Breh...we don't even know if any of that was real
He prefers his past to be multiple choice because it's more fun that way
We know that the murders are real but even the whole involuntary laughter thing...for all we know that's bullshyt that he was telling the doctor at Arkham for sympathy, and he's just the same psychopath clown we know!!
wait now you got me thinking i missed something during the last scene at Arkham... was he rehashing his whole story to her? by that point I was so giddy with how dope the movie was did I miss something there?!