominable. In 1885 a Royal Act reflected the social conception of the mental patient of those times: a strange being, to be feared; a beast possessed by diabolic and demonical forces. The aim of the mental institution of those times was still to isolate the patients in order to protect society. There were no therapeutic aims behind this and once inside it was almost impossible to get out.

The aftermath of the Second World War saw psychiatric reforms in both Europe and in the United States. These aimed at changing the social conception of mental patients and eliminated closed-regime internment. Such reforms dramatically changed the conception of mental institution in force until then.

Thanks to these reforms, the care of mental patients, associated with beneficence, became the responsibility of the state. The governments themselves enacted reform policies to improve conditions and important programs aimed at the resocialization and social reintegration of patients were developed; attempts to make the institutions more humane were promoted, together with the creation of many community mental health centres. The activity of such centres began to be less and less medically oriented and, by means of prevention and multidisciplinary teams, a new interventional model for addressing the psychosocial problems of society was introduced.

Within the reformist spirit, which has not ceased since then, in 2001 the WHO made a public recommendation to completely replace traditional mental institutions by community attention centres, supported by the presence of psychiatric wards in general hospitals.

In Spain the Franco years relegated psychiatric care to an obsolete level, completely divorced from the situation in Europe and it was not until the eighties that a new psychiatric reform was initiated. This aimed at replacing the asylum system of institutionalisation by an integral model based on a structured network of community services.

Currently, development is relatively unequal among the different Autonomous Regions and only in the case of Andalusia have psychiatric hospitals been completely eliminated. In all Spanish Communities, mental health care has been included within the general health field; mental health units have been built, together with other similar edifices (Rehabilitation units, Therapeutic communities…) in the general hospitals and better coordination/integration between these and community social services has been promoted, such that the situation in Spain is now promising.

For centuries, however, mental patients were kept in jails, leper colonies…., and psychiatric institutions were suspiciously reminiscent of penitentiaries. Such places were grotesque and wholly divorced from the true aims of medicine. Nevertheless, since psychiatry began to be reformed around the middle of the twentieth century, these institutions have undergone huge transformations. Today, they by no means resemble the hell so often portrayed in the movies. The advances made in the field have been constant over decades, and now, although much remains to be done, the network is more than acceptable.

The cinema has perpetuated this image of former psychiatric hospitals and has failed to testify to the reforms that have appeared over the past century, transmitting an obsolete, and hence false, image of the reality of such institutions. Although it cannot be denied that this was indeed the true facet of asylums for many centuries, it would be unjust to overlook the beneficial psychiatric reforms that have been brought into play and deny that today’s panorama is radically different. There is thus to some extent a true basis and justification for what the cinema has portrayed as asylums for the insane, even though it has failed to portray the transformations that have been implemented in recent times, and it would appear that, as mental institutions are seen today, little has changed in the past 50 years. This is certainly not true1, 2.

A historical view of asylums for the insane in the cinema

Robert Wiene was the first film-maker to set a film -Das cabinet des Dr. Caligari (1920)- in an asylum. In this famous expressionist film, the Director of a mental institution becomes, in the demented mind of the main character, the author of murders that have been terrorizing a small village in Germany. The spectator ends up doubting the falsehood or veracity of such accusations (figure 1).

Towards the middle of the forties, Bedlam (1946) was run. The film was directed by Mark Robson and the action takes place in London, in one of the first asylums for the insane to exist in Europe. The film was to start a trend that would continue to our own times: that of portraying Directors of asylums as cruel task-masters; even madder than the patients they are in charge of.

At the end of the same decade, The Snake Pit (1948) was made. It was directed by Anatole Litvak and for the first time on the wide screen we witness an acerbic denouncement of the mental institutions system prevailing at the time. In the movie, Virginia Stuart Cunningham (Olivia de Havilland) is interned in a sanatorium for a minor ailment that is intensified by the nefarious treatments she is subjected to (figure 2). The same accusatory trend is seen in the movie by Sam Fuller Shock Corridor (1963), in which a journalist pretends to be a madman in order to gain entrance to the institution and work on a research article and ends up totally mad from the electric shock treatment he is given. Only one year later, Shock Treatment, by Denis Sanders (1964), appeared. The underlying argument was very similar: a detective pretends to be insane in order to regain a million dollars hidden in an asylum and he, too, must undergo the terrible trials of the sanatorium.

