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Seeing the Sensation: Sketch-Journaling and the Embodiment of Mental Illness in Autographics

By Irene Velentzas

Gillian Whitlock and Anna Poletti, who prefer “autographics” to “graphic memoir,” describe it as “[l]ife narrative fabricated in and through drawing and design using various technologies, modes, and materials” (v). Given the particularities of autographics’ multimodal and multimedia composition, critics “are now called upon to develop more advanced visual and cultural literacies to interpret the intersections of various modes and media and the complex embodiments of avatar, autobiographer, and reader/viewer gathered under the sign of autographics” (vi). As Whitlock and Poletti suggest, the complex composition of autographics allows for multifaceted verbal-visual self-representations and the induction of other documentary genres, such as photographs, journal entries, charts, and reference sketches to inform such self-representations. Multimedia combinations work to highlight and elide the boundaries between protagonist, author, and reader in the autographic, crafting new avenues for engaging with the self and other. Examining autographics’ propensity for multimedia intertextuality can illuminate the contribution, interplay, and significance of different media in the construction of life narratives.

Krista Quesenberry and Susan Merrill Squier elaborate on the particular characteristics of the form to suggest that since “graphic narrative is multimedia (or inter-media) and life writing is multigenre (and, again, inter-genre), [there is an] opportunity for gestures and objects to amplify narratives of difference” (77). They describe narratives of difference as narratives that draw “attention to non-normative bodies, identities, and experiences that are not typically acknowledged in areas of literary study where disciplines tend to limit, police, and stabilise the spectrum of accepted subject positions” (77). Some modes of life-narrative, such as the sketch-journal, include private self-created media outside of the limitation and policing of societal normalization. The literary inclusion of such private spaces can be a welcome addition to autographics’ address of difference. This paper examines how the sketch-journal, a hybrid diary and sketchbook composed by the artist, can amplify and address difference narratives. Through a close analysis of Ellen Forney’s Marbles: Mania, Depression, Michelangelo, and Me, an autographic detailing Forney’s psychiatric experience of Bipolar Affective Disorder (BAD), I will argue that the sketch-book entries included within the text function to amplify, question, and ultimately challenge curative narratives. The inclusion of the personal sketch-journal in this autographic functions as an object that negotiates narratives of difference; affects the complex embodiments of the autobiographer, avatar1, and reader/viewer; and establishes a self-reflecting, self-advocating, and socializing platform that enables the author to create a disability counternarrative through the multimedia autographic form and a disability community with the reader.

Considering disability as a construct, Lennard J. Davis writes that “disability and normality can be looked at as sociohistorical concepts” and that models of disability have operated for the disabled across the previous century (506). The most prominent disability model—the medical model—”treats disability as a disease in need of a cure,” developing as a linear narrative that identifies the disability through diagnosis and systematically progresses towards its cure or a return to a pre-disability stage—normality (Davis 506). Rosemarie Garland-Thompson examines the impact of the medical model of disability on self. She explains, “we expect medicine to wipe away all disability. As a consequence, when disability enters our lives, often our only available responses are silence, denial, shame, or determined and desperate vows to ‘fight it.’ Seldom do we imagine disability as an aspect of all lives that our society, government, and community should accommodate and include” (525). Narratives of difference speak back to the silence, denial, and shame, but also to the desperate need to cure disease couched in the medical model of illness. They function as an inclusive space for disability to exist and challenge stereotypical public images of disability. Garland-Thompson builds upon Nancy Eisland’s work, arguing that “achieving equality for people with disabilities depends on cultural ‘resymbolization,'” a practice of re-imaging disability and disabled people to create ideological shifts in public perception that foster social change (525). When included in the autographic, the sketch-journal creates a platform where variant identity-construction can coalesce and coexist through web-like associations, opposing the linear hierarchy of the curative narrative. The sketch-journal thus works to resymbolize the potential reaction to and trajectory of the disability experience.

