Psychological Analysis of Martini
In the movie, One Flew Over the Cuckoo’s Nest, Martini (no other name is given) is an
approximately thirty to forty year old male who resides in the same mental institution as the main
character of the show, Randle McMurphy. McMurphy is obviously not insane, but faked being
so presumably to abbreviate his stay in a prison work camp by “earning” a transfer to a mental
institution. Eventually, McMurphy becomes “friends” with a number of the patients there
including Martini. Among the group of acquaintances accumulated by McMurphy (or “Mac” as
he becomes known to his fellow patients), Martini possesses the most laid back and passive
personality. He rarely speaks unless spoken to and never expresses any aggressive behavior.
However, though Martini seems unaware of his mental status, he is undoubtedly sub-average in
mental capacity and ability.
After observing Martini throughout the movie, I believe Disorganized Schizophrenia is
the proper diagnosis for him. Characterized by disorganized thinking and behavior, and
inappropriate or absent expression, this particular type of Schizophrenia seems to fit Martini’s
behavior patterns perfectly (Mayo Clinic). The first of the behaviors expressed by Martini that
led me to this diagnoses appeared near the beginning of the movie when Martini approaches
McMurphy and randomly inquires, “can you borrow me a dime?” Martini’s improper use of
common English hints at problems with disorganized thinking, which is one of the key
symptoms of this type of Schizophrenia (Book).
The second incident hinting at the nature of Martini’s mental disability occurred
while playing cards with several of the other patients in the ward and, when Martini’s turn to
play comes, he simply stares absent mindedly into space. Dale Harding, another patient at the
ward, attempted several times to acquire Martini’s attention before successfully awakening him
from his dream-like state. To further reinforce my belief that this behavior is in fact a symptom
of his mental disorder and not just a one-time occurrence, Martini slips back into his dream state
only moments after Harding awakens him the first time. I consider this particular instance
conclusive evidence that Martini does, at times, live in his own world. This detachment from
reality, also known as psychosis, is another symptom of Disorganized Schizophrenia (Mayo).
A third example of Martini’s symptoms appears while he is outdoors on a sort of
“recess” and is playing with a basketball. After dribbling the ball aimlessly in circles for several
moments, Martini proceeds to pass the ball to an empty portion of the court while simultaneously
yelling, “Catch it! Catch it!” This action indicates that Martini is imagining a player where, in
reality, no one is present. In other words Martini is experiencing yet another symptom of
Disorganized Schizophrenia, delusions (Book).
A fourth indicator of Martini’s disorder occurs shortly after Martini passes the
ball to the “ghost” player when Washington, an employee at the ward, tells Martini to go get the
ball and Martini promptly and forcefully responds, “No!” Assuming that Martini is no longer
interested in playing, Washington runs to fetch the ball. As he does so, however, Martini seems
to suddenly change his mind and begins yelling, “I get it! I get it!” and begins to chase after
Washington in pursuit of the ball. This general inconsistency in his desires suggests, again,
disorganized thought processes.
A fifth indicator appears at not one singular point in the movie, but rather,
throughout the film. Several instances occur where Martini shows a general lack of
comprehension in regard to fairly simple tasks. One example of this happens, again, as Martini
plays cards with the rest of the gang. In almost every instance when this situation occurs, Martini
seems lost and generally lacks knowledge of how the game should be properly played despite
frequently repeated efforts of Harding and the others to teach him the rules. This general
disorientation is displayed by Martini on several occasions as he often must be told several times
to do simple tasks like “pick up my hat.”
The final clue, again, comes not in one single scene but throughout the film.
About halfway through, I began to notice an abnormality involving Martini’s display of
emotions. Or, rather, lack there of. It came to my attention that, no matter the situation, Martini
seemed to display the same quirky smile. Even in very emotionally charged scenes such as the
one in which Nurse Ratched discovers the wreckage that remained of the previous night’s
unauthorized party in the ward, Martini seems unfazed and continues wearing his signature grin.
Upon further investigation, I determined that this is indeed a symptom of Disorganized
Schizophrenia and is termed the “flat effect” (Mayo Clinic). This final piece of evidence really
locked in the diagnoses because Martini now displayed all of the general symptoms of
Disorganized Schizophrenia.
Though easy enough to identify in this instance, the origins of the disorder are largely
unknown. However, scientists believe this form of Schizophrenia is the product of both genetic
and environmental factors (Mayo Clinic). Generally, scientists believe neurotransmitters in the
brain may contribute to the disorder, and studies that image the brain have shown marked
differences between patients with Schizophrenia and those considered normal (Book). However,
what these differences may mean is not completely understood.
In general, Martini’s prognosis is not outstanding as only 15% of those diagnosed with
the disorder recover to the level of functionality they were previous to the onset of the disease
(Schizophrenia Prognosis). Several other factors lessen the likelihood he will make a full
recovery. The first of which is that Martini is a male, and males generally have lower recovery
rates than females (Schizophrenia Prognosis). Another factor that comes into play is the severity
of Martini’s disorder. As previously stated, he displayed all of the possible general symptoms
associated with Disorganized Schizophrenia also lowering his chances for recovery. The final
factor working against Martini’s recovery is the poor support system from the nurses and staff he
has at the ward.
Numerous other indicators of a prognosis one way or the other may also be
present; however, the background information provided by One Flew Over the Cuckoo’s Nest is
quite limited on this particular character. Some of these other indicators include a family history
of Schizophrenia, a low level of functioning prior to the onset of the disease, and a history of
substance abuse, none of which can be determined conclusively from the film (Schizophrenia
Prognosis).
As for treatments for Schizophrenia, the main options are medications, psychotherapy,
hospitalization, and electroconvulsive therapy (Mayo Clinic). In my opinion, two of these
treatment options may prove productive for Martini. These are psychotherapy and
electroconvulsive therapy. However, the latter is often considered a last resort due to its harsh
side effects including confusion, disorientation, and memory impairment (Book). Medication
would be largely ineffective because antipsychotics are the only proven medication that work to
combat Schizophrenia. These antipsychotics can treat only “positive symptoms,” like
hallucinations (Book). Martini’s positive symptoms seem very mild while his major
complications lie in the “negative symptom” category like social withdrawal.
This leaves one logical treatment option: psychotherapy. In particular, I believe
the cognitive behavioral branch would prove most effective. Cognitive therapies in general are
based on the premise that distorted ideas about oneself may be manipulated for the better and
that behaviors posing a problem to everyday functioning can also be combated. On the other
hand, behavior therapies focus on changing the trouble behavior itself and far less on the reasons
behind the behaviors (Book). Putting these two terms together then, Cognitive Behavior therapy
is a treatment that focuses primarily on the trouble behaviors themselves with the intent of
changing them. This treatment seems more appropriate than insight therapies that focus more on
the underlying causes for psychological problems because Disorganized Schizophrenia has no
definite known cause. Plus, it seems far more appropriate than the treatment he currently receives
at the ward consisting of a daily pill (presumably nothing more than a mild sedative) and what
appears to be a form of group therapy. Martini seems calm enough as it is and the group therapy
does not seem productive for any of the residents of the ward.
Even so, I would expect only moderate success from psychotherapy treatment because
Martini struggles with comprehension of even the most basic language. This could make
communication with the therapist rather difficult. While still not impossible, it does drastically
complicate matters. Also, in many psychotherapy techniques, a willingness of the patient to
change his or her behavior is crucial for success (Book). Martini displays no such desire for
change. Rather, he seems perfectly content to live in his own world in ignorance of reality.