The previous decade had seen the début of Head Against the Wall/ La tête contre Les murs (1958), directed by Georges Franju, in which François (Jean-Pierre Mocky), a rebellious adolescent, is interned in a mental institution by his parents. The terrifying end shows François unsuccessfully trying to escape from the asylum and the spectator’s retina is seared by the image of the patient’s horrified face as he is returned to his “quarters” again. Underlying the film, there is again a declaration of principles towards a more humane treatment of patients interned in psychiatric institutions. There is a call for reform of the mental health system, although in fact this was already being put into operation at the time. The films produced during the fifties and sixties reflect a series of social movements that demanded the complete abolition of mental institutions; these movements arose under the ideology of the so-called anti-psychiatry, which pervaded Europe for more than two decades.

1975, was a key year in the cinema addressing asylums for the insane, with the production of One Flew Over the Cuckoo’s Nest, by Milos Forman. As detailed below, this was to be one of the films that have most influenced the public at large as regards mental institutions.

Among more recent movies, it is worth mentioning the Sci-Fi thriller Twelve Monkeys (1995), by Terry Gillian, set in the year 2035. Bruce Willis plays the part of James Cole, a man who is obliged to return to the past in order to collect a sample of virus that is killing off people in the future. Once he has “returned, however, he is unable to get back to the “future” (his present) and is interned in a mental hospital as a delirious schizophrenic. The first part of the film shows Cole’s passage through the asylum: rooms chock-a-block with patients; the insulting and humiliating behaviour they all receive; the jail-like nature of the institution; the drugs used as a means to subjugate the patients… (it should be recalled here that the “past” is 1990). As has been frequent in the cinema, the film reflects the angst of the sane person confused with a madman and locked away involuntarily, with no possible chance of validating his/her sanity. The bars of the asylum “protect the people on the outside from us”, Cole is told by one of the inmates (Figure 3).

Another film meriting comment is Girl Interrupted (1999) by James Magnold. This is an adaptation of the autobiography of Susana Kaysen, a teenager who spent 18 months in a mental hospital owing to her uninhibited and rebellious behaviour so frowned on in a conservative setting. The girl, played by Winona Ryder, is diagnosed with a borderline personality disorder and, through flashbacks, we learn of the circumstances that led her to be interned in the first place. The film reflects the anxiety of a healthy person interned without reason and, once again, the shambolic situation of violence, drugs by the fist-load, patients tied to beds, electroshocks, cold baths and isolation rooms…; all portraying a psychiatric hospital of the times. There is also another very common stereotype: that of the mental institution as a place where nothing functions as it is supposed to and in which everything that is done is exactly the opposite of what should be done.

One year later, Quills appeared (2000) by Phillip Kaufman. This is a portrait of the last days of the eccentric Marquis de Sade, who in the last decade of his life was interned in various French asylums and finally died in one of them –the Hospital Real de Charenton (one of the icons of classic French psychiatry together with la Bicêtre and La Salpetriètre), where his remains lie today (figure 4).

Also of interest is K-Pax, by Iain Softley (2001), although the film is probably more interesting for the media scramble generated when he was sued by the Argentinean director Eliseo Subiela, who accused Softley of having plagiarised his film Hombre Mirando al Sudeste (1986). It is true that both plots are almost identical: a man interned in a psychiatric hospital claims to have come from another planet. The attending psychiatrist begins to doubt reality and starts to believe that the patient may be telling the truth.

