Literature review

‘Confessional comics’ are a growing art form, increasing exponentially with the internet, and Art Spiegelman (2013), the creator of Maus, credits Justin Green’s 1972 comic Binky Brown meets the Holy Virgin Mary for inventing the term. My searches on the internet revealed hundreds of confessional cartoons, comics, and graphic novels that reach a wide audience on the web, in a manner that was impossible in the 1970–2000 era of underground printing, zines and small publishing. The audience plays an integral role in the process. As McCloud (1993; 2006) explains, cartooning is a subtle art of using symbolic representation to evoke an emotional response or relationship with the audience, and is a language understood by readers. Warhol’s essay ‘The space between’ (2011) expands on McCloud’s theory to demonstrate how comics are a powerful tool for expressing complex emotion by describing the invisible language between the panels. Warhol (2011) argues that Alison Bechdel’s graphic autobiography Fun home (2006) challenges the dualistic (image/words) narrative of autobiographical comics previously accepted by theorists, such as Hatfield (2005). Warhol extends comics theory to include more layers, including ‘feeling’ in spaces between the images and words. This is echoed by Giarelli and Tulman (2003), who assert cartoons contain truths, or secrets, in the semiotics that can be unravelled and used as data; further, the polysemous or multiple layers used in creating comics make them a rich complex language.

Learmonth and Huckvale (2008) discuss the Schaverien triangle in art therapy as the differentiating factor between art psychotherapy and talking-based therapies. Comics reflect this triangle naturally due to the relationship with an audience. The audience plays a role as witness. Ben Snakepit (2007) demonstrates how the audience receives the artist’s work, relates to it, and feeds back that the artist is not alone and that his pain provides some comfort for others. This is demonstrated via sales and online comments, ‘shares’, and ‘likes’. For decades Judy Horacek (2013) has used cartooning to communicate feminist issues with humour, and her audience purchases these messages as magnets, tea towels, and cards. Similarly, Celia Allison has created a business from her character Cecily, because the audience empathises with the character. Michael Leunig, Charles Shultz (Peanuts) and, recently, Christopher Grady (Lunarbaboon) have also generated income from their characters because their audiences relate. Likewise, Art Spiegelman’s Maus has been a bestseller since its release 30 years ago, while Binky Brown has also remained in print. This shows that comics are timeless, meaningful to the reader and the author, with a relationship forming between the audience, artist, and comic. This role of witnessing is one the art therapist could play, sitting within the Schaverien triangle of art therapy.

Seiden (2006) is an art therapist who uses an autobiographical comic to display art as a personal healing form and has written about the narrative being important for processing trauma. He says that comics provide an opportunity to create and explore with control (Seiden, 2006; Mullholland, 2004). Art therapist Lucas-Falk (2010) says comics are “accessible to the average person and not as intimidating as fine arts mediums might be” (p.233). Because comics provide storytelling potential beyond verbal narrative and visual image-making alone (Sabin, 1993; Lucas-Falk, 2010; Mullholland, 2004), they provide unique scope for use in art therapy. Lucas-Falk states that “the use of comics as a self-healing agent has arisen naturally within contemporary society, and offer[s] compelling argument for its inclusion as a medium in art therapy” (p.233). Sabin and Triggs (2002) identify the same themes in confessional comics, saying they are also the themes that frequently occur in therapy, including single motherhood, mental and physical health, trauma, abuse, midlife crisis and social issues. This raises the question as to how artists are intuitively using comics as therapy.

Howie et al. (2013) and Gantt and Tinnin (2007) focus on the verbal and non-verbal “brains” and how art therapy can help trauma sufferers using an intensive “graphic narrative trauma processing” (Gantt & Tinnin, p.39). Gantt and Tinnin report flaws in their study, but the findings indicate it would be worthwhile revisiting it using better parameters, as it strongly suggests that comic-based narrative therapy has beneficial outcomes with trauma. Andrew Hore is a Canberra-based cartoonist who runs a successful program he calls Quick Draw. On his website he describes Quick Draw as using “art therapy-based workshop programs”. Hore draws (cartoons) people’s ‘strengths’. He is not formally trained in counselling or art therapy, but rather uses his sporting and youth-work background to promote wellness with his cartooning.

Carp (1998) refers to Jungian archetypes to demonstrate that the creation of a clown character in drama therapy gives the participant the opportunity to become aware of their ability to heal themselves by connecting with, and listening to, their own inner clown as a healer. The paper argues that an individual’s creation of a character removes the Ego and allows Self to emerge (p.249), meaning that the barriers created by society or our own experience have caused a formal presentation (Ego) that blocks our Self or free expression. The therapist acts as ‘witness’ to the clown and can contain the client’s experience. This article shows the benefit of a therapeutically supported creation of character, due to the potential power or intensity of the experience for the client. It also shows the importance of being witnessed as part of recovery. Aspects of both drama therapy and comics rely on creating or discovering an inner voice (character). Mullholland (2004) discusses his personal benefit of using comic-making therapeutically: “As a medium, comic books provide their creators a wide variety of resources to aid their mental health. They allow for expression of the self in terms of body image, verbal expression, physical action, and emotion” (p.43). He concludes that comics are therapeutic because they are a safe way for people to express situations while maintaining control of the outcomes and being removed from the consequences.

Wiid et al. (2012) observe, “While pictures tell stories, in the case of cartoons, stories also tell pictures” (p.543). They discuss the political cartoon theory, observing how cartoons reflect societal sentiment as it shifts over time. Graphic devices in cartooning are used to persuade the reader, by using visual techniques to influence the emotion and judgement of the reader (Wiid et al., 2012; McCloud, 1993). Cartooning invites people to “create their own rules; this in turn, made work unique, visceral, and compelling” (Brunetti, 2011, p.3). Brunetti teaches cartooning and has observed that the best work comes from students that expose themselves, while a guarded student, or “the narcissist” (p.6) student, who is not self-critical or open to criticism, rarely produces anything relatable or interesting. Brunetti emphasises in his lessons that a key ingredient of cartooning is “life” (p.16). This tells me that for a cartoon to be received by an audience, to be relatable, the author needs to be suffering and putting that suffering into the cartoon. The therapeutic benefit for the author comes from the relationship with the process of creating the autobiographical comics, and the connection with the witness/audience.

In 2007, Ian Williams started a website for collecting comics written by medical professionals, patients, and artists about physical and mental medical conditions. He called this Graphic Medicine, having completed an MA dissertation on comics as a resource for healthcare professionals, where combining comics and medicine proved to have benefits in recovery and education. Venkatesan and Peter (2018) have noted the value of graphic medicine as a therapeutic tool in trauma recovery, and show the effectiveness of art as a therapeutic device, noting that comics are particularly useful owing to their narrative and visual elements, which enable authors to tell their story in space and time. Mulholland (2004) confirms the benefits of comics, saying art therapists can support clients to create autobiographical comics to “release some of the negative aspects of their feelings in a constructive and creative manner” (p.43).

The creation process of comics follows Herman’s stages of recovery (2001); first, to create a safe place; second, to retell the story (mourning) repetitively until the feelings neutralise; and then, to reconnect (this could be to the audience, therapist as witness, or people in their lives). Herman states that sharing experiences and social action is an essential part of reconnecting and reconciling the trauma.

The literature overwhelmingly supports that autobiographical comics and cartoons are an intuitive form of self-therapy employed by artists. Comics can be a powerful medium that combines art and narrative, which could be employed in a formal art therapy situation.