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Letter to the Editor

Game of Thrones: A Cliché About Madness? (Spoiler Alert)

Jasmina Mallet, MD, PhD

Published: April 16, 2020

Game of Thrones: A Cliché About Madness? (Spoiler Alert)

To the Editor: As a spectator of Game of Thrones and a psychiatrist, the end of the series concerned me (spoiler alert—stop reading right away if you follow the show and do not know the end). It was a controversial turn for one of the show’s most sympathetic and admirable protagonists, and all fans criticized it.

However, for some, this turn was inevitable. During season 6, scenarists were laying the groundwork for Daenerys to become the series’ final antagonist. On the whole, her story has been an empowering and inspiring one. But, the great power her dragons gave her also gave her the capacity for great violence, which she sometimes called "justice." For instance, she decided to burn Tarly’s father because he refused to kneel to her.

Does the book1 on which the series is based predict the same outcome? One character in the book states, "Madness and greatness are 2 sides of the same coin,"1(p803) describing the Targaryen family. All along, Daenerys seems to be afraid of what she herself might do. All fans know that her father was the "mad King" and that her brother died mad. Still, she pretends to be different, saying "I won’ t be the queen of ashes." She does not want to become the "mad queen"; however, that is what happens and the reason that she is murdered, as no other solution seems possible in this show.

As a psychiatrist, I find the many commentaries from friends and colleagues (from other medical specialties) concerning. Some of them estimate that Daenerys could have avoided madness by refusing power and maintaining a quiet lifestyle. In other words, she was responsible for provoking fate and this hereditary madness. Others (nondoctors) assure me that the end was inevitable, as the protagonist (Daenerys) inherited the madness of her father (and of the Targaryen family) as a curse.

The authors thus perpetuate the (wrong) idea that madness is largely hereditary2 and that one cannot fight against it. They spread the idea that some people are responsible for their psychiatric disease through their way of life.

Finally, they also contribute to the confusion regarding the relationship between madness and violence, intensifying the stigma already surrounding psychiatric disorders. Still, the overall impact of mental illness as a factor in the violence that occurs in society as a whole is overemphasized.3

I do not thank them, as a psychiatrist or as a spectator.

Jasmina Mallet, MD, PhDa,b

aAP-HP, Department of Psychiatry, CHU Louis Mourier, Colombes, France

bINSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, University Paris Descartes, Paris, France

Potential conflicts of interest: None.

Funding/support: None.

Published online: April 16, 2020.

Prim Care Companion CNS Disord 2020;22(2):19l02529

To cite: Mallet J. Game of Thrones: a cliché about madness? (spoiler alert). Prim Care Companion CNS Disord. 2020;22(2):19l02529.

To share:

© Copyright 2020 Physicians Postgraduate Press, Inc.


1.Martin GR. A Song of Ice and Fire : The Complete Box Set of All 7 Books. London, UK: HarperCollins; 2012.

2.Kendler KS. From many to one to many—the search for causes of psychiatric illness. JAMA Psychiatry. 2019;76(10):1085-1091. PubMed CrossRef

3.Rueve ME, Welton RS. Violence and mental illness. Psychiatry (Edgmont). 2008;5(5):34-48. PubMed

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