Cartooning for Health

Organized by the Alexander von Humboldt Foundation and the International Journalists’ Programme.

Amadeo Gandolfo & Lisbeth Schröder, 2024

Cover illustration: Clayton Junior – www.claytonjunior.com

Design: Tamara Luz Ferechian – www.instagram.com/tamaraluzferechian

This project originated in the fifth edition of ComLab (Communications Laboratory) that was held place in May 2022 by the Alexander von Humboldt Foundation and the International Journalists’ Programmes. Nothing would have been possible without their support and encouragement, and we are infinitely grateful for it.

Cartooning for Health © 2024 by Amadeo Gandolfo, Lisbeth Schröder, Femimutancia, Pedro Mancini & Clayton Junior is licensed under CC BY-NC-SA 4.0. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

It may be just a stroke of the pencil for some, but for people all over the world, it is a way of dealing with their grief, fear, or anger. Art can give us new ways of caring for our mental health. Especially in today’s world, that’s what’s needed.

In Sweden, the share of people with anxiety rose from 31 percent to 41 percent within ten years, in Argentina, it tripled, going from 16 percent to 48 percent during the pandemic, and according to a German study, corresponding symptoms have increased significantly since the start of the war in Ukraine. Psychiatrists speak of a “tsunami of mental illness” and a “second pandemic.” According to Katharina Domschke of Freiburg University Hospital, the situation will get worse: insecurity, inflation and rising energy prices are affecting more and more people.

That’s why we are taking you on a journey with this fanzine: to comic artists who have found themselves through art, gained freedom, or worked through a difficult relationship with their parents; to researchers who use their work to explore how art therapy can help. And to current facts and figures on the relationship between the COVID pandemic and mental health. Together we will find an answer to the question: How can art help our mental health in these times? We hope you'll read it and find some useful info, a glimmer of hope, or even, perhaps, the beginning of an artistic career.

Yours sincerely,

journalist

Comic studies scholar

Science

COVID-19: Challenges to our psychological well-being

The greatest threat to mental health since the second world war

Dr Adrian James in the Guardian

The lockdown could lead to a tsunami of referrals

Prof Wendy Burn on the BBC

a second pandemic – Mental health spillover from the novel coronavirus

Choi et al, 2020

50%

the 6,509 participants in a study in Germany said that they suffered from anxiety and psychological distress regarding the COVID-19 pandemic.1

48%

29,64% of Argentinians suffered from anxiety during the pandemic suffered from depression. 2

1 Source: Petzold et al., 2020. https://onlinelibrary.wiley.com/doi/10.1002/brb3.1745

2 Source: https://www.telam.com.ar/notas/202205/591819-argentina-trastornosansiedad-pandemia.html

3 Sources: National Center for Health Statistics (NCHS and the US Census Bureau

In 2019, 8.1% of adults in the USA aged 18 and over had symptoms of anxiety disorder, in 2023, it rose to about 27,28%3

Large Differences

In 2015, there were 193.99 psychologists per 100,000 inhabitants in Argentina. It is the highest rate of psychologists in the world. 4 According to documentation from

According to statistics from the German government, in 2022, there were between 16 and 63 psychologists per 100,000 inhabitants (In the federal state Mecklenburg-Vorpommern 16, in Berlin 63).5

4 Source: https://link.springer.com/article/10.1007/s44202-022-00033-7

5 Source: Wissenschaftliche Dienste Deutscher Bundestag

Art therapy

Which activities can be beneficial for mental health?

dance, theatre, singing7

digital and electronic

according to the World Health Organization

writing, reading, attending literary festivals

7 These are just examples

going to museums, galleries, concerts

design, painting, photography

About three months before I was born, my biological father decided that he no longer wanted to take part in parenthood. He left. The only thing they told me is that he liked to draw and that he was fascinated by comics. So, in my head, comics were bad, they were wrong.

When I was 10 years old, my cousin and I found, in a nearby abandoned house, a magazine that caught our attention. At that time, I lived in a rural area of Buenos Aires. The publication was called Skorpio. The name and images contained in those pages stuck with me. Mischievously, we hid it under the bed and went outside to play. When we returned, we smelled smoke and saw some embers in the fireplace in the dining room. We were able to make out the remains of burned panels among the ashes. No one said anything, but the message was very clear. Comics were bad.