The work of cultural resymbolization can be achieved through the comics medium, which embraces fluid word and image associations, web-like narrative structures, multi-generic representational embodiments of the disabled individual, and reader-author narrative co-construction. Taken together, these characteristics form a powerful platform for creating disability counternarratives that “expand options for depicting disability. They question dominant assumptions about what it means to be able-bodied and they offer resistance to the dominant normalcy narratives that may otherwise marginalize or exploit certain people” (Curwood 21). Disability representation permeates many aspects of cultural representation including art, photography, and prose. In comics, these many modes coalesce, allowing free-associations between the modes of representation to question and disrupt multimedia constructions of disability and normality. The inclusive multimodal and multimedia space of comics enables the protagonist to represent themselves in plural ways, challenging singular or static modes of self-representation, by oscillating between representative modes. Comics also provides a safe space for author and reader alike to examine this oscillation between representative modes and identity constructions. As Zach Whalen et al. note, comics can provide “a safe context for the kind of looking not sanctioned in public” (4). They can apply pressure to the “normalizing or oppressive stare of their implied readers” (4). They are capable of including such varied embodiments of disability through multiple modes of representation. Such inclusion pluralizes the self-representation of disability, countering the singular view of normalcy that relies on sameness. The representative diversity of disability in comics challenges the homogeneous expectation implied by the normalizing stare.

Negotiating Narratives of Difference

The use of the sketch-journal in autographic narrative creation has a similar preparatory, documentary, and reflective function as that of the diary entry in composing a coherent autobiographical narrative. The autobiographical memoir has a long-standing textual history with the diary entry. As early as the seventeenth century, keeping a diary was a means to record personal experience “in the midst of stirring national events” and was often combined “with the writing of a brief autobiography” (The Oxford Companion to Family and Local History). The diary offered a method by which writers could situate and express their unfiltered subjective concerns and impressions of self (and their broader socio-political context) that would then serve as preparatory material for the creation of a cohesive self-narrative. The artist’s sketchbook is a similar, but pictorial, documentation process that dates to the Middle Ages; it, too, is a means by which artists “used drawings to test ideas…and make note of things seen from direct observation” (Grove Encyclopedia). As the sketch is “a rough drawing…intended to serve as the basis of a more finished picture” (OED), the sketchbook, then, functions as “a book intended for preliminary studies” and a place “where we find preparatory images” of those studies (Grove Encyclopedia).

For the author of autographic narrative, the sketchbook is a medium through which an artist can express their subjective experience, examine their position in a broader socio-political context, and create touchstones for building a cohesive self-narrative. Unlike the diary entry, the sketchbook’s compilations are not structured under a linear chronological narrative; rather, the preparatory images offer a more freely associated collection of observations. Cumulatively, they represent the transitory self through the medium of self-portraiture. They capture and negotiate one’s changing self-image and continual identity construction over time, speaking back to the artificially-polished, final product of other images such as the photograph or cartoon avatar. The ability to self-examine and document one’s transitory self pictorially through the private practice of sketch-journaling gives agency to the individual experiencing the illness, thus working against the medical model of illness whereby the medical practitioner externally observes the “patient” and draws a conclusion with the aid of numerical and literal data.

In “Disability and Narrative,” Michael Bérubé explains that “the dynamics of disability compel us to recognize that there will always be among us people who cannot represent themselves and must be represented” (572). However, controlling traditional and sociocultural representations of disabled individuals prevent a broader understanding of the multi-faceted representations that disability takes. Though some individuals may lack the ability to communicate their internal experiences outwardly due to their disability, there is a prevailing pattern amongst traditional literature that reflects the cultural belief that individuals with mental illness cannot accurately comprehend or communicate their individuality and experience, casting disabled characters as passive participants, not agents (Baskin and Harris; Bilken and Bogden; Curwood; Franks). This belief is echoed in scholarly responses to the medical model of disability, which asserts authority over the view, diagnosis, and understanding of the disabled individual over the individual’s personal disability experience and subjective identity (Williams; Price). This type of categorical response to disability and its representation is problematic as “[c]ategorization may lead to false stereotypes such as the stereotype that all or most individuals with the same disability share important characteristics, experiences, or perceptions” (Smart 9). The importance of representing the personal disability experience in multimodal and multimedia forms goes beyond the expressive capacities that cultivate self-agency to also challenge the pervasive image of disability circulated in public consciousness, which is one that perpetuates stigma towards and appropriation of the disability experience.

