CHAPTER TWENTY-FIVE
Sharon Packer
Batman’s Arkham Asylum—in any of its many media representations—is a force to be reckoned with, if for no other reason than its popularity in Batman’s fictional universe. Batman himself is extremely popular in his own right and is one of the three longest-surviving superheroes since the superhero genre started in the late 1930s. Historically, he has been the preferred superhero because he also functions as a detective. Arkham Asylum, the horrific mental institution, stands in stark contrast to the opulent Wayne Manor in Gotham City.
Besides being a colorful and entertaining form of speculative fiction, Arkham Asylum in its many manifestations makes important albeit tacit statements about the public’s attitudes toward mental illness. It traces shifts in the ways that psychiatry explains mental illness. It also alludes to many more medically related controversies that are outside of our scope here.
There are many ways to interpret Arkham Asylum and its representations of mental illness—and of those who treat such illnesses. Some readings are opposite of others. Yet no one disputes that negative images of mental illness abound in the Arkham universe.1
On the upside, Arkham Asylum for the Criminally Insane, as an institution, showcases progressive views that distinguish the clinically mentally ill or legally insane from the “generic” criminal class. The graphic novel’s narrator—Dr. Amadeus Arkham—laments that the greatest “crime” of so many institutional inmates is the “crime” of suffering from mental illness. “True” criminals include sociopaths who have no conscience or remorse. They commit crimes of their own volition, with full awareness, even if they are reacting to uncontrollable impulses. They do not have a clouded consciousness or cognitive impairment that obscures their ability to distinguish between right and wrong, which is the current standard for the “insanity defense.” Insanity defenses are not new at all and date back as far as the Code of Hammurabi.
Antisocial offenders who do not meet Arkham’s criteria for “insanity” go to Blackgate Penitentiary, which is an ordinary (albeit fictional) prison, and not a treatment facility, as is the equally fictional Arkham Asylum for the Criminally Insane. Consequently, inmates with serious psychiatric disorders are segregated from the general prison population—unless there is a prison break, when Blackgate inmates storm Arkham, as occasionally occurs.
This magnanimous reading conforms to current psychiatric concerns about the conflation of mental illness with criminality—a view that was standard before reformer Dorothea Dix catalyzed the 19th century mental hygiene movement. Dix campaigned against housing persons with psychosis with common criminals. She won—at the time. To this day, Dix’s achievements are admired by both historians of psychiatry and practitioners of psychiatry. However, her cause was upended when economic changes as well as clinical advances closed most of those asylums.
Sentiment toward psychiatric hospitalization was not always so favorable. During the heyday of the counterculture, from the mid-1960s to the mid-1970s, many members of the youth culture, as well as some established academicians, campaigned against excessive and oppressive psychiatric hospitalization. Researchers such as David Rosenhan published persuasive studies on “being sane in insane places.”2 Using exemplary experimental psychology techniques that merited publication in the esteemed journal Science, Rosenhan essentially proved how easily shills acting as patients can feign mental illness and dupe trained psychiatrists into diagnosing them and admitting them to hospitals. The fact that psychiatric diagnoses had so little consistency from one psychiatrist to another fortified the contentions of “anti-psychiatrists.”
Erving Goffman’s often-cited sociological study Asylums: Essays on the Social Situation of Mental Patients and Other Inmates3 also comes to mind. The book title alone proclaims the parallels between psychiatric hospitals and prisons; the text amplifies his conclusions. Goffman contended that society is simply an insane asylum run by its inmates. Considering that the first mention of Arkham Asylum (the institution) appears in an October 1974 Batman comic, it is entirely possible that the original authors intentionally conflated prisons and asylums. But Arkham Asylum has a far more convoluted history than that simple reference from 1974. Arkham evolved and mutated over the decades, as so often happens with comic book stories.
