GOTHAM's Mental Health Issues, Part 2
Author: Vasilis Pozios, M.D. (Follow @BTDOCS)
October 5, 2014

EDITOR'S NOTE: CLICK HERE for Part 1 in this series of articles.

As GOTHAM unravels with S1E2, “Selina Kyle,” it continues to showcase characters with a variety of mental health concerns. This week, we see dysfunctional family relationships, the aftermath of trauma, children’s mental health issues, psychopathic villains, and an apparent anti-psychiatry sentiment.

Bat Out of Hell
The aftermath of the Wayne murders continues in this episode. First off, we learn that a troubled Bruce hasn’t been sleeping, and when he does, he’s having nightmares. He’s also been burning and cutting himself, listening to heavy metal, and drawing pictures of heads dripping with blood. So what’s going on with Bruce?

Perhaps Bruce is simply grieving the loss of his parents – a normal process called bereavement. However, his behaviors suggest something more. Is he depressed? Probably – he just witnessed his parents’ violent murders. So while Bruce dismisses his self-injurious behaviors as “testing” himself, this might be a ruse. Some people cut or burn themselves out of guilt and self-loathing or to relieve anguish, sometimes feeling a “high” from it. Could this mark the beginning of Batman’s penchant for physical punishment? Or maybe Bruce’s disturbing doodles and death metal (thankfully, he didn’t bite off a bat’s head) indicate the start of a nihilistic mindset. And while bereavement or depression may be the source of his sleep difficulties, there could be other causes.

The death of both his parents is certainly a huge loss to Bruce, undoubtedly shattering his innocence. But to make matters worse, he saw them gunned down before his very eyes. Does experiencing that kind of trauma mean Posttraumatic Stress Disorder is to blame for Bruce’s behavior? Possibly. Bruce’s nightmares may be a form of re-experiencing the trauma – although we don’t know their content – and many trauma survivors engage in increased risk taking behaviors.

Bruce’s diagnosis (if any) will hopefully become clearer as the season progresses.

Do You Know Where Your Children Are?
Mayor James asserts that half of Gotham’s petty crime is committed by homeless children. He uses the recent child abductions as an excuse to rid the streets of the problematic homeless kids and starts shipping them upstate to a youth corrections facility. Gordon then questions the legality (or at least the morality) of incarcerating minors without adjudication. Could something like this ever happen in real life?

In the real world, homeless minors (not just the “cute, undamaged ones”) would typically enter the foster care system and would not be sent to such a facility for delinquents. Also, simply being in trouble for something like running away from home wouldn’t be enough for long-term confinement in a juvenile corrections center. What’s more: Kids have rights, too. Guess Gotham doesn’t believe in due process.

And who happens to find herself among the kids being shipped upstate? Selina Kyle, a.k.a. Cat, of course. With a history of juvenile detention, she’ll do anything to avoid going back. And, like a feral cat, she can be dangerous when cornered – just ask Doug and Patty’s enucleated henchman. But Selina’s claws aren't her only weapon. She’s highly manipulative. Look at how she threatens a police officer with a sexual molestation charge if he doesn't allow her to speak to Gordon. Selina then bargains with Gordon, offering the identity of the Wayne murderer in exchange for saving her tail.

Talk about nine lives.

Pin-teresting Drug
The MacGuffin of the week is “ATP” – no, not adenosine triphosphate, but a fictional fast-acting pharmaceutical previously used at Arkham to “bring down troublesome patients.” Child abductors Doug and Patty stick Gotham’s homeless kids with giant ATP-laced pins to render them unconscious, then trafficking them to the Dollmaker. (For those unfamiliar with the Dollmaker and his “family,” think Leatherface from The Texas Chainsaw Massacre as head of a Pleasantville-esque Manson Family.)

Although Arkham's been closed for 15 years, apparently there are three pharmaceutical suppliers in Gotham who still have a stash of vintage ATP. In case you’re wondering, no, ATP doesn’t exist in the real world. But a slower-acting correlate, which has therapeutic use in the real world, might be intramuscular benzodiazepines (like Ativan) or antipsychotic medications (like Haldol). These medications are often used to treat acute agitation in emergency and inpatient psychiatric treatment settings and might cause sedation as a side effect. Whether ATP will have any other uses in GOTHAM remains to be seen.