Ellen Forney’s avatar in Marbles, repeatedly fears that her medical diagnosis as a bipolar individual will efface her subjectivity, negatively impact her social relations, and reduce her ability to compose creative texts. Visualizing disability through surface documentary images such as the photograph creates a superficial understanding of disability representations from a normalizing perspective. The redrawn photographs in Marbles are used to create normalizing self-images. After Ellen reveals her bipolar diagnosis to her father, he “[takes] out his camera and we clowned around with the pineapple we’d bought for breakfast…normalizing things with the familiar taking of family photos” (63). The redrawn photo-montage displays a happy individual capturing a typical vacation routine without any reference to her shifting feelings and anxieties of her recently divulged bipolarity. Additionally, photographs of bipolar artist Georgia O’Keeffe prompt Ellen to reflect on the photograph’s inability to express the bipolar individual’s internal state and her subjectivity. She writes: “Photographer Alfred Stieglitz…took portraits of her over the course of twenty years. Some were startlingly erotic, with her in various states of undress. / I was manic for my sexier photoshoots. Could she have been too? / I pored over the photos, trying to summon a bipolar insider’s sensor…Disappointingly, I didn’t seem to have any special insight” (141). Ellen compares O’Keeffe’s photographic persona to her own earlier experience, highlighting the photograph’s inability to depict the inner-workings of the subjective disability experience even to those who share a similar disability categorization. Admittedly, Ellen’s initial perception from O’Keeffe’s photographs is that O’Keeffe was “austere” (140).

Unlike the photograph, however, the sketch medium allows Ellen to create “self-portraits [that] were depictions of how [she] was feeling” (99) and “where [she] could face [her] emotional demons in a wholly personal way” (92). In contrast to the photograph, the sketch-images move past surface depictions to document and communicate the internal state of the individual experiencing disability. In Marbles, Forney overtly addresses how representations external to the disability experience enact a type of disability voice-appropriation that thwarts the individual’s subjective experience and self-activism. Her protagonist remarks: “My own brilliantunique personality was neatly outlined right there, in that inanimate stack of paper…like I’d been covered by a heavy blanket, like a parrot” (19, emphasis in original). The metaphorical covering of the disabled individual through modes and media that only allow external normalizing perspectives suggests a reduction to a parroting role by the disabled individual that suppresses their agency to express their subjective identity or experience.

To counteract this type of appropriation, Forney reclaims authority over her newly imposed medicalized self-image by visually representing herself and her subjective experience in cartoon form alongside the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Figure 1). These two textual constructions—the DSM-IV and Forney’s autographic—function in a verbal-visual, medical-experiential, objective-subjective tension with each other as each depiction takes equal space on the comics page. The DSM is presented as a textual authority imposing an external identity and narrative onto Ellen and her experience, one that Forney’s autographic works to subvert. The DSM’s verbal criteria for BAD include key words that suggest the negativity of the bipolar experience from a normalizing standpoint of moderation and conservatism. These key words also fuel public perceptions of disability as abnormal or threatening. Words and phrases such as “period of abnormally…irritable mood,” “mood disturbance,” “grandiosity,” “more…than usual,” “agitation,” “excessive,” and “painful consequences” describe the BAD criteria listed in the DSM as negative identity markers (15-18).

Figure 1: Ellen Forney, Marbles, pages 17

Forney challenges the medical model’s authority through her autographic compositional choices in the diagnostic sequence and her self-representative choices throughout the text. Notably, the pre- and post- diagnostic narratives in Marbles are composed in markedly different ways. Forney expresses her undiagnosed experiences of mania as “an initiation ritual,” “being transformed,” and a “burst into my consciousness” (5). Unlike the diagnostic sequence, Marbles‘ opening chapter is composed in a highly fluid, rather than linear, style. Wherein the images are drawn across the double-page spread, the graphic narrative lacks a traditional panelled structural organization, and the word-image relation is loosely connected or fragmented. Instead of rupture or silence, these associated words, phrases, and symbols are collectively described as “a network” that lights up in Ellen’s head and allows her to express herself and her ideas (6). Descriptions such as “transforming,” “energy going up,” “look badass,” “positive, joyful,” “showing my commitment,” and “the comfort and meditative qualities across all senses” manifest throughout a mental flow chart alongside stars, exclamation marks, question marks, and arrows that describe the positivity of Ellen’s experience, identity, and state of mind (6-7). The notebook icon at the end of the flowchart reinforces Ellen’s ability to document and express herself through such free associations.

