GOTHAM's Mental Health Issues
Author: Vasilis Pozios, M.D. (Follow @BTDOCS)
September 26, 2014

Although the infamous Arkham Asylum didn’t make its debut in the GOTHAM pilot, the series premiere featured plenty of mental health issues. Here are some potential psychiatric conditions to follow during the upcoming season of the series…

Psychological Trauma
We all knew young Bruce was in for a rough night, but psychological trauma ran rampant in the Gotham pilot. We saw how trauma can affect people differently. Pen- er, sorry, Oswald Cobblepot appeared to respond to his near-death experience by inexplicably killing the first person he saw. But although GCPD detectives Jim Gordon and Harvey Bullock were left hanging – literally – as they awaited their fate, they didn’t seem much worse for wear following their almost meat-locker massacre. Maybe we can credit their resiliency, just as Bruce appears to be forging his resolve following the death of his parents.

Ivy Pepper is another traumatized character. Ivy appears to be a victim of physical and emotional abuse perpetrated by her father, Mario, who also commits domestic violence against his wife. Ivy describes her father as “mean,” and is timid in his presence, careful not to anger him. Ivy mimics her mother by calling her father a “bastard.” Abuse, especially sexual abuse, can be associated with the development of personality disorders such as Borderline Personality Disorder. And having grown up in chaotic, abusive households is a commonality among criminals. Are we seeing the start of Borderline and Antisocial Personality Disorder traits in Ivy?

Antisocial Personality Disorder traits
Second only to the absence of parents, antisocial personality traits seem to be the most common characteristic among Gotham’s citizens – crooks and cops alike. The hallmark of Antisocial Personality Disorder is a general disregard for the law and the rights of others. Although many Gothamites might fit the bill, the starkest examples of antisocial traits include Harvey Bullock’s “bending” the law and Mario Pepper’s despicably brutish behavior. Even juvenile delinquent Selina Kyle demonstrates traits of Antisocial Personality Disorder’s precursor, Conduct Disorder, through her penchant for theft.

Beyond antisocial traits, GOTHAM’s villains display elements of psychopathy. Psychopathy is a collection of personality traits that include innate callousness, lack of caring, and lack of empathy. Ms. Mooney is one cold Fish – her charm belies her ruthlessness. And Penguin follows suit. But in terms of sadism, Fish can’t hold a candle (or umbrella) to Oswald, who derives giddy pleasure from beating down one of her crew. And let’s not forget Carmine Falcone, who fits the mold of a classic “snake-in-a-suit” psychopath.

Autism Spectrum Disorder
The most commonly accepted psychological explanation for The Riddler’s behavior is a compulsion to ask riddles coupled with a narcissistic need to claim ownership of his criminal schemes. However, these aspects of the character may not fully explain GOTHAM’s Edward Nygma. Nygma seems less than smooth in his interaction with Bullock and Gordon. Nygma’s difficulty recognizing social cues, coupled with his obsessive interest in riddles may be indicative of something more pervasive – Autism Spectrum Disorder. Regardless of the diagnosis, it’s clear Edward displays abnormal behavior, not so subtly suggested by Bullock when he tells Nygma he needs “professional help.”

Anger (Mis)Management
The retro GOTHAM goes "Back to the Future" in more ways than one: Oswald turns into a regular "Marty Mc(Can't)Fly" whenever he’s called "Penguin." What do we make of this? Well, his “flipping” out could be conceptualized as a combination of extreme irritability, low frustration tolerance, and aggressive impulse dyscontrol.

Although these symptoms might be part of Penguin’s disordered personality (particularly if he has traits of Antisocial, Borderline, and Narcissistic Personality Disorders), impulsivity, low frustration tolerance, and irritability can also be found in several psychiatric conditions, including Attention Deficit-Hyperactivity Disorder, Intermittent Explosive Disorder, Bipolar Disorder, and Post-traumatic Stress Disorder. The symptoms can also be a result of in utero exposure to, intoxication from, and withdrawal from alcohol and drugs. A history of being bullied could have also conditioned Oswald to adopt this dysfunctional response. Time will tell if Oswald displays evidence of any of these potential explanations for his sudden aggression.

Substance Use Disorders
With Harvey Bullock drinking heavily into the night and needing an “eye-opener” to get his day started, and Bullock later referring to Major Crimes Unit Detective Renee Montoya as "that pill-head looney bird," it seems safe to say alcohol and drug use will be a theme explored this season in GOTHAM

While we’re on the subject of pills, what was up with the GCPD HQ hostage-taker wanting his? Was that an attempt to portray a person with mental illness committing a crime as a result of being "off their meds?" The facial expressions of the hostage-taker seem to either imply the portrayal of some sort of mental disorder or a person experiencing symptoms of withdrawal. People with a mental disorder such as Schizophrenia or Bipolar Disorder who are very symptomatic likely wouldn’t have the insight to request their medication, let alone have the desire to hold someone at gunpoint demanding it. And someone who’s dependent on pain medications would likely be very familiar with the physical characteristics of their pills and wouldn’t be fooled by a bottle of aspirin. Gordon’s aspirin bait-and-switch came off as glib, insinuating that people with mental illnesses are simple. And, of course, the situation is solved with a punch.

Hey, at least Gordon didn't let Bullock shoot the guy. - 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.

comments powered by Disqus

BATMAN ON FILM, © 1998-present William E. Ramey. All rights reserved.