If we view Arkham from the lens of contemporary culture, we can make very different inferences. Without saying so directly, the Arkham franchise casts shadows on the current state of psychiatric hospitalization, or, rather, on the lack of psychiatric hospitalization, which has led to mass incarceration of persons with mental illness in jails and prisons rather than in treatment facilities. Presently, New York City’s Rikers Island houses more mentally ill than the entire country’s state hospitals. L.A. County and Chicago’s Cook County jails come a close second and third. Veteran psychiatrist Alan Frances, who chaired the American Psychiatric Association’s (APA) task force on the DSM-IV, addresses this unrelenting problem in a 2016 issue of Psychiatric Times.4 He is hardly the first or only psychiatrist to condemn this situation. Almost all popular “psychiatric tabloids” include articles about the criminalization of the mentally ill.
The closing of asylums, begun in earnest in the 1950s, left many seriously mentally ill persons without supervision and without any housing at all. True, there was a time when persons were committed on shaky grounds, sometimes on the word of rapacious relatives, as dramatized in Tennessee William’s Southern Gothic novel, Suddenly Last Summer (1959), which made it to stage and screen. Some persons even underwent unnecessary lobotomies.
Some scholars retrospectively impute financial motives to the deinstitutionalization movement, while others insist that it was intended as a humanitarian gesture. Either way, the results were the same. Premature deinstitutionalization allowed some seriously ill persons to fall prey to the criminal milieu. Many adopt criminal behavior simply to survive—or to appropriate illicit drugs. Such activities lead to arrests and incarceration, not in now-defunct state hospitals, but in dangerous jails and prisons. Some scholars call this unintended consequence “transinstitutionalization,” to emphasis that one institution is substituted for another.5
With the advent of managed care around 1990, even acute care psychiatric stays were shortened dramatically, with emergency rooms often triaging out seriously ill and sometimes dangerous persons, as demonstrated by the tragic example of David Bernstein. Bernstein had a long history of schizophrenia. He had repeated hospital stays—but apparently not enough. In Bernstein’s case, his father pleaded with psychiatric staff to admit his son to an in-patient unit. Father and son visited not one but several New York area hospitals. The elder Bernstein alerted staff of his son’s deterioration and voiced concern about David’s delusions. Despite his father’s best efforts, Bernstein was not rehospitalized before his final fatal act. Obsessed with blonde women, he eventually pushed a blonde-haired tourist named Kendra off a New York City subway platform. Kendra fell to her death. This act led to New York’s implementation of Kendra’s Law, which permits involuntary commitment to outpatient (not inpatient or hospital-based) psychiatric treatment. This treatment provision persists, and is known as AOT (assisted outpatient treatment) and includes over 1,000 patients in New York City as of 2016 (per Bronx AOT Medical Director).6
Ironically, Bernstein’s NGRI (not guilty by reason of insanity) plea failed at trial, to the surprise of many psychiatrists. Prosecutors argued that his choice of a blonde woman in particular was premediated and indicated that he had the foreknowledge to stop his act. He was sentenced to a prison term rather than to the treatment facility requested by the defense. This is but one of the more dramatic examples of the push and pull between incarceration and treatment.
Since the institution of Kendra’s Law and Bernstein’s conviction, America has witnessed many more brushes between murder and mental illness, enough to fill an entire chapter, if not also a whole book. The subsequent surge of mass murders perpetrated by persons with serious psychiatric diagnoses eclipsed attention from this single tragic—yet potentially preventable—act.
Arkham Asylum, Its History, and Its Present
Arkham Asylum has had many incarnations, even though this construct did not exist from the start. Batman: Arkham Asylum (2009), the video game, became so popular so quickly—and so financially successful—that it is difficult to imagine a Batman universe without Arkham Asylum. Yet the fictional Arkham was late to the party, although it swiftly made up for lost time. The game inspired a string of successors: Arkham City (2011), Arkham Origins (2013), and Batman: Arkham Knight (2015). Suicide Squad, a big-screen production about Arkham Asylum, with its array of sundry characters and psychotic psychiatrists, was released in summer 2016. In the midst of this, an animated film, Batman: Assault on Arkham, appeared in 2014. A 2005 Batman film, starring Cillian Murphy as the diabolical mind doctor, Dr. Jonathan Crane (a.k.a Scarecrow), alludes to Arkham Asylum. Arkham also figures prominently in a popular prime-time television show, Gotham, which began in 2014 and continues to the present (Fall 2016).