For a long time, I almost completely refused to read them, I was in a state of denial. I just read a few during my adolescence: Luna Roja in some neighbours' magazines, Quino’s jokes, some issues of my cousin’s Cazador, Spawn, Witchblade.

However, I always liked to draw, so I took Illustration and Anatomy courses while I was studying Sociology. But with time I found, almost unknowingly, not looking for it too much, my own language.

In 2018, I finished my first graphic novel called Alien, the context of wich was that of an unloving separation where I was left without a job and without a home. But it also coincided with a new universe of discovery: of my sexual orientation and my gender identity. I wrote, drew and self-published it over a period of four months. During this time, I only slept five hours a day due to anxiety.

At the end of that year, I started therapy, followed by psychiatric treatment. Due to social prejudices, it took me several months to take the decision to start it.

During 2019, I made Piedra Bruja, my second book, which is about a witch who has to take a journey to get rid of family ghosts and find themselves. In 2020, during the pandemic, I drew Banzai, which was about sexual-affective relationships, difficulties, childhood traumas, separation, dreams, ghosts. My psychologist told me the following year: “Next time, don’t make it so surreal and fictional, think about what you want to tell your mom”. After I finished drawing La Madriguera, my latest book, I did it, I told her almost everything. Shortly after, she passed away.

Today, I always think of comics as my shelters. In the plural. Because they were my space for reflection, but also my celebration for being who I am, my nightmare, my insomnia and my dream, my reunion, my destiny, my choice, all the contradictions that go through me. And even if I wanted to, even if I tried, I couldn’t think of myself any other way.

Femimutancia, 2023

How art can help you to handle fear and sadness

Before stories were pressed into pages and comics were printed, people smeared their emotions on barren rock walls. Our ancestors painted screaming people, demons, or spider-legged hermaphrodites. Creatures that might symbolize their fight with fear.

When Monika Wigger says that people have used art to deal with basal emotions since the dawn of civilization, she refers to copies of these 30,000-year-old artworks. These were shown in an exhibition in Germany. According to the art therapist and professor from the Catholic University in Freiburg, the old paintings are a source of inspiration, perhaps even a “precursor to the comics of modernity.”

But how does art help? Is it really that simple to just visualize inner demons?

Facing the unspeakable

“When you’re lost, there draw monsters,” writes the comic artist Linda Barry in one of her books. The unplanned scribbling of these creatures would not only help us to remember how things can be created without planning, drawing the monsters also keeps a certain “door open to the unknown”.

This means that through the scribbling of monsters we can learn to trust our intuition more. But it can also give us feelings like solace. This is what the cartoonist, gender scientist, and researcher on graphic medicine Susan Squier from the Pennsylvania State University describes in one scientific paper from 2021. She tried it out for herself: She started doing a comic diary during the pandemic. Every day she listed seven things she

did, seven things she saw, one question, and one thing she noticed on the left-hand page. On the right-hand side, she combined one of these things with her own image. That was how the “Coronavirus Medusa” was created, a colorful monster that looks at a human in a mirror. As Squier describes it, she saw a version of herself in the monsters she had drawn – for example the “unspeakable fear of the coronavirus.”

“When you’re lost, there draw monsters”

Lynda Barry, comic artist

Such exercises are also part of art therapy, in which people with mental health issues create photographs, form sculptures, or even draw comics. In Germany, it is well established in the inpatient sector. For professor and psychiatrist Katharina Domschke from the Medical Center of the University of Freiburg, art therapy is especially helpful for patients who have difficulty verbalizing their feelings. Together with a therapist, “something often clicks when the patients can really look at or touch their feelings in the form of a picture or a sculpture,” says Domschke. It would be very important to reshape and change these feelings through the artwork.

Wigger narrates that this is exactly what happened to one of her patients. A young woman was suffering from a brain tumour. So, she wanted to present her disease in the form of an octopus made of red wool. Thanks to the form and fluffy material, the woman was able to take away the monster’s horror by throwing it angrily against the wall. This helped her to cope better with her condition. For the art therapist, such a process should be accompanied by sustainable relationships.

