Part one. How a mental disorder is incubated

There are three fundamental sources that seek to describe reality: history, the media and art. Of the three, it is art that comes closest to reality. Films, as such, almost always attempt to photograph aspects of human reality. The film Joker — which stages the famous DC Comics character, known for being Batman’s sworn enemy — and which is breaking box-office records, is no exception. It is a film, directed by Todd Phillips, that plunges us into the underrated world of mental health, with a profoundly human sense.

The character of the Joker is played by Joaquin Phoenix, who will probably win, for this dazzling performance, the Oscar for best actor. There is in this film a profound psychological richness to be explored. That is what makes its value.

Some have said that it was problematic and that it romanticised violence; others assure us that it is a necessary film. It is said to promote violence, even though violence has always existed, including at a time when there were no films.

Of course, if we content ourselves with looking at the Joker’s violence — like those who look only at their children’s rebellion —, we shall disapprove of it; but if we make the effort to look beyond the Joker and if we stop to examine his history and his family, like someone who looks at themselves as a parent, we would begin to reflect — and we might even discover with astonishment — where the origin of so much violence and so much rebellion may well be lodged. That is what is interesting: Joker puts its finger on the wound by masterfully describing the clinical history of the way a mental disorder is incubated. In many of the character’s key phrases, we can analyse the account of a person who has suffered, marked by a story of unlove, and who ends up turned into a mentally ill man.

A collector of symptoms and diagnoses

It is obvious that the Joker suffered from a mosaic of psychological disorders, beginning with an undeniable psychosis, characterised by his delusion of grandeur as a hero disguised as a villain; he renounces being Arthur Fleck — his real name — and asks to be called the Joker, thereby abandoning his own identity in order to take on another. He is deluded into being a happy clown who, deep down, covers over an unhappy man. He also displays profound sociopathic traits, which lead him to kill without feeling guilt, as when he kills his mother — even though, beforehand, she herself, like others, had already murdered him psychologically.

He suffered besides from a chronic depression, manifest in his loneliness and in that tic of forced laughter behind which he hid his profound sadness. Neurosis was not absent either, expressed in the strong anxiety he sought to soothe with cigarettes… that is who Arthur was: a collector of symptoms and diagnoses that made his life miserable and anguished, like the life of thousands of human beings who suffer from mental disorders and are not understood: not even by their own family, and still less by the society that surrounds them.

Neither genetics nor destiny: bonds

But how does an innocent come to be transformed into a threatening monster? How does Arthur, the good child, become the Joker, the evil adult, who ends up a demented criminal? How does a person come to develop a mental disorder? Where does all psychological pathology sink its roots? A broad swathe of classical psychiatry, with its biologising ideology, has made us believe that the majority of mental disorders have a genetic origin, that most of the people affected have a genetic predisposition they were born with and that they are condemned to live for ever with their affliction; to the delight of the pharmaceutical industry and the enrichment of the owners of the great laboratories, who will make patients dependent on their pills, but will not cure them.

One is not born with a mental disorder, since a foetus begins its conception more or less perfectly; a pathology is formed in the environment in which it grows, from the mother’s womb onwards. There may be exceptions, but they are only that. It is not genetics that is responsible for a mental disturbance, it is the unhealthy bonds in which a foetus and then a child grow up that can lead to psychological illness. It is not cerebral biology, it is unhealthy relationships that engender pathologies. Our axiom is that every unhealthy personality is incubated in unhealthy bonds. Arthur — that is his true identity, and I refuse to call him Joker, the jester — did not have a genetic predisposition to become a demented criminal; what he had was a relational atmosphere that converted him into one. That does not justify his act, but it explains it.

Every child needs to arrive and to grow up in a relational environment characterised by love, the only one capable of guaranteeing their mental health. A love that was never present in Arthur’s life: he himself says that in his whole life he has not known a single moment of happiness. An unhappy childhood prepares a potentially disturbed adulthood. It is in an unhappy childhood, marked by unlove, that the great human psychopathologies are incubated. Almost all psychological illnesses, and many physical illnesses too, have their origin in unlove (Maturana, 1993). There is the nest in which the great personality disorders grow. That is why another of our axioms is that, behind every unhealthy personality, there is always a story of unlove that explains that conduct. An unlove that expresses itself in unhealthy bonds capable of destroying a child’s identity, as happened with Arthur. Let us therefore now plunge into the story of unlove of our sorely tried character, whose existence is given shape in an extraordinary screenplay that moved me deeply and pleasantly surprised me when I saw the film.