So far, Arkham Asylum has outsold all other video games—and video games as a medium sell well, reaping three times the profits of films.7 Not that Batman movies do badly at the box office. Quite the contrary. Christopher Nolan’s The Dark Knight Rises (2012) ranks among the top ten grossing films ever. The Dark Knight Rises (2012) was released just after Arkham Asylum’s first video sequel, Arkham City (2013).
The Arkham video games changed the landscape of video games to come. That accomplishment is especially impressive, considering that the Arkham video games came by way of a comparatively obscure studio. Historians of video games will someday shower attention on this matter—but let us focus on the graphic novel responsible for the Arkham craze—and also mention the comic books that hinted about Arkham before the elaborate story arc launched.
Arkham Asylum (the institution) first appears in the Batman universe in October of 1974, a creation of Dennis O’Neil and Irv Novick. It merits only an anemic mention when it premieres in issue #258 and where it is identified as “Arkham Hospital.” Even that modest debut was long delayed, considering that Detective Comics introduced Batman in 1939. In the 1980s, yet another writer, Len Wein, author of Who’s Who: The Definitive Directory of the DC Universe #1 (1985), expands on the backstory of Elizabeth Arkham and her descendants. Elizabeth is the namesake of the asylum and the matriarch who passed on her neurodegenerative gene to her progressively more impaired progeny—who coincidentally (or probably not so coincidentally) became psychiatrists.
Over time, we learn more about Elizabeth Arkham and the other Arkhams who followed. In 1989, 15 years after Arkham’s initial appearance, writer Grant Morrison and artist Dave McKean collaborated on a graphic novel, Arkham Asylum: A Serious House on Serious Earth. McKean’s hand-painted artwork set a trend for graphic novels that followed. Fans’ infatuation with Arkham Asylum skyrocketed after that graphic novel. The literary-artistic collaboration brought conflicts between the creators as well as successes. The author has since spoken out against the artist—yet the book became a best seller and inspired annotated editions and set precedents in graphic art in general. The subtitle derives from a poem, “Church Going,” by Philip Larkin.
Arkham Asylum: A Serious House on Serious Earth capitalized on the public’s growing affection for graphic novels—and reflects the serious critical recognition accorded to graphic novels.8 The main motif of Arkham Asylum: A Serious House on Serious Earth concerns a plot to bait Batman to Arkham Asylum while asylum inmates hold hostages. We later learn that the asylum superintendent, Dr. Cavendish, engineered the “inmate uprising.” Cavendish follows the leads of Norman Bates in Psycho (1960) and the transvestite psychiatrist in Dressed to Kill (1980), and perhaps also the ritualistic killer of the early Hannibal novels of the 1980s, who sewed his own clothes from flayed women’s skins. For Dr. Cavendish also cross-dresses as he plots murder. Dr. Cavendish joins a long line of psychotic psychiatrists at Arkham Asylum.9
The Elizabeth Arkham Asylum for the Criminally Insane (better known as Arkham Asylum or sometimes simply as “Arkham”) memorializes the matriarch (or the “founder,” to use genetic terminology) who carried the destructive neurodegenerative and psychotogenic gene. As often happens in comic book story arcs, the backstory leaks out in drips and drabs over time. By the 1980s, Batman fans learn that the asylum’s namesake, Elizabeth Arkham, developed delusions and then dementia as an adult, after inadvertently passing on the presumably autosomal dominant gene for this unnamed neurodegenerative disorder. Later, she came to believe that the spirit of a bat hovered over her, and hence developed an antipathy for Batman himself.
