Jhe classifies starts with the following assignment: draw a four-panel comic strip about your day. In five minutes, the students – including writers, artists, stay-at-home moms, a graduate student and a movie director – produce light-hearted but touching skits about play dates, tedious chores and a questioning chicken.
By the end of the session, however, the drawings they submit express raw emotions: regret at not saying goodbye to a loved one, feelings of inadequacy in motherhood, and memories too painful to otherwise articulate. For four years, Kaye Shaddock, an art therapist, has guided these informal workshops in a Massachusetts studio or online, with Anna Moriarty Lev, a cartoonist whose topics have included her mother’s experience of breast cancer (see photo). Their objective is to show how comics can serve as a tool for reflection. “Putting words and pictures on paper clarifies things I’m otherwise alone with in my head,” said one participant.
The exact date when the therapeutic virtues of comics were recognized is unclear. Justin Green, an American cartoonist, gave clinicians a boost with “Binky Brown Meets the Blessed Virgin Mary”, a bawdy autobiographical account of growing up tortured by religious guilt and compulsive neurosis, published in 1972. Green, who died on last month, was finally diagnosed with obsessive-compulsive disorder (knock). (He is also credited with pioneering autobiographical comics and being the inspiration for Art Spiegelman, creator of “Maus.”)
Anecdotally, comics have been used in treatment since the late 1980s. But in recent years, they have increasingly come to the attention of doctors, therapists, and even government agencies. In 2017 the nhs Authorities in Manchester, England, funded the publication of comic book-style manuals on panic attacks and insomnia. The United States Agency for Defense Technology Innovation, darpaviewed comic book design software as an emotional tool for Afghanistan War veterans.
Katharine Houpt, an art therapist in Chicago, explains that drawing comics gives people agency in their stories. Malleable imagery and conventions, such as thought bubbles, perspective shifts, and the personification of inanimate concepts, can help convey tricky ideas and experiences. Asking patients to draw a daily six-panel strip and other similar exercises can reveal cognitive patterns and potential triggers of distress.
Cartoonists can disassociate themselves from their ailments by portraying them as separate characters. Take insomnia: Ms Shaddock encouraged a child to draw a comic about why she had trouble sleeping. The child conceived “Wornight”, a monster that filled his head with worries at night. “It took the problem away from her and put it on something external,” says Ms Shaddock.
Engaging with comic book characters can also encourage patients to take it easy. John Pollard, who researched the use of comics in psychotherapy as part of his training as a counselor in Britain, notes that readers develop empathy with, for example, superheroes when that they endure and overcome the trials. So why, patients can be gently asked, “can’t you feel the same level of compassion for yourself?” In the same way, “pathographies,” usually autobiographical accounts of illnesses such as bipolar disorder or depression, can inspire people to be kinder to themselves.
When experiencing trauma, such as sexual assault or post-traumatic stress disorder, the drawing offers a sense of control when revisiting painful memories. The panel-by-panel format allows patients to regulate the rate at which they re-enact the events in question. They can identify gaps in the story and present the episode and the people involved from their perspective.
Physicians can also benefit from comics. A study of clinicians who read “My Degeneration”, Peter Dunlap-Shohl’s account of living with Parkinson’s disease, found that the graphic novel increased their empathy for sufferers. Making one can be a self-help tool for medical professionals as well as patients. After trying writing and painting to cope with the stress of her job as HIV/AIDS A nurse in Chicago in the 1990s, MK Czerwiec turned to comics. “That little combination of image and text in a sequential fashion,” she says, “was really, really helpful for me.” She published her drawings as a graphic novel in 2017 and now teaches medical students how to use art to deal with tension.
The roles of comics are multiplying. They can simplify medical information, making obscure concepts more accessible to children and people with learning disabilities or language barriers. This involves, for example, helping patients understand the notion of informed consent, understanding how electronic health records work or negotiating transfers between caregivers. Government health agencies exploit the medium of public education. In 2020, Stark County, Ohio commissioned artist Cara Bean and the Vermont Center for Cartoon Studies to produce a comic book to teach students about mental health.
Behind this explosion of activity is a group of enthusiastic health professionals and artists. Some have been fans of the medium since childhood; others, like Ms. Czerwiec, fell on it as adults. In 2007, Ian Williams, a Welsh doctor turned artist, created a website to bring together those interested in what he calls “graphic medicine”. The name stuck.
It is still a young field. Mr Williams – who in 2014 published ‘The Bad Doctor’, a semi-autobiographical graphic novel about a doctor with knock— recalls being asked to speak at conferences as a comic relief rather than a practitioner. But a growing body of evidence attests to the uses of this art form, and new textbooks are codifying its applications. “The idea of graphic medicine is now entering the medical mainstream in ways that would have been unimaginable a decade ago,” says Michael Green, who teaches the subject at Penn State University and edits the digital comics section. of Annals of Internal Medicinea respected journal.
Comics aren’t for everyone, notes Mr. Pollard, the researcher, and using them in therapy takes tact and expertise. But he can vouch for their potential from personal experience. Reading them helped him overcome dyslexia. “If I hadn’t had any contact with comics,” he recalls, “I have my doubts that I would have gone to college.” ■