Podcast: Reviewing Netflix’s Ratched



Have you seen the Netflix series Ratched? In today’s Not Crazy podcast, we discuss whether the show gives an accurate portrayal of 1940’s mental illness treatments. And to help us out, we welcome Rachel Star Withers, the podcast host of Inside Schizophrenia and a person who lives with schizophrenia, to discuss her views of the show.


Are the lobotomies and hydrotherapy treatments portrayed in the show realistic? Did doctors really do lobotomies on children? Join us as we take a deeper look into this popular miniseries.

(Transcript Available Below)

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Guest Information for ‘Rachel Star Withers- Reviewing Ratched’ Podcast Episode

Podcast: Reviewing Netflix’s Ratched 2

Rachel Star Withers is an entertainer, speaker, video producer, and schizophrenic. She has appeared on TV shows including MTV’s “Ridiculousness,” “TruTV,” “America’s Got Talent” and is the host of “Insanity with Rachel Star” on Amazon Prime. She grew up seeing monsters, hearing people in the walls, and intense urges to hurt herself.

Rachel creates videos documenting her schizophrenia, ways to manage and let others like her know they are not alone and can still live an amazing life. She has written Lil Broken Star: Understanding Schizophrenia for Kids and a tool for schizophrenics, To See in the Dark: Hallucination and Delusion Journal.

Fun Fact: She has wrestled alligators.


About The Not Crazy Podcast Hosts

Podcast: Reviewing Netflix’s Ratched 3

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.





Podcast: Reviewing Netflix’s Ratched 4

Lisa is the producer of the Psych Central podcast, Not Crazy. She is the recipient of The National Alliance on Mental Illness’s “Above and Beyond” award, has worked extensively with the Ohio Peer Supporter Certification program, and is a workplace suicide prevention trainer. Lisa has battled depression her entire life and has worked alongside Gabe in mental health advocacy for over a decade. She lives in Columbus, Ohio, with her husband; enjoys international travel; and orders 12 pairs of shoes online, picks the best one, and sends the other 11 back.



Computer Generated Transcript for “Rachel Star Withers- Reviewing RatchedEpisode

Editor’s NotePlease be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Lisa: You’re listening to Not Crazy, a Psych Central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts.

Gabe: Welcome, everyone, to the Not Crazy podcast, I’m your host, Gabe Howard, and with me, as always, is Lisa Kiner.

Lisa: Hey, everyone, today’s quote is by Bell Hooks. Movies do not just mirror the culture of any given time, they also create it.

Gabe: I’ve always really liked that quote, but I wonder, did she say anything about Netflix streaming?

Lisa: I think it’s assumed.

Gabe: Is it assumed? I mean are? Do you remember when we were younger that there was a really big demarcation between movies.

Lisa: Mm-hmm.

Gabe: And television? And you’re right, it has all sort of blurred together. But I suppose for Ms. Hook’s purposes, what she means is the things that we consume in popular media, like in movies, either reflect culture or create culture.

Lisa: Or do both.

Gabe: Ooh. One of the coolest things about hosting multiple podcasts on the Psych Central Network is I get to work with a lot of really cool people. And the other day when I was working with Rachel Star, who is the host of Inside Schizophrenia, a very, very cool podcast, I recommend that you check out. She said to me, Hey, Gabe, have you seen the new Netflix miniseries Ratched? And I said, No, what? What’s that? And she said, it’s the show on Netflix that is a prequel to One Flew Over the Cuckoo’s Nest. And I was like, oh, my God. You mean Nurse Ratched, like the most evil iconic nurse ever from pop culture? And she’s like, yeah, it’s that she goes, I liked it. You should check it out. And I was like, All right, well, that’s weird because we tend to look at her, and that movie is very, very evil and villainous. But from a mental health advocacy standpoint, we just tend to look at it is as like an example of what not to do. But, you know, I found on the back of my mind and we went on and we worked a couple of days later, my dear co-host Lisa, who we all know and love because we’re currently on her show, said, hey, Gabe, have you seen the Netflix miniseries and prequel Ratched? And I said, you know, Rachel was telling me about that. And Lisa was like, I hate it. It’s awful. It’s mental health advocacy back like thousands of years. It’s evil. I can’t believe that they did this. And I was like, OK, those are two very extreme views. So I thought, hmm, what can I do with this information? What can I do with two people with differing opinions? I can put them on a podcast. Rachel, welcome to the show.

Rachel: Hey, what’s up, Gabe and Lisa?

Lisa: Hey, it’s good to have you here.

Gabe: Well, I’m very, very excited about this because I have not seen the miniseries like full disclosure, I have not seen it. I am the moderator and no doubt opinionated observer.

Rachel: Not sure what you’re waiting on, I mean, it came out like a little bit ago.

Lisa: Yeah, plus, you knew this show was coming, so

Rachel: Yes.

Lisa: It’s not like you couldn’t have been prepared.

Gabe: Rachel, you live with schizophrenia, like we should establish a couple of bona fides right now for potential reasons that maybe you saw it through different lenses, you, Rachel, as you live with schizophrenia.

Rachel: I do. It lives in the back.

Gabe: It’s like a roommate that you can’t kick out, no matter how hard you try the eviction courts, they won’t hear the motion.

Rachel: Yeah, she’s cool. It’s all right.

Gabe: It’s fine. You’ve gotten used to her

Rachel: Yeah,

Lisa: She’s hardly ever home.

Rachel: Yeah.

Gabe: So, as I said, Rachel is over on the living with schizophrenia side. And then Lisa, her advocacy has taken just like I mean, it’s like a blob, right? It’s not a straight line at all. Lisa’s done caregiver advocacy. She’s done family member advocacy. She’s saved my life. She lives with depression. She’s done certified peer support in the state of Ohio. So Lisa’s coming at it from, well, frankly, like 800 different directions, which is very different from the specific advocacy and lived experience of Rachel. And the fact that they’re so different is why I thought that this would be an interesting conversation. Just FYI, there’s spoilers, you’ve been warned.

