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While comics have found a distinguished position in medicine through the work of graphic medicine, they also have a long, vexed history in other areas of the medical field, namely psychiatry. I explore one way superheroes have previously entered mental health discourse by lingering over the rhetoric of psychiatrists who have attempted to understand the superhero and the supervillain through analysis and diagnosis. The writings of psychiatrists invested in comics and superheroes provide insight into the psychiatric discipline, and the superhero genre supplies new ways to think about mental health practice. After considering a selection of psychiatric readings of the superhero (and villain), I offer my own interpretation of The Killing Joke. By placing The Killing Joke in the context of discussions of mental health, Alan Moore and Brian Bolland's text complicates questions of evil as well as empathy through the depiction of the villainous Joker in pain. The reader's identification with and connection to the character facilitates opportunities for both clinicians and laypeople to listen to and to witness the story of a villain, to know what he is, and to contend with the ambivalent feelings that emerge from such a situation of knowing both his sad history and his violent actions.