Walk Like a Man
In S1E2, Oswald “Don’t Call Me Penguin” Cobblepot’s labored gait now accompanies his stilted speech. Shuffling down the shoulder of a highway, Oswald flags down an SUV full of frat boys. After punking Penguin, the boys give him a ride and even share a beer with Oswald. When one frat boy insinuates that Oswald walks like a penguin – you guessed it – the kid gets stabbed in the neck. Later, the not-so-loveable loser Oswald can't even get a kidnapping right: when he demands ransom from one of the surviving frat boy’s mother, she dismisses Oswald’s demand as a joke – which doesn't bode well for his hostage.

Mommy Dearest
Speaking of mothers, Oswald's mother – Gertrud Kapelput – clearly idealizes her son, but in a bit of a Bates Motel-ish kind of way. She laments her estrangement from her son, which she blames on “a woman,” and adds, “Some slut has him in her clutch.” Is Oswald’s mother jealous of a potential amorous rival, in a converse-Oedipal sort of way? Or, instead of the Jocasta complex, is Ms. Kapelput simply overbearing?

Sometimes a cigar is just a cigar.

Social Distortion
Edward Nygma is clearly one smart cookie, but his social awkwardness is on full-display once again. He brilliantly identifies the chemical used in the abduction of Gotham’s children, but the future Riddler intrudes on a meeting in Essen’s office and fails to recognize his dismissal. Is this evidence of a possible Autism Spectrum diagnosis? Nygma also appears disappointed that his discovery didn't garner more adulation, perhaps signaling traits of a Narcissistic Personality Disorder.

Swim With the Fishes
Carmine Falcone calls Fish Mooney’s bluff in a psychopathic game of poker oozing with deceit, manipulation, and intimidation. With his deadpan demeanor, Falcone shows fish who’s boss, leaving Fish in a displaced fit of rage.

No Psych for You!
When Gordon asks Alfred if Bruce has gotten professional help, Alfred goes full Tom Cruise and responds, “No psychiatrists... that’s the rule.” Apparently, Thomas Wayne’s posthumous instruction to Alfred was no mental health treatment for Bruce so that he can “choose his own course.” Does this reinforce the trope of psychotropic medications as “mind-altering,” and psychiatrists as foes of free-will?

Although some physicians look down on psychiatry, it seems a bit unusual for an esteemed physician such as Dr. Wayne to have such an extreme opinion. Maybe his wariness of mental health treatment is colored by the corruption at Arkham Asylum? Whatever the reason, his blanket denial of medical treatment for Bruce seems a bit out of character – and neglectful.

Gordon encourages Bruce to seek psychotherapy, like he intimates he did when dealing with combat trauma. Maybe Gordon considered calling Child Protective Services to ensure that Bruce gets the medical care that is in the boy’s best interests. But instead, Gordon becomes Bruce’s surrogate therapist – at least for the episode. And, with a nod, Gordon acquiesces to Alfred’s no psychiatrist rule when he tells Bruce that the homeless kids need someone who cares for them, like Bruce has. The “all you need is a friend” trope (à la The Soloist) seems consistent with Wayne Manor’s “no psych” doctrine, perhaps foreshadowing an explanation for Batman’s maladjusted psyche. - Vasilis Pozios, M.D.

Vasilis K. Pozios, M.D., is not only a lifelong Batman fan, but also a board-certified physician specializing in forensic psychiatry, experienced in the evaluation and treatment of criminal defendants and convicted criminals – a real-life Dr. Arkham!

Dr. Pozios is a co-founder of Broadcast Thought, a media consultancy and creative collective dedicated to evolving the representation of mental health issues in the media and entertainment industries.

Broadcast Thought has been featured in The New York Times, Time, The Huffington Post, Wired, ABC News, Entertainment Weekly, Discover, and other publications. They have served as creative consultants and subject matter experts to the media and entertainment industries, and are currently creating mental-health related original content.

Find out more at, and follow on Twitter @BTdocs.

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