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Graphic Medicine in Art Therapy

Getting Started with Graphic Medicine in Art Therapy

Liaison: Katharine Joy Houpt

Bio: Katharine Joy Houpt, LCPC, ATR-BC is an artist and art therapist living in Chicago. She works with adults impacted by interpersonal, collective, and socio-political trauma through arts-based telehealth in private practice and community-based initiatives. She has also worked in various capacities with people with dementia including artist-in-residence, art therapist, consultant, collaborator, stakeholder-centered research coordinator, and administrative roles. Katharine is an Assistant Professor, Adj. at The School of the Art Institute of Chicago. She teaches graduate courses as well as an undergraduate course she created, “Comics Narratives: Illness, Disability, and Recovery,” which draws on the graphic medicine movement. Katharine has presented nationally at conferences including Comics & Medicine, Performing the World, “Yes And” Mental Health Therapeutic Improv Conference, Aging in America, Harm Reduction in the House, and national and local art therapy conferences. Katharine co-authored, “Anti-Memoir: Creating Alternate Nursing Home Narratives Through Zine Making,” with people living in a skilled nursing facility. This paper included comics and zines as knowledge production of people living in long-term care and was awarded Best Paper from the American Art Therapy Association in 2016. Katharine is currently working on a graphic novel contextualizing her family history of neurodivergence and psychiatric disability with the harm of ableism and context of often forgotten histories of disability activism in Texas.

Contact: Reach Katharine by email at houptarttherapy@gmail.com or khoupt@saic.edu, find her on Instagram, or visit her website: www.houptarttherapy.com

Image description: In the top left corner is a photo of a one-story blue house with a pink door with two large trees and some plants in the yard. A large line drawing of a teen girl shows her searching through a cluttered vintage purse. She is saying “Ummmmmmmm ughhhhhh.” Abstracted teal and pink colors flow in and around her. A red line is sharper, tangled around and in her body and leading into a photo collage of pieces of red ribbons on the right side of the page.    Image description: The photo collaged images from the previous page extend from the left side of this page and become more clear. A line drawing of a woman in front of abstracted blue, green, and pink imagery shows her smiling and holding onto the red ribbon. She says, “Oh Katharine! You need a long red ribbon on your keys, like me.” A faded image of keys can be seen attached to ribbon in the bottom right corner of the page.

Images from a comic-in-progress by Katharine Joy Houpt

Introduction: Hi! I have drawn comics throughout my life, starting with an “homage” (being kind to myself) to The Far Side by Gary Larson when I was a kid. I would draw copies of my absurdist one panel comics and hand them out to relatives like the morning paper. From that time onward, I have used comics to understand who I am, the communities I belong to, and the systems that impact us. I still remember when someone handed me my first zine, and a world of learning outside corporate interests opened up to me. As someone who has ADHD, comics help me pay attention– both when I read them and make them. I think in pictures first; I solidify, edit, question, and name my embodied art-based experiences with words. As an art therapist, comics are an important medium to offer art therapy participants a way to give voice to the complexity of their experiences. They can be used for personal processing or a form of social action around disability, mental health, and care when shared publicly. I use them as a way to respond to art therapy participants as well, rather than only sharing verbal dialogue. I can reflect themes, strengths, relational dynamics, embodied knowledge, questions, and patterns I am noticing, practicing self-reflexivity around our therapeutic and social positionality power dynamics as I mindfully share words and text. Comics can also be a collaborative medium in groups, drawing on the strengths and interests of participants. In institutional settings, this can be a powerful way to push back against dominant biomedical models of care and form relationships outside of “patient” and “staff.”

My introduction to graphic medicine happened shortly after I made comics as a form of narrative analysis for my Masters thesis examining relationships built during an intergenerational mail art exchange in 2011. As I began my art therapy career working in a skilled nursing facility, I saw “Comics Nurse” MK Czerwiec present at a conference about aging about her use of comics to process her work as a nurse in an AIDs unit. In 2016, I consulted with MK five years after I saw her present, as I developed the first known graphic medicine-based course in an art school setting at The School of the Art Institute of Chicago.

