In a panel on ‘Altered Realities’ at SPX 2024 that included comic book artists Christie Furnas, Peter Kuper, Laura Pérez, and Nate Powell, Furnas claimed that “the concept of truth” always depends on one’s perception (SPX 2024). In a graphic work conveying multiple realities, Furnas explains, “the truth comes from how people receive” what is represented, it is that “agreed upon part” (SPX 2024). In saying so, Furnas not only evokes the emotional connection, or the “empathic bond,” that is created between comic artists and readers (Williams 354), but also suggests the idea that the act of reading creates collective knowledge about the experience of mental illness (in Furnas’ case, schizophrenia). To put it differently, according to Furnas, if comics offer any truth or knowledge, it can only exist in the interaction between artists and readers, who may be general readers, other artists, or medical and/or healthcare professionals.
Scholars in graphic medicine—broadly understood here as “the intersection of the medium of comics and the discourse of healthcare” (“What Is ‘Graphic Medicine’?”)—such as Sathyaraj Venkatesan and Sweetha Saji have argued that graphic memoirs about illness have cultural power insofar as they exist at the crossroads of lived experience and clinical description (39). Other scholars have claimed that the comics medium is particularly suitable for challenging psychiatric authority (Spandler 115), and for offering non-stereotypical portrayals of lived experiences of mental illnesses that could help build communities among neurotypical and neurodivergent people (Donaldson 154–168). Such scholars mainly refer to one of the types of graphic medicine, namely the pathography (or autobiographical narrative of one’s lived experience of illness), as a means of promoting epistemic justice, that is, the idea that the knowledge provided by one’s lived experience is as valuable as that of medical expertise. While I contend that the cultural work that pathographies are doing is essential, I would like to return to Furnas’ conceptualization of truth, and to the contribution that readers and medical/healthcare professionals can offer when it comes to shaping knowledge about complex mental illnesses.
In my project on twenty-first-century schizophrenia memoirs and graphic memoirs, I investigate knowledge about schizophrenia as produced by multiple actors and agencies. Another way to articulate this multi-actor understanding of mental illness is through the notion of ecology. Ecological approaches to rhetorical circulation, as Dan Ehrenfeld underlines, move away from a focus on a single situation to consider how “rhetors—in particular times and places—come to shape, reinforce, subvert, and reinvent the logics of the ecologies within which they are enmeshed” (45). Inspired by rhetorical ecology, I would like to suggest that comic artists constitute some of the rhetors, among many others (writers, bloggers, associations, clinicians, psychiatrists, caregivers, patients and relatives in support groups, …), who contribute to constructing our medico-cultural understanding of mental illness. Susan M. Squier, one of the spearheads of the field of graphic medicine, has shown that comics often reproduce the actor-network model of environmental studies, not only by actively engaging readers and fostering community building, but also (for this, she gives the example of Ken Dahl’s Monsters) by highlighting the various actors and agencies responsible for environmental phenomena such as chemical spills (53). By adopting such ‘ecological’ approaches, comic artists revise the fallacious idea that autobiographies offer the author’s objective or completely reliable (because factual) truth, a truth that is at times perceived as ‘universal.’
Instead, life writing scholars Julia Watson and Sidonie Smith explicate, autobiographical truth is “subjective,” since writers are both “making ‘history’” and “performing rhetorical acts: justifying their own perceptions, upholding their reputations, disputing the accounts of others, settling scores, conveying cultural information, and inventing desirable futures among others” (10). In narratology, the notion of “fictionality” also challenges assumptions about truth and reality inasmuch as any work of global nonfiction can include passages of “local fictionality” (e.g., a thought experiment) used as rhetorical strategies for communicating feelings, values, and knowledge to audiences (Phelan 235–38). Furnas’ idea of the ‘agreed upon part’ renegotiates our understanding of the author’s subjective truth in autobiography as an interactive and collective endeavor involving the artist and multiple readers.
