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The Dark Knight: Antisocial Personality Disorder

Kristin Carter
PSYC 001
Kimberly Costello
November 26, 2012

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In the movie The Dark Knight, the character the Joker portrays several signs and

symptoms of suffering from Antisocial Personality Disorder (ASPD). These signs and
symptoms are portrayed through failure to conform to social norms, lack of remorse,
deceitfulness and reckless disregard for safety. Although the Joker exhibits several other
disorders like psychopathy and schizophrenia, he also shows an extremely severe case of
antisocial personality disorder, which this essay will focus greatly on. ASPD is normally
treated by psychotherapy through a therapeutic tactic that focuses on two main
approaches.

Antisocial Personality Disorder (ASPD) is a disorder usually caused by biologic,

genetic, and environmental contributing factors. ASPD can be triggered by substance
abuse such as alcohol or drug addictions. Associating disorders that are present in ASPD
patients are attention deficit hyperactivity disorder (ADHD), reading disorders and
substance abuse. People at risk for ASPD are thought to have a history involving
childhood physical and/or emotional abuse, neglect and/or abandonment, association with
ASPD peers or having a parent with ASPD. In the motion picture The Dark Night, the
Joker states that his father was a drinker and a fiend. Alcoholism can be inherited from
parent to child, so because of this it could trigger the Jokers ASPD. Antisocial Personality
Disorder, has several signs and symptoms, according to Psych Central people suffering
from this disorder usually display a lack in social norm behavior, Because there is
usually a pervasive lack of remorse, and many time any feelings at all, they are assumed
not to have any real feelings by many professionals. (Psych Central, 2010). As seen in
the motion picture The Dark Knight, the character The Joker displays this by repeatedly

attacking batman in an attempt to stop him, as well as continuously performing acts that
ground for arrest. By continuing to perform acts that can get him in trouble with the legal
system not only is he is rebelling against the social norms of society, he is also showing a
lack of remorse for his actions. As seen at the very beginning of the movie, a bank is
robbed and the joker ends up killing all of his own men to gain a one hundred percent
profit from their earnings. Throughout this process we are able to see that the joker is a
deceitful person because he has lied, manipulated. Conned and used an alias. When
deceiving a person it is usually done without feeling, or remorse, which is one of the
main signs of ASPD. Another symptom of ASPD is disregard for safety of self and
others; this is shown several times throughout the entire movie. During the movie people
are being held captive, the Joker is constantly dealing with guns and bombs putting him
and others in harms way. The joker appears to get some form of gratification by
constantly trying to break down the hope of Gotham; it is almost as though his ASPD has
led him to believe that he can play God of the city with no consequences. When
diagnosing a patient with ASPD there is no specific test that can positively assess the
presence of ASPD, psychological professionals conduct a mental-health interview that is
assessing for the presence of antisocial symptoms. According to the European Journal,
A prevalence of 3% in men and 1% in women is the generally accepted figure
(American Psychiatric Association, 2000; National Institute for Health and Clinical
Excellence [NICE], 2009) showing that ASPD is diagnosed more in men than woman.
The mental health interview is checking to see if they are mentally stable, as well as
checking for the following ASPD symptoms; failure to conform to social norms,
deceitfulness, impulsivity, irritability, recklessness, irresponsible and lack of remorse.

Because there is not an entirely accurate way of assessing for ASPD, sometimes-false
positives do occur.

Psychotherapy treatment of Antisocial Personality Disorder is seen to be the best

approach according to The European Journal of Psychotherapy & Counseling. The
treatment begins with setting up the study and treatment program, this is where the focus
of how mentally stable the patient is, are there substance dependencies and past
experiences like abuse are present. These contributing factors to ASPD are important to
know so that they can be addressed as well in the therapy sessions. After comes
assessment & outcome measures, this is the stage where the patients fill out reports each
night to assess their violence and behavior level towards themselves, objects and others.
These assessments are done as a pre-group entrance test just to make sure the patient is
stable enough to enter a group setting. The third step is patient profile, this is the step
where any other diagnosiss like depression, paranoia, anxiety and violent lifestyles are
addressed and questions are asked to get an understanding of their current situations and
the level of concern that they are, so that these issues an be properly dealt with.
Preliminary results, the step where aggression, irritability and suicide rate are graphed on
a chart, and kept track over the weeks. The data collected is given from the patients to the
therapist and later recorded. The European Journal states, The preliminary results for
the OAS-M suggest that the patients rated their aggression towards others and themselves
as decreasing in severity over the first6.5 months of treatment, whereas their rating of
their irritability remained
Constant (American Psychiatric Association, 2000; National Institute for Health and