Among the most recent films to appear is The Jacket (2005), by John Maybury, in which Adrien Brody interprets Jack Starks, a veteran of the Gulf War with amnesia. He is accused of a crime that he does not remember committing and is declared innocent on the grounds of temporary insanity, but is still interned in a psychiatric hospital “for the criminally insane”. The hospital seems to be some kind of prison, with cold corridors, gloomy wards, and desolate bare walls. The first thing that happens on his arrival is that he is shot full of drugs, awoken in the middle of the night, given some kind of sedative, tied hands and feet and taken to a kind of morgue, where he is shut up for the rest of the night as though he were a corpse. This is the first of many treatment-torture sessions to which he is subjected by Dr. Becker and his assistants on the basis of drugs, straight-jackets, lock-ups and isolation. “We’re here to help you. We want the best for you” the psychiatrist tells him dispassionately. The worst part in the scenario is that the psychiatrist actually believes in what he is doing: for him it is not torture but treatment and he thinks it correct and efficient, justifying his behaviour “rationally” in pseudo-scientific prose. Scenes like this have undoubtedly helped to propagate the urban myths about psychiatric institutions to persist until our days. While Jack is locked up in the cold morgue he finds out that he is able to travel through time and see his future demise, such that he makes every effort to remain inside the hospital for as long as possible (figure 5).

And then there are also comic approaches to life in mental asylums. We see this is films such as High Anxiety (1977) by Mel Brooks or the Spanish film Torapia (2004) by Karra Elejalde. The comic note does not eliminate, however, the sombre myths of psychiatric hospitals. In Torapia, the first thing the physicians do to Basilio (Karra Elejalde) immediately after he has been interned San Quintín is to give him electroshock treatment, which fries his brain and leaves him stultified for hours. Javier Gurruchaga, in the role of the director of the hospital and a cruel lunatic if there ever was one, has no qualms about blasting his patients’ brains, as though they were guinea-pigs available for some kind of scientific research of doubtful ethics.

Brooks’ film is a crazy parody of the movies about asylums for the insane. The “Psycho-neurotic Institute for the Very, Very Nervous” receives a new psychiatrist, Dr. Richard Thorndyke (played by Brooks himself), who is in fact more neurotic than the patients themselves. The setting, apparently idyllic and a paragon of peace and tranquillity where the patients are allowed rest and recover happily, turns out to be the scenario of a series of strange happenings, each of them weirder than the one before. The other psychiatrists are not much better: viz. is Dr. Charles Montague, who is into SM and bondage and who wants to keep the inmates locked up for his own economic ends (figure 6).

Asylums in Horror films

Mental institutions are a frequent scenario in horror films. Clear examples of this are Asylum (1972) by Roy Ward Baker; Dark Asylum (2001) by Gregory Gieras, Gothika (2003) by Mathieu Kassovitz, Hellborn (2003) by Phil Jones and Madhouse (2004) by William Butler.

In the cinema, directors also often portray asylums as lugubrious and mysterious scenarios, where unsuspected phenomena are likely to occur. This is the case of Session 9 (2001), by Brad Anderson, which in fact has the peculiarity of having been filmed in a real former asylum: the Denver Mental Hospital. Another case of this is the thriller House on the Haunted Hill (1999), by William Malone. The film begins in 1931, when the institution was still functioning. We learn of the questionable treatment given to a restrained patient by the team of psychiatrists, followed by patient revolt, the slaughter of the psychiatrists, and the overtaking of the institution by the patients. The institution ends up in flames and is burned down. This was an institution for the criminally insane; an asylum of death directed by a mad surgeon who did away with hundreds of patients.

Today, the asylum remains closed and empty, until some eccentric millionaire decides to buy it up and get some publicity by offering a million dollars to whoever dares to spend a night there and come out of the ordeal alive. In the film, the hospital is haunted, full of ghosts and maledictions, and is surrounded by the souls of the poor unfortunates who were tortured there (figure 7).

Horror films have tended to portray mental institutions as dark, tenebrous places, with cold, high walls, harbouring diabolical nurses and demented directors. However, it is not only horror movies that have used this formula; in general all movies based on such institutions present them in such a light.

Overall, the mental institution as presented on the wide screen tends to portray disorder and disorganisation. In this sense, there is a panoply of images that repeat themselves in movies based on mental institutions, such as the mad person who must be restrained in a straight-jacket by several burly nurses, or the images of collective wards occupied by too many inmates, full corridors, overcrowded refectories…. Again it seems impossible to leave out the scene of the inmates’ common room, where each patient plays out his or her demented role in a cage-like setting. All films addressing the topic seem to include a scene such as this.

