Joaquin Phoenix’s ‘Joker’ Laughing Condition Is a Real Disorder

Joaquin Phoenix’s role in Joker earned him four major awards and stoked considerable controversy about the dark nature of the film. For Phoenix, controversy is nothing new, and he has had experience with facing serious and difficult issues.

Phoenix’s turn as the Joker has been hailed as a masterpiece. It shows the character’s search for acceptance and his descent into madness and violence. 

It turns out that the Joker’s struggle was based, in part, on an actual disorder. The uncontrolled laughing episodes are typical of a disorder that some people struggle with.

How ‘The Joker’ was born

In Joker, viewers saw how one of Batman’s main enemies was created. It follows the journey of a man called Arthur Fleck, and how his mental illness, isolation, and lack of support cause him to turn to violence. 

At one point in the film, the character’s social worker tells him that his treatment program has been eliminated because the funds it relies on have been cut. She tells him that the people in charge don’t care about people like him.

After that, Fleck carries a card to show people when he laughs inappropriately. It reads, “Forgive my laughter. I have a condition.”

The card doesn’t seem to reassure people, and Fleck becomes even more isolated and rejected. But it turns out that his condition isn’t a Hollywood invention. It’s based on a real condition that affects roughly 1 million people in the U.S. 

Pseudobulbar Affect (PBA) is a real condition

People who have had a stroke, brain injury, or live with neurological conditions like Parkinson’s or multiple sclerosis sometimes develop PBA. Although more research is needed, it’s thought to be caused by an interruption in the communication between the frontal lobe and other areas of the brain. These parts of the brain — the cerebellum and brainstem — help regulate reflexes. This impacts how people express emotions.

People with PBA will react to normal emotions with uncontrollable laughter or crying. When these outbursts occur at inappropriate moments, other people feel uncomfortable. People with PBA can end up isolated, both because they feel embarrassed about their condition and because other people are unsure of how to react. 

The Joker’s behavior was inspired by PBA

Joaquin Phoenix
Joaquin Phoenix | Axelle/Bauer-Griffin/FilmMagic

Todd Phillips, who was the director and co-writer of Joker, had PBA in mind when creating Arthur Fleck. He even showed Phoenix a video of a person with the condition when they met to talk about his character. But as Phoenix prepared to play the role, he came to think of his condition as something that was far more complicated.

“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,” he said. “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.”

Obviously Arthur Fleck suffered from much more than PBA, because becoming a murderous madman is not even close to any of the symptoms of the condition. Not everyone experiences the severe form of the condition, so it’s not always even noticeable. Many people who live with it are able to control their symptoms with techniques such as deep breathing, changing their position, distracting themselves with tasks such as counting, and consciously relaxing their forehead and shoulders. 

Hopefully, the Joker’s uncontrolled laughter won’t increase people’s discomfort around those who live with PBA. After all, one of the important themes of the film is how much pain it can cause when people are excluded and hurting.