Lisa: We don’t necessarily want you to stop listening to go watch it, but maybe.

Gabe: Rachel, I want to ask you the first question since you brought this topic up. You really are on that you thought it was a reasonable portrayal of mental illness. In what year was this show set in?

Rachel: I think it’s set in the 40s. I don’t think it’s a reasonable portrayal of mental illness. I think it is of the treatments of that time. I think this is the most realistic, like I’ve ever seen portrayed as far as lobotomies. They actually do hydrotherapy in it; which I know I’ve never really seen. I have it in any movies or stuff and how intense certain things are. And they show actually two different types of lobotomies in great detail. Kind of like you’ve never seen them before. I mean, I’ve read about them. I’ve seen diagrams. But the show, which I wouldn’t say can get kind of gory at parts. It’s a pretty realistic thing. What they show drilling into the brain by hand, the icepick like it’s all pretty. And he’s talking his way through it like it’s very impressive from like especially if I was like a psych student. Yeah. Seeing like, oh, wow, that’s OK. That’s exactly what happened there.

Gabe: I have a follow up question to that, but, Lisa, I want your impression, did you think that it was a realistic portrayal of medical treatments in the 1940s?

Lisa: Sadly, probably, yes, it probably is, in fact, a realistic portrayal, but it was set up like it’s not supposed to be, I half thought it was a hallucination for the first couple of episodes. So it was set up as if the characters didn’t think it was realistic. The characters are play-acting, so I just found it confusing.

Gabe: Ok, so confusion aside, I remember when the movie Saving Private Ryan came out in the 90s and people said that this was the most realistic portrayal cinematically of war. You know, they had people getting shot, people talking to their friends and their friends, getting their heads blown off while they were talking to them, just carrying on. And they felt like this did an excellent job of showing the horror show of what it was like to storm the beach at Normandy. And now and I’ve never been in war, so I can’t compare just I’m assuming, Rachel, you’ve never had a lobotomy, so you can’t compare. But I think Rachel and please correct me if I’m wrong, your point was, look, if you got a lobotomy in the 40s and you were standing in the corner of the room, this is what it looked like.

Rachel: Yes, and Ratched is made by the same people who do American Horror Story. So you have to understand, like, yes, you still have some kind of cinematic horror to it. What I liked about Ratched is that there’s no ghost stuff. The scary characters in it are not the people with mental illness. It’s the people like what’s happening, there is no set bad character. You end up kind of seeing the human side of each. One thing I liked is with the lobotomies, the people they did it on, they weren’t just zombies afterwards. One of them like was a kid, which I didn’t realize. I thought there’s no way they would have done a lobotomy on a kid. And then I researched. I was like, oh, wow, no lobotomies were mostly done on women and quite a few children. So that was a pretty normal thing. But yeah, you would be talking afterwards. You could still hold a conversation. Some people some of them did go like brain dead, though, but I’d never seen that. Usually we see, you know, the One Flew Over the Cuckoo’s situation where he’s like dead at the end. 

Gabe: Right, he just like laid there.

Rachel: You never really see someone be OK from it and continue on with life.

Gabe: Lisa, did you get the same impression?

Lisa: Now that you’ve said some of this, Rachel, I guess I am thinking about it a little bit differently. I had trouble looking at it as a realistic portrayal of treatments because I felt like it was such an unrealistic portrayal of the staff and the characters. And like you said, the bad people, the villains are not the patients. Always a nice twist in a movie, by the way. But, yeah, if you look at it isolated as this part of it, has this special realism or even horror. Yeah, OK, never mind. I take back my previous objection and agree with what Rachel is saying now.

Gabe: Just like that,

Lisa: Well, the other thing.

Gabe: Rachel, Rachel, I’ve been trying to do this for 25 years, to have like one succinct argument that Lisa was like, all right, Gabe, I have suddenly been enlightened to your way of thinking. Arguing is over. Let’s have a nice day. What did you do? Rachel is the Lisa whisperer.

Lisa: The one part I did really like was, like you said, where they showed these people as being functional afterwards and some of them were not, but a couple of them were. And also there’s this wide variety of people that they’re doing lobotomies on, ranging

Rachel: Yes.

Lisa: From the people who were clearly very, very ill to people who you’re like, you know.

Rachel: Yeah, one was a lesbian.

Lisa: Well, one was a lesbian.

Rachel: But that’s representative of the time, was they consider that a mental disorder.

Lisa: Yeah, and then, of course, one was pushed entirely by family who didn’t like the way that he was. So there’s also this idea of people with mental illness not being in control of their own lives because they’re so overburdened by their families or the state as a whole.

Rachel: Yeah, none of them the way it portrayed them were like just these crazy people, like attacking, biting,

Lisa: Right.

Rachel: You know, drooling in the corner. All of them were, I don’t say normal, but, yeah, you could easily be like, OK, this person is like a problem or two. But I would never think this is how we’re going to fix it.

Lisa: Yeah, they don’t have a problem so serious, they need brain surgery.

Rachel: Correct, yes, that would never occur to you.

Gabe: It sounds like what you’re both agreeing on is you like that the villains were not the mental patients. Like that’s what we normally get in these things, right? It’s just that the patients are the villains. But then who was the villain?

Rachel: Well,

Lisa: Well, it’s an anti-hero.

Rachel: Yeah, and I’d say like each one had good and bad. The doctor in it, good and bad. And what I appreciated with that, there were some intense scenes with him throughout the season where all he wants to do is help, you know, and you’re just like, OK, well, I just watched you put an ice pick through someone’s eyeball, but that’s what he thought was helping at the time. And some of the other things that they show you’re watching like that obviously could never help anyone. You’re torturing them. But the way he’s talking is I want to make a difference. I want to help. And it’s just that kind of warped view where you kind of feel like, oh, man, you know, this guy feels for these people, but he’s also destroying them. So many of the characters were like that. They would have humanity, but at the same time turn around and do something you just couldn’t believe.