On of the resources often used by the cinema to reflect the maximum expression of terror is that of the sane person interned in an asylum against his or her will. If to this is added the myth that once inside it is well nigh impossible to get out, one has a perfect formula for the creation of a scene of terror and despair. Underlying the narrative trait, of course, is the idea that psychiatrists are incapable of distinguishing between sanity and insanity and even that they delve impossible depths in search of insanity where it does not exist in order to expand their patient numbers. The many films that have used this situation to develop their plots has led the public to believe that being confused with someone who is mad and being interned in an asylum are possible and even common within daily psychiatric practice.

Asylum treatments: electroshock and lobotomy

Many films set in the sphere of mental institutions highlight the inhuman and humiliating treatment to which their patients are subjected. Two techniques are commonly used in the cinema: electroshock and lobotomy. Both were used for decades although today lobotomy has fallen completely out of use and although in some cases electroshock is still used the technique has been improved upon and hardly resembles the original procedure at all.

Lobotomy, as mentioned, is now obsolete. It consists of the total or partial removal of the frontal lobes of the brain, or severance of the nerve fibres that join them to the rest of the brain. The frontal lobes are mainly responsible for planning, “conceptualisation” and will. This surgical technique was most popular between the thirties and the sixties of the last century and was used as treatment in very severe depressions, obsessive-compulsive disorders refractive to treatment, and severe schizophrenia.

Among the films that have portrayed this technique is Suddenly, Last Summer (1959), by Joseph L. Mankiewicz, in which in the very first scene the audience finds itself witnessing a patient being lobotomised in an operating theatre (figure 8).

A Fine Madness (1966), by Irving Kershner and based on the novel of Elliot Baker, also touches on this. Sean Connery plays Samson Shillitoe, a bohemian poet who must face up to the decision of his psychiatrist to undergo a lobotomy. His behaviour and attitudes do not fit within the bounds of conservative society that sees no further than solving the problem by limiting the mental capacity of our character with the procedure.

A horrific portrayal of life in an institution is also seen in Frances (1982), directed by Graeme Clifford, in which Jessica Lange plays the actress Frances Farmer, who for years was subjected to abusive and inhumane treatments at the different institutions she was interned in. These range from the induction of coma with insulin, to electroshock therapy, to prefrontal lobotomy.

The issue is also addressed in the documentary Monos como Becky (1999), directed by the recently deceased Joaquín Jordá. This is a lucid testimony of life inside a psychiatric hospital, loosely based on the biography of Egas Moniz, a Portuguese psychiatrist and Nobel laureate who introduced techniques for brain surgery, among them lobotomy. Jordá proposes to the inmates of an asylum that they could make a play portraying the life of the psychiatrist and films the documentary about how the play is rehearsed. The documentary mixes images in black and white of the testimony of Moniz’s family and friends with the opinions of psychiatrists, sociologists and philosophers and with the rehearsal of the play by the inmates. The title of the film refers to Becky, the chimpanzee that acted as a guinea-pig for the first frontal lobotomy carried out. In 1935, a research team carried out an experiment that would mark a milestone in psychiatry: they removed the frontal lobes from the brain of Becky, an aggressive and neurotic animal. After the operation, they discovered that the animal was calmer and less anxious. This surprising discovery was presented at a Congress held shortly afterwards, at which the marvelled Portuguese neurologist Egas Moniz was present. It was he who, based on the experimentation conducted on Becky, decided to replicate it in a human subject. Only one year later, Moniz told the scientific community about the results of his first twenty lobotomies. However, it was Walter Freeman, an American psychiatrist, who was to report the wonderful effects of the technique as a treatment for mental illness across the United States. Accompanied by his faithful surgeon, Freeman was to perform thousands of lobotomies on mental patients over the ensuing decades. It is a rapid procedure (Freeman managed to conduct almost a hundred lobotomies per week) that sometimes only needed an ordinary ice-pick and a hammer. This tool was inserted through the ocular globe and was struck with the hammer to sever the connections between the frontal lobe and the rest of the brain (figure 9).