Disconfirmation, the most destructive of all forms of maltreatment

From our therapeutic position, we believe that the unhealthy bonds in which unlove expresses itself and which damage a person’s psyche are principally five in number. Several of them were present in Arthur’s life. The main one was the unhealthy bond of disconfirmation (Watzlawick, 1969), which is the most destructive form of psychological maltreatment of all: it makes the child feel that they do not exist for the most significant people in their life, their parental figures, and that their existence does not matter to them. Such was Arthur’s experience: he had a mother for whom he did not exist, since she lived clinging to the past and only her memories counted, along with the hope of being rescued by that rich man who had made her pregnant. That is why she lived in the compulsion of sending letters that never received an answer. She became bogged down in an over-connection to the father, but was never able to connect to the son. Arthur was invisible to her, just as he did not exist for his father either.

This is what we call disconfirmation: parents who lose interest in their offspring because they are very busy with their own professional affairs, their marital conflicts or their personal frustrations, rendering their children invisible and, thereby, disconfirming them. The worst of it is that, after telling them implicitly “you do not exist for me”, we explicitly demand of them a successful and happy existence, without caring about what they think and what they feel. It is a double disconfirmation, and it is what Arthur’s mother did in repeating to him that he must always smile, that he must be happy and that his mission was to make others laugh; in other words: “act as if you were happy, never mind that you are unhappy”. The meta-message is: “do not be you, you must be someone else”.

It is therefore not surprising that Arthur says he has never existed for others, and that he came to think that he did not even exist for himself. That is exactly the feeling of someone who has lived in the unhealthy bond of disconfirmation. There is the embryo of a future psychotic personality. One is not born like that: one is made like that. No one can exist while feeling like a nobody and without identity; that is why, as a defence mechanism, they have to build themselves an alternative identity with which they feel that they exist and that they matter: I am Napoleon. Arthur was denied by his family the possibility of configuring his own identity, forcing him to build himself an identity borrowed from a cruel, vengeful and bloodthirsty character, such as the Joker was.

Never mind the price to be paid, what matters is to exist and to be recognised. As Arthur, he is a marginalised nobody; but now, as the Joker, he is someone recognised. For, of course: if my real self is despised, I invent myself an unreal self that guarantees I shall be valued; never mind that I am recognised for being evil and that this destroys me, what matters is to be recognised and for others to notice that I exist.

Part two. Between grief and nothing

The famous novelist William Faulkner, in his novel The Wild Palms, tells us: “Between grief and nothing I will take grief”; that is to say: between not existing and suffering, I choose to suffer. Never mind being an outcast pursued by the police; what matters is that, now, I exist, at any price. That is why the conduct of a problem child or of a rebellious adolescent is very often a cry — “I exist, I matter” — and a plea for a healthy bond. That is why, behind the Joker’s costume and make-up, there was hidden a human being who desperately sought to be able to exist, to be accepted, listened to, understood, loved, respected… he wanted to be Arthur Fleck, but he ended up being the Joker.

Very often, children end up becoming what their parents do not want them to be, but which was nevertheless, without their realising it, the screenplay they wrote for their lives. Arthur ended up transformed into that evil character that is the Joker because his family wrote him that screenplay out of the unhealthy bond of disconfirmation, which is nothing other than the psychological murder of a child, since their identity is destroyed. To this, many children could answer: “mum, dad, I would be the perfect child you want if, at least, you had paid attention to me”. But many live affectively abandoned and emotionally orphaned.

Delusion, or tragedy turned into comedy

Another key phrase in which Arthur’s psychotic narrative reveals itself is the one he repeats to himself, trying to believe it in earnest: his life would not be a tragedy, but a comedy. Thus appears delusion, the psychotic’s principal symptom, which is triggered in Arthur’s life and which consists in denying painful reality in order to escape into an unreal world of apparent happiness. He did not want to be aware that his life was a sad tragedy; he must therefore flee into an invented world of joyful comedy. For no one can live immersed in a sea of anguish, feeling that they do not exist for the most significant people around them — one of the worst tragedies a human being can live through, all the more so in childhood. Faced with this anguishing experience, a person will always seek to cling to the lifebuoy of a narrative that keeps them afloat; it is for this reason that Arthur embarks on the delusional idea that his life is a comedy, as a defence mechanism that prevents him from foundering in his painful reality of tragedy. This means: I cannot live in the tragedy of feeling myself a nobody; I must therefore think of myself as someone, even if my life turns into a comedy. For if my real self experiences life as a tragedy, it needs to invent itself an unreal self in which it can experience life as a comedy.

