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The story of Batman is one that could in reality be the story of almost any person in America. Bruce Wayne is the real identity of the Batman, who is born to wealthy socialites Dr. Thomas and Martha Wayne. Bruce grows up in a wealthy family in the Wayne Manor. Bruce and his family are well known in the city of Gotham where they live. In exploring the property that Wayne Manor is situated on a young Bruce, he is 8 years old, falls into a well shaft (that he eventually learns leads into the Bat Cave which has an underground railroad built by his grandfather in it). When he falls into the well shaft he is unable to get himself out and is in the shaft for sometime until his father realizes that he is missing. During the rescue attempt bats from below in the cave are frightened and awakened. It is at this time that Bruce and his father learn that the bats use the well shaft as an entry to their cave. The bats flock out of the cave past Bruce and his father. The bats flying so closely to him terrify Bruce. This is the beginning of his phobia of bats. Bruce is extracted from the cave, obviously terrified. His father gives him instruction to not be afraid and to allow this to be a growing and learning experience. Thomas Wayne tells Bruce that we all fall in order to learn to get up. Shortly after this experience Bruce and his parents go to the theater to enjoy a show. Depending on the history you subscribe to, the family was either watching a movie or a play. If you follow the play storyline, during the show Bruce becomes scared as he remembers the events of falling into the well shaft. He becomes increasingly scared and asks his father to leave, which they do. As they walk out an alley exit, into the alley a man who attempts to rob them holds them at gunpoint. The attempted robbery goes awry and Bruce’s parents are shot and killed in front of him. As one might imagine, Bruce carries the guilt of his parent’s death with him his entire life, as he feels responsible for their death. As Bruce grows into a young adult, he decides to rid Gotham city of the evil that took his parents away from him. He embarks on a journey of mental and physical training that will allow him to use the resources of the company that was left to him to fight crime as a vigilante. This is where we find Batman as he enters our office for his first therapy session.

An interesting side note to be mentioned at this point speaks briefly to the primary villains that Batman battles. There are several villains that Batman encounters with regularity. Batman vowed along the way not to take the life of any of his villains, so he does not. None of the criminals however go to jail. In Gotham city is Arkham Asylum, home for the criminally insane. This is where all of Batman’s main villains go once Batman thwarts their criminal efforts. This is an interesting side not given the deep psychological overtones in the mind of Bruce Wayne that are being struggled through by him. This phenomenon also speaks to the constant appearance of a psychological theme that permeates through the story of Batman. Batman’s story is almost as much a psychological thriller as it is an action thriller.

At this point, now that Batman has sat with us and we have been able to gather some of the background history that makes Batman Batman we are able to begin to look towards diagnosis and the recommendations for treatment. Before we look at disorders that Batman is diagnosable for, it might be helpful to consider what Batman can’t be diagnosed with. Afterwards, we will consider other possible diagnoses for Batman.