How graphic medicine and art therapy intersect: Art therapy can describe a wide range of practices depending on the practitioner’s approach, the setting, and the participants, so it’s important to note that other art therapists might answer this question a different way. Broadly, art therapists facilitate artmaking in addition to or in place of talking in order to meet personal, collective, social, and/or political therapeutic goals. Critical art therapy perspectives have asked art therapists to question the ways individualistic conceptions of disability, normality, and mental health care should be questioned based on their neoliberal, colonial origins (Gipson, 2017) and have called for shifting the “expert” role to artists and activists with lived experiences of disability and marginalized identity (Yi & Moon, 2020). Talwar has called for a definition of art therapy that “is transdisciplinary, self-reflexive, and destigmatizing, and that honors the voices of those who use our services” (2016). I attempt to emphasize a critical, relational lens in art therapy through a self-reflexive examination of intersectional social positionality of myself and art therapy participants within a socio-cultural context.

This critical conception of art therapy aligns with graphic medicine, as it is a “movement for change that challenges the dominant methods of scholarship in healthcare, offering a more inclusive perspective of medicine, illness, disability, caregiving, and being cared for.” (Czerwiec at al, 2015, p. 2).

Intersections between art therapy and graphic medicine include:

  • Acknowledgment that images can communicate emotions and embodiment of health experiences with context that words alone may not
  • Centering voices of people with lived experiences rather than “experts” or “helpers” to shift power dynamic (applies to critical approaches in art therapy)
  • Movement from individualistic to collective views of wellness (applies to critical approaches in art therapy)
  • Acknowledgement of a multiplicity of experiences of disability, health, and care rather than a “universal patient”
  • Misconception that comics/art therapy are only for kids
  • Dialectic of constraint of working within a medical model while recentering the lived experiences of people who use services within systems that uphold oppression and make true “safety” impossible
  • Consideration of ethics in impact of sharing traumatic stories and thinking through possible benefits and harm

How to get started: For art therapists interested in incorporating graphic medicine, consider

  • Question notions of “helper” and “expert”
    • Wegner, G. (2020). Reflections on the boom of graphic pathography: The effects and affects of narrating disability and illness in comics. Journal of Literary & Cultural Disability Studies, 14(1), 57–74. https://doi.org/10.3828/jlcds.2019.18
  • Learn about the history of comics as resistance to neoliberal models of care: Crafting Psychiatric Contention Through Single-Panel Comics by Helen Spandler
  • Try drawing a daily six panel diary comic yourself, to understand how the medium might work for you and potentially others
  • Pay attention to art therapy participants – who is already interested in comics, zines, combining words and images, social justice? Can they lead the way?
  • Practice exercises from What it Is and Making Comics by Lynda Barry alone and with art therapy participants
  • Practice accessibility: Blind Accessible Comics
  • Use the search box on graphicmedicine.org to find comics specific to art therapy participants’ interests, questions, identities, cultures, disabilities, illnesses, etc.
  • Question what might contribute to art therapy participants’ experiences outside a DSM diagnosis– is there a comic that represents the impact of racism, ableism, ageism, capitalism, transprejudice, heterosexism, or other forms of oppression that might resonate with the people you are working with? Do they want to investigate queer comics, Mad pride creators, comics made by care partners of elders?
  • Consider how the medium might complement therapeutic goals – Draw yourself and your inner critic sitting on a park bench to interview each other about unmet needs and motivations? Draw out possibilities and implications as you consider an important decision? Integrate the personal, social, and political through representations of character, environments, and narrative? Consider power dynamics through choices around layout and “camera angle” of panels? Slow down processing trauma through thoughtful pacing and use of the gutter to increase agency, somatic grounding, and window of tolerance? Let a nursing home administrator know the food is terrible (or great, for that matter)? Draw an anger comic about the continual state-sanctioned violence against BIPOC, trans, and disabled people?
  • Connect art therapy participants with comics/zine communities (fests, online groups, etc) in order to build sense of identity and pride around shared experiences.
  • Share DIY collective care practices that are culturally relevant to art therapy participants made by people with similar cultural experiences.
  • Question your biases and assumptions by reading comics from perspectives  of lived experiences you are unfamiliar with, recognizing that any one narrative is not representative of all people’s stories.
  • Make a comic to plan how you want to practice accountability as an art therapist.
  • Question how pop culture images have been used to reinforce stereotypes and harmful ideas about normality and wellness based on eugenics, settler-colonialism, nationalism, and capitalism (Gipson, 2017; Talwar, 2019; Yi & Moon, 2020) and how DIY comics might be created intentionally to counteract those tropes.
  • Learn about Disability Art & Culture and consider how art therapy has historically harmed disabled people, especially BIPOC disabled people. What is the role of comics by disabled creators in reclaiming agency over care?
  • Consider how comics might support mutual aid mobilization and sharing information.

If you are not an art therapist, but would like to pursue it as a career: Information on becoming an art therapist.

Key texts, reading suggestions, and resources:  

 

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