Lisa: He was wrong, but sincere.

Rachel: Yeah, misguided, none of it was hahaha . . . Let’s see what happens when a pop an ice pick through someone’s eyeball.

Lisa: Yeah, he wasn’t just torturing for no reason.

Gabe: But no, no, wait a minute, though, I recognize that I haven’t seen it, I apologize, but didn’t he like sew a dead person’s arms onto a living patient after he cut off the living patient’s arms?

Rachel: You see now, Gabe, you haven’t watched it, so it’s hard for you to make that argument. So the scene your referring to is pretty much he gets poisoned, but it is showing something that they really used to do where they would give patients LSD before therapy sessions. And this is something that I don’t think has ever really been shown in any movies or TV shows, with the exception of documentaries, where they used to give LSD to different people with mental disorders, thinking that would make them, I don’t know, be able to talk better in therapy. 

Gabe: But they cut off the arms.

Rachel: Yes, that’s true.

Lisa: Well, but that’s coming back around.

Rachel: Mm-Hmm.

Lisa: Right?

Rachel: Yes.

Lisa: That’s something people are doing again.

Gabe: Nobody has answered the arms, the arms.

Rachel: I just, well, I don’t want to ruin the show for them, that’s like a huge spoiler. I mean,

Gabe: All right.

Lisa: I found that very disturbing as a scene.

Rachel: It is yes, this is not an easy to show to watch, I would say has lots

Lisa: No.

Rachel: Of trigger warnings. It’s actually

Lisa: Yeah.

Rachel: Been petitioned by Netflix to have some sort of like beginning part because like the first scene of the season is incredibly disturbing and gory.

Lisa: Yeah, it’s very graphic and it was very disturbing. But that was also, I thought, a good part because it’s showing that there’s these horror elements to things that really did happen.

Rachel: Yes, that was one of my favorite things is just pretty much the realistic horror of it. Just watching it is intense and you’re like, but then you realize, oh wow, these were actually procedures done on people, you know, and there is no ghost running around. There is no person trying to, like, attack you from the corners.

Gabe: Did anybody in this show actually have a real mental illness? You talked about the woman who is a lesbian, etc.?

Lisa: Well, but the whole point is that mental illness is culturally constructed. So here are these people that have, for example, lesbianism, which we do not consider to be a mental illness, but was very much treated as one in 1947. That’s part of the appeal of the show, this idea that mental illness is arbitrary and some of these people are just victims of the larger perception of society.

Rachel: Because if you go ahead and you look up the show, it’s going to say serial killer because yes, the very first scene is a serial killer. What I appreciated about the show and this isn’t spoiling anything, is that at one point someone pretends to be a schizophrenic to pretty much say this is why they killed all these people. And the doctor calls them out. And there’s a really great monologue where the doctor calls and just says, OK, you’re exhibiting all these different signs, but to perfectly like you’re playing. And I can tell you’re playing. You’re pretending to say you’re this is why you did all these horrible things. And I really like that in the show. They never actually have any schizophrenia represented throughout, or at least I did notice that they did. But I really love his monologue because I think it’s important because so many people think, oh, gosh, serial killer, they must have been schizophrenic.

Gabe: And it also points out that a doctor can catch it, right? There’s this sort of misconception in society that all you have to do is pretend and the doctor will just be handcuffed and have to give you the diagnosis.

Lisa: First, we think, oh, he’s just evil, he’s just a serial killer, he’s just a bad person, but of course, later on we have more backstory, we have more explanation. And going back to your thing about how the mental patients are not the evil ones or the scary ones or the villains, it turns out all along he wasn’t the evil one or the other. And these are spoilers. And this is just your own problem, you should watch the show. So he’s not evil or the villain. But everyone looks at him as if he must be violent for no reason, because after all, he’s mentally ill. And what other explanation could there possibly be? He couldn’t possibly have a valid reason for this violence or even any reason for this violence. It must just be because he’s crazy. There can’t actually be any backstory to it. 

Rachel: One thing I will throw out that I loved was, not the main character, Nurse Ratched, but there was a separate nurse who’s very much seen as, you know, a villain. But you definitely are on the line of understanding because she follows out the orders exact. If they tell her to do something, she does it. Exactly. And it really comes off as torture. And later on, she makes a comment where someone is refusing to do the treatments and she’s like, well, that’s the difference between being a real nurse. You can’t have compassion if you want to help a person. Sometimes helping them hurts them to get there. And I just thought that was really important. You know, when you think about hospital situations and things that have to happen, things you have to do. And I was like, yeah, that’s a really good point. As a nurse, it’s not my job to question what the doctor says. I mean, no one wants to go through a surgery, and thinking back to those times, she wouldn’t have been trained to do differently. Her job is to do what the doctor says and he’s trying to help them. And so is she.

Gabe: But it really sounds like you’re trying to make Nurse Ratched out to be not evil, she’s evil. She’s

Rachel: No, no

Lisa: No, no.

Rachel: And I don’t think she was evil in the original movie, either.

Gabe: Society agrees that the bitch is evil

Rachel: No, 

Gabe: Really?

Rachel: No, she’s not.

Lisa: She wasn’t evil in the original movie you don’t think?

Rachel: No,

Gabe: She was evil as hell.

Rachel: No, I watched the movie right before the show, not on purpose, I didn’t realize this was coming out. I didn’t realize that’s why Netflix was pushing One Flew Over the Cuckoo’s Nest.

Gabe: She just accidentally watched One Flew Over the Cuckoo’s Nest.

Rachel: I did.

Gabe: You know how you do that. You’re minding your own business, an iconic horror movie comes on.

Lisa: Had you seen it before?

Rachel: Yes, but like so long ago.

Lisa: Because I would think that would be very, very triggering, frankly, I mean, why

Rachel: No, because it

Lisa: We all know One Flew Over the Cuckoo’s Nest is about, you know, why do that to yourself?

