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In the novel, Kesey suggests that a healthy expression of sexuality is a key component of sanity and that repression of sexuality leads directly to insanity. For example; by treating him like an infant and not allowing him to develop sexually, Billy Bibbet's mother causes him to lose his sanity. Missing from the halls of the mental hospital are healthy, natural expression of sexuality between two people. Perverted sexual expressions are said to take place in the ward; for example; Bromden describes the aides as "black boys in white suites committing sex acts in the hall" (p.9). The aides engage in illicit "sex acts" that nobody witnesses, and on several occasions it is suggested that they rape the patients, such as Taber. Nurse Ratched implicitly permits this to happen, symbolized by the jar of Vaseline she leaves the aides. This shows how she condones the sexual violation of the patients, because she gains control from their oppression. McMurphy's sanity is symbolized by his bold and open insertion of sexuality which gives him great confidence and individuality. This stands in contrast to what Kesey implies, ironically and tragically, represents the institution.
One of the most controversial points McMurphy makes in the novel is fear of woman as castrators. The women in One Flew over the Cuckoo's Nest are uniformly described as threatening and terrifying figures. Most of the male patients have been damaged by relationships with overpowering women. For example; Bromden's mother is portrayed as a castrating woman; her husband took her last name, and she turned a big strong chief into a small, weak alcoholic. According to Bromden, she "got twice his size; she made him too little to fight anymore and he gave up" (p.
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