Snaiha Iyer Narayan
India

 

The Joker & His Frankenstein, 14th September 2021. By Snaiha Iyer Narayan.

In recent decades, cinematic portrayals of medical conditions have garnered variant review. The Joker has been an iconic film in popular culture in part because of its portrayal of mental illness and depiction of societal stereotypes. An often disregarded facet in the character of the Joker lies in the realm of epigenetics.

The Joker, also known as Arthur Fleck, is brought to life by actor Joaquin Phoenix in director Todd Phillips’ take on the character’s backstory. It follows the narrative of a man with mental illness, pseudobulbar affect (PBA)—a condition which leads to sporadic episodes of inappropriate laughing or crying. The Joker also has hallucinations and psychopathic tendencies that point to a traumatic brain injury suffered during childhood. While societal contributions to the development of such a condition are better understood today, analyses of individual factors that may lead to the creation of a serial killer are scarce.

Much like Frankenstein molding a monster, we see the Joker’s adoptive mother, Pennyworth Fleck, play arguably the biggest role in turning him into a serial killer. Referring to him as “Happy” through the exposition, she remains his beloved mother. However, as the narrative unfolds, it becomes evident that she suffers from delusional psychosis (DP) and narcissistic personality disorder (NPD), which led to her having a lobotomy. Such cofactors perhaps led her to delude herself and Fleck about the story of his adoption.

At the movie’s climax, it is revealed that Pennyworth remained apathetic towards the abuse Fleck faced at the hands of her former boyfriend, including severe bruises and head injuries. Such evidence negated her prior accounts of having had an illicit affair with a Gotham political figure, Thomas Wayne. While the synopsis is rather confounding due to the merging of hallucination and reality, it is clear that Pennyworth’s lies and by-standing prompted the mutation of once ordinary idiosyncratic Fleck to the mass murderer and insurrectionist Joker.

To understand the Joker, we must first understand Pennyworth and the extent of her mental disarray. She underwent a lobotomy, “the surgical treatment of certain psychiatric illnesses by means of localised lesions placed in specific cerebral sites,”¹ affecting areas of the prefrontal cortex (PFC) that play a “central role in cognitive control functions, and dopamine in the PFC modulates cognitive control, thereby influencing attention, impulse inhibition, prospective memory, and cognitive flexibility.”² It can be assumed that the procedure was a method for symptomatic relief of DP and NPD, however, today lobotomies are controversial as they only turn patients docile—seen in Pennyworth who is compliant albeit with her DP persisting. A flashback of her time at Arkham State Hospital reveals her saying Thomas Wayne was the biological father of Fleck, and the paperwork related to his adoption was “all made up.”³ She tells Fleck in the present day: “We had a connection. I was so beautiful then. We were in love.”⁴ Unknowingly, she instils within Fleck a sense of insecurity as she says, in an effort to console him, that if the truth were out people would call him “a little, unwanted bastard.” Ironically, Fleck feels perplexed and agitated, drowning in the thought of his “father” remaining oblivious of their dire condition.

Abandonment and rejection are psychosocial mediators. Studies investigating the background of serial killers have shown that “numerous cases describe early adoptions, neglect and abandonment as some of the childhood characteristics possibly accounting for violent crime and serial killing.”⁵ Though seemingly counterintuitive, “many serial killers are actually insecure individuals who are compelled to kill due to a morbid fear of rejection.”⁶ Fleck’s drastic reaction can be potentially attributed to physiochemical alterations that occur after sustained traumatic brain injury (TBI). Based on contextual assumptions, the Joker may have had monoamine-oxidase-A (MAO-A) enzyme deficiency caused by TBI lesions to his PFC and/or a genetic predisposition. Studies from the US National Institutes of Health have shown that “patients with the highest levels of aggression preferentially presented lesions in PFC territories.”⁷

The Joker may have also had lessened MAO-A synthesis, responsible for the metabolism of norepinephrine, serotonin, and dopamine, due to his genotype; he could have had a low activity allele of MAO-A that has been correlated with higher aggression towards others. “Men with low MAOA activity are three times more likely to be convicted of a violent crime by the time they are 26 years old than men with high MAO-A activity.”⁸ Excess concentrations of dopamine and norepinephrine cause schizophrenia, thus it can be inferred that this gradual build-up of neurotransmitters resulted in Fleck becoming a psychopath. While pharmacological drugs can modify their concentrations, early on we see Fleck lose access to medication—causing his dopamine and norepinephrine levels to spike and his mania to intensify.