Rachel: But it’s because I watch him, and especially if you watch it in today’s terms, you really dislike them. I forget that actor’s name, but you really dislike his character. At one point. I mean, he raped 15-year-old girls

Lisa: Jack Nicholson.

Rachel: Yeah, that’s like a major plot point. One of the reasons the nurse is, like, so protective and there was other things that

Lisa: Oh,

Rachel: He did.

Lisa: Good point that, you know, that gets left out,

Rachel: Yes.

Lisa: Doesn’t it?

Gabe: Yeah,

Lisa: It gets glossed over

Gabe: We see him as a victim.

Lisa: Oh.

Rachel: Right. And they’re saying this woman is doing all these mean things and you’re also watching like, well, no, she has a very specific schedule set out for these people. And he’s trying to actively disrupt these people’s treatment like it’s always about him.

Gabe: Or he’s trying to allow them to live their life in this culturally constructed thing where they’re not, I mean, these men aren’t even allowed to talk about women without

Rachel: No,

Gabe: Getting messed up.

Rachel: I’m going to say he wants them to live his life, it’s what he thinks. He wants to watch the baseball game so everyone has to watch it because that’s what men do. We watch baseball games. We hang out together. We go drinking. Yeah. And you have these people who are there for a lot of serious reasons who probably shouldn’t leave the mental ward for a day to go sailing around the ocean getting wasted.

Gabe: Oh.

Lisa: But in One Flew Over the Cuckoo’s Nest, she’s not really a person, you know, she’s the representation of institutional apathy or institutional violence.

Rachel: Yes.

Lisa: She’s not really meant to be a human. She’s just an archetype.

Rachel: And I feel it’s also kind of like following orders You know, nothing she does in it is illegal, is bad. She’s literally just following orders to a T. Everyone in the movie who doesn’t follow orders ends up screwing everything up. There’s like the night watchman who they end up having this huge party with and everything. And you’re like, oh, well, that’s because he let them party. Again, people in severe mental health hospital situations don’t need to be partying, you know, but it’s easy to watch and be like, man, they’re so mean for not letting them have a good time. It’s like, yeah, they’re also really drugged up. And I think watching the show Ratched, I personally thought they were going out of their way to kind of like reshow lobotomies. Because I do know that electroconvulsive therapy, lobotomies were pictured so bad in the movie. And that’s done like a horrible stigma for ECT. There is no ECT in the Netflix show, but it’s all in that same vein. I just really like that they showed the characters with lobotomies a whole lot better. Like you’re not just this drooling blob. It wasn’t just like a torture. Like we’re going to give this person a lobotomy because haha I can’t deal with this attitude.

Lisa: Which is the way that psychiatric

Rachel: Yeah,

Lisa: Treatments are often portrayed in movies

Rachel: Right.

Lisa: It is done specifically as a means of torture. There is no thought that this might

Rachel: Correct,

Lisa: Be beneficial or a treatment.

Rachel: Yes.

Lisa: And you have a good point about if you looked at, oh, we’re going to we’re going to cut into your flesh and reread your organs. Oh, is that a horror movie? No, that’s a hospital, because that’s what medicine does, because, like you said, it has to hurt to help. Well, that’s what these people thought they were doing. Of course, I would argue that that’s kind of like a whole. Oh, I was just following orders thing. I don’t know that absolves you of moral responsibility, but that’s an interesting point.

Rachel: No, I agree, but I also think, you know, then the time, you know, you have someone, the nurses literally I mean, what medical knowledge do they have? You’re still in the dark ages of so much and you have a lot of people who are, hey, let’s see what happens when I do this.

Lisa: Well, and at the end, they even have the nurse saying, hey, here comes all these new treatments. Wow, I just I can’t even believe some

Rachel: Yeah.

Lisa: Of the things we used to do. I just look back on that and think, oh, my goodness. 

Rachel: Yeah, yeah.

Lisa: Like you said, she’s trying to do the best that she can, or that she’s doing the best that she thinks she can. People often talk about One Flew Over the Cuckoo’s Nest as stigmatizing ECT, which many people think has legitimate medical value and is still done today, etc. 

Rachel: I’ve had it.

Lisa: I didn’t know if you wanted to talk about that.

Rachel: Oh, that’s good, because I always stress that because it causes so many issues, so many people are against ECT. And for me, it was a lifesaver.

Lisa: Really?

Rachel: It’s not for everybody, but I wouldn’t be here had I not had it. And it is always on the docket, like I have no problem having it again, although it’s not a first line of defense. But yes, in the original movie, it’s shown pretty much as a torture mechanism. And even the show Stranger Things just I guess maybe two or three seasons ago, it’s a huge plot point where they use it literally as torture and to erase people’s memories, not as, OK, let’s help this person. That we’re trying to help this person with depression. It’s oh, man. We need to, like, just figure out how we can erase brains and, oh, you didn’t want to do this? Well, let’s turn up the electricity. You don’t just like that. I mean, I’m sure it did happen, but that wasn’t the point. To try to just torture people.

Gabe: I mean anything can be used to torture, right?

Rachel: Correct, yeah.

Gabe: I mean, you know, having your leg cut off, if it’s gangrene or has a flesh-eating bacterium, it’s going to ruin the rest of the body that that is, in fact, something that is medically necessary for some people. We’ve seen it in in trauma surgery. But you can also cut off somebody’s leg just to torture that which we’ve seen in many horror movies. I think the difference is society understands the difference between the medically necessary leg removal and the torture leg removal, whereas society doesn’t understand the medically necessary ECT and the torture ECT. They just think that it’s all the same.

Rachel: Mm hmm.

Gabe: So that’s like a society issue, right?

Rachel: Yeah, and I really felt that that was in the same vein, though, with the lobotomies, I’ve never seen them portrayed as, OK, this is really going to help you guys.

Lisa: Well, but ECT

Gabe: Ok.

