A “superhero” is defined as “a fictional hero having extraordinary or superhuman powers (2).” Superheroes are beloved by modern society, and serve a variety of functions, notably as modern-day deities (3), moral models (4), and vessels for our fantasy lives (5). One of the aspects of superheroes that most endears them to society is that they, like us, are not perfect—they have flaws.

Batman was first introduced in May of 1939, as Detective Comics #27 (6). The reader is first introduced to socialite Bruce Wayne (created by Bob Kane). Later, “Batman” foils the villain, and the story ends with the revelation to the reader that Bruce Wayne and Batman are the same person. Since that time, the Bruce Wayne/Batman character has been depicted in a variety of media, including graphic novels, television, animation, video games, and film. With regard to the cinematic depictions of the character, Batman (7) was released in 1989, followed by Batman Returns (8), Batman Forever (1), and Batman and Robin (9). These movies create a unified timeline, and, subsequent to their release, the Batman movie franchise underwent a “reboot,” with the release of Batman Begins (10) and The Dark Knight (11), which retell the story and are not a part of the original movies’ timeline.

It has been previously observed (12, 13) that Bruce Wayne appears to exhibit some symptoms of posttraumatic stress disorder (PTSD). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (14), the diagnosis of PTSD requires that symptomatic criteria be met within clusters of symptoms: traumatic event, re-experiencing, avoidance, and increased arousal.

The aim of this article is to systematically consider each of the individually-listed DSM-IV symptoms, citing examples from various media incarnations of the character, in order to demonstrate that Bruce Wayne experiences an adequate number of symptoms to meet criteria for the diagnosis of PTSD. The specific argument will be made that the creation of the Batman persona can be viewed as a symptom of Bruce Wayne’s PTSD. Last, the case will be made that there is a valid rationale for this exercise beyond literary discussion.

The “A” criteria of PSTD read as follows: “the person has been exposed to a traumatic event in which both of the following were present: 1) The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others; and 2) The person’s response involved intense fear, helplessness, or horror.”

The “back-story” of Batman first appeared in Detective Comics #33 (15), in November 1939. The reader is shown Bruce Wayne as a boy, walking home from a movie with his parents, when a mugger demands his mother’s necklace. Wayne’s father pushes the mugger and is shot and killed. Wayne’s mother starts calling for the police and is shot and killed herself. The text reads “The boy’s eyes are wide with the terror and shock as the scene is spread before him (15).” Bruce Wayne is pictured with tears streaming down his cheeks stating “Dead! They’re D-Dead (15).” The traumatic experience of witnessing the murder of both parents clearly meets the “A” criteria for PTSD.

The “B” Criteria for PTSD read “the traumatic event is persistently re-experienced in one or more of the following ways: 1) Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions; 2) Recurrent distressing dreams of the event; 3) Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated); 4) Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event; and 5) Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.”

The first symptom, frequent recurrent and distressing recollections of the event, are especially noteworthy in cinema depictions, as the traumatic memories are themselves depicted on-screen; thus, the audience sees what Bruce Wayne is thinking and seeing. In the literature, the reader has access to Batman’s internal monologue, and, in several story arcs, he recalls his parents’ deaths. In one sequence, while on the way to a crime scene, Batman thinks to himself “It’s a .45-caliber bullet; hollow-point; it explodes in his chest. I feel the shock through his fingers. For the hundred-thousandth time—my father dies (16).”

Bruce Wayne meets criteria for Symptom 2 as well, and is depicted awakening from a distressing dream with traumatic content, in both cinema (10), as well as graphic novels (16, 17).

In the movie Batman Forever, the character indicates that “flashbacks,” Symptom 3, are occurring when he states “my dreams are coming to me when I’m awake now (1).” In the movie Batman Begins, a villain causes Batman to inhale a hallucinogen, and he experiences flashes of his parents’ murder while intoxicated (10). In the video game Batman: Arkham Asylum (18), the Batman character relives the deaths of his parents—hearing their last words, then seeing them lying dead in the alley. At this point, the character of Batman transforms into an 8-year-old Bruce Wayne, and it is this character whom the player must control through the game.

Symptoms 4 and 5 of the B criteria—psychological distress and physiological reactivity to cues—appear to be present. Bruce Wayne experiences psychological distress at being reminded of what his parents' killer said to him (7) and upon the image of a pearl necklace (1), which his mother had on that night. Physiological reactivity is harder to gauge, given that one cannot take Wayne’s vital signs. Nevertheless, an adequate number of symptoms are present for the B criteria for PTSD to be met.

The C criteria for PTSD read as follows: “persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: 1) Efforts to avoid thoughts, feelings, or conversations associated with the trauma; 2) Efforts to avoid activities, places, or people that arouse recollections of the trauma; 3) Inability to recall an important aspect of the trauma; 4) Markedly diminished interest or participation in significant activities; 5) Feeling of detachment or estrangement from others; 6) Restricted range of affect (e.g., unable to have loving feelings); and 7) Sense of a foreshortened future.”

In the original back-story comic, in the next panel after his parents are killed, we are told that “Days later, a curious and strange scene takes place.” Bruce Wayne swears by his deceased parents’ spirits to avenge them by dedicating his life to fighting crime. Finally he sits pondering his need for a disguise when a bat flies into his study window, and he is inspired. “A bat! That’s it! It’s an omen. I shall become a BAT! (15)” The dedication of his life to vengeance and the creation of the Batman character constitute the conscious efforts of Bruce Wayne to avoid the feelings of helplessness and horror associated with the trauma, meeting the first symptom criterion. In the movie Batman and Robin, the character of Alfred voices a similar sentiment, telling Wayne:

Whereas the creation of alternate personalities, as is seen in dissociative identity disorder, is often the result of a severe trauma, this does not seem to be the case with Bruce Wayne, because the creation of Batman is a conscious, planned act.