Several decades later, advances in psychopharmacology led lobotomy into decline and the technique finally died out towards the sixties. Even then, in 1951 more than 15,000 North Americans had been subjected to the procedure.

Only a few years ago, the romantic comedy -A Hole in One (2004)- appeared on the screen, the opera prima of Richard Ledes, although the film has not been screened in Spain. In the middle of the fifties, in a small village of the American Mid-West, Anna (Michelle Williams) decides to undergo a lobotomy, a revolutionary procedure that promises to be the cure for all her woes. The film also attempts to be a pseudo-biography of Walter Freeman, the guru psychiatrist of the technique (figure 10).

However, the institutional treatment par excellence is undoubtedly electroshock. Developed in 1930, it consists of subjecting the brain to strong electrical currents; the biological changes elicited by such treatment lead to a change in brain chemistry that is believed to be the key for restoring normal functions. The treatment involves two or three sessions per week over several weeks. It is a hugely controversial technique, and although in recent years it has been improved and there are physicians who still defend its use in cases of depression or schizophrenia, others assert that it induces profound cognitive damage and that the supposed benefit is more due to the brain damage it causes, leaving the patient in a catatonic state, than to a true solution to the disturbance

Currently, the technique continues to be applied in cases refractive to pharmacological treatment. During the procedure, the patients are under general anaesthesia and are administered a muscle relaxant in order to prevent brusque movements and to ensure that during the convulsions only minimal muscle contraction will occur.

Perhaps An Angel at My table (1990), by the New Zealander Jane Campion, can be considered one of the best achieved representations of electroshock treatment. This film deals with the autobiography of Janet Frame, novelist and writer of New Zealand tales, who after a suicide attempt was admitted to a psychiatric hospital, where she was to spend no less than 8 years mistakenly diagnosed with schizophrenia, while in reality all she had was problems of social adaptability due to her timid and introverted personality. During her time at the hospital, she was subjected to a plethora of humiliations and underwent continuous sessions of electroshock therapy, which slowly reduced her ability to think. The film portrays -without pulling any punches- the coldness of the nurses and other members of the sanatorium, who show not an jot of compassion towards their wards. Finally, Janet, on the verge of undergoing a lobotomy, manages to save herself thanks to the publication of her poems.

The cinema has portrayed the harmful effects of electroshock in other films, such as The Snake Pit (1948), One Flew over the Cuckoo’s Nest (1975), Requiem for a Dream (1999), by Darren Aronofsky, or A Beautiful Mind, by Ron Howard (Figure 11).

The figure of the proprietor/director of the mental asylum

Almost irremediably associated with the actual asylum is the figure of the Director, usually portrayed as merciless, with dark motives, interested in acquiring fame with experiments of more than questionable ethics, or bent on destroying the brain of anyone who crosses his/her path.

In some cases, the psychiatrists or doctors in charge of the hospital are seen as insane themselves, while in other cases they are simply unscrupulous and -through skulduggery, their suggestive powers and mind games- are able to use the patients for experimental purposes, dominate their minds and thus have them completely at their mercy.

The idea of mental health workers as suffering from mental disturbances is another recurrent resource in the cinema, and this is often exacerbated when the films are set in mental institutions. The asylum for the insane run by a person who is demented is a evidently hugely attractive scenario for directors.

Special mention can also be made of the psychiatrists charged with administering the electroshock treatment, who are usually treated as overpowering sadists who have no qualms about raising the generator to maximum power and frying their patients’ brains.

In the forties, in full swing of Freudian theories, The Raven/ Le Corbeau came out. This is one of the best films directed by Henry G. Clouzot. Inspired by a true-life story, the film narrates the trials and tribulations of the inhabitants of a small French village who receive frequent threat-letters, causing discord and mistrust. At the end, we discover that the author of the poison letters is no other than Dr. Vorzet, played by Pierre Larquey, the Director of the psychiatric wing of the village hospital (figure 12).

Bedlam (1946), by Mark Robson, which is set in the Bethlehem Hospital in London, the oldest asylum for the insane in England, is a raw and veracious picture of the mediaeval asylum. The Director of the institution, played by the famous Boris Karloff, is seen as a depraved physician who has accumulated all kinds of evil perversions in his personal baggage and who asserts that mad people belong to a world without reason and without soul because they are no more than animals who deserve to be punished and locked away.