The asylum was the site of one horrific event after another and was headed by one horrific psychiatrist after another, many of them members of the Arkham clan, rendered psychotic by this immutable genetic predisposition. Arkham Asylum publications do not debate ideas about psychogenic sources of psychosis, which had become passé by 1989, when the graphic novel cemented the legend of Arkham. The 1980s were a time of tremendous change in psychiatric theory and practice, when the highly publicized Osheroff v. Chestnut Lodge case convinced psychiatrists—as well as their patients—that psychiatric treatment must be based on fact rather than on belief. Freudian “beliefs” lost ground to the scientifically proven neuropsychiatry.10 Previously popular concepts about “refrigerator mothers” or “schizophrenogenic mothers” faded to grey, although recognition of the role of environment and nurturing in personality disorders (which are distinct from psychotic disorders suffered by the Arkhams) has never faded away. Interestingly, more contemporary research into schizophrenia shows the importance of familial support in shaping the prognosis of persons with first schizophrenic breaks—even though this research does not override data about basic biological predispositions to such severe illness.11
Arkham Asylum’s emphasis on the biological basis of mental illness is striking, especially in the face of so many dramatic “family romances” (to borrow a term from psychoanalytic lore). This attitude is also a sign of the times: the mid- to late-1980s. Like the legally insane inmates at Arkham who are not held culpable for their crimes, the Arkham clan members also evade punishment for diabolical deeds performed in the throes of their psychoses. Because of their biological inheritance, the Arkhams lack agency, and have not chosen their fates. Their acts are sinister, to be sure, but they do not act solely of their own volition. In fact, they initially try to aid other mentally ill persons—but fall short of those goals early on.
Elizabeth’s son grows up to become a psychiatrist named Dr. Amadeus Arkham. After his mother’s mental state has deteriorated and she becomes too preoccupied with the occult and with the phantasmagorical bat figure, Amadeus euthanizes his mother. Initially, Amadeus represses the memory of his mother’s murder and comes to believe that she suicided instead. This excuse is entirely plausible, given the dire circumstances related to her psychosis. Amadeus then transforms the family mansion into a sanitarium, hoping to save others from suffering as much as his late mother did. With that, Arkham Asylum becomes a landmark on the landscape of Gotham City.
The “adventures” of Dr. Amadeus Arkham do not stop there—for if they did, there would be no reason for endless versions of video games, superhero stories, graphic novels, or animated shorts. As time passes, Dr. Amadeus Arkham’s attitude changes. He shows little compassion for his patients. He experiments on them and tortures some with ECT (electroconvulsive therapy) to retaliate against one patient in particular, Martin “Mad Dog” Hawkins. “Mad Dog” murders Amadeus’s family members in the graphic novel.
Having raped and killed his doctor’s wife and daughter, “Mad Dog” is admitted to Arkham and treated by Dr. Amadeus Arkham for six months before Amadeus arranges Mad Dog’s “death sentence.” Dr. Amadeus straps Mad Dog to an electroshock couch and intentionally electrocutes him. Thus begins Amadeus’s descent into the same madness that befell his mother. He, too, becomes engrossed in the occult and he also hallucinates bats and other apparitions. Dr. Amadeus Arkham later becomes a patient in his own asylum, the first of several Arkham psychiatrists to be admitted into the very institution where they practice psychiatry. Once again, the fox is guarding the henhouse and the madmen run the asylum.
Other Arkham family members carry on the family tradition of “caring” for inmates of the asylum, even though the same gene twists their minds in the way that it afflicted their forbearers. The advanced education acquired before the onset of the disease cannot override the mental effects induced by their genetic inheritance. The Arkhams are examples of “determinism” at its best (or worst). Their mental landscapes are metaphorically “set in stone,” immutable, in their cerebral cortex.
Deprived of his children or other direct heirs, Dr. Amadeus Arkham passes the mantel to his nephew, Dr. Jeremiah Arkham, who is also saddled with this same destructive neurodegenerative gene. Dr. Jeremiah Arkham proves to be even more evil that his uncle and mentor. In addition to heading this ignominious institution for the “criminally insane,” Dr. Jeremiah Arkham has a secret side. In contrast to superheroes who live ordinary daily lives and hide their identities behind masks so that they can fight crime, rescue the helpless, and help society’s weaker ones, the Black Mask cloaks his face so that he can perform more heinous acts.
