Did You See 'Joker'? Here's the Real-Life Medical Condition Behind His Uncontrollable Laugh (2024)

The Joker has had many origin stories throughout the 80 years since his debut. These alternating narratives of how Batman's nemesis came to be have become part of the infamous comic book villain's mythos, an extension of the anarchy the character loves to inflict on Bruce Wayne and the residents of Gotham.

In Joker, the latest film from Todd Phillips that opened on October 4 and stars Joaquin Phoenix as the titular character, the villain's origins are once again explored with a darker twist that deviates far from past iterations of his backstory.

Phoenix plays Arthur Fleck, a man struggling with a variety of mental illnesses that keeps him from finding acceptance in a city that is slowly slipping into chaos itself.

One of these illnesses causes Fleck to uncontrollably laugh at inappropriate times, leading him to carry an informational card that explains the condition to people who may be near him during an episode. While the movie never names what specific illnesses Fleck has been diagnosed with, these fits of controllable laughter are based on an actual disorder called Pseudobulbar Affect, or PBA.

According to Mayo Clinic, the condition causes bursts of uncontrollable laughing or crying and usually manifests in people with ALS, MS, neurological conditions or traumatic brain injuries.

Did You See 'Joker'? Here's the Real-Life Medical Condition Behind His Uncontrollable Laugh (1)

These episodes can go on for minutes at a time, the organization says, and can cause embarrassment, social isolation, distress and depression.

"I thought of him having these reactions that one would consider inappropriate," Phoenix told Indie Wire. "I thought of the movie as a commentary on humor in our PC culture. Somebody who was out of touch with the world, laughing at school at something horrible that has happened. How to explain that to the principal?"

In Joker, Fleck's outbursts were triggered when he became angry, embarrassed, shocked or nervous, especially in public situations. Eventually, it's an incident during a PBA episode on a train that sparks Fleck's transformation into Joker and his descent into villainy.

According to Indie Wire, the idea of Fleck having PBA came from Phillips. Phoenix, though, isn't entirely convinced that Fleck has the disorder.

"I never decided which one it was, but I liked the idea that it was perhaps his real nature emerging that other people were trying to suppress," Phoenix explained to the outlet.

"I recognized from my previous work with You Were Never Really Here the signs of PTSD, and I saw that in certain moments he was in [fight] or flight," he added. "I recognized these signs that allowed me to think about him differently."

Though Fleck/Joker commits despicable crimes, showing what the character is undergoing psychologically could allow audiences to sympathize with him, Phoenix said.

"It's hard not to have sympathy for somebody who experienced that level of childhood trauma: An overstimulated medulla looks for and perceives danger everywhere," he told Indie Wire. "For someone in that state, does it mean his actions make sense or are justified? Obviously not."

Did You See 'Joker'? Here's the Real-Life Medical Condition Behind His Uncontrollable Laugh (2024)

FAQs

Did You See 'Joker'? Here's the Real-Life Medical Condition Behind His Uncontrollable Laugh? ›

The condition known as pseudobulbar affect (PBA) is characterized by brief uncontrollable outbursts of crying or laughter that are incongruent with the patient's feelings of sadness or joy.

What condition did the Joker have that made him laugh? ›

The above-mentioned characteristics make the Joker's laughing episodes compatible at first sight with the pseudobulbar affect, a clinical entity characterized by episodes of exaggerated or involuntary expression of emotions, including uncontrolled laughing or crying.

What is the disease Joker has in his smile? ›

Arthur Fleck, the central character of the 2019 film Joker, displays signs of pseudobulbar affect, which are said to be what Joaquin Phoenix used as inspiration for his character's signature laugh.

What disease was Joker suffering from? ›

In addition, we can assume that Arthur suffers from pseudobulbar affect, or emotional incontinence, which is a disorder of regulation of emotional expression, caused by neurological disease or injury affecting the brain.

What is the condition where you laugh uncontrollably? ›

Pseudobulbar affect (PBA) involves uncontrolled or inappropriate episodes of laughing or crying. These emotional responses don't match the intensity of your inner feelings. PBA results from certain underlying neurological conditions. It's manageable with medication.

Is uncontrollable laughter a medical condition? ›

Pseudobulbar affect (PBA) is a condition that's characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

Is the pseudobulbar affect real? ›

Abstract. Pseudobulbar affect (PBA) is a dramatic disorder of emotional expression and regulation characterized by uncontrollable episodes of laughing and crying that often cause embarrassment, curtailment of social activities, and reduction in quality of life.

What mental illness does Harley Quinn have? ›

Personality Disorder, specifically, Histrionic Personality Disorder plays a key part in Harley Quinn's life. People with Histrionic Personality Disorder are “pervasive and excessive emotionally and display attention-seeking behavior” (Bornstein 1998).

Why is the Joker so skinny? ›

Director Todd Phillips considered the character's body size as one way to represent his vulnerability. It is important to emphasize that unlike most people who diet to lose weight or who develop an eating disorder, Phoenix's weight loss was intended for the short amount of time it took to shoot the movie.

Who is Joker's wife? ›

History. Jeanie was married to the man who would become the Joker when he worked as a chemist at the Ace Chemical Processing Plant.

Was the Joker all a hallucination? ›

The Joker movie makes it clear that not all of the events we see are real and that much of the action is imagined or hallucinated. It is never made apparent, however, just what events might be real, giving rise to the possibility that nothing we've seen actually happened and that the whole film is a madman's dream.

Why does the Joker always lick his lips? ›

This is actually because of the prosthetic scars that Heath Ledger wore. They kept falling off, so Heath would lick his lips to keep them in place. Gradually, it became a part of the Joker's character.

Who is the Joker's dad? ›

In Joker, Thomas Wayne (Batman's father) and Penny Fleck (Joker's mother) are key characters. Penny claims that Thomas is actually Arthur's father.

Did the Joker have pseudobulbar affect? ›

While the movie never names what specific illnesses Fleck has been diagnosed with, these fits of controllable laughter are based on an actual disorder called Pseudobulbar Affect, or PBA.

Is uncontrollable laughter a seizure? ›

Gelastic seizures (GS) are a rare form of epilepsy characterized by inappropriate, uncontrolled laughter. They are highly associated with abnormal cognitive development and behavioral problems in patients.

What is laugh syncope? ›

Laughter-induced syncope is similar to other causes of vasovagal syncope, such as cough, micturition, defecation, and Valsalva-induced syncope. There is an increase in intrathoracic pressure that causes an exaggerated response of the autonomic nervous system.

What is the PBA Joker Pseudobulbar affect? ›

Called Pseudobulbar Affect, or PBA, it is a neurological condition that is characterized by frequent, involuntary, and uncontrollable outbursts of crying or laughing that are exaggerated or not connected to your emotional state. Laughter often turns to tears.

Why Joker kept licking his lips? ›

In the documentary I Am Heath Ledger (via Digital Spy) it's revealed that, in order to keep the prosthetics in their place as they got loose when he spoke, Ledger had to lick his makeup to keep it in place, and it ended up becoming part of the Joker's manic personality, as well as his most memorable mannerism.

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