Lisa: Is still done today and, you know, health people, et cetera, what about lobotomies? Is that something we should bring back or investigate more, or is that something we should just put back in the trash of history?

Rachel: We still do it, although it’s done completely differently and isn’t referred to more as lobotomy, but they still have psycho surgeries, there’s actually a similar surgery that it’s done for epilepsy where they separate some of the lining between the brain and basically a lot of people who have very severe epilepsy that somehow prevent seizures. So we still do these types of things. They’re not as archaic as they used to be. No one’s pulling out an icepick. No one’s getting a hand drill and crunching in there. You know, we have lasers. We had things like that. And you wouldn’t think of them today as being, oh, God, I can’t believe they did that to you. It’s oh, wow. That seems like a really scary surgery. But, you know, you’ll be good.

Lisa: That is a very interesting way to look at it, because, yeah, isn’t all surgery that way.

Rachel: I mean, you think about like getting your eyes laser

Lisa: Yeah.

Rachel: Surgery for your eyeballs. Cutting into your eyeball with lasers like that sounds horrific. Like that blows my brain. How do you do that? And you think if they were pulling out knives, doing it, you might be like, whoa, wait a minute, that’s a little bit more intense, but it’s the same exact thing. I have no clue. But

Gabe: It’s

Rachel: Yeah.

Gabe: Fascinating, though, because when I had laser eye surgery, I told everybody I was like the evil villain that lives in the lair in the mountain, shot me in the eyes with a laser, and I was so strong, I just corrected my own vision and then took them down. So, I think people get the idea of this idea that being shot in the eyes with a laser can be scary. And it was the stuff of James Bond movies and, you know, other movies that had evil people living in island mountain lairs. But they didn’t think the doctors were evil for doing it because they looked a little further. Do you think that one of the things that maybe this show portrays well, is this idea that we need to look a little further at why we’re doing these things rather than just paying attention to the thing that’s being done?

Rachel: Absolutely. Go back to you have to make money off shows, there has to be a reason people watch or then you’re sitting around with the documentary and it’s not as interesting. So, I say, you know, there’s a good and bad when it comes to media portrayals. There’s only so much you can do to get people to watch it and still be like friendly to everybody.

Lisa: Well, it’s the same way that all hospital shows or doctor shows are so dramatic and so over the top and or police or crime dramas, no one actually behaves that way, thank God. But otherwise it’s boring 

Rachel: So much paperwork, you’d be watching them just filling out, you know, oh, God, we ran after that guy. I had to fill out 10 pages here till what I put in. I said I can’t do overtime. So actually, I’m off the case, guys.

Gabe: And of course, when you run after the guy, that that’s all it is, you just you just ran after a guy. There’s no bullets flying. There’s no guns out. There’s just it’s just a boring foot chase that you have to answer a bunch of questions about, fill out a bunch of paperwork and then, you know, Book ‘em, Danno, I guess maybe I guess they did make booking exciting back in the 80s anyway. But you’re right, police work is ultimately boring, but they portray it on television as this very high stakes, life threatening, bullets flying, need military. In reality, it’s just a person walking around.

Lisa: Well, but this is one of the reasons why we have these problems, because we all look at the popular perception of it in media and think, oh, look, police officers are under constant threat. It makes sense that they need a tank.

Gabe: Ok, well, are we looking at people with mental illness as a constant threat, so they need a lobotomy?

Lisa: Maybe. Isn’t that the way they’re always portrayed on TV as violent and scary?

Gabe: That is true, but aren’t they portrayed on Ratched as violent and scary? 

Lisa: No.

Gabe: Are they portrayed as, like, kind? Do you want them to come over for coffee with your kids?

Lisa: Yes,

Rachel: Well, yeah, some you’re watching,

Lisa: Yeah,

Rachel: You’re like, why is this person there?

Lisa: And the answer is because they have no power in society and they’re trapped.

Rachel: Yeah, one is ADHD, and, you know, they’re acting like it’s so crazy that this boy’s, you know, easily distracted. We got to do a lobotomy and you’re just like, well, no, I really think that’s a 

Lisa: Oh, this is so terrible, this is so serious. Yeah.

Rachel: That’s what it seems like, a jump that the 12-year-old has distracted thoughts and he’s not even like crawling up the walls as they’re talking. He’s acting like a 12-year-old.

Lisa: And the point being that he has no power or agency, he’s trapped

Rachel: Mm-Hmm.

Lisa: by his parents and what they decide for him.

Rachel: Yeah, what they decide is uncontrollable.

Lisa: Right. And who gets to define such a thing? 

Gabe: We’ll continue this discussion in a minute and we’ll be right back.

Gabe: We’re back with the host of the podcast Inside Schizophrenia, Rachel Star, discussing the Netflix series Ratched.

Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player.

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Lisa: I was actually thinking about what you said earlier, about there’s no horror, there’s no supernatural element. But I kept waiting for there to be. 

Rachel: Yeah, they definitely play it up.

Lisa: Right, I’m waiting for there to be ghosts or demons

Rachel: Yeah.

Lisa: Or, oh, is she possessed? What is it? Because isn’t that the way asylums work? I mean, when you’re on TV, all asylums are haunted. That’s what asylums are. Another statement about the popular perception of these things that, oh, obviously, there must be demons involved.

Rachel: Yeah, there has to be some dead patient ghosts that are like hanging out.

Lisa: Right, exactly.

Rachel: I mean, although I got to say, though, that if you watch the show, it is visually stunning.

Lisa: Oh, yeah, that was the best part.

Rachel: Oh, it’s so colorful and stunning, and then you’re like, this hospital is gigantic and there’s like, what, five patients?

Lisa: Yeah.

Rachel: That was my bag. It’s like, how is this place open? I’m very confused. I mean, they’re talking about shutting it down. I’m like, well, clearly you guys need to. Literally five patients.

Lisa: I know. You’re maintaining all of this? How many beds do you have?

Rachel: Yeah.

Lisa: There’s only like four people here.