Some successors at Arkham Asylum have no genetic ties to the Arkham clan but prove to be no better than direct descendants who carry Elizabeth Arkham’s tainted bloodline. Dr. Hugo Strange and then Dr. Crane (also known as “Scarecrow”) take over, as does Dr. Alyse Sinner, the one-time medical student who befriends and is presumably bedded by Dr. Jeremiah Arkham. We later learn that she, too, murdered her own family, much in the tradition of Amadeus Arkham. Each of these deranged doctors is admitted to Arkham at some point.
It may sound as if Arkham Asylum exists to house its own psychotic psychiatrists and no one else, but that was hardly its purpose. The original Arkham Asylum housed villains who were deemed criminally insane. Many of the most interesting characters from the Batman comics make their way into Arkham. Patients include the Joker, the Penguin, Poison Ivy, the Riddler, Two-Face, Scarecrow, Bane, Killer Croc, and Harley Quinn. Quinn starts as a resident psychiatrist before going rogue.
The Joker, for one, is in and out of Arkham Asylum, where he is treated by the equally colorful and occasionally criminal psychiatrist, when she is still known as Dr. Harlene Quinzel. Quinzel sheds her white coat, assumes the name of “Harley Quinn,” and becomes Joker’s accomplice—as well as his paramour and the person who springs him from the jail cell. The comic-tragic tale of Harley Quinn and the Joker are discussed in detail elsewhere.12
The Connection between Batman’s Arkham and Lovecraft’s Arkham
Admittedly, the fictional Arkham Asylum did not exist in the early Batman universe or even in Gotham City, where most of the Batman action takes place. Yet another fictional city named Arkham merits mention. Arkham, Massachusetts exists in H. P. Lovecraft’s universe, and dates to Lovecraft’s short story “The Unnamable” (1923). A different mental institution—run by Miskatonic University and its medical school—hovers over the landscape of Lovecraft’s Arkham. Lovecraft’s institution bears important parallels to insane asylums in Batman while it recollects landmark German expressionist films about the charlatan asylum superintendent, Dr. Caligari, from 1919, and the self-proclaimed psychoanalyst, Dr. Mabuse, who starred in dozens of films, starting with Fritz Lang’s silent Weimar cinema of 1923.
Batman writers and editors had good reason to appropriate the Lovecraftian term—and not solely because of the content of Lovecraft’s story but also because of Lovecraft’s family history. Both parents died in mental asylums. His father went first, when Lovecraft was still a child. His father’s death certificate attributed his demise to neurosyphilis. Neurosyphilis patients occupied 10 to 15 percent of psychiatric beds in those years.
Lovecraft’s mother became psychotic enough to enter the same institution many years later, when H. P. was already an adult. Nonmedical biographers considered the possibility that his mother acquired psychosis-inducing neurosyphilis from his father, given that syphilis is sexually transmitted. Since there is a 10- to 20-year lag time between initial infection and the evolution of debilitating neuropsychiatric symptoms of tertiary syphilis, such speculation was within the realm of possibility, even though later authors eventually discounted those theories.
Lovecraft’s personal and creative histories are interesting—but for now, let us simply say that naming the Gotham City asylum that houses—and is hosted by—persons with varying degrees of “neurodegeneration” was fitting homage to a horror/science fiction/fantasy writer who was reared under the shadows of real life psychosis, degenerative disease, and actual asylums. Lovecraft’s works often revolved around inheritable evil or bizarre mutations, such as “Shadow over Innsmouth” (1931) and “The Case of Charles Dexter Ward” (1927; published in 1941).
Perhaps Batman’s Arkham was anticipated or indirectly influenced by Lovecraft’s life and the settings of his short stories. Perhaps Arkham Asylum incorporates aspects of Edgar A. Poe’s much earlier work about familial degeneration, “The Fall of the House of Usher” (1839), as well as Poe’s short story “The System of Doctor Tarr and Professor Fether” [sic]. “Doctor Tarr and Professor Fether” introduces the meme about psychotic psychiatrists and inmates running the asylum, a meme that reaches its zenith in The Cabinet of Dr. Caligari (1919) and that continues in popular culture to this day. Len Wein’s Batman: Nevermore, written in 2003 for DC Elseworlds, hints at the link between Batman and Poe.