Moreover, Pennyworth silently spectated while Fleck suffered abuse at the hands of her boyfriend. “Research into the impact of childhood abuse and neglect on violent behaviour of adults who became serial killers concluded that adults who had been physically, sexually, and emotionally abused as children were three times more likely than were non-abused adults to act violently as adults.”⁹ In this manner, Pennyworth was the primary cause for Fleck having post-traumatic stress disorder (PTSD) which manifested itself unreservedly after the revelation of his adoption and childhood. PTSD is also known to increase levels of neurotransmitters from the catecholamine, “including dopamine (DA) and norepinephrine (NE), derived from the amino acid tyrosine. Increased urinary excretion of DA and its metabolite has been reported in patients with PTSD,”¹⁰ as shown by prior research. Moreover, norepinephrine is known to respond to traumatic reminders via hyperactive release. While Fleck had an array of biological precursors that led to his condition, his turning point was the moment of truth at Arkham Hospital when he struggled to cope with what he had learned about his mother. In this way, Pennyworth acts as a shadow figure behind Fleck’s transfiguration.

While it is understood that Pennyworth too had her own cognitive impairments and diagnoses, she knowingly or unknowingly fueled Fleck’s insecurities by calling him “Happy,” an explicit disregard for his psychological and emotion condition. Trying desperately to fit into the mold his mother prepared, he tried a career in stand-up comedy, which lead people to taunt his humor and oddities. His self-esteem depletes every time he tries to act “happy.” Moreover, Pennyworth was ignorant of the many mental and social barriers Fleck created around himself, even as an adult. He confides in his mother that he “just had a big date” and she responds with a laugh; while it is unclear if she knew he was hallucinating, this would suggest that she chose to overlook such indicators of his deteriorating mental health.

“What do you get when you cross a mentally ill loser with a society that treats him like trash?”¹¹ the Joker asks, a satirical rhetoric which his existence itself answers. Beneath the layers of social stigmatization of mental illness are a multitude of biological components making up the Joker, accompanied by the catalytic role played by Pennyworth. The culminating scene where masked crowds wreak havoc is heavily symbolic of the social fragility of mental health.

 

End notes

1. Gostin, L. O. “Ethical Considerations of Psychosurgery: The Unhappy Legacy of the Pre-frontal Lobotomy.” Journal of Medical Ethics. September 1980. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1154827/.
2. Pardini, M., F. Krueger, C. Hodgkinson, V. Raymont, C. Ferrier, D. Goldman, M. Strenziok, S. Guida, and J. Grafman. “Prefrontal Cortex Lesions and MAO-A Modulate Aggression in Penetrating Traumatic Brain Injury.” Neurology. March 22, 2011. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068009/.
3. Inc., StudioBinder. “StudioBinder: Video, TV & Film Production Management and Collaboration Software.” StudioBinder App. Accessed September 14, 2021. https://app.studiobinder.com/company/580e85847e7982164664e844/collab/5e34afdbfd8db4073721e955/projects/5e2101e40495020963c3b9ad/document/5e3478034e7060974a743c53?utm_source=blog&utm_medium=post&utm_campaign=sb-app-link&utm_term=joker-script-quotes-studiobinder-screenwriting&utm_content=joker-script-quotes-studiobinder-screenwriting.
4. Inc., StudioBinder. “StudioBinder: Video, TV & Film Production Management and Collaboration Software.” StudioBinder App. Accessed September 14, 2021. https://app.studiobinder.com/company/580e85847e7982164664e844/collab/5e34afdbfd8db4073721e955/projects/5e2101e40495020963c3b9ad/document/5e3478034e7060974a743c53?utm_source=blog&utm_medium=post&utm_campaign=sb-app-link&utm_term=joker-script-quotes-studiobinder-screenwriting&utm_content=joker-script-quotes-studiobinder-screenwriting.
5. Allely, Clare S., Helen Minnis, Lucy Thompson, Philip Wilson, and Christopher Gillberg. “Neurodevelopmental and Psychosocial Risk Factors in Serial Killers and Mass Murderers.” Aggression and Violent Behavior. April 18, 2014. Accessed September 14, 2021. https://www.sciencedirect.com/science/article/pii/S1359178914000305.
6. Allely, Clare S., Helen Minnis, Lucy Thompson, Philip Wilson, and Christopher Gillberg. “Neurodevelopmental and Psychosocial Risk Factors in Serial Killers and Mass Murderers.” Aggression and Violent Behavior. April 18, 2014. Accessed September 14, 2021. https://www.sciencedirect.com/science/article/pii/S1359178914000305.
7. Pardini, M., F. Krueger, C. Hodgkinson, V. Raymont, C. Ferrier, D. Goldman, M. Strenziok, S. Guida, and J. Grafman. “Prefrontal Cortex Lesions and MAO-A Modulate Aggression in Penetrating Traumatic Brain Injury.” Neurology. March 22, 2011. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068009/.
8. Sheffler, Zachary M. “Physiology, Neurotransmitters.” StatPearls [Internet]. May 09, 2021. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/books/NBK539894/.
9. Allely, Clare S., Helen Minnis, Lucy Thompson, Philip Wilson, and Christopher Gillberg. “Neurodevelopmental and Psychosocial Risk Factors in Serial Killers and Mass Murderers.” Aggression and Violent Behavior. April 18, 2014. Accessed September 14, 2021. https://www.sciencedirect.com/science/article/pii/S1359178914000305.
10. Sherin, Jonathan E., and Charles B. Nemeroff. “Post-traumatic Stress Disorder: The Neurobiological Impact of Psychological Trauma.” Dialogues in Clinical Neuroscience. 2011. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182008/.
11. Inc., StudioBinder. “StudioBinder: Video, TV & Film Production Management and Collaboration Software.” StudioBinder App. Accessed September 14, 2021. https://app.studiobinder.com/company/580e85847e7982164664e844/collab/5e34afdbfd8db4073721e955/projects/5e2101e40495020963c3b9ad/document/5e3478034e7060974a743c53?utm_source=blog&utm_medium=post&utm_campaign=sb-app-link&utm_term=joker-script-quotes-studiobinder-screenwriting&utm_content=joker-script-quotes-studiobinder-screenwriting.