Rachel: You got like a whole wine cellar that you keep one guy in, like, why do we have a wine cellar in this hospital that apparently stretches for miles? Watching the show visually is just stunning. The way they do all the colors and

Lisa: Yeah,

Rachel: The sets is just incredible.

Lisa: The first couple of episodes, I really thought, wow, I could watch this just for the clothes.

Rachel: Yes, even if they’re covered in blood.

Lisa: Well, yeah, yeah, well, it wasn’t a perfect system, but

Rachel: Yeah.

Lisa: It just yes, the cinematography was amazing. And again, like I said, because I’m expecting some supernatural of into it, I thought, oh, that’s why the colors are so saturated,

Rachel: Yes, and almost like a dreamlike state, like you were saying earlier, you weren’t sure yet? No, it does come off very dreamlike.

Lisa: I was watching this with my husband, and I kept saying to him, I’m telling you, I’m telling you this is going to be a dream. This is a hallucination. This isn’t real. And again, spoiler alert. That is not how it went. And that is a change because, of course, obviously, if you’re having a show about psychiatric patients, it must be because it’s not real.

Rachel: As I said, this is made by the same people who do American Horror Story. They also did Scream Queens, they did Nip/Tuck. I mean, so many different shows that have some very gory parts to them, but especially American Horror Story. And that’s definitely a huge trigger type show. Each season is set differently. And it’s funny because the second season takes place in an insane asylum. And that’s my favorite. And everyone’s always shocked because they would think Rachel seems like that would be the one you definitely don’t like and you would have a problem with. But I really think it’s a great representation minus all the supernatural, because they have a ton of demons and aliens and ghosts and everything you can imagine. But I think it’s a great representation because insane asylums used to be run pretty much by churches. That was who it was. You’re going to be looked over by priests and nuns. So how are they going to treat you?

Gabe: How are they going? I mean, I think that’s an excellent point, how?

Rachel: Yeah, God, so you’re going to have a lot more demon possessions, you’re going to have a lot more starving people things because they didn’t have medications, like how are they supposed to treat you? And they’re very much overrun with people just dropping off every ailment you can imagine. And the family just abandoning them.

Gabe: My wife back talks. Here, fix her. My wife won’t clean, I mean, and these are

Rachel: Yes.

Gabe: These are true stories, right? I mean, just husbands who would get tired of their wives would drop them off. This is excellent because I never thought about the idea that in early mental illness advocacy or intervention, it was largely driven by the church. And we had medical doctors who we assume have some sort of science background with religious leaders who we assume are going completely from, you know, biblical teachings or, you know, prayer, faith, etc. and those two get together. And I guess lobotomy is the only result? Is this portrayed in the show, this idea that religion is driving a lot of this?

Rachel: Not in the new Ratched show I was just referencing yet, that American Horror Story, that that line very much, I think in its 20s or 1910s or something, but it’s even set before that Ratched is in the 40s, I think.

Gabe: So in a way,

Rachel: Ratched, not ratchet.

Gabe: It’s Ratched, yeah,

Rachel: Sorry, I keep saying ratchet. When I first saw the name, I was not expecting this to be the show I

Gabe: Yeah, that word means something different now,

Rachel: Yeah.

Gabe: But it sounds like what you’re saying, based on their body of work, that their thinking has evolved or at least their portrayal has evolved because they used to portray mental illness as supernatural, then they portrayed mental illness as, you know, like Freddy Krueger horror movie. And then they portrayed it from the lens of we have to, you know, pray the mental illness away. And now they’re portraying it from early medical intervention and using science. So if you look at their entire body of work, they’re giving you a history lesson with, like, colorful costumes and probably a cool background soundtrack.

Rachel: So cool.

Lisa: The soundtrack was also very good.

Rachel: Yes.

Gabe: Is that what you’re saying, though, I mean, is that.

Rachel: I think it’s an evolution. I could easily see this being like part two of that American Horror Story season, the kind involving the asylum.

Lisa: I have to watch American Horror Story then.

Rachel: Oh, you’ve never seen it? Oh, my.

Gabe: And the American Horror Story that you’re talking about, is season 2, right?

Rachel: Season 2, yes, each season is a stand-alone story.

Gabe: Also, a series I’ve never watched, however, I did watch Nip/Tuck because I was dating this woman at the time who loved Nip/Tuck and there was no DVR. So when it came on, we had to drop everything and watch this thing. She loved it. Crazy woman. I forget her name.

Lisa: Oh, I loved Nip/Tuck. I don’t remember the name of that actor, but he was so hot.

Gabe: You said that constantly, it was not annoying at all.

Rachel: The blond one or the brown haired one? Aaron Eckhart, I think was the blond, that I liked.

Lisa: No, no, the dark haired one, Christian Troy, he was the hot one.

Rachel: Oh, Christina, yeah.

Gabe: You would say he’s hot.

Rachel: That’s who my mom liked.

Lisa: Yeah, right.

Gabe: And I would say, why are you saying that? And you’re like, Oh, it’s OK, he’s a doctor. And I would say he’s fake. And you’re like, look at that. Look at his shirt is off again. He interviewed the babysitter with no shirt on. Who does this?

Lisa: Well, he would later have an affair with that babysitter.

Gabe: Yeah, he would later have an affair with this.

Lisa: Hmm.

Gabe: I have tried to emulate this behavior. Didn’t work.

Rachel: I mean, if you got it, flaunt it. Why am I wearing like six layers if I if I got this sweet pecs?

Lisa: Exactly, you know how hard he works on those?

Rachel: Yeah.

Lisa: He’s just going to hide those?

Rachel: Yeah,

Lisa: No, I don’t think so. That’s just dumb.

Rachel: It’s like driving a flashy car.

Lisa: Rachel’s so wise.

Gabe: But Nip/Tuck, though, was about plastic surgeons, right, it had it had no mental illness involved at all. Right. Nice trip down memory lane, but not mental illness related.

