How accurate is Ratched? The truth behind the show’s treatment scenes

The show features a number of disturbing scenes in the fictional Lucia State Hospital.

Hydrotherapy as depicted in Ratched on Netflix (2020)

Ryan Murphy is returning to Netflix for Ratched, a stylised prequel to One Flew Over The Cuckoo’s Nest, exploring the backstory of the eponymous nurse.

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Set largely in a psychiatric institution, the series features unflinching depictions of medical treatments so unpleasant that it’s hard to imagine why it was thought they would help anyone.

The most uncomfortable scenes involve so-called hydrotherapy, in which a patient is subjected to extreme temperatures of water, and the barbaric lobotomy returning from One Flew Over the Cuckoo’s Nest.

But how accurate are these depictions?

Hydrotherapy

Ratched’s depiction of hydrotherapy is really rather horrifying, used in a sickening bid to “cure” a lesbian woman of what was then viewed as a psychological condition.

An intense scene in episode three sees Nurse Bucket place her patient in a large bath tub filled with warm water and seal her in using two metal covers, before increasing the temperature rapidly.

After some time in the incredibly hot water, the patient is then transferred to a different bath filled with ice for five minutes to cool off. It’s nasty.

Of course, the ordeal is utterly traumatising for all involved (apart from Bucket, apparently), with the patient claiming to be “cured” afterwards in a desperate bid to avoid another round of treatment.

Sarah Paulson stars in Netflix original series Ratched, from producer Ryan Murphy
Netflix

Shockingly, this form of hydrotherapy was a type of treatment for mental illness in the early 20th century.

Psychology Today details the long history of water being used to treat psychiatric conditions, dating back to spiritual beliefs about water as a divine healer.

The surprise of being immersed in the high or low temperature water was intended to shock the patient out of their ailment, with a record from London Asylum, Ontario in 1910 claiming to have found success.

That same record states a maximum temperature of 105 degrees Fahrenheit was reached, while other facilities typically ranged between 92-97 degrees.

As a result, Ratched’s depiction of a bath reaching 119 degrees is certainly an extreme example, but in the experimental early days of psychiatric medicine, it can’t be ruled out that this never occurred.

The lengths of these treatments varied wildly, with some going on for days, while variations included wrapping patients in ice-cold towels.

Typically, warm baths were used for patients who struggled to settle, suffering from insomnia or manic episodes, while cold baths were used on patients displaying more lethargic symptoms.

Lobotomies

Cynthia Nixon plays Gwendolyn Briggs in RATCHED on Netflix
Netflix

Predictably, the lobotomy plays a large role in Ratched, just as it does in One Flew Over the Cuckoo’s Nest, but its depiction here is far more graphic than it is in the 1975 film.

We see several lobotomies over the course of the series, first as a trepanation in which a hole is drilled into the human skull, and later with an ice pick hammered in through the eye socket.

Both were real, but fortunately the barbaric procedure is no longer used in treating psychological problems, with the last recorded lobotomy in the US taking place back in 1967.

In Ratched, Dr Hanover references António Egas Moniz, the neurologist who initially developed the lobotomy, believing that mental illness originated from abnormal connections in the frontal lobe.

Howard Dully, who survived a lobotomy from notorious specialist Walter Jackson Freeman, recalled feeling like a “zombie” after the procedure in an interview with The Guardian.

Radical deterioration in the personality and behaviour of patients was a frequent outcome of the surgery, but it was deemed a worthy compromise for treatment of mental illness.

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Ratched is available to stream on Netflix from Friday 18th September. Looking for something else to watch? Check out our guide to the best TV series on Netflix and best movies on Netflix, or visit our TV Guide.