 

References

• Allely, Clare S., Helen Minnis, Lucy Thompson, Philip Wilson, and Christopher Gillberg. “Neurodevelopmental and Psychosocial Risk Factors in Serial Killers and Mass Murderers.” Aggression and Violent Behavior. April 18, 2014. Accessed September 14, 2021. https://www.sciencedirect.com/science/article/pii/S1359178914000305.
• Gostin, L. O. “Ethical Considerations of Psychosurgery: The Unhappy Legacy of the Pre-frontal Lobotomy.” Journal of Medical Ethics. September 1980. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1154827/.
• Inc., StudioBinder. “StudioBinder: Video, TV & Film Production Management and Collaboration Software.” StudioBinder App. Accessed September 14, 2021. https://app.studiobinder.com/company/580e85847e7982164664e844/collab/5e34afdbfd8db4073721e955/projects/5e2101e40495020963c3b9ad/document/5e3478034e7060974a743c53?utm_source=blog&utm_medium=post&utm_campaign=sb-app-link&utm_term=joker-script-quotes-studiobinder-screenwriting&utm_content=joker-script-quotes-studiobinder-screenwriting.
• Pardini, M., F. Krueger, C. Hodgkinson, V. Raymont, C. Ferrier, D. Goldman, M. Strenziok, S. Guida, and J. Grafman. “Prefrontal Cortex Lesions and MAO-A Modulate Aggression in Penetrating Traumatic Brain Injury.” Neurology. March 22, 2011. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068009/.
• “Prefrontal Cortex.” Prefrontal Cortex – an Overview | ScienceDirect Topics. Accessed September 14, 2021. https://www.sciencedirect.com/topics/medicine-and-dentistry/prefrontal-cortex#:~:text=The prefrontal cortex (PFC) plays,prospective memory, and cognitive flexibility.
• Sheffler, Zachary M. “Physiology, Neurotransmitters.” StatPearls [Internet]. May 09, 2021. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/books/NBK539894/.
• Sherin, Jonathan E., and Charles B. Nemeroff. “Post-traumatic Stress Disorder: The Neurobiological Impact of Psychological Trauma.” Dialogues in Clinical Neuroscience. 2011. Accessed September 14, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182008/.

 

 

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SNAIHA IYER NARAYAN is an eighteen-year-old medical aspirant currently garnering work experience before going abroad for her higher education. She has written a paper on Dementia for Sage Journals, and also published a chapbook titled 2121 words. She is the creator of MedStat, and thoroughly enjoys reading and writing about medicine and its many intricacies.

 

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