Such a fluid compositional style reflects Ellen’s experience of mania. However, in the second chapter featuring her diagnosis, Forney juxtaposes her cartoon avatar against the generalizing diagnostic narrative of the medical field. This second chapter is structured in a highly regimented style as both Ellen and the reader are introduced to the medical model of disability through the DSM text (15). Here, Forney uses a traditional panel-to-panel narrative sequence, dialogue that emanates directly from the characters’ mouths in linear scripts, and conversational figures seated in the portrait position. The first panel of the diagnostic sequence shows the medical practitioner—Ellen’s psychiatrist, Karen—from Ellen’s focal point, gazing directly out of the page-plane at the reader. Like Ellen, the reader is confronted with the observational medical gaze of diagnosis, experiencing the scrutiny and categorization that Ellen rebels against in subsequent panels (15).

Ellen’s first act in the diagnostic sequence, however, is to reject the standardized medical label: “My mother and I both have bipolar tendencies, but I’m not like, bipolar bipolar” (15, emphasis in original). It is Forney’s page composition that highlights the textual authority from which this label originates: the DSM-IV and its opposition to her earlier self-constructed identity in the opening chapter. The prominent placement of the DSM pulls the reader into a non-linear reading of the page, which depicts the moment of Ellen’s diagnosis and the new identity she’s assigned from the textual authority of the medical model (15). As the initial page of the diagnostic sequence is composed of a linear grid depicting two seated talking figures (practitioner and patient), the introduction of the DSM in panel 5 replaces the medical practitioner’s image. The manual is drawn askew into the otherwise linear frame, conferring focus onto it as a special object. The book is further highlighted with emanata—short lines drawn around the text—attracting the reader’s attention to this object in the middle of the page over Forney’s first narrative panel. This suggests that Ellen’s disability experience is also non-linear and that much of Ellen’s anxiety and response to diagnosis will focus on this new interpretation of her identity.

Proportionally, the DSM-IV takes more space in the panel than Ellen does, giving the medical model of disability great importance, perhaps even more importance than Ellen herself, a dynamic that Forney’s composition works to subvert over subsequent pages. Ellen’s recollection of the Involuntary Psych Unit in panel 6 demonstrates how threatening the medical model of disability is to her sense of subjective identity. Labels above two of the psychiatric patients read: “Obsessive Compulsive Disorder 300.3” and “Paranoid Schizophrenia 295.3” (15). These individuals are itemized and categorized extradiegetically despite Ellen’s attempt to personalize them by using their given names: “How’s it going, Stanley?” (15). This quick address foregrounds Ellen’s fears of being re-identified by the medical model at the expense of her personal identity. As Kristen Gay notes, “Forney’s post-diagnosis comics insist that her doctor does more than give her an official name for her illness when she tells her that she is bipolar—she also gives her an identity to inhabit” (176). The reader can see that the dehumanizing labelling process of the medical model alongside her emerging categorization as bipolar is unacceptable to Forney, who represents her comic avatar as closed-off to the idea of such categorization through her gestural design in the final panel. Ellen’s arms are crossed against her chest as she looks down over the medical text that occupied such a prominent position in the panel above her. Through her page design, Forney attempts to regain the position of power from the medical textual authority in the previous panel and assert her own subjective presence over that panel and subsequent narrative.

Forney’s attempt to assert her individuality over the homogenizing medical authority of the DSM-IV is expressed through the dualistic page composition that follows the diagnostic moment. In the subsequent pages, the DSM is read over Karen’s shoulder through Ellen’s personal perspective, privileging Ellen’s point of view over that of the medical authority. Both the page composition and Ellen’s focalization emphasize her desire to subvert the categorical power of the medical authority on her identity. The composition of these pages demonstrates Ellen’s subversion of her new designation as bipolar as each DSM criteria and Ellen’s personal experience vie for prominence on the page, describing the BAD symptom in starkly different ways. The DSM panel-design describes each BAD symptom with a uniformity that implies a regimented and homogenous understanding of bipolarity from a normalizing categorical perspective. The DSM BAD panels are composed in square frames that mimic neat and contained categorical boxes. The depiction of the DSM’s straight book lines, the neat linearity of the printed text, and Karen’s finger tracing a line under each BAD symptom further emphasize the medical model’s linear understanding of disability that supports the curative disability narrative. Forney’s free-floating, scalloped, and amorphous balloon panel composition, however, subverts the suggested categorical homogenizing and linear experience of disability presented by and through the DSM and the standard diagnostic narrative sequence.