Since one cannot live in a constant deep existential anguish, one has to escape into an unreal world in which life is a profound joy. Being unable to live with one’s own identity, one looks for an alternative identity that guarantees the recognition that has been refused (Linares, 2010). That is why Arthur refuses to be himself, the subject who lives swallowed up in the abyss of tragedy, escaping from his own identity in order to acquire a new one, such as that of the Joker, the jester clown, in which he can experience life from the summit of joy. Very often, deceiving oneself is a matter of psychological survival, in order to bear the pain of tragedy. Psychosis is self-deception carried to the extreme: the one in which one renounces being oneself, someone unhappy, in order to convince oneself that one is someone else, but someone happy.

Depression, rejection, and the body that speaks

The other pathology concomitant with the schizophrenia from which Arthur suffered was a profound depression, manifest in his narrative: he wants his death to make more sense than his life. In other words, he meta-communicates to us: “my life makes no sense, my death makes more”. He values death more than life, a feeling typical of a depressed person with suicidal ideas, who finds no defined purpose to their existence. But if a psychosis is incubated in the unhealthy bond of disconfirmation, the depressive personality nests, for its part, in a disqualification (Linares, 2010) not free of rejection. If the message of the first unhealthy bond is “you do not exist for me”, the message of the other two is “you exist, but I do not like you and I do not want to be with you”. This was another unhealthy experience of unlove from which Arthur suffered throughout his life: the implacable rejection to which he was subjected. He was rejected by his absent father, by his indifferent mother, by the mockery of his schoolmates, by the contempt of a potential lover, by the indolence of a boss who dismisses him, by the negligence of a government that withdraws the pills it was giving him, and even by a television host who invites him only in order to mock him.

Arthur’s whole life was marked by the tragedy of rejection and disconfirmation; it is therefore not strange that he should want to turn it into comedy, in which his own body collaborated. For part of Arthur’s “comedy” consisted in developing a neurological disorder called emotional lability, or pseudobulbar syndrome: a condition characterised by episodes of sudden, uncontrolled and inappropriate fits of laughter (or of tears), which occur when the patient feels like crying or is nervous; episodes that can last several minutes and cause shame, social isolation, anguish and depression. Arthur suffered from all this, but he tried to deny his depression by building himself the narrative of a life that would be a comedy. Yet everything that does not explode outwards will implode inwards. There is the origin of many psychosomatic illnesses. Thus Arthur denied his depression by asserting that his life was not a tragedy but a comedy; now, when we deny something with our psyche, our body demands its due, and a short circuit can occur in our nervous system, which may translate into a neurological disorder such as the one from which Arthur suffered.

For what the soul keeps silent, the body says. Denying the sadness of his soul made his body speak through a syndrome; which demonstrates that many physical or psychological illnesses may be nothing but metaphors, which conceal the message of a painful reality that we refuse to accept. Arthur preferred to live in the lie of a laugh rather than in the truth of a tear.

True criminal madness

The unhealthy bonds, such as disconfirmation and rejection, in which a person may live produce psychological wounds in them: shame, guilt, rage, and so on, which are the foundations on which a personality disorder is built. Most accumulate resentment and rage, which make them aggressive against themselves or against others, as was the case with Arthur. But the greatest violence we observe in the film is not the violence he commits against others: it is the violence that others exercised against him first. Arthur does it in a visible and brutal way, but the violence against him was invisible and progressive. It is true that he is a demented criminal, but it is also true that the true criminal madness is the one that was carried out against him, with an environment marked by maltreatment, which murdered him psychologically with the unlove of disconfirmation and rejection, and which ended up blowing apart his fragile identity.

After living in so contaminated a relational atmosphere, can anyone dare to say that he ended up psychotic and depressed for some genetic cause? Whoever did so would be madder than Arthur. There is no doubt that it is in the unhealthy bonds of unlove, with which a child is psychologically maltreated, that the true cause is to be found which makes them physically and psychologically ill, and can even lead them to madness.