In the literature, Bruce Wayne does not exhibit Symptom 2—efforts to avoid activities, places, or people that arouse recollections of the trauma—as Batman does the opposite, patrolling the sky and streets of Gotham City, looking for criminals upon which to exercise vengeance.

Evidence that Bruce Wayne meets criteria for Symptom 3—inability to recall an important aspect of the trauma—is provided in the movie Batman Forever. Wayne says “I don’t remember a lot of what happened; what I do, comes to me in my dreams, flashes. There’s a new element now, though.” He goes on to describe events immediately after his parents’ wake, which he had previously been unable to remember (1).

Bruce Wayne meets criteria for Symptom 4—markedly diminished interest or participation in significant activities. Given that the creation of the persona of Batman is an avoidance symptom, this leaves the non-Batman activities of Bruce Wayne as those for which participation must be ascertained. Bruce Wayne has markedly diminished interest and participation in average activities (friends, romantic relationships, raising a family, having hobbies) preferring to dedicate his time to the Batman role (16, 20).

Bruce Wayne, especially when adopting the Batman persona, exhibits Symptom 5—feelings of detachment or estrangement from others. He limits his interpersonal relationships to a few confidantes (Robin, Alfred), and is noted to not trust even other superheroes when interacting with them in the “Justice League of America” (19).

Last, for the C criteria, Bruce Wayne frequently demonstrates Symptom 6—restricted range of affect. Batman, especially as acted by Michael Keaton (7, 8) and Christian Bale (10, 11), rarely smiles, although Bruce Wayne is seen smiling socially when out of the Batman costume/character. Batman’s restricted range of affect is commented on by the Joker, who is frustrated by Batman’s lack of a sense of humor and tells him to “lighten up (20).” The affect restriction even extends to Batman “action figures” (21).

The D Criteria for PTSD read “persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: 1) Difficulty falling or staying asleep; 2) Irritability or outbursts of anger; 3) Difficulty concentrating; 4) Hypervigilance; and 5) Exaggerated startle response.”

There are many examples of Bruce Wayne/Batman meeting criteria for Symptoms 1, 2, and 4. Wayne’s sleep difficulties, Symptom 1, appear in both print and cinema incarnations. In The Dark Knight, Wayne’s butler Alfred jokes that “when Wayne Manor is rebuilt, [he] can swap not sleeping in a penthouse for not sleeping in a mansion (11).”

Bruce Wayne becomes a very angry person after the trauma, and exhibits Symptom 2—anger outbursts. When confronted by supervillains who have hurt the people of Gotham City, Batman has difficulty controlling his anger, taking it out physically on the perpetrators. On extreme occasions, individuals such as Commissioner Gordon have had to beg him to exercise restraint (22, 23).

Neither Symptom 3—difficulty concentrating, nor Symptom 5—exaggerated startle response, seem to be present for Bruce Wayne. His training for the Batman role, both intellectual and physical, required great ability to concentrate. Batman is frequently, in both print and on screen, exposed to loud noises—gunshots, explosions, motor vehicle collisions—and is not seen to startle to these noises.

Symptom 4, however—hypervigilance—could sum up Batman’s character in a nutshell. He is vigilant about his own surroundings, but also about the entirety of Gotham City. He watches over the city at night, ever-vigilant.

Although many have discussed the philosophical function of superheroes in society (5, 24), we may raise the question of the usefulness of arguing that Bruce Wayne meets diagnostic criteria for PTSD; assuming the diagnosis is valid, is there any value to this exercise? First, there is didactic utility in using pop-culture characters to teach medical students and psychiatry residents how to recognize the symptoms of this diagnosis. Batman is a character with whom students are likely to be already familiar, so discussing PTSD in this context allows the students to practice viewing the world through a psychiatrist’s eyes. Previous work has been published on the use of fictional movie characters to illustrate psychiatric diagnoses (25, 26) in medical school curricula. Options for presentation of material of this type could include showing a Batman movie during a psychiatry interest-group meeting, showing clips in a classroom setting, or presentation of Bruce Wayne as a “case.”

Second, with the diagnosis of PTSD highly prevalent in society today (27, 28), finding a superhero who also meets criteria for the diagnosis could be of comfort to those experiencing the symptoms themselves. Especially in light of depictions of supervillains, which focus on negative stereotypes of mental illness, as recently described (29) in the Joker character, to have a hero with a mental illness portrayed in a positive light could provide hope and encouragement, or lessen the feeling of isolation in those fighting mental illness. In this respect, Batman is not alone among superheroes: in the universe of Marvel Comics, Bruce Banner/The Incredible Hulk struggles with dissociative identity disorder (called “multiple personality disorder”) stemming from childhood abuse (30). Also, Tony Stark/Iron Man is an alcoholic and has been depicted binge-drinking to deal with stress, as well as making efforts to maintain his sobriety including attending Alcoholics Anonymous meetings (31).

Being orphaned is also common among heroes—Superman, Spiderman, Luke Skywalker, and Harry Potter all share the common past of parental loss (32–35). In mythology, both modern and ancient, heroes are forged by adversity. Traumatic events are requisite as catalysts for personal development, allowing heroes to triumph over adversity and thus act as role-models for the mortals who imagine them. But it is the flaws of heroes, from Achilles’ heel to Superman’s kryptonite, which allow us to connect to them on a personal level. By seeing superheroes struggle with inner demons as well as supervillains—with mental illness despite their physical strength—we, the audience, can see ourselves in the characters.

The author acknowledges Renate H. Rosenthal, PhD., Brian Wakefield, Steven Allen, Blair Walden, and Elizabeth Campbell for their contributions.