Currently, in Spain the film entitled El Hombre de Arena is in the post-production phase. By José Manuel González, the film is set in the Psychiatric Hospital of Extremadura during the sixties. Again, the sinister figure of the Director (Alberto Jiménez) emerges as a man with no conscience devoted to making life miserable for his patients (figure 13).

The influence of One Flew over the Cuckoo’s Nest

If any film has become the prototype of the representation of asylums for the insane it must be One Flew over the Cuckoo’s Nest (1975), directed by Milos Forman and based on the novel by Ken Kesey. The movie was a block-buster and received recognition from the Academy in the form of no less than 5 Oscars.

The portrayal of the mental institution made in this film, far from being different from that seen in most movies addressing the issue, is in fact very similar. The problem arises when considering that the film received such huge acclaim that millions of people saw it: it thus became a clear point of reference in the minds of a society that really knew very little about such institutions, apart from what was reported in the media, among which the cinema is one of the most powerful.

The film recounts the story of Randle Patrick McMurphy, played by Jack Nicholson, a low-life cheat who feigns a mental disease to avoid prison for minor crimes. He manages to convince the panel and is interned in a psychiatric institution. However, his rebellious and maladapted personality soon begins to grate against the order and routine of the hospital. Randle questions the regulations and urges his fellow patients to do the same, leading to a face-down with the unyielding tyrant Nurse Ratched, who has a compulsive penchant for following rules.

At the hospital, the character is subjected to all sorts of humiliations and abusive treatment. First, they drug him (for the cinema, it would appear that the only function of drugs is to send people to sleep and keep them in a state of permanent catatonia). He is then subjected to brutal session of electroshock “therapy”, which slowly wears down his capacity to reason, and finally he is lobotomised, thus completing his punishment.

The asylum scenario portrays a labyrinth of corridors and rooms, full of barriers, doors, locks and ties that starkly reflect feelings of repression, control and fear.

In this film, the mental institution is converted into a repressive agent utilized by a society bent on breaking the creativity of free spirits. The film perpetuates the myth that asylums are places where one can enter but never leave and in which the aim is not to cure but to subjugate and alienate the inmates. The role of the demon psychiatrist discussed above is in this case especially explicit.

Randle thus becomes a hero who, despite all his suffering within the four walls of the institution, ends up vanquishing the “baddies”. This absolute manichaeism of presenting the patients as heroes and the health professionals as the villains is undoubtedly one of the most reproachable aspects in the movie.


The Editors would like to thank the translation team of the Languages Service of the University of Salamanca for their collaboration in the English version of this Journal.


  1. Ferrer A, García-Raffi X, Lerma B, Polo C. Psiquiatras de celuloide. Valencia: Ediciones de la Filmoteca. Instituto Valenciano de Cinematografía. 2006.
  2. Porter, R. Breve historia de la locura. Madrid: Ediciones Turner S.L.. 2003

Figure 1: German poster for Das Cabinet des Dr. Caligari

Figure 2: USA poster for The snake pit, showing the main character

Figure 3: USA poster for Twelve Monkeys, with James Cole in the foreground

Figure 4: USA poster for Quills, with the Marquis de Sade

Figure 5: USA poster for The Jacket with characters

Figure 6: USA poster for High Anxiety, reflecting the comic nature of the plot

Figure 7: The colours of the USA poster for House on the Haunted Hill alert the viewer to the genre of the movie

Figure 8: USA poster for Suddenly, Last Summer, showing Catherine Holly, the main character

Figure 9: Poster for Monos como Becky, a documental by Joaquín Jordá

Figure 10: The main character in A Hole in One (2005): Anna Watson (Michelle Williams) at the front

Figure 11: John Nash (Russell Crowe) the schizophrenic in A Beautiful Mind (USA poster)

Figure 12: French poster for The Raven/ Le Corbeau (design by Jaques Bonneaud)

Figure 13: Spanish poster for El Hombre de Arena

Figure 14: Randle Patrick McMurphy in the USA poster for One Flew over the Cuckoo’s Nest