Todd Phillips's Joker

Todd Phillips's Joker, a 2019 psychological thriller film starring Joaquin Phoenix, is a far cry from the previous incarnations, which is stirring up a fierce debate about the portrayal of the character's mental disorder.^{Reference Rai and Banerjee4–Reference Knafo6} The director turned a comic icon into a neuropsychological study drama that reflects on how society views and treats the mental health problems of certain individuals. According to some critics, Joker runs the risk of being perceived as a glorification of what one angry and disturbed loner is able to accomplish and raises debate over whether the film turns an archetype of a violent man into a heroic figure (intentionally or not).^{Reference Singh7} Andrew A. Nierenberg concluded that ‘Sadly, the movie will increase stigma for those with psychiatric disorders and make people afraid. It will take great efforts to combat this setback in the battle against stigma’.^{Reference Nierenberg8} Furthermore, doctors Annabel Driscoll and Mina Husain wrote in an opinion piece for The Guardian soon after the film's release, ‘Severe mental health conditions, such as psychotic illnesses, remain shrouded in stigma and are consistently misrepresented and misunderstood […] Portrayals of mental illness in film can perpetuate unfounded stereotypes and spread misinformation’.^{Reference Driscoll and Husain9} Meanwhile, British neurocriminologist Adrian Raine was impressed by how accurate the film's depiction of the psychology of a murderer was. In an interview with Vanity Fair, he described it as ‘a great educational tool’ and stated that he planned to present film clips during his classes.^{Reference Miller10}

In general, Joker is closer to an art-house film than a typical comic book film, since it shows less explosive action but more social commentary. Unlike other interpretations, we discover a lonely, timid and uncharismatic man. The plot of the film centres on Arthur Fleck, a socially inept party clown and aspiring stand-up comedian living with his ailing mother Penny in Gotham City. Gotham is struggling with crime, unemployment and poverty. Arthur is a middle-aged, underweight and pale-faced man suffering from a medical disorder that causes him to laugh uncontrollably at inappropriate times and he depends on social services for medication. His communication skills are generally poor; he stares at people for too long, uses abnormal facial expressions and misses important interpersonal cues, making others feel discomfort. In the evenings Arthur and his mother watch a TV show with host Murray Franklin, and Fleck imagines himself being on the show and getting everyone's attention. Arthur experiences a romantic feeling towards his neighbour Sophie, but later the film reveals that he was actually imagining all of their dates. During the film, a series of events in close succession ultimately tips him over the edge: Arthur guns down three men on the subway train ride home after he was mocked; his therapy sessions are terminated, he stops taking his medications and later he reveals that Penny adopted him after he was found abandoned. Penny had a mental disorder and her case history records at the mental health clinic mention Arthur having a head injury after she abused him, tied him to a radiator and beat him alongside her abusive boyfriend. Then the dream of the character comes true: he becomes a guest on Murray Franklin's show and asks the host to introduce him as Joker. While it initially seems that Arthur intends to kill himself live on air, he shoots Franklin instead. In the end, we find Joker in a therapy session at the mental health clinic. He is then seen running, dancing and leaving bloodied footprints in the hospital's corridors, implying the psychiatrist's death.

Diagnosing Joker's mental conditions

Although Arthur's disease remains unspecified throughout the film, we can make some conclusions if we take a look at Joker's symptoms and mental condition throughout the film. During the therapy sessions, Arthur describes his complaints as loneliness, isolation and ‘constant negative thoughts’. An entry in his notebook states that ‘the worst part of having a mental illness is that people expect you to behave as if you don't’. We know that the character attends therapy sessions for a long time and that he is prescribed several psychotropic medications. He even had sufficient insight to say, ‘I need my medication to be increased’. Unfortunately, we have very little information on his family history since he was abandoned as a child. His foster mother has delusional disorder and probably a personality disorder and she underwent in-patient therapy. Arthur was brought up by a foster mother and did not have a father figure. The foster mother herself describes him growing up as a fun and kind boy, but later he was abused and beaten by his adoptive parents and even had a severe head injury. Thus, we can find a number of risk factors for mental disorders in our fictional patient's case history.

From flawed man to cartoon supervillain

Although the film provides the audience with identifiable components of real mental disorders, in general, the psychopathology that Arthur exhibits is foggy and the combination of his symptoms is unusual. Such diagnostic vagueness helps to create a more relatable character who reflects the burden of any mental disorder; but for the mental health professional it can be confusing and leave the impression that different neurological and mental disorders have been mixed. Actually, the plot moves from a portrait of an individual who is struggling with mental disorder and striving to make a life for himself into pure supervillain caricature. Joker as a character makes it incumbent on the film to drop its pretence at serious character development to enter the comic book mode. Arthur Fleck ceases to be a human being for whom we might feel empathy and descends into a one-dimensional stereotype. The film uses Arthur's childhood trauma as well as his struggle with mental disorder as a means to earn sympathy from the audience, rather than disgust at his actions. It is an age-old cinema psychology cliché: the character hasn't had enough love. Thus, as a character, Arthur appeals deeply to the human tendency towards self-pity. From this point of view, the character's mental illness just happened to be one of the stressors that are the true cause of Arthur becoming the Joker. His mental illness was only important to the overall plot as a way of connecting all the other stressors together. Therefore, to reduce all of Arthur's actions down to his mental health problems is extremely simplistic.

In conclusion, it would be worthwhile to recall an episode from the film. When Arthur's diatribe is booed on the Murray Franklin Show, he tells the audience that ‘humour is subjective’. Likewise, any considered response to divergent interpretations of Arthur Fleck's diagnosis forces specialists to acknowledge their own subjectivity.