07 - Graphic medicine and visual arts

Visual arts impacts

Growing body of research supports positive impacts

Visual arts impact on Patients

Improved self-esteem and self-respect

Reduced depression and anxiety

Re-engagement with wider social world

Visual arts impact on Providers

• Increased empathy

• Observational skills

Transdiscipinarity

• Commitment to working across disciplines

• Bypassing or abandoning subject boundaries

• Characterized by creative inquiry and intellectual risk taking

• Embraces diversity (socioeconomic and otherwise)

• Foregrounds creation of new knowledge

Drawing

• Oldest form of visual arts

• Predates writing by at least 25,000 years

• Don’t know what drawings communicate…Perhaps used as a form of communication?

• “mark-making for meaning” (p. 302)

Ardeche valley caves in Southern France

cave drawings from 17000-22000 years ago, depicting a scene of (subjective interpreatation) people on a savanna with animals

Blombos Cave, South Africa

fragment of rock has ochre pressed into it to form lines - don't know what it is, since the rock is a very small fragment of a possibly much larger piece

Drawing as noun

physical drawn artifact

Drawing as verb

the process of drawing

Drawing and everyday life

• Children make meaning of their world visually

• Self-directed drawing dwindles around 8-12 years old

• Corresponds with emphasis in school curriculum on text-based literacy and numeracy

• Intellectual capacity tacitly associated with word-based outputs

• Drawing becomes marginalized in adulthood

• When asked to draw, adults become anxious!

universally ubiquitous

everyday, ordinary, present, everywhere.

Drawing is for everyone

• “[Drawing is a] universally ubiquitous means for generating and critiquing ideas and forms and for investigating the world. It is entirely democratic: belonging to everyone, blurring distinction between art and everyday usage.” (p. 303)

• “When drawing, a trace or imprint of the thinking process is left on the page and the externalizing of thoughts helps structure thoughts.” (p. 306)

trace/imprint of the thinking process

throughout an artpiece, the artist's thought process and background will inevitably end up entangled within

Objective drawings

• All diagrams are drawings!

• Draw to explain concepts

eg. diagrams in textbooks, images that aim to show a representation of things as they are. Pathways, flow charts, anatomy diagrams

Subjective drawings

• Expressive, unconcerned with accuracy

• Capture a “sense” of situation

• Open-ended, intuitive, provisional, expansive, evocative, experimental

• Visual thinking, exploration, making new knowledge

• “Draw-and-write” or “Draw-and-tell” method

“Draw-and-write” or “Draw-and-tell” method

• People draw and then write or talk about their drawing

• Used to explore lived experience

Comics

• Not a genre but a medium

• Increasingly not only fiction but also non-fiction and documentary

• Enable us to enter, imaginatively, complex, ambiguous debates…potential of a comic to express complex issues and thus be pedagogically useful in discussions of medical ethics

• Stigma around comics?

Crusade against comics

1948, symposium on “The Psychopathology of Comic Books”, American Association of Psychotherapy

• Comic books promoted violence

• Undermined moral values

• Negatively influenced young readers’ psychological development

• Contributed to juvenile delinquency

• Encouraged disrespect for authority figures

1954, Comics Code

• Self-censorship rules adopted by US comics publishers

• Addressed public concerns about influence on youth

• Outlawed sympathetic portrayals of criminals, excessive violence, disrespect for authority

• Era officially ended in 2011 when DC Comics and Archie Comics withdrew

Comics as “third space”

A zone where one can play with ideas not yet accessible to linear thinking, draw together concepts, communities, and practices conventionally kept separate, and enjoy the fireworks that result

A meeting point, a hybrid place, where one can move beyond existing borders…a place of the marginal women and men, where old connections can be disturbed and new ones emerge…a precondition to building a community of resistance to all forms of hegemonic power

Hegemony

• Term popularized by Antonio Gramsci

• Refers to how the worldview of a dominant group is imposed and accepted as “common sense” or the norm by society

• Makes alternative perspectives seem unthinkable or dangerous

• Dominance is achieved through institutions like media, education, and religion

• Subtly reinforces the status quo and interests of those in power

historical hegemony

British empire in 18th & 19th century, dominated quarter of world’s landmass

cultural hegemony

Hollywood/ American movies and pop culture dominate global entertainment

social/ideological hegemony

English as most prominent global language

educational hegemony

Western-centric curriculum

Why comics?

• 21st century is a visual culture

• Digital age is driven by combination of images and text

• Comics are particularly adept at conveying information when:

• High density of information to be learned

• High level of importance to the information

• Learners are in a high-stress situation

Stigmatized topics

• Disability

• Death and dying

• SA

• Social and political activism

  • Racial and gender bias

  • Healthcare as a basic human right

social and political activism

comics touching on topics of human rights and political parties in power advocate for change

comics for community

• Comics are a medium of social connection

• Appreciation for comics transcends geography, language, social status, culture

• Illness isolates, but comics are a potent antidote for both social and physical isolation

Graphic medicine

• Coined by physician/ comic illustrator Ian Williams in 2008

  • “Could the graphic be the medicine?” (p. 353)

• Use of comics in context of medicine, patient care, stories of health, disability, illness…

• Form of visual storytelling that combines image/ text, research/ experience, time/ space, language/ line

  • Convey complex messages

Understanding Comics

• Reading visual texts asks us to develop skills in visual literacy

• Poetics (the study of linguistic techniques in written arts) also shapes visual texts

• Visual images possess their own visual vocabulary and grammar

loiterature

Refers to the kind of looping, recursive movement, a wandering in and out of the frame, back to the past and forward to the future, that is produced by the specific spatial affordances of comics—panels separated by blank spaces known as gutters

Why would anyone…respond to a cartoon as much or more than a realistic image?

• “Amplification through simplification” (McCloud)

• Abstracting an image does not so much eliminate details as focuses it on specific details

• The cartoon thus focuses our attention on an idea

comic - gutter

the space between two panels in a comic

comic - panel

individual frame in a comic's image sequence

comic - closure

observing the parts but perceiving the whole

Williams, “Culpability”

• Comic/ graphic portrait of therapeutic relationship; mental illness (depression); the ill person’s story (involves both health practitioner and client/ patient

• Presents a case study of visual means of communicating pain and mental illness

ineffable

that which cannot be put into words, to be described or explained.

Reasons to use images in research

• Represent and explore the ineffable – that which is hard to put into words

• Convey an all-at-oneness – holistic depiction of ideas and feelings

• Make us attentive to things in new ways – unnoticed details

• Memorable – iconic images

• Develop empathetic understanding – humanitarian issue given new weight

• Provoke action for social justice – social change

• Vitalizing – jolt our sensibilities

Photography

a cultural critique, and a therapeutic practice of capturing the moment with a camera

"The Final Project" by Jo Spence

She used her camera as a way to document her journey with breast cancer, as a part of her that was analytical and critical, but still attached to emotional vulnerability of the experience of having breast cancer.