“Something often clicks when the patients can really look at or touch their feelings in the form of a picture or a sculpture”

—Katharina Domschke, psychiatrist

So, in psychotherapy, it is not just important to face your fears, but also to overcome them or handle them in a different way. This

can be done through a comic image or through exercises like Katathymic Imaginative Psychotherapy. In the latter, the patient speaks about their conflicts or skills in pictures. These pictures can be interpreted together with a therapist. If someone has a snake phobia, they can imagine what the snake looks like or even that it bites. But in the imagination, it is also possible to find an antidote against it. For example, the knowledge that the person survived similar situations in the past.

Find helpers

Sure, everyone knows a good coping strategy and for some, it’s just about facing your fears. But for Wigger, just from an art-therapy point of view, putting your inner monsters down on paper in isolation would not be very conducive to a constructive coping strategy. The visualization could reinforce the idea and the negative feeling associated with it. And we as humans tend to focus on the negative aspects. It would be better if the artistic confrontation contained a constructive component, for example, a place of retreat or a helper figure.

For scientist Susan Squier the constructive component of her artistic confrontation was a “gratitude” altar. She painted what had kept her well during the months of the pandemic: meditation, her family, or listening to audiobooks.

So doing art by oneself can be strengthening, supporting, and identity-forming. According to German scientists in the book Art Therapy For Mental Disorders, it can also help us remember things, as, for many, it was an activity we did in our first years on this planet. The creative act could also provide us with a communication tool, for example, enabling us to speak with our friends about our fears.

Passive therapy

But not only the making of art is an important aspect to handle strong feelings. Also, the viewing of art can have a therapeutic

effect – something Wigger calls “aesthetic reception.” This means everything that goes beyond the work itself. For example, a pictorial subject can be an occasion for a conversation. The examination of the biographies of artists can contribute to to processing traumas better.

For example, Frida Kahlo: Due to a serious accident, the Mexican painter suffered severe orthopedic and gynaecological injuries. She had to undergo many operations and for some time wore a full body cast or a steel corset. During her recovery, Frida began to paint. Over 100 works show her dealing with chronic pain, loss, and physical suffering. She herself was the central motif in her painting. For Wigger, such work can be an important resonance space to pursue questions about one’s own identity and to find forms of expression for it.

But the perception of art can even help us to cope with extreme fears or sadness: In a research article in the “Journal of Positive Psychology” from 2021 it is stated that visiting art museums is associated with a decrease in depression and and anxiety. In the Canadian Region of Quebec physicians can prescribe a visit to a national art museum. So even when we just look at art, discuss it and think about it, we can experience its benefits.

Let’s go

All of these beneficial effects contribute to a new way of helping people. Slowly, world is discovering this special power of art. According to the World Health Organization, there has been a major increase in research on the effects of the arts on health and well-being over the last two decades. So, art can support child development, help people understand mental illness, and support end-of-life care. It can also form a bridge between different groups; for example, activities such as art classes have been shown to foster greater social inclusion in patients with dementia and their carers.

With a constructive way of doing it, maybe even together with a therapist, it can be an important tool in our armory against fear, sadness or anger – probably as it was 30,000 years ago.

Lisbeth Schröder, 2023

MORE INFORMATION

Katharina Domschke: Angst in der Kunst: Ikonografie einer Grundemotion (Kohlhammer, 2019)

Lynda Barry: Making Comics (2019)

Susan M. Squier: Drawing Monsters with Emil Ferris and Lynda Barry: An Exploration of the Drawing Process as Part of Graphic Medicine (2021)

Graphic Medicine: https://www.graphicmedicine.org/

IF YOU NEED HELP

Please contact your local help number. In Germany, for example it's 0800/1110111 for the telephone helpline (Telefonseelsorge) which is available all the time, or 116 117 for an appointment with a psychotherapist. For non-German-speaking people, the organization Ipso Care offers counselling sessions. For Argentina, you can contact Mental Health Responds CABA: it provides confidential telephone counselling for residents of the city of Buenos Aires. The telephone numbers 4863-8888/48615586/4123-3120 work from Monday to Friday from 8 p.m. to 8 a.m. Additionally on holidays, weekends and from 20 to 8, you can call 4123-3100 ext. 3484/3485.