Rachel: Yes,

Lisa: Another thing I thought was interesting about Ratched was many of the patients were there voluntarily. And we’ve all been trained to think of mental hospitals or asylums or psychiatric hospitals as being these incredibly scary, horrible places. Why would you ever go there voluntarily? They are places to be avoided at all costs, but here are these people who are so desperate that they’ve shown up. So even though they’re scared, they’re very, very sick and desperate to do whatever it takes.

Rachel: And a lot of it was very family oriented, the family is the ones being like, this person needs help. And the person sitting there like I mean, I guess, you know, you kind of like want to question, like, if I was in that position, you know, and my husband is dropping me off there because I talk too much or I’m interested in women and that seems really bizarre. Or I’m dropping my child off because he’s the only kid that won’t sit still in class and everyone’s telling me he’s weird. Where’s the line on things? So, it just makes you think like I feel like a lot of the characters, you could be like, oh, I know someone like that.

Lisa: There are a couple of characters that were clearly just suffering so much and they had such faith.

Rachel: Yes, they were desperate.

Lisa: They were desperate. They tried everything else. They were hopeful that this would be the answer. They tried all these other things. This is going to be the one. This is going to be the thing. Science is going to save us.

Rachel: Yeah, I don’t think there’s any involuntary treatment being like they signed up for everything they did, no one was like, you have to have this lobotomy. They pretty much knew what they were signing up for.

Lisa: Exactly.

Rachel: They might have regretted afterwards, but they definitely went in knowing what was going to happen.

Lisa: We couldn’t exactly call it informed consent because they didn’t understand the consequences necessarily, but they did know the specifics of the procedure and they consented to this because they were desperate. Especially the first two people who got lobotomies, because one of them is clearly supposed to be coded as bipolar and you just felt so much sympathy for them. She’s so desperate, she’ll do whatever it takes.

Rachel: One thing that’s had a lot of blowback is the character Charlotte, that actress was incredible. I thought she like blew away all of her scenes. But the way they show dissociative identity disorder is the big blowback the by. That’s all incorrect. And I got to be honest, I did some research and I could find every reference that they did. I could find there being a basis for it. So, I don’t know. I know that’s a that’s something that’s going through saying that they did that wrong, that her character is just a horrible representation. But that’s I kind of think what’s so interesting is you’re watching it and you’re not really sure. Is she real? What’s happening here? Is she faking? Is she not faking? It’s just very confusing to watch her. 

Lisa: So dissociative identity disorder previously called multiple personality disorder, which I am not a big believer in, but the thing I did like about the character was that she comes to this through trauma.

Rachel: Yes, she very much so wants to be helped. I mean, this isn’t someone who’s like a crazy serial killer running around killing people and, you know, we have to stop her. This was a woman who is clearly sad and upset and she’s like, I’m losing my life. Please help me. Please do whatever you have to do to help me. And regardless of what the disorder is, she’s a powerful character that she wants her life back. She’s not trying to hurt anybody. She just wants

Lisa: Right,

Rachel: To be normal again.

Gabe: So what is the takeaway? I mean, obviously, it’s entertainment. I think we can all understand that the goal of this was entertainment. But is there a silver lining that people watching this will understand the plight of people living with mental illness better? Rachel, what are your thoughts on that?

Rachel: Right after I watched it, because I had never seen portrayals of lobotomies that way, I immediately started Googling lobotomies because I thought the whole scene with them doing it on kids, I’m like, there’s no way that was a thing. There’s no way they did it on someone because they thought they were lesbian. There’s no way they did it because this person was depressed. And it blew my mind what I read and pretty much how common it was that they got up to the point in history where they were doing lobotomies just quickly in the office. It was great. You didn’t have to go to a hospital. The doctor psychiatrist could do it right there. And you’re out. Like they were trying to make that a thing, like a little McDonald’s kind of situation. Just go and get out. You’re good. Nobody has to do anything except, you know, just pop the ice, pick through your idea when could do it. And I just this was things I didn’t realize about history. The other was the hydrotherapy. I, you know, maybe seen a picture or two in a book before, but I’d never actually seen it portrayed. And that was just kind of crazy. And I was like, I have to Google this because there’s no way they would scald people. Oh, no, they did OK. Yeah, no, that was apparently a normal thing. All right. And for all types of ailments, not just mental illness. So, for me, I learned so much that was different than I’m used to seeing it portrayed. More realistic as far as the not the serial killing. But you know what I mean, not the horror type part that of the show.

Gabe: Lisa, what are your thoughts?

Lisa: I would agree that it was portrayed in a more realistic manner, and I also had never seen hydrotherapy represented, but because it is so surreal and with this otherworldly type thing. So I don’t know that the average viewer is going to say to themselves, oh, my, that’s how it really was. I think they might just think it’s part of the fictional concept of the show. So, hey, people. Yeah.

Gabe: It’s all live, right? Your mileage may vary, I guess.

Rachel: Mm hmm.

Lisa: Well, but if you think about it, that’s the creepy part of it, that you’re thinking, oh, no, this is just for TV, but then you get more information. You’re like, oh, not just for TV basis in real life. Oh, ick.

Rachel: Which is one reason I’ve always loved American Horror Story is that every season they base so much stuff off stuff that happened in real life, which was actually horrific things that happened, people that actually existed, but they interweave it, you know, into their stories and stuff. Going back to asylum, one reason that’s my favorite as you watch it and you think there’s no way this is real and there’s a very powerful episode where the reporter sneaks in and does a report about it all, how twisted everything is. And the fact is that really happened, except it was a children’s hospital. And that’s how Geraldo Rivera is so famous. He snuck in a camera. If you ever watch this video, it’s ten times worse than anything that American Horror Story could have even touched on. You know, and it’s just like these places exist. These treatments exist. Real life is scarier sometimes than the ghost, than an alien ship or whatever, 

Gabe: An alien ship?  What are you watching?

Rachel: American Horror Story has done everything. OK, they hit it all.

