Story at a glance

  • In “Joker,” Joaquin Phoenix plays a character with Pseudobulbar affect, a neurological impairment resulting from a brain injury.
  • Experts say that in reality, the mentally ill are less likely to commit violence than the general population.
  • Some critics worry that the film’s dark themes could inspire mass shooters.

Todd Phillips’s “Joker” is on track to become the highest grossing R-rated movie of all time, not adjusted for inflation, making $737 million worldwide in its first 18 days, according to Forbes. This in spite, or because, of the fact that it generated controversy before anyone had even seen it. 

One concern has been that the portrayal of a mentally ill person turning to violence will perpetuate false ideas about people with mental health issues, undermining broad gains made in public understanding in recent years. That concern is encapsulated well in the Guardian article “Why Joker’s depiction of mental illness is dangerously misinformed.”

In the film, Joaquin Phoenix plays Arthur Fleck, who has Pseudobulbar affect, which isn’t a mental illness, but a neurological impairment resulting from a brain injury. It makes people laugh or cry in exaggerated or inappropriate ways, so it can look like a mood disorder. With Arthur, it manifests in a cackle he cannot control. He also has delusions, believing he has a partner that he doesn’t have (well … who hasn’t done that?). Kamran Ahmed, a psychiatrist writing in the Brisbane Times, who has high praise for the movie, says Arthur also shows psychopathy and narcissism, which are considered traits, not mental illnesses. 

On top of it all, he’s hard-up and beaten down in a sleazy, violent New York of 1981, yet he believes he’s meant to make people laugh. 

We also know that he’s been institutionalized, but the institution diverges from the Arkham Asylum of the Batman cannon in a significant way, says Troy Rondinone, author of “Nightmare Factories: The Asylum in the American Imagination.” In “Joker,” the institution becomes Arkham State Hospital.

“This is the failed state hospital of [‘Halloween’s’] Michael Myers,” in an era of awful conditions and no one getting well, Rondinone says. Real-life patients at such facilities in the early and mid 20th century were subject to a hellish life that could include squalor, overcrowding, starvation, electroshock therapy and lobotomies. Deinstitutionalization, the shutting down of large state institutions, was supposed to put patients in smaller, more community-based care but many were left with no support at all. 

This is the world Arthur lives in, but at least he has a home, a job, a social worker and medication, though he’s treated with suspicion by many people thanks to the stigma of mental illness. Although the mentally ill are better regarded than they were in past centuries, there are still lingering fears and suspicions. But then budget cuts cost Arthur his social worker and his medications, and this is where his deterioration into violence begins, Rondinone says. And that’s where he’s reborn as Joker.

Stereotypes of violence

Rondinone found the movie “engrossing,” chock-a-block with complexities, nuance and references to parse, but agrees that at the same time it perpetuates the stereotype of violence in mentally ill people. 

He was reminded of President Trump, calling for the revival of mental institutions after back-to-back mass shootings.This is also a mental illness problem,” Trump said of the shootings. “These are people that are very, very seriously mentally ill.”

However, according to the American Psychiatric Association, people with severe mental illness are responsible for less than 1 percent of all gun homicides in the U.S. annually. The U.S. government mental health website says the mentally ill are 10 times more likely to be the victims of violent crime than the general population.

William H. Reid, professor of psychiatry at the University of Texas at Austin and author of A Dark Night in Aurora: Inside James Holmes and the Colorado Mass Shootings,” says that, on average, “psychiatric patients are less violent than the general population in almost every kind of violence,” unless you add substance abuse to the mix.

“I’m much more worried about the meth head next door than I would be about the paranoid schizophrenic,” he says. 

Going off medication is the most common reason people with severe mental illness relapse, says Reid, who hasn’t seen “Joker” but is aware of the controversies. Some psychiatric disorders, like paranoia, are more likely to make a person violent if they’re off their meds, but mostly if a mentally ill person commits a crime, “it’s usually something like peeing on someone’s storefront,” minor, nonviolent offenses.

“As a professor I work very closely with the Disability Resource Center,” Rondinone says, “and the treatment and the ability of students to discuss their psychological issues with me and with the resource center has vastly improved since when I was a kid, when everything was stuffed under the carpet. I think we talk about these things in our society a lot more and that we’re aware of problems and stigmas,” which makes mental health issues easier to address.

Reid says that the public view of mental illness is a lot better than it was but “we still have a long way to go, with both stereotypes about severity and violence,” as well as the idea that psychiatry can fix everything if patients would see them earlier and stay in treatment and on meds. “Most serious psychiatric illnesses can be treated and very often ameliorated, but not ‘cured.’ Better access to mental health care would “help millions of people, but it probably wouldn’t stop many mass killings,” though better access to and funding of care would probably prevent a lot of suicides.

Links to shootings?

America suffers a mass shooting every two weeks so it’s not surprising that potential violence in the mainstream was another fear about “Joker.” Prior to its release a group of family members of Aurora shooting victims paired with the nonprofit Guns Down America, and wrote to Warner Bros. They didn’t ask for the film to be pulled, they asked WB to commit to safety by ending “political contributions to candidates who take money from the NRA and vote against gun reform.”

On Sept. 24, Warner Bros. made a statement saying that the company has a long history of donating to gun violence victims, including Aurora, had recently joined with other companies trying to get legislation enacted to address the problem and never intended for the Joker in this film to be a hero. (See the complete statement here.)

Reid was one of two court-appointed psychiatrists who evaluated the Aurora shooter before trial. It’s important to remember, he says, that the Aurora shooter did not identify with the Joker character “or anything related to Batman.” The shooter said that someone at the jail “might have called him the Joker,” and “the media picked up a baseless rumor about the coincidence of his red (dyed) hair and the movie title.” He opened fired at a midnight premiere showing of a Batman movie “The Dark Knight Rises” because the theater would be full and at midnight “few children would be attending.”

“It was the place where he could kill the most people,” Reid says.

Rondinone sees the movie’s “problematic aspects” as able to “shine a light on bigger problematic aspects of our society.”

To him, the film may comment on the narrative of “the wounded white man.” Someone at the bottom of society, maligned, mistreated and ignored, has “a fantasy of payback,” Rondinone says (which is often the mass shooter narrative).

Rondinone and Reid both say “Joker” could inspire a copycat, but that censorship isn’t the answer.

John Hinkley Jr, who attempted to assassinate Ronald Reagan in 1981, was inspired by “Taxi Driver,” Rondinone says. “But I’m not blaming Martin Scorsese for the assassination attempt on Reagan.” 

Movies don’t happen in a vacuum — they do influence their audience. However, “if you point your finger at a movie director and you ignore the appalling gun violence statistics, incarceration failures and mental health failures, the structural things,” you’re missing the bigger picture, he says.

“If it’s a legitimately nice piece of work, in writing and art and acting, or even if it’s not, who am I to keep that off the screen?” Reid says, though if he were running a psychiatric hospital, he wouldn’t want vulnerable patients watching “Joker,” not because it could inspire violence but because it could be an upsetting experience. The same goes for young adults whom he wouldn’t even want reading his book. It’s not about them becoming violence but about how they live their lives.

“How many people don’t like to swim in the ocean because of ‘Jaws’?” he says. “By the way, I’m one of them.”

What art does, Rondinone says, is to hold up “a fun house mirror to what’s going on in society and it lets you interpret it.”

Well, who better to have in the fun house but a clown?

Published on Nov 04, 2019