It is said that the Joker represents murderous violence incarnate, and so he does; but behind him there is a still greater violence, the one that engendered him: the violence of unlove, expressed in his parents’ disconfirmation and in the rejection of others. All are accomplices in having created the monster they now repudiate. Arthur is not innocent, but his environment is the great culprit in his creation. He did not fail entirely: his environment failed more. He is the worthy son of unlove. He was violent because violence was done to him. It is true that neither the pain nor the wound justifies violence, for just as one can learn aggressive behaviour, one can unlearn it; but that is easy to say, and what is not fully understood is that the recovery of a disturbed person does not depend on them alone, but also on their environment — ourselves included.

Very often, his own tormentors ought to be his carers; but, on the contrary, they go on being his abusers. That is why Arthur remarks that the worst thing, when you have a mental disorder, is that people expect you to behave as if you did not have one. He is required to behave well and it is not understood that he cannot, because of his illness. It is as if one demanded of a paralysed person that they start running. Most people affected by a disorder are understood neither by their family nor by society: they are expected to act well, as if they suffered from no disorder. Their legs are cut off, and then they are asked to walk normally.

It is true that there are children who escape this curse, but that is a subject requiring an explanation that goes beyond the scope of the present article.

For the moment, we underline the consequences of unlove and the failings of the environment. Arthur was born and grew up in a family context stuffed with unlove. Since childhood, he has known only the language of violence and has never learned to speak another tongue. It is not that he was born the black sheep of the family: it is the family that converted him into one. His only fault was not being able to break with the programmed screenplay and to dare to write his own life story. He was condemned by justice, but his environment remained unpunished; that is why, in the end, he wanted to do justice for himself.

“There are families in which one suffers more than in a concentration camp”, wrote a former inmate of Auschwitz, the Nazi extermination complex. For when the unlove of disconfirmation and rejection is what prevails in a home, children suffer more than those who lived in those extermination camps. They need to breathe a family atmosphere close to paradise in order to grow up healthy and happy. Let us not engender a Joker: let us form a being capable of succeeding. Neither the one nor the other is a matter of genetics or of luck: it is a matter of bonds. If a child grows up in unhealthy bonds of unlove, their personality will set out on an unhealthy trajectory; but if they develop in healthy bonds of love, their identity will travel along the path of functionality and full fulfilment. Unfortunately, Arthur lived the first situation.

Part three. An embrace that could have changed everything

Throughout the film, one finds the heart-rending and silent cry of an Arthur who meta-communicates to us, in every way: “I need to be loved”; up to the moment when he is going to communicate it openly, the moment when he meets his father. It is one of the most moving and most powerful scenes in the film, watched with a tightened heart. Arthur had done the impossible in order to manage to see his father, rich and inaccessible; and now, at last, he had him there, in front of him. He tells him that he sought him out not to claim the inheritance to which he is entitled or the family name that is his due, but only to be able to pronounce that word never said before: father; a word he was never able to say to anyone else, since his mother denied him the possibility of a new father, having never been able to get over her impossible love. The most moving scene is the one in which he addresses to him a request which, had it been accepted, could have changed his destiny. Up to that instant, his life could have been otherwise; afterwards, everything became irreversible. It was an instant that could have changed everything, but that only made everything worse. Arthur was asking only for a gesture of love that could have healed him, but he received, once again, a gesture of unlove that finished off his disturbance. It is the moment when he makes the man in front of him understand that he is not asking him for his money, but only for a father’s embrace. He was claiming neither money nor anything in particular; he says only that he has come to ask for a father’s embrace, so long deferred and sought; he was pleading only for a caress of love that would fill with love the hole in his soul.

We must satisfy our children’s physical and material needs, but let us never forget that their deepest needs do not lie there: they are psychological and spiritual, and the child needs to think of themselves and feel loved in order to grow up healthily. For just as there are unhealthy bonds of unlove — such as disconfirmation and rejection — that made Arthur ill, there are also healthy bonds of love, such as tenderness and caresses, that could have healed him; because if unlove makes ill, love heals. Arthur lived his whole life in unlove, and that is why he fell ill; he now had the opportunity to receive the little love he was crying out for and, thereby, to be able to heal.