One compelling example that Furnas provides in her discussion of truth and reality is a panel from her book Crazy Like a Fox: Adventures in Schizophrenia (2024) in which Fox Foxerson, the anthropomorphic fox she employs to express her experience of schizophrenia, is depicted as upside down (Furnas 170). Applying the law of gravity to this panel would be preposterous, not only because Furnas published her story as a graphic novel and not as a memoir, thus fictionalizing her illness narrative, but also because the idiosyncratic styles and techniques of comics constantly defy our preconceived ideas about truth and reality (e.g., via exaggerated traits to express emotions, evocative visual metaphors such as a character literally cracking when stressed, …). In doing so, artists sometimes aim at representing emotions and affects in ways that would be more convincing than, for example, with photographs or autobiographical texts. By drawing Fox upside down, Furnas wanted to display an emotion (SPX 2024). Since there are still several relative gaps in our medico-cultural knowledge about the etiology and symptoms of schizophrenia, which continue to lead to misdiagnosis, poor treatment, and stigma (Granger and Naudin), Furnas’ drawing is a welcome addition to existing psychiatric knowledge about schizophrenia. What I am suggesting here, however, is that the drawing is not just a contribution by the artist herself but, rather, an invitation to make sense of her affective state, to shape collectively its meaning, one that may not be possible with written words alone. To understand how people are living with mental illness, we need this collective knowledge, namely communities of artists, readers, and medical/healthcare professionals alike that strive to reach the ‘agreed upon’ truth about experiences and symptoms. The power of graphic medicine might be to act as a springboard for that.
Works Cited
Donaldson, Elizabeth J. “Psychosis Blues: Schizophrenia, Comics, and Collaboration.” PathoGraphics: Narrative, Aesthetics, Contention, Community, edited by Susan Merrill Squier and Irmela Marei Krüger-Fürhoff, Penn State University Press, 2020, pp. 153–72.
Ehrenfeld, Dan. “Ecological Investments and the Circulation of Rhetoric: Studying the ‘Saving Knowledge’ of Dr. Emma Walker’s Social Hygiene Lectures.” Methodologies for the Rhetoric of Health & Medicine, edited by Lisa Meloncon and Blake J. Scott, Routledge, 2018, pp. 41–60.
Furnas, Christi. Crazy Like a Fox: Adventures in Schizophrenia. Street Noise Books, 2024. Amazon.
Granger, Bernard, and Jean Naudin. Idées reçues sur la schizophrénie. Le Cavalier Bleu, 2022. Amazon.
Phelan, James. “Fictionality.” A/b: Auto/Biography Studies, vol. 32, no. 2, 2017, pp. 235–38. DOI.org (Crossref), https://doi.org/10.1080/08989575.2017.1288008.
Smith, Sidonie, and Julia Watson. Reading Autobiography: A Guide for Interpreting Life Narratives. First edition, University of Minnesota Press, 2001. Google Books.
Spandler, Helen. “Crafting Psychiatric Contention Through Single-Panel Cartoons.” PathoGraphics: Narrative, Aesthetics, Contention, Community, edited by Susan Merrill Squier and Irmela Marei Krüger-Fürhoff, Penn State University Press, 2020, pp. 115–35.
SPX 2024: Altered Realities. Directed by SmallPressExpo, Bethesda North Marriott Hotel & Conference Center, 2024. YouTube, https://www.youtube.com/watch?v=drWvBROhr18.
Squier, Susan M. “The Uses of Graphic Medicine for Engaged Scholarship.” Graphic Medicine Manifesto, edited by M. K. Czerwiec et al., Penn State University Press, 2020, pp. 41–66.
Venkatesan, Sathyaraj, and Sweetha Saji. “Drawing the Mind: Aesthetics of Representing Mental Illness in Select Graphic Memoirs.” Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, vol. 25, no. 1, Jan. 2021, pp. 37–50. DOI.org (Crossref), https://doi.org/10.1177/1363459319846930.
“What Is ‘Graphic Medicine’?” Graphic Medicine, https://www.graphicmedicine.org/why-graphic-medicine/. Accessed 17 Nov. 2025.
Williams, Ian. “Autography as Auto-Therapy: Psychic Pain and the Graphic Memoir.” Journal of Medical Humanities, vol. 32, no. 4, 2011, pp. 353–66. DOI.org (Crossref), https://doi.org/10.1007/s10912-011-9158-0.
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