In Joker, Todd Phillips’ newly imagined origin story for the infamous DC villain, Joaquin Phoenix plays Arthur Fleck, a downtrodden man who erupts into uncontrollable laughter at the most inappropriate moments. As the film progresses, the audience learns that his outbursts are the symptom of a brain injury. And while the script never names the Joker’s disorder, it’s based on a real-life medical condition called pseudobulbar affect.
Pseudobulbar affect (PBA) is characterized by frequent, involuntary bouts of crying, laughter, or other emotional displays, which are exaggerated or disconnected from the individual’s actual emotional state. It’s most commonly caused by brain injuries or neurological disorders that impact how the brain processes emotion.
According to the Mayo Clinic, people who have PBA will feel and experience emotion in much the same way as anybody else, but they’re prone to expressing it in an “exaggerated or inappropriate way,” and these outbursts can last for several minutes. Laughter can often turn into tears, and because uncontrollably crying is such a common symptom of PBA, it’s often mistaken for depression—which is actually also very common for sufferers of this condition.
Phoenix’s portrayal of a character battling mental illness, and his frustration in being denied the treatment he needs, has been praised by critics and described as a timely commentary on the way many Americans struggle to access mental health services. However, ultimately this nuanced characterization gives way to violence, in a manner which some have said scapegoats mental illness.
“What could have made Joker a good film for 2019 would have been a better focus on the mental health issues it only briefly explores,” writes Herb Scribner, who believes that the film’s descent into violence, “distracts from what could be a serious conversation about mental health.”
“It’s hard not to have sympathy for somebody who experienced that level of childhood trauma,” Joaquin Phoenix said of the character. “An overstimulated medulla looks for and perceives danger everywhere. For someone in that state, does it mean his actions make sense or are justified? Obviously not. There’s a point where he crosses the line where I am no longer able to stick by his side. But it allowed me to approach him with less judgment and more compassion than what I had when I first read the script.”