Arthur was expecting these two things from his father: that is why he was there, begging for a little love. And yet, instead of an embrace, what he receives is a punch in the face, which represents the physical violence of rejection; but that would not be the blow that hurt him most: it would be that other punch received in the soul, when his father makes it plain to him that he is not his father and that he must never approach him again; in other words: “I am not available for you”, the representation of the psychological violence of disconfirmation. It is in this final act that there occurs, I believe, the culminating point of the consummation of his ruin. The process of the gestation of a demented criminal was reaching its term. Arthur dies as such, and the Joker is born as a criminal.

Why would the son of the vice-president of General Electric enter the Sandy Hook primary school, in Newtown, Connecticut, to blow apart the little bodies of twenty first-year children? Why did he act in this way, if his father had him live in abundance and gave him everything? Surely because he satisfied all his material needs, but left his psychological needs empty. Was he always available for his son, or always busy with his work, disconfirming him? Did he know how to embrace him and compliment him all the time, or did he reject him? Tenderness and caresses are, among others, bonds of love, as vital for a child as physical food; and when they are not satisfied, the soul falls ill and wounds open, such as resentment, which stands behind many expressions of violence and which, in extreme cases, can lead to killing others, as this son did.

“Evil exists, and it is the absence of love”, Juan Luis Linares tells us; that is to say that wickedness is not only an explicit act of insults and slaps, it is also an act of omission and absence, such as the refusal of caresses. To cease embracing is to maltreat; and it is in this context of a story of unlove, and not in a genetic inheritance, that disturbed personalities are incubated. Arthur’s destiny could have changed with a simple embrace, which would have made him feel loved and touch the sky; but instead of that, he received a punch that made him feel rejected once again and cast into hell. The punch in the face was a visible physical violence that hardly hurt him; the true punch in the soul, that of rejection, is the true invisible psychological violence, the one that finished off making his soul even more ill.

There are many parents who, instead of embraces, give their children punches: blows of indifference, of absence, of shouting, of insults, of criticism… and then we ask them to be good people and to succeed in life. We maltreat them, and then we demand of them that they not be Jokers; and yet it is indeed the unlove of many parents and the negligence of a sick society that create so many Jokers in today’s world. Let us therefore be parents and people who go about the world giving embraces instead of punches. If the blow of rejection is the violence of unlove, the caresses of the embrace are the expression of love. As we have already said: if unlove makes ill and produces a mental disorder, love, for its part, heals, and it can transform the life of more than one disturbed person. We must believe that there is a profound therapeutic power in love. That is why, when we see a badly brought-up child or a rebellious adolescent who goes too far, what they are probably crying out to us for, behind that conduct, is that we love them, as Arthur did; but perhaps we shall reject them and punish them still more, and thus, without realising it, we shall pave their road to pathology.

Arthur is guilty, but he is also an innocent who has been driven off the rails. Let us neither judge nor condemn him as an evil being; nor is it a matter of exonerating him from his acts, but let us keep in mind that today’s tormentor was yesterday’s victim. The true villain is the one who does not want to change, and Arthur wanted to, but he was not allowed to. Let us not be careless in our way of judging and criticising disturbed people for their bad conduct. Let us remember what Eckhart Tolle says: “When you are tempted to judge a person, think: if their past were your past, if their pain were your pain, if their level of consciousness were your level of consciousness, you would think and act exactly as he or she does. This understanding brings with it forgiveness, compassion and peace.” It is the capacity to feel empathy and to put ourselves in the other’s place. Perhaps the other received many punches and we many embraces, and it is that which made the difference between our identities. Let us always keep in mind that, behind every disturbed human being, there is a story of unlove that needs to be understood: it is necessary to look at others with compassion before judging them.

Let us not go about the world giving punches: let us go about it giving embraces. Aggressions abound, while caresses grow rare. Let us reject neither our children nor our neighbour, even if they provoke us to the utmost; let us be agents of love, let us offer tenderness and caresses at all times, and thus contribute to the healing of so many wounded people around us. That is why, after reading this article, ask your child’s forgiveness for having maltreated them and tell them that you love them; give them an embrace, a kiss and constant psychological caresses. Even in the midst of discipline, you can show them love, so as to be able thereby to kill the budding Joker and to raise a healthy and happy child, capable of succeeding and of contributing to the building of a better Peru and a better world.

Thanks to Joaquin Phoenix, the actor; to Todd Phillips, the director; to Warner Bros., the production company; and to all those who made possible this heart-rending film which, beyond exalting violence, clearly confronts us with its origins: the unlove that makes ill. But love, for its part, heals.

Lima, October 2019.