In The Fall of the House of Usher, Poe chronicles the lives and deaths of two siblings stricken with an unnamed inheritable insanity. The sister, Madeline, is prone to “catalepsy” while her brother hallucinates. Poe wrote nearly a century before Lovecraft, well before America’s Civil War. Lovecraft was aware of Poe’s work, so much so that he devotes an entire chapter to Poe’s oeuvre in his much-quoted 1929 essay “Supernatural Horror in Literature.”
The physical structure of the actual Arkham Asylum cannot compare to Usher’s crumbling gothic mansion, which came to life—and died its own death—as its last remaining heir died. Roderick Usher identified himself as “the last of the line.” Poe plays on the double-meaning of the word “house,” which can refer to an actual home or to the family line, or to the family that occupies the house. Rather than focusing on the Arkham Asylum edifice itself (to date), the story of the family that owns and operates Arkham Asylum takes center stage and is arguably even more convoluted than the doomed Usher clan in Poe’s short story by that name.
We could go on and on about Arkham and its associations with psychiatry and mental illness and even “hereditary degeneration” and antipsychiatry were it not for space constraints. We could write an entire essay about Arkham Asylum as an antipsychiatry text and as a parody of the psychiatric profession. The presence of Mr. Zsasz (a play on the name of Thomas Szasz, MD, who gained fame for writings such as The Myth of Mental Illness (1960) and his staunch antipsychiatry attitude) reinforces this interpretation, which deserves further exploration.13 In the end, it becomes clear that the mythos of Arkham Asylum is rich enough to make it a Rorschach test that reflects the interests and inclinations of the reader/viewer/player.
Notes
1. Travis Langley, Batman and Psychology: A Dark and Stormy Night (New York: Wiley, 2012).
2. D. L. Rosenhan, “On Being Sane in Insane Places,” Science 179.4070 (January 1973): 250–58, accessed October 13, 2014, doi:10.1126/science.179.4070.250, PMID 4683124.
3. Erving Goffman, Asylums, Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, NY: Anchor Books, 1961).
4. Allen Frances, “Psychiatry and Anti-Psychiatry,” Psychiatric Times. February 26, 2016.
5. Howard Forman et al., “Orange is the New Color of Mental Illness,” in Mental Illness and Popular Culture (Santa Barbara, CA: Praeger, in press).
6. My thanks to psychiatrist MB for firsthand insights into the operations of New York City’s Assisted Outpatient Treatment Program (AOT).
7. Matthew K. Manning, Arkham Universe: The Ultimate Visual Guide (New York: DK, 2015).
8. See Sharon Packer, Book Review, Graphic Women by Hilary Chute, Metapsychology, August 23, 2011; see also Sharon Packer, “Comics and Medicine: A Conference—or a Movement?” Psychiatric Times, August 26, 2014.
9. Sharon Packer, Cinema’s Sinister Psychiatrists (Jefferson, NC: McFarland, 2012); see also John Watson, Cinemania: A Brief History of Psychiatry in Cinema, May 4, 2016, accessed November 20, 2016, http:www.medscape.com/features/slideshow/psychiatry-in-film.
10. See Sharon Packer, “A Belated Obituary: Raphael J. Osheroff, MD,” Psychiatric Times, June 28, 2013.
11. Benedict Carey, “New Approach Advised to Treat Schizophrenia,” New York Times, October 20, 2015.
12. M. Keith Booker, ed., Comics through Time: A History of Icons, Idols, and Ideas, 4 vols. (Santa Barbara, CA: Greenwood, 2015); Justin Edwards and Agnieszka Soltysik Monnet, eds. The Gothic in Contemporary Literature and Popular Culture: Pop Goth (UK: Routledge, 2014); See also Lawrence C. Rubin, Mental Illness in Popular Media: Essays on the Representation of Disorders (Jefferson, NC: McFarland, 2012).
13. My thanks to professor and department chair Lisa Hermsen for opening this dialogue.