National Hospital Specialized in Mental Health and Addictions

Lic. Laura Bonaparte: has an Emergency Committee that conducts telephone interviews for advice and containment, attended by mental health professionals. The telephone number is (011) 4305-0091 to 96, extension 2106.

Does drawing help to deal with anxieties and anguish? To expel demons? Does it work as sublimation? A few years ago, I would have answered with a resounding yes. Now I don’t know.

Around 2007 I was pretty lost. I was going through one of my worst existential crises at all levels. I had split up from my first girlfriend, I abandoned a university career, a job I didn’t like, and I stopped playing drums in a band. All this to dedicate myself completely to drawing comics. Maybe it doesn’t sound so terrible, and perhaps you could even see these changes in a positive light, if they hadn’t been accompanied by a strong social phobia with sudden paranoid attacks. Whole months locked up without seeing anyone, smoking marijuana and drawing. Setting foot on the street terrified me. I began to draw a comic strip that I later titled “The Octopus Torturing Machine.” I made the first page and re-drew it several times, listening to Aphex Twin’s album Drukqs on loop. As the main character of the comic had a cockroach as a pet, I also had one, dead, like stuffed. It functioned as a model, but also as my only companion.

I finished this fifteen-page comic and felt really liberated. I felt like I finally found a way to say something that I was very distressed about and couldn’t express in any other way. It was a story of a half-hearted reconciliation with the world. With it under my arm I presented myself everywhere. I carried a folder with the printed pages in my backpack and if I had the opportunity, I would show them to anyone who wanted to see them. I thought they legitimized

me as a person. It was like saying, “Okay, I’m a mess, a social klutz, but look, I can do this too.”

I remember one day in particular during that process. I was drawing in my room at my parent’s home. Without knocking, my grandfather pushed open the door. He watched for a few seconds in silence. As if drawing a conclusion from the image he was receiving, he said in his spectral voice: “the artist”. Something changed in my head at that moment. As if that pronunciation by my grandfather gave entity and meaning to what I was doing. That ritual became something deeper. And I think it has to do with sublimation. The magical act of saying what one could not say in any other way.

My grandfather, Ricardo Passano, was an Argentine actor with great success and recognition in the 1940s. During the military dictatorship led by General Pedro Eugenio Aramburu that was in power between 1955 and 1958, he was blacklisted because his father was a communist. From the place of privilege and recognition he had occupied for years, he became unemployed and forgotten by the public. This plunged him into a state of chronic depression and I might even say a certain degree of insanity. This experience scarred him and he developed the belief that to be an artist, you need to suffer. And he instilled this belief in my family. You had to go to the bottom of the pit and delve into the darkest feelings of the human being. Then transform and return them expressed in artwork. For many years I also believed this.

In 2018 I got a one-year residency in Paris to work on Niño Oruga, a graphic novel that metaphorically narrates my relationship with my grandfather. This trip became one of the most incredible experiences of my life, but everything that had to do with the concrete work on the book was quite tortuous. Delving into that relationship was heavy and emotionally draining. I returned to Buenos Aires with the book half done and what followed was worse. My mother was diagnosed with cancer (she died a year after my return) and the pandemic began. Finishing Niño Oruga was

a hellish odyssey. At times I wondered if it wasn’t doing me more harm than good. What about the blessed sublimation I heard so much about all my life? When would I feel more relieved? I don’t think there is a certain answer. My aspiration is to continue searching, groping for where the path is, what is the healthiest way to express myself without leaving my life doing so. To work in a way that comforts me but does not make me suffer. This is an emotional path, that’s clear from the start. And it is difficult when one thinks of oneself as a sensitive person. It will probably take me a lifetime to find answers to these questions. And it is quite likely that I will never find them. But maybe that’s what it’s all about. Asking oneself things, even though you know there are no answers.

Pedro Mancini, 2023

cartooningxhealth@gmail.com