I think despite his deviant behaviors; many of which I'm sure could fall into some DSM 5 categories, his attempted strangulation of Ms. Ratched was symbolic of the despair and fury many reasonable people would feel when broken by all the heartless machinery and corrupted authority in the world.

I wonder if the multitude of ad banners with the tiny fucking (x) that I miss several times factor into this

I had the pleasure of reading it during a week I spent in a seedy motel. I remember having to pause and step outside now and again when my imagination started to get away from me.