Ellen’s personal experience of each symptom is composed in direct opposition to the uniformity and linearity of the medically-oriented criteria of BAD. Panels depicting Ellen’s experiential understanding of each BAD symptom oppose the linear composition of the medical practitioner’s panel perspectives and demonstrate the need for alternate interpretations of the disability experience. Whereas the DSM panels describe each BAD symptom with square uniformity, panels devoted to Ellen’s understanding of the BAD symptoms are scalloped, their contents pictorially instead of verbally rendered, and feature labeled visual metaphors like “spinning wheels burning out” as the racing-mind experience of mania (18). Forney’s panels also constantly threaten to overlap and overtake the medical narrative of the categorical criteria of her mental illness, encroaching over the medial line of the page and disrupting the medical panel’s border in favor of her subjective experience. Even Forney’s written descriptions are more pictorial than those of the medical model categorizations, as she features many different types of fonts, sizes, and comics conventions to communicate her personal experience of BAD. The use of such comics conventions as balloons, caption boxes, sound effects, and words that break out of the linear arrangement around the inserted emanata further indicate the nonlinearity of her disability experience.

As more DSM symptoms are listed, Ellen’s assertion of subjectivity becomes more disorderly and assertive. Her words flow out of her subjective experience panel and back over the previous diagnostic panel, effacing more of the medical model’s authority with each criterion through such assertions as “‘Unimportant or irrelevant’? That’s subjective” (17, emphasis in original). The final panel in the diagnostic scene shows how far she and her psychiatrist have been pushed apart across the divide between the medical definition of bipolarity and Ellen’s self-image and personal experience. As Karen and Ellen look at each other across the divide of the panel, they are both pushed into separate corners while Karen’s medical authority is squashed in favor of Ellen’s self-representation as an overly excited heart caricature. Though Ellen’s final caption box indicates, “These [symptoms] were all describing me!”, the caption box visually aligns with her subjective recollections of the symptoms and not with the medical authority’s representation on the opposite side of the page (17, emphasis in original). This strongly privileges her personal disability experience and further suggests her desire to speak back to the imposed diagnostic narrative and establish an experiential disability counternarrative.

Ellen’s anxieties of subjective erasure are also illustrated at the end of the diagnostic sequence, where she reflects “My personality reflected a disordershared by a group a people” (19, emphasis in original). She feels obscured by this newly-designated medical identity “like [she’d] been covered by a heavy blanket” (19). This verbal covering is juxtaposed with a full-page visual self-representation that recalls Ellen’s earlier recollection of the psychiatric unit, as the patient’s categorical and numerical labels are evoked through their arthrological connection to the opening panels in the diagnostic sequence.2 Ellen’s subjectivity is erased as she takes on the prominent label “Bipolar I Disorder 296.4” (19). Though she is shown in full frontal view of the reader, who is now in the position to gaze at this medically categorized self-image, it is important to note that Ellen does not return the reader’s or the medical gaze; at this point, she is represented as an object to be looked at, not as an individual who does the looking. In this way, the medical model has obscured Ellen’s individuality not only to others (reader, viewer, etc.), but also to herself.

Notably, the artist’s polished cartoon avatar does not return the artist’s gaze in this compositional style, suggesting that the avatar is unable to engage empathetically with the reader, but also that the artist is unable to engage empathetically with her own avatar. Ellen admits, “My euphoric mind just couldn’t conjure up that dramatic shift within itself” (30). Thus, another way to view herself, for herself, outside of her diagnosis and the medical practitioner’s observational lens must be devised. As I will also show later in this paper, Ellen re-gains the ability to look on and exchange gazes with herself and the reader through her sketch-journal. She does this by documenting her changing identity alongside both her progressive and regressive disability experience.

Creating Complex Embodiments

Identifying and articulating alternate facets of a disability experience through a range of preparatory and refined multimedia images over time also helps construct and communicate a cohesive self-identity amid the shifting internal states of mental illness. This process increases the individual’s sense of agency. For Sara Newman, this sense of agency is what distinguishes life writing about disability from “writing by others about those individuals and their conditions” (9). She specifies, “writing about disability refers to texts by people who identify with their disabilities and write about their embodied conditions. Thus defined, life writing encompasses a range of formats in which individuals write about themselves, for example, autobiography, letters, diaries, pathography, visionary prophecies, poetry, and memoirs” (9).3 Newman emphasizes both the individual experiencing the disability and their attempt to (re)identify themselves with respect to their disability and against identifications by non-disabled individuals peripheral to the disability experience. Through the self-writing process, then, an individual documents and manifests his or her internal experience. In autographics, however, where the body manifests visually, the inclusion of the protagonist’s fluctuating embodiments are particularly important for resymbolizing the links between subjectivity, identity, and the body. This is especially so for the body experiencing disability as mental illness because it is (often) devoid of the physical markers that visually identify other disabilities.

