Billy Murphy Case Summary

1. Billy is a voluntary patient and can leave the ward at any time. He has attempted to commit suicide more than once. He is deathly afraid of his mother and authority figures. I think that Billy has Anxiety disorder as well as social phobia. I do not think that Billy should be in the ward, he would do better at a rehabilitation facility. The ward is for insane or criminally insane and Billy does not belong there.

2. I do not think that McMurphy (Mac) was voluntarily committed. Someone who is voluntarily committed is a person who seeks help on their own. They check themselves into an institution and may leave whenever they want. Civil commitment is when a person is committed against their will. This happens when it is found by the court
McMurphy's (Mac) behaviors do not seem to be symptoms of insanity. The case of Durham vs. United States held that "the accused is not criminally responsible if his unlawful act was the product of mental disease or mental defect". Mac was trying to get out of the work farm by acting out and convincing the staff that he was insane. Once he was brought to the ward it was determined by the doctors and Nurse Ratched that he was not insane, but could be dangerous. In 1972 the Durham rule was replaced because of confusion in the courts about the definition of "disease". It was replaced by legal guidelines formulated by the American Law Institute and was combined with the M'Naughten principle. Basically it states that a person is not responsible for a criminal wrongdoing if at the time they do not understand the difference between right and wrong and they have not repeated the criminal offence because of their mental disease. Mac knows the difference between right and wrong and he tells the other patients that they are not insane. At the beginning of the movie when Mac is talking to Dr. Spivey, it is mentioned that Mac has had at least 5 arrests for assault. This shows that he knows that he is wrong, but continues to do
▪Harding is a paranoid schizophrenic. He should be treated with individual therapy, focusing on his wife. He should not be hospitalized and should be on medication. Using the drugs would be a biological perspective in Harding's treatment. ▪Billy has an anxiety disorder. Cognitive behavioral therapy is used along with drug therapy. The cognitive therapists combine training in relaxation skills and learning skills of avoiding tendencies to think the worst. I think this would work well with Billy because after he was caught with Candy and all the other patients were applauding him, he stood up to Nurse Ratched for a moment and was not stuttering. He showed that when he has support he can stand up for himself and has more self esteem. This is the cognitive perspective. ▪Taber is a trouble making Sadist who is not a voluntary patient. Psychoanalysts attempt to bring childhood sexual conflicts into awareness so that they can be resolved. Although Tabor would probably not benefit from this type of treatment since there are not many cases where a psychodynamic perspective on treatment has been successful. ▪Cheswick is a paranoid neurotic who lacks self confidence. A neurotic is a person who constructs an ideal self-concept and wants to become that person. He presents his ideal self concept to society for approval. He is afraid of being his real self, particularly if it is not good enough, as defined by society. Afraid of social rejection, he pretends to