One Flew Over the Cuckoo's Nest

Students study the institutional processes and popular beliefs surrounding mental health in One Flew Over the Cuckoo's Nest, as they discuss and debate the themes of power, order, and authority.

Unit Summary

Ken Kesey’s novel, popularized by the Oscar-winning movie adaptation of 1975, serves as a study of the institutional processes and the truth (or fictions) behind societal beliefs about mental health. The novel has been widely read and adapted into a Broadway play as well as the film.

Students will analyze the power struggle between the patients on the ward and the terrorizing character of the Big Nurse that serves as the major conflict of the novel. This analysis will draw students into debates and discussions about some of the central themes such as power, order, authority, and the consequences when these are abused. The novel’s instances of raw humanity also allow for students to relate to patients in a mental institution in the 1950s and consider their plight. The empathy Kesey builds in his readers helps to draw them into questioning the “truth” about “sanity” and “insanity,” thematic topics that students will consider in this unit and in other units in 11th and 12th grade English.

Texts and Materials

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Core Materials

Supporting Materials

See Text Selection Rationale


This assessment accompanies Unit 3 and should be given on the suggested assessment day or after completing the unit.

Unit Prep

Intellectual Prep


  • Read and annotate both the book and this unit plan. 
  • Watch the film adaptation of the novel.
  • Take the unit exam, including writing the essay response.
  • Read and annotate all paired texts.

Essential Questions


  • Sanity and Insanity: What does it mean to be “crazy” and who gets to decide?
  • Truth: Is truth in the eye of the beholder or is it decided by society?
  • Big and Small: What makes someone “big” or “small?”
  • Rules/Order/Authority: Are rules necessary for society?  At what point do rules become corrupt or oppressive? 

Writing Focus Areas


This unit focuses on a type of writing that is frequently assessed on the new SAT. Specifically, students will explain how an author uses specific literary devices to convey his/her message in a single text. In the future, students will need to do the same for a pair of texts, but for this unit they will focus on just one text.

Spiraling Literary Analysis Writing Focus Area

  • Develop a clear thesis that answers the prompt.
  • Create clear and cohesive arguments to support the thesis.
  • Choose the most relevant evidence to support the claims.



Literary Terms

metaphor, onomatopoeia, diction, analogy, allusion, juxtaposition, theme, motif, pathos

Roots and Affixes

-otomy (lobotomy, leucotomy), aud- (auditory), jur- (jurisdiction), circ- (circumvent)


Part 1: hullabaloo (5), precise (5), calculated (5), enamel (5), seclusion (9), admission (10), acute (15), chronic (15), nuisance (16), ornery (19), persecutes (22), cagey (24), whirring (25), hefting (25), orient (25), hypodermic (27), manipulator (27), intolerable (28), efficiency (29), accumulate (29), appraises (30), hostility (34), frenzied (38), nimble (40), lolling (43), brawn (44), insubordination (45), democratic (49), grievance (49), fester (49), subconscious (50), acoustic (50), murky (55), cadaver (55), prosecutors (56), quaint (57), fracas (57), taut (58), braggart (59), vitals (60), grimace (61), veritable (61), incapable (63), devour (64), astute (65), bashful (65), sly (66), vogue (69), consolation (70), matriarchy (71), juggernaut (71), impregnable (73)
Part 2: scant (77), transmit (79), branded (80), stoicism (80), spiel (80), lacerations (82), flusters (83), hydroelectric (86), bloated (89), outlandish (90), shrewd (91), policy (93), convalescent (97), physique (100), gaudy (100), heathen (105), reminisce (108), maudlin (108), nostalgia (108), auditory (110), spell (117), turmoil (118), mope (119), scowling (120), assets (123), procedure (140), hex (142), jurisdiction (144), recrimination (145)
Part 3: bile (151), fiendish (151), defy (152), comparative (154), thwarted (154), authoritarian (155), smoldering (157), brashness (157), femininity (159), sufficient (159), manufacture (161), haywire (162), silage (165), commenced (165), lope (165), gripe (167), spite (177), confound (179), haggard (180), schematic (182), curtail (183), inadequacies (184), concise (189), perverse (190), rational (190), jargon (191), lucid (192), committed (194), rebellious (199), impose (199), circumvent (199), tactic (205), menace (207), treachery (209), hovel (211), fraternize (212), squalor (212), metropolis (214), sterilized (229), predicament (230), speculation (233), gawk (234), sullenly (238), waiver (242), idle (245), cormorants (247), gaff (248), grim (252), rigorous (255), vaguely (256), woebegone (257)
Part 4: maneuver (261), martyr (264), stingy (266), chicanery (266), cautionary (270), initiative (273), trudging (274), clatter (276), drawling (277), hunkered (277), cogs (282), anoint (283), corrosion (283), vulnerable (291), peaked (293), chastity (296), artificial (301), tranquilize (304), recuperations (306), mellow (308), discretion (315), forcibly (315), contemptuous (316), ordeal (317), shudder (317)