Non-Diagnoses, What Batman isn’t
On the first look there are multiple diagnoses that could possibly explain why Batman acts the way that why does. Many of these ‘first look’ diagnoses don’t work when you look further into Batman’s psychology. The first disorder that seems plausible for Batman is Dissociative Identity Disorder. This diagnosis doesn’t work, because Batman only has two ‘personalities’ and they don’t appear to be completely void and unknowable by each other. For Dissociative Identity Disorder to work for Batman, there would need to be more conflict within himself as he switches from Bruce Wayne to Batman and back. A diagnosis of Paranoid Personality Disorder might be appropriate, except for Batman is not worried or paranoid about people being ‘out to get him’. This diagnosis seems plausible given his penchant for undoing all the evil in Gotham, however there is no fear of the villains in Batman himself. Nor does he read personal attacks into normal, un-attacking comments. Batman acts too calculatingly for him to be diagnosed with Paranoid Personality Disorder. It also may appear on the surface that Batman is in someway diagnosable with Obsessive-Compulsive Disorder. True, he meets some of the criteria for this diagnosis, but not enough to be diagnosed. It would seem that he is obsessively-compulsive in the ways that he approaches being a vigilante crime-fighter. He does spend much of his time thinking over and contemplating the problem of criminals in Gotham, however he doesn’t meet the criteria in that Batman doesn’t feel that the focus f his obsessions (crime in Gotham) is beyond his control. He obviously believes that he can do something to affect the crime or else he wouldn’t be Batman. Additionally, his obsessions are not self-imposed, meaning that there actually is a high crime element in Gotham. Also, his compulsive behavior, fighting crime, is for the purpose of pleasure or gratification and not simply to alleviate the obsession. Batman fights crime in order to remove the criminal element, to feel like he is giving back to society, not just to remove his own stress. Obsessive-Compulsive Personality Disorder could possibly be misdiagnosed as well. Again, due to his obsessive-compulsive like need to fight crime one can begin to see some of the criteria for OCPD in Batman. Upon close reflection, Batman doesn’t meet quite enough of the criteria. Batman does have many of the criteria needed for this diagnosis; like being excessively devoted to work and productivity to the point that personal relationships suffer, is reluctant to relegate tasks to others unless they are carried out to his standards. Some if the other criteria might fit but many don’t. Batman isn’t preoccupied with the details to the point that the task is lost, he doesn’t show a perfectionism that inhibits him from completing the tasks at hand. All-in-all this diagnosis doesn’t work for Batman.

If these diagnoses don’t accurately describe Batman what does?

300.29 Specific Phobia, Animal Type (Chiroptophobia)
The first disorder that Batman can be diagnosed with is that of a fear of bats. As we discussed in the introduction Bruce gained this phobia at the age of 8 when he fell into a well shaft that lead to a cave where many bats resided. When the bats flocked and left the cave they flew past him terrifying him. Strangely enough, it is his fear of bats that caused him to use the bat a his own symbol as he became a vigilante. Batman knew that in order to be effective as a crime-fighter he must be able to strike fear into the hearts of those who oppose him. As Bruce is contemplating his career choice as Batman he realizes, “Criminals are a superstitious and cowardly lot”, Wayne remarks, “so my disguise must be able to strike terror into their hearts. I must be a creature of the night, black, terrible…” As if responding to his desires, a bat suddenly flies through the window, inspiring Bruce to assume the persona of Batman. As far as any specific treatment for this phobia, Batman seems to have developed the most effective treatment himself. Immerse himself in the image, persona and physical presence of the bat in order to assist him in overcoming this fear. Beyond this, the only suggestion to be made is to assist Bruce in realizing that his fear of bats is reasonable in the sense that when he encountered the bats they were menacing and terrifying. At the same time, there is not real need to fear the bats, as they in reality are unable to deliver any real harm to him. For the most part, Batman appears to have appropriately handled his own treatment.

The next diagnoses, he doesn’t get away so easy, though.