Gabe: That’s awesome.

Rachel: If it could remotely be scary, you got like, anything they’re going to go after it.

Gabe: Anything goes, it’s covered. Rachel, we love hanging out with you. Tell us for a quick minute before Lisa and I talk behind your back what is Inside Schizophrenia and why do you host it?

Rachel: If you haven’t it checked out Inside Schizophrenia, it’s not as fun as this show, I got to be honest, Gabe.

Gabe: It’s more educational.

Lisa: I’ve actually really enjoyed it.

Rachel: We don’t have as much fun on that show.

Gabe: Way, way to sell it.

Rachel: It’s really boring.

Lisa: That’s making me want to go watch it right now.

Gabe: Tune in, it sucks, I hate hosting it. What’re you doing? It does not have the same feel, it’s an educational show.

Rachel: Yes, it is a more educational show. I do have schizophrenia, so we talk very in depth about that. But we also bring on a lot of experts, doctors, people who specialize in areas. I love doing the show because to me it’s so interesting. And I know someone out there is like edutainment. That’s right. Some

Lisa: Yes.

Rachel: Great entertainment if you want to hear from, like, some really cool different people that you’re would not normally when you Google mental health news. I’d say we’re not like the typical. 

Gabe: And you can find that over on PsychCentral.com/IS or Inside Schizophrenia on your favorite podcast player. Obviously, the obligatory plug for Inside Schizophrenia hosted on the Psych Central Podcast Network, but what does Rachel Star do? Talk about yourself.

Rachel: Well, one thing I really like to talk about is since COVID happened, lots of kids at home, lots of people don’t have access to mental health and kids always weigh heavy on my heart. So at the beginning of all this, I made a comic book line, a mental health comic book line for kids. The first three issues deal with schizophrenia, depression and ADHD, and they are completely free. So they’re free on Apple Books. I think even the adults would like them. And pretty much each one’s a different little kid who becomes a superhero dealing with their mental disorder. So check it out. 

Lisa: Yeah, they’re adorable. They’re free over on Apple books. The first one is called The Adventures of the Fearless Star and the main character is called Lil’ Star.

Rachel: Yes, yes, it’s actually the whole concept is it’s me talking to a younger version of myself, what I wish would have happened as a kid.

Gabe: Very cool. Well, I hope everybody checks that out. Once again, Rachel Star, everyone.

Rachel: Thank you so much for having me.

Lisa: Thank you for being here, Rachel.

Gabe: Ok, Lisa. That did not go exactly how I thought it was going to go, because when we discussed doing this episode, you said, I’m really worried about disagreeing with Rachel and I don’t want to piss her off. Yeah, you pretty much agreed with every single thing she said which honestly surprised even me. Did you have a change of heart?

Lisa: No, not really, I do agree with everything she said, it’s because when you first discussed let’s do this episode, you said Rachel watched Ratched and says that it’s an amazing fictional portrayal of schizophrenia. And I thought, what are you talking about? I don’t think they’re even are any schizophrenics in that. I don’t I don’t understand.

Gabe: I need to defend myself, I believe what I said is that Rachel said that it was an excellent portrayal of the treatments of schizophrenia, which

Lisa: That’s not what you said.

Gabe: I believe that’s what I said.

Lisa: You said it’s an excellent portrayal of schizophrenia and I thought, what is she talking about? I’m going to have to review this. I don’t think there even are any schizophrenics in this. So I don’t know if I didn’t understand what you said or you didn’t understand what she said or it’s like a telephone lost in translation thing. But no, the thing that you said is completely not what we ended up talking about. I maintain that I was right with the original version of what was happening here. But no, not the actual version.

Gabe: I’m glad that you fought so hard to make sure that our listeners knew that you didn’t agree with me.

Lisa: Well, excuse me for taking you at your word and thinking you knew what you were talking about in the planning stages.

Gabe: Lisa, I know we’ve dropped a lot of spoilers here for our listeners, but if any of them are considering watching it, do you recommend them? Like if you were, if you got to be Siskel and Ebert right now, how many stars would you give it? And do you recommend that they tune in for any reason?

Lisa: Probably not. There’s plenty of stuff on Netflix that’s better. It was vaguely entertaining. I liked the clothes, as we’ve already discussed. I liked the clothes, liked the soundtracks, I liked the set. I like that actress, although I don’t think this was one of her better works. But overall, yeah, I just didn’t really like it that much. And it had so many twists. You were like, what? What? And in terms of, oh, I want to watch this so I can have a better understanding of mental illness. Only if you went in already knowing a whole lot about mental illness. 

Gabe: All right, well, I am so glad that I saved 10 hours by just listening to you and Rachel discuss it, and now I can claim knowledge of something that I did not do and all of you can as well. That is the Not Crazy promise.

Lisa: Again, it had some good parts, it wasn’t completely worthless, there are certainly a lot of worse things on Netflix that you could watch, but there’s a lot of way better stuff too. Especially, like you said, to give up that many hours.

Gabe: It’s also important to remember that Lisa is a middle aged woman, so it is certainly possible that if you trend younger, you might just think this thing is bad ass. It could be Lisa’s advanced age that is causing her not to like the show.

Lisa: How do you know it’s not the reverse? Maybe if you trend older, you’re going to love this show, maybe I’m too young for the show. How do you know?

Gabe: Because of Rachel. Rachel liked it and she’s younger.

Lisa: Oh.

Gabe: Thank you, everybody, for listening to this week’s Not Crazy podcast. My name is Gabe Howard and I am the author of Mental Illness Is an Asshole, which you can buy on Amazon. If you head over to gabehoward.com, though, and buy it there, you’ll pay less money. I’ll sign it. And I will include free stickers from the podcast and, well, also from me personally. 

Lisa: Don’t forget the outtake after the credits and we’ll see you all next Tuesday.

Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person?  Not Crazy travels well. Have us record an episode live at your next event. E-mail show@psychcentral.com for details. 


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