Idioms and Cultural References

Combine (3), Public Relations (9), Eisenhower (21), vial (27), Inside vs. Outside (28), wheelers (28), vegetables (28), latrine (35), spine tap (36), Seconal (37), Punch & Judy (37), Korea (45), shindig (57), takes the cake (60), synthetic opiate (63), Red Chinese (66), Marilyn Monroe (71), black jack (81), Catholic (83), dam (87), catwalk (87), scalpel (88), conman (92), Canada honkers (94), geriatrics (98), twitches (102), IOU (105), Monopoly (114), buck (138), Napoleon, Genghis Khan, Attila the Hun (154), hydrocephalus (172), epileptic (177), Dilantin (177), anti-convulsant (179), hoity-toity (185), herded (188), c’est la vie (189), lobotomy (189), raise Cain (190), frontal lobe castration (191), on the ropes (193), canteen (197), Chinook salmon (209), Hiawatha (212), Spearmint Gum (217), crazy like a fox (264), dry (267)

Content Knowledge and Connections


  • Mental health, specifically: Asylums, Anti-psychotic medication, Electroshock therapy, lobotomy, and other historical approaches to treatment of mental illness and the mentally ill in the United States.
  • Because of the narrator’s identity, there will be some exploration of the history of Native Americans and the United States government, particularly the creation of reservations.

Previous Fishtank ELA Connections

Future Fishtank ELA Connections

Lesson Map


  • One Flew Over the Cuckoo’s Nest pp. 85 – 90

Explain how Bromden’s dream reveals theme.  


  • One Flew Over the Cuckoo’s Nest pp. 188 – 196

Debate the factors that keep the men in the ward.


  • One Flew Over the Cuckoo’s Nest pp. 276 – 283

Explain the shift in power dynamics.



Common Core Standards

Reading Standards for Informational Text
  • RI.11-12.1 — Cite strong and thorough textual evidence to support analysis of what the text says explicitly as well as inferences drawn from the text, including determining where the text leaves matters uncertain.

  • RI.11-12.2 — Determine two or more central ideas of a text and analyze their development over the course of the text, including how they interact and build on one another to provide a complex analysis; provide an objective summary of the text.

  • RI.11-12.9 — Analyze seventeenth-, eighteenth-, and nineteenth-century foundational U.S. documents of historical and literary significance (including The Declaration of Independence, the Preamble to the Constitution, the Bill of Rights, and Lincoln's Second Inaugural Address) for their themes, purposes, and rhetorical features.

Reading Standards for Literature
  • RL.11-12.1 — Cite strong and thorough textual evidence to support analysis of what the text says explicitly as well as inferences drawn from the text, including determining where the text leaves matters uncertain.

  • RL.11-12.2 — Determine two or more themes or central ideas of a text and analyze their development over the course of the text, including how they interact and build on one another to produce a complex account; provide an objective summary of the text.

  • RL.11-12.3 — Analyze the impact of the author's choices regarding how to develop and relate elements of a story or drama (e.g., where a story is set, how the action is ordered, how the characters are introduced and developed).

  • RL.11-12.6 — Analyze a case in which grasping point of view requires distinguishing what is directly stated in a text from what is really meant (e.g., satire, sarcasm, irony, or understatement).

Speaking and Listening Standards
  • SL.11-12.1 — Initiate and participate effectively in a range of collaborative discussions (one-on-one, in groups, and teacher-led) with diverse partners on grades 11—12 topics, texts, and issues, building on others' ideas and expressing their own clearly and persuasively.

  • SL.11-12.2 — Integrate multiple sources of information presented in diverse formats and media (e.g., visually, quantitatively, orally) in order to make informed decisions and solve problems, evaluating the credibility and accuracy of each source and noting any discrepancies among the data.

  • SL.11-12.3 — Evaluate a speaker's point of view, reasoning, and use of evidence and rhetoric, assessing the stance, premises, links among ideas, word choice, points of emphasis, and tone used.

Writing Standards
  • W.11-12.1 — Write arguments to support claims in an analysis of substantive topics or texts, using valid reasoning and relevant and sufficient evidence.

  • W.11-12.4 — Produce clear and coherent writing in which the development, organization, and style are appropriate to task, purpose, and audience.

  • W.11-12.9 — Draw evidence from literary or informational texts to support analysis, reflection, and research.