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Pseudobulbar palsy or Psychological Disorder? A screen adaptation of the Joker film about a problem in society or about the problems of people with mental disorders?


Author: Issabayeva Madina

Translated by: Yurankyzy Saltanat





          The film "Joker" by Todd Phillips managed to cause widespread resonance. Someone saw in him the story of a lonely person abandoned by society, someone - a sharp social commentary, and another - an ordinary superhero (more precisely, super villainous) origin. Thus, the film brought to a common denominator completely different diseases, differing in their course, consequences and danger to others.


      Arthur Fleck's disease is a composite of many different disorders. Todd Phillips did not want to reduce the story of such a legendary character as the Joker to one disease, so he simply demonstrated that «something» was wrong with the hero by showing a variety of symptoms. According to the director himself, the film was supposed to simply draw attention to the problems of people with mental disorders. The author wanted the audience to experience for themselves what the sick go through and show them more compassion. Unfortunately, the film contains several errors in the portrayal of mental illness that can harm suffering people, further worsening their situation. Therefore, I will devote today's article to a variety of errors and theories of psychological as well as neurological diseases.


      As you know, neurological diseases arise from changes in the nervous system, but mental illness is a special case. This case can be congenital or acquired, temporary or permanent, lead to mild discomfort or make a person completely incapacitated in society. From the beginning of the film, is shown that Arthur Fleck suffers from unconscious violent laughter, which is characteristic of the pseudobulbar syndrome. This is a neurological disease, not a mental one, since the pathways that conduct impulses to the muscles of the face and larynx are affected. Grimaces occur without the patient's will, like hiccups or an asthma attack. This is important, because with pseudobulbar syndrome there are no mental disorders, and the protagonist in such situations is not funny.


       That really real psychiatric symptoms are hallucinations and delusions that the hero experiences throughout the film. Such symptoms are combined into the paranoid syndrome characteristic of schizophrenia. This is a severe, incurable progressive disease in which a person cannot adequately perceive the world around him. Ultimately, schizophrenia leads to the destruction of thinking and the extinction of a person. Only special drug treatment can help the patient slow down the course of the disease.

       Of particular note is dissocial personality disorder, formerly known as "psychopathy" or "sociopathy." Patients with such a disorder are characterized by increased aggressiveness, selfishness, cruelty, ignorance of social norms, which are more prone to crimes and antisocial acts. But it should also be borne in mind that people with dissocial disorder do not have thinking disorders and clearly understand what they are doing.


       Hence the common misconception that the mentally ill are most often dangerous and have a great threat to life. Unfortunately, the Joker continues to cultivate this stereotype, showing a string of murders that the protagonist commits. In fact, most of the mentally ill are not dangerous. According to statistics, they themselves become victims of criminals - 2.5 times more often than healthy ones. The harm is usually carried by people who use alcohol and drugs, and also suffer from sociopathy, but these are not typical mental disorders. Therefore, there is no connection between mass shootings and mental illness. The converse is also true, only 3-5% of crimes in the United States are committed by mentally ill people. Most of these criminals are just ordinary decent people who have the same chance of committing a crime as healthy people. And the seriously ill are not at all capable of complex crimes. It follows that it is impossible to diagnose only one act, otherwise all criminals would be considered mentally ill for antisocial behavior.


      The most important thing here is not to forget that each disease has its own unique course. Oligophrenia requires special training with people from childhood, and with due attention, patients can become a full-fledged part of society. Depression affects the emotional sphere, but does not affect reason and thinking. And what we call psychopathy, antisocial behavior, manifests itself only through the actions of a person and can go unnoticed for a long time. That is why one cannot judge the mentally ill in general by the example of Arthur Fleck. In the composite image of the Joker, the authors tried to cover as many different groups as possible, but in the end, none of them were fully represented. And patients with schizophrenia, and people with depression, and with post-traumatic disorder, and with an antisocial character - all in the end are shown unreliable, in a negative way, with unusual features.