When it comes to discussing The Joker, it's pretty common for all sorts of descriptive words to be thrown around, in an attempt to properly describe his - often baffling - mental state. Whether it's psychotic, psychopathic, crazy, mentally ill, disturbed, homicidal, or something else entirely, we tend to reach for very specific terms to frame something which, due to the majority of us not possessing medical degrees, we don't really understand.
With the villain about to take center stage in the DC universe once more, however, played by Jared Leto in next years Suicide Squad, it might well be time to take a closer look at...
...Just Why The Joker Is the Way He Is
And, as it turns out - it's not at all what you'd expect.
For one thing:
The Joker ISN'T Psychotic
As forensic psychiatrist Vasilis K. Pozios, M.D. - an expert in forensic and adult psychiatry - puts it:
"Someone who is 'psychotic' is experiencing symptoms of psychosis, a mental disorder, which can include auditory hallucinations, such as hearing voices; visual hallucinations, where they see objects that are not truly there; or have delusional thoughts, despite evidence to show that such beliefs are incorrect -- such as believing that one's movements are being tracked by deep space satellites -- or disorganized behavior...In the vast majority of depictions, the Joker is not experiencing such symptoms; rather, the Joker has shown symptoms of psychopathy."
Which means, however, from a medical standpoint:
The Joker IS a Psychopath
As H. Eric Bender, M.D. puts it:
"Psychopathy reflects interpersonal characteristics and behavior that are often rooted in a lack of empathy...In the comics, television shows, and films, the Joker is much more akin to a psychopath and is not psychotic."
An interesting point to note, though, is that - due to his diagnosis as a psycopath - Bender wouldn't prescribe any sort of medication as a form of treatment:
"Psychopaths are not prescribed medications to treat their psychopathic personality traits...They would be prescribed medication if they had a mental disorder, such as major depressive disorder or bipolar disorder, that causes clinically significant distress or impairment in functioning. In the vast majority of depictions, the Joker does not exhibit signs or symptoms of these or other mental disorders for which medication would be appropriate; therefore, we would not prescribe him any medication."
The Joker ISN'T Mentally Ill
That's right - despite decades of being described as 'crazy,' the Joker isn't, in actual fact, necessarily mentally ill in the sense in which we mean it. As Bender points out:
"Just because a behavior is aberrant or considered 'crazy,' it does not mean that the behavior is the result of mental illness."
And, crucially, as Praveen R. Kambam, M.D. argues:
"Batman villains, both serial murderers and non-serial murderers alike, are frequently referred to as 'insane' in the comics, but insanity is actually not a psychiatric or mental health term, but a legal concept...In the real world, only 1 percent of criminal cases plead not guilty by reason of insanity; only 20 percent of those 1 percent are successful."
Which explains why:
The Joker WOULDN'T Be Admitted to Arkham Asylum
After all, if he only suffers from psychopathy - which is widely considered to be a personality disorder, as opposed to mental illness, then he isn't a likely candidate for committal to an asylum. Instead, as Jennifer Skeem, PhD, argues...
“Psychopathy tends to be used as a label for people we do not like, cannot understand, or construe as evil.”
...suggesting that much of The Joker's time in Arkham may have more to do with politics (or a successfully argued legal defense to keep him out of conventional prison) than actual medical treatment.
As Pozios puts it:
"There is still a misunderstanding to the portrayal of insanity in the Batman films and movies and what it means to be legally insane... the Joker has been repeatedly hospitalized at the Elizabeth Arkham Asylum for the Criminally Insane, even though, in real life, he probably wouldn't qualify."
Are there other conditions, though, that we need to identify in order to properly understand The Joker? In other words:
Could The Joker Be Diagnosed With Anything Else?
After all - this isn't the behavior of an entirely well man:
Well, there are certainly a few leading candidates...
For one thing:
He May Well Have ASPD
Otherwise known as Antisocial Personality Disorder, ASPD is a similar - but crucially, very much distinct - diagnosis to psychopathy. As Robin S. Rosenberg, PhD, puts it:
"Antisocial personality disorder is a psychiatric diagnosis in the Diagnostic and Statistical Manual (DSM, fourth edition). The DSM includes 10 different personality disorders, each of which involves a different set of maladapative behavior patterns. The criteria for antisocial personality disorder require a pattern of at least three types of criminal behaviors (e.g., repeatedly breaking the law, even in small ways, such as disturbing the peace) or somewhat related behaviors, such as being impulsive, irresponsible, aggressive, or lying."
That being said, though - while having ASPD very much doesn't indicate that you're likely to also be a psychopath, there is a strong correlation between the two in the other direction. As Rosenberg argues:
"Only a minority of people (less than 40%) of men with antisocial personality disorder are also considered to be psychopaths. But over 80% of men with psychopathy also have antisocial personality disorder."
Which - since we have a fairly solid diagnosis of psychopathy, seems to be the case with The Joker.
He May Also Have Intermittent Explosive Disorder
Described by the Mayo Clinic, Intermittent Explosive Disorder:
"...involves repeated episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation...People with intermittent explosive disorder may attack others and their possessions, causing bodily injury and property damage. They may also injure themselves during an outburst."
Which, once again, seems to fairly accurately describe The Joker.
It's also possible, however, that:
The Joker Is Just Really, Really, Really Old
After all, if - as has recently been suggested in the comics - The Joker is actually a seriously ancient immortal, there's a whole other possible explanation for his behavior.
Y'see, between Interference Theory (which suggests that newly learned information interferes with our ability to recall previously learned data) and the fact that we seem to (scientifically) perceive time as going more quickly as we get older, there are some pretty serious consequences to immortality when it comes to retaining your sanity.
As Cracked.com memorably put it:
"Live to be a million, and people will seem to be just exploding in and out of existence around you, like a time lapse video of a mountain slowly eroding over eons while cities and nations appear and disappear around it, unnoticed."
And, were that - or even a fraction of that - the case for The Joker, it wouldn't be all that surprising if either a) he actually did become mentally ill, or b) we, not understanding him, incorrectly perceived him to be so.
Either that, of course, or:
He Just Really, Really Hates Batmen
I mean, that's got to be a medical condition somewhere, right?
What do you think, though?