309.81 Posttraumatic Stress Disorder, Chronic
Batman experienced at a very early age one of what must the most traumatic events a child can experience. He watched in horror as his parents were gunned down. Batman meets the criteria for this diagnosis because he:
A. He was exposed to a traumatic event where both of the following were present (condensed to fit his diagnosis)
1) He experienced and witnessed an event that involved actual threat of death or serious injury.
2) His response involved intense fear, helplessness and horror.
B. This traumatic event is persistently reexperienced in one the following ways:
1) He has recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Bruce is often preoccupied with playing the event over and over in his mind and he holds the guilt of his parent’s death on himself. He believes that he is personally responsible for their deaths as it was because of his fear that they left the theater.
2) He has recurrent distressing dreams of the event. Bruce also often has dreams of the event that terrify him.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness indicated by:
1) A feeling of detachment or estrangement from others. Batman has very few, if any real relationships that have any substance them at all. Batman intentionally doesn’t let people into his life.
2) Restricted range of affect. Batman finds it very hard to express or even have any true intimate feelings for others.
3) Sense of foreshortened future. Batman doesn’t expect hat his life will ever be normal and that he will always be burdened with the self-imposed burden of ridding Gotham of it’s criminals.
D. Persistent symptoms of increased arousal indicated by:
1) Difficulty falling or staying asleep. Batman is plagued with the ability to remain awake all night for days in order to be available to fight crime. His inability to sleep is most likely tied to the fact that he is terrorized by nightmares of his parent’s murder.
2) Hypervigilance. Batman has a hyper sense of his need to be the vigilante that rids Gotham of criminals. He is hyper vigilant in the sense that he cant stop thinking about or acting on this need to fight crime.
E. The disturbance has lasted more than a month, in fact it has lasted the majority of his life since the age of 8.
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Batman is lucky to Bruce Wayne, millionaire, otherwise he would not be able to hold down a job as he is consumed with being the vigilante because of the traumatic event he experienced. His preoccupation with being Batman impairs his ability interact socially.
It is specified that the duration of the symptoms have persisted longer than 3 months and therefore it is a chronic disorder.
As far as treatment for PTSD there are many options for us to continue with. Part of Batman’s struggle with PTSD is that he never received any treatment for it and has not allowed himself to be treated for it. One important element in therapy is simply to begin to deal with and treat the disorder. Cognitive Behavior Therapy would be the first place to begin in order for Batman to begin to think differently about the traumatic event of the death of his parents. Batman blames himself for their death, and the therapy would be geared towards assisting Batman in realizing and understanding that he is not to blame for his parent’s death. Once he is able to alter the way he thinks about the traumatic event he will begin to be able to move beyond the guilt feelings that have crippled him. This treatment will be intense and long. After he is well on the way to appropriately coping with the death of his parents, Batman would be encouraged to participate in Group Therapy to further aid in him being able to change the way he thinks about the death of his parents. This would serve an alternate purpose as well. He will then be able to use his experiences and his lack of dealing with this traumatic event to aid others in coping with trauma in their lives.

Other Possible Diagnoses.

Batman potentially suffers from Antisocial Personality Disorder. He meets many of the criteria for a diagnosis of this, but it doesn’t necessarily fit him. In order for this diagnosis to fit Batman would have to begin exhibiting the symptoms for it at age 15. There is no evidence that he has a pervasive pattern of disregard for and violation of the rights of others. The only individuals that Batman has a disregard for is criminals, which means that his disregard isn’t widespread enough for this diagnosis to apply. If not Antisocial Personality Disorder may be Conduct Disorder fits. Again, this diagnosis doesn’t fit for Batman. As far as we know as a child he didn’t exhibit any of the symptoms that are required criteria for the diagnosis of Conduct Disorder. Any of the symptoms of Conduct Disorder seem to have appeared in late adolescence or early adulthood. Similarly Dissociative Disorder comes close to a viable diagnosis. But again, Batman doesn’t quite meet enough criteria for diagnosis. All of these diagnoses come close to fitting Batman, however he doesn’t seem to fit a full diagnosis. Lastly, one might think to diagnose Batman with Delusions of Grandeur. This diagnosis would be hard to make fit because he doesn’t appear to be delusional. He does actually encounter and fight the crime element in Gotham, that occurs in reality not delusion.
Batman has many deep-rooted psychological issues. It seems probable that many if not, all of his issues can be explained and handled while diagnosising and treating PTSD. Batman is consumed with intense guilt feeling, feelings of helplessness and responsibility for his parent’s death. Batman’s incessant need to be Batman is deeply rooted in the death of his parents. PTSD can explain all of Batman’s issues. Batman does exhibit symptoms of several other mental health diagnoses, but upon further reflection they don’t work for him.
Treatment for Batman is going be intense and long. Batman has long unresolved guilt feelings due to his parent’s death and has never allowed himself to cope with and deal with the death of his parents. Treatment for Batman is going to include Cognitive Behavior Therapy and eventually Group Therapy. Batman needs to understand that he isn’t to blame for his parent’s death. Batman must change the way that he thinks about their death. This will not alleviate him from being Batman, because at this point this is the only life that he knows. However, it will aloe him to be a healthier, more grounded Batman.

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