Psychological theatre rehearsal becomes a social experiment

This is the Accepted Manuscript version of a Published Work that appeared in final form in the British Journal of Wellbeing, copyright © MA Healthcare, after technical editing by the publisher. To access the final edited and published work see, Originally published March 2011


A new production of One Flew Over the Cuckoo’s Nest ran in March 2011 at Theatro Technis in Camden. This article describes how the production took an experimental approach with its interactive rehearsals to challenge misconceptions of mental illness.

The work week bustle around Warren Street station has fallen to a hush, replaced by a quiet Sunday buzz. The rain is falling and the usually near-empty Barclays cycle hire rack is full. A man in blue patient scrubs turns the handlebars and eagerly watches them spin. Next to him, another man playfully wheeling around in his chair pushes the communal bin and laughs. A nurse in white uniform frantically struggles to put the bin back while holding an umbrella over his head.

Behind them, more than half a dozen other patients, all dressed in the same sterile blue, cause a stir as they pile into McDonalds. One has bandages wrapped around his wrists and holds a soiled toy rabbit he calls David in a stutter. Another plays with the fire extinguisher, stopping only to stare at a passerby with wide eyes and a forehead creased with paranoia. Others twitch, salivate and scratch at their skin in response to their medications. People watch the scene unfolding—some look curious, others uncomfortable.

This is a group of mentally ill patients. They’re enjoying a therapeutic day out in the city. Moments before, they were actors discussing the day’s rehearsal for their upcoming play, a modernised version of One Flew Over the Cuckoo’s Nest. The scene is an act. The public’s reactions are real.

Challenging stereotypes

EmpathEyes, a young and ambitious theatre company aiming to produce politically involving psychological theatre has organised the day trip to Tottenham Court Road as part of a rigorous rehearsal process.

The characters learn about themselves and their relationships with one another outside the confines of the play. The absence of a script and uncontrolled public environment means they will be challenged to explore their characters’ reactions to situations they wouldn’t otherwise find themselves in, says producer Imogen Lewis, who co-directed the play with Tahsin Gemikonakli.

The cast is made up of professional and amateur actors from different backgrounds and ages ranging from 16 to 63 years. The play raises questions about the abuse of power and the victimisation of the weak.

It aims to draw attention to stereotypes surrounding mental illness, and ultimately, to smash them wide open.Thiru Thirunimalan, who plays a newly created version of Ellis, has spina bifida and has been in a wheelchair all his life. His character is a heavily sedated epileptic who cannot speak. In trying to play up Ellis for maximum theatrical effect, he hopes he is not inadvertently conforming to stereotypes of mental illness or of people in wheelchairs. ​

Former Psychiatrist, Paul Wolfson, who practiced in southeast London for 30 years until his retirement last April, says stereotypes are difficult to avoid because they are based on reality at the time the story was set.

Despite the play being based in fiction and taking place in 1960s America, Mr Wolfson says there are definite similarities to the system as it existed in Britain when he first started in psychiatry. ​

‘The mentally ill were like subhuman people,’ he says. ‘They just gestured about like teapots. They would line up and have deodorant squirted under their armpits. They often defecated in the corridors.

‘If you treat people badly, they behave badly.’

Mr Wolfson, along with Gul Davis, who plays Cheswick in the production and who has written extensively about mental illness, spoke to members of the cast about mental health so they could play their roles as accurately as possible and infuse the production with enough realism to hit an emotional chord with the audience.

'An experimental variation'
The play, which ran from 1–12 March, was well attended and several members of the audience commented on its power and ability to invoke empathy towards the mentally ill. The production was an experimental variation on Dale Wasserman’s original. To keep it fresh and set it apart from the memorable 1975 film, Mr Gemikonakli and Ms Lewis created, eliminated and combined some of the characters. They incorporated intervals of physical theatre where patients became noisy robotic cogs to create the psychiatric institutional machine described in Ken Kesey’s 1962 novel.

They also incorporated a live orchestra in patient costume. When the musicians were not weaving mournful tunes into the play, they were draped over their instruments, biting at their knuckles or seemingly asleep with their mouths hanging open.

‘They look like they’re doped up on methadone,’ said a member of the audience.‘Then by some miracle they come alive through their music.’.

During the intermission, a patient was left groaning at the centre of the stage, alone and in the dark. Ruckley, in EmpathEyes’ production, is a patient who usually hangs from the back wall of the ward drooling and wetting himself as a result of a lobotomy. He was left on the floor during intermission to symbolise the patients who are neglected and forgotten. His loud complaints, which Ms Lewis says make up the music of an asylum, interrupted audience members’ chatter over coffee until the audience eventually tuned them out and their complaints faded into background noise.

The power differential between staff and patients is clear during the play with the nurses sitting in their elevated glass station and communicating with patients via microphone.

Daniel Addis’ character, Randall Patrick McMurphy, symbolises the liberation of the patients and subsequently, a threat to the running of the machine. Although it seems the play becomes about a personal battle between him and the domineering Nurse Ratched, their exchange is symbolic of a larger tension at play, he says.

‘Nurse Ratched is really just a face for the whole institution,’ says Mr Addis. ‘She’s probably the most mentally ill person in there.’

Despite the issues associated with the hospital staff, Mr Davis says they’re the ones who determined the public’s reaction towards the patients during the rehearsal day out on Tottenham Court Road.

‘You don’t need to be completely bonkers to start seeing massive reactions from people—you just need to be walking in line and led by figures of authority,’ he says. ‘People’s reactions followed the behaviour of the authority rather than the behaviour of the patients themselves.’​

His character, Cheswick, was treated kindly, seen as vulnerable and even given a free hat when accompanied by caring Dr Spivey. Yet, when he reacted to being manhandled by one of the nurse’s aides in the street, he was seen as dangerous and hostile. ​

When some of the other patients went into Prêt a Manger with their own pocket money for a bite to eat, they were given free food by the staff. Still, some members of the public moved away from the patients in fear, while others looked intrigued but kept their distance.

‘There’s a lot of stigma still related to mental illness and that hasn’t really broken down yet,’ says Mr Wolfson. ‘But things are a lot better than they were.’

This progress became especially obvious towards the end of the day when the group headed towards the University College London quad to play ball. As the patients tossed the ball around, Bianca Gidwani and Emma Lake, both third-year history of art students at UCL, saw them and without a second thought, joined in the game. ‘One of them asked us to play and it was really fun,’ said Ms Gidwani. ‘I was surprised to see them but they should do this more often. I’m sure other students would love to get involved.’

According to Mr Wolfson, the more people share individual stories of mental illness, the easier it will be to break down stigma. Healthcare professionals can play a key role in the process as well, he says.

‘What healthcare professionals should do is work in a service, where if they were mentally ill, they would like to be treated there.

‘In other words—empathise.'