Clinical Excellence [NICE], 2009). Although their thoughts of suicide and aggression are
rapidly decreasing week by week the irritability is staying the same because ASPD is still
present but the patients are getting better at with holding and disregarding aggression and
suicide thoughts. Lastly, The experience of facilitating the group, challenges and
modifications, after reviewing the data collected is used to form another form of patient
plan, this is used for facilitation of patients together. If the patients need for aggression
and suicide do not decrease they are not usually facilitated without company. For
challenges and modifications this is where issues are brought forward and dealt within
the group. Example, substance abuse a be discussed in the group so that the patients can
talk as a group about experiences and issues and coping mechanisms are then taught.
Throughout this process therapists are trying to build therapeutic relationships with
therapist-patient and patient-patient. By establishing theses relationships, patients can
start to draw the line from behavior to feelings with makes it easier to distinguish
between positive and negative social norms.

It helps to form an in-patient and out patient plan. In-patient plans focus on the problems
that need to fix before they are released. Therapists work on forming therapeutic
relationship with the patient which can be hard considering that the patient has most
likely never had such a relationship before and that can be intimidating for the patient.
Establishing this relationship can be difficult because it forces the patient to trust, open
up and begin to feel; feelings are extremely disconnected with ASPD patients. The goal
of the therapist is to discuss and try to draw connections between their behavior and
feelings. Joker did not really receive a lot of treatment in the movie The Dark Knight,

there were times when hostages were held and police investigators had to try to talk the
Joker into releasing them, and they tried to make him realize his actions were wrong. The
European Journal states that, Crisis management and psychiatric review form an
important part of treatment (Gill McGauley, Jessica Yakeley, Andrew Williams &
Anthony Bateman, 2011) it is important to also focus on these two factors to access the
patient to figure out ways of forming a plan to prevent future outburst of former
behaviors. Throughout the movie the Jokers actions escalated and he fails to realize that
his behavior is affecting himself and others. If the Joker was admitted and had to go
through Psychotherapy & Counseling it would be a long and tedious process but he
would benefit from it greatly. As a part of psychotherapy its recommended improving
social relationships with family and friends, the Joker exclaims in the movie that his dad
was abusive and severely hurt his wife, these issues can be discussed in the patient profile
because the Joker was also most likely abused. For outpatient care in regards to the Joker
his views on goals, relationships and coping. The group therapy would benefit him
greatly with exposure to people in a safe environment with the possibility of forming
healthy relationships and setting up a support system. If the Joker had a valid support
system it would make the process of going through the five-step psychotherapy process
easier. Have people to rely on and motivate you and vice versa can really benefit ones
progress. Not only will the group therapy help but also the charting will determine if the
Joker is prepared to be exposed to people again or not. It will be hard to base his success
with this therapy without going through it, and ASPN is thought to be untreatable with
proper motivation and therapeutic relationships there is a potential for the Joker to
connect with his inner self and learn how to fit in with society without negatively

standing out. Overall, the effectiveness of the psychological treatment is questionable, it

seems to be based mainly on how the establishment of the relationship between patienttherapist and patient-patient. If the relationship lacks connection than the treatment would
not be as effective, but at this time psychotherapy appears to be the only sufficient
therapy for ASPD.

In conclusion, the motion picture The Dark Knight does an outstanding job of
demonstrating Antisocial Personality Disorder, with all of the lying, deceit, recklessness
and lack of social norms. This movie might have over played the average ASPD patient a
tad, but it definitely was an eye opener to how difficult ASPD is to treat. The viewers
could perceive that ASPD is normally as severe as the Jokers case, its important to keep
in mind that the Joker also had other disorders aside from ASPD (schizophrenia). Its also
important to note that ASPD cases are not normally as severe as a villain trying to destroy
a City like Gotham; its in most cases less severe. Society could potentially have a fear of
somebody with ASPD after watching and researching this movie. Overall, this movie was
thoroughly entertaining, and did an excellent job of portraying a sever case of ASPD.
References:
John M. Grohol, Psy.D. (January 1, 2010). Psych Central. In Antisocial Personality
Disorder Treatment. Retrieved November 18, 2012, from
http://psychcentral.com/disorders/sx7t.htm.

Gill McGauley, Jessica Yakeley, Andrew Williams & Anthony Bateman. (2011).
European Journal of Psychotherapy & Counseling,


http://www.tandfonline.com/doi/abs/10.1080/13642537.2011.629118

Roxanne Dryden-Edwards, MD. (October 9, 2012). Medicine Net. In Antisocial

Personality Disorder. Retrieved November 21, 2012, from
http://www.medicinenet.com/antisocial_personality_disorder/article.htm.