Psychiatric disabilities are considered invisible because they “are not inscribed on the skin of the patient…but are felt or produce psychological suffering” (Williams 119; see also Smart). As Elisabeth El Refaie notes of embodiment, “our sense of self is related to body awareness and body image. In recent years, a lot of autobiographical writing has engaged explicitly with the links between subjectivity, identity, and the body” (56). These links are especially important to mental illness narratives where relations between subjectivity, identity, and the body are typically invisible both to the individual and to the public. El Refaie elaborates this argument by noting that autobiographical comics artists “draw themselves and those around them, [so] they cannot avoid engaging with the sociocultural models that underpin body image…Pictorial embodiment is thus always a profoundly social and political activity” (73). Re-drawing the body in a way that communicates the fluctuating manifestations of the mental illness experience to the reader can help destabilize the sociocultural models and assumptions that are otherwise attached to seemingly normative body images.

While the brain, encapsulated within the body, remains physically invisible to the surface view of the individual, it is a conduit for the behavioral manifestations that comprise the individual identity of and social reactions to those individual identities. Julie Smart notes that both the categorization process and the “invisibility” of the disability create interpersonal and societal stigmatization for the individual with the disability. She clarifies that psychiatric disabilities are “often viewed by the general public as self-imposed” or “exaggerated by the individual” (17). It is also problematic, Smart acknowledges, that diagnosis and categorization are the chief mechanisms by which individuals can receive societal services and benefits for their unique needs, so that where mental illness does not manifest into bodily markers no financial assistance or accommodation is given to the struggling individual. As such, documentary processes capturing alternate modes of “invisible” disability embodiment—for example, sketching, photographic, or verbal forms—are worth closer investigation because they can: 1) offer both the disabled individual and the reader a complex and robust engagement with the internalized disability experience and its multi-faceted manifestations, 2) speak against the singular and linear view of the medical model, and 3) bolster public and private assistance for individuals struggling with mental illness. Such a pluralistic and non-linear approach promotes understanding, coping strategies, and advocacy that counter current social scripts of mental illness predicated on silence, denial, medical diagnosis, cure narratives, misunderstanding, and insufficient accommodation.

However, diagnosis can also impose a group identity that erases the individual’s subjectivity and fosters social stigma. Smart warns that “the categorization of the disability impacts the self-identity of the individual with the disability…Professional vocabulary, including diagnoses, often affect self-images of those who are given the diagnosis” (9). The personal multimedia account and verbal-visual embodiment of the autographic text work in opposition to the socio-cultural disability narrative imposed by the diagnosis and categorization of the medical model that “treats disability as a disease in need of a cure” (Davis 506). The autographic text is a platform where the artist struggling with a disability categorization can reassert his or her own subjectivity, craft a self-created text to negotiate their own complex self-image, and engage in their own activism.

In Marbles, multimodality plays a prominent role in the complex negotiation process of autographics. Forney writes of her subjective sensation of Bipolar Affective Disorder: “It occurred to me later that a sense of electrical current was part of my own experience of being manic. The sensation that my mind was spinning and overheating would sometimes build to a sensation like an electrical short” (171). As suggested throughout Marbles, seeing the manifestations of mental illness and particularly psychiatric disorders is difficult both for the individual experiencing the disorder and for the public. In the first chapter, the protagonist self-reflexively represents herself with a variety of embodiments ranging from the photo-realistic to the simplistic cartoon, exaggerated caricature, disembodied facial features, and symbolically in an attempt to capture her subjective sensation. Forney begins with a detailed cartoon likeness of her face in profile (3) that on the next page is substituted with a white silhouette figure emanating a laser-like starburst from her head (4). That embodiment gives way to a dismantled body with only large cartoon eyes and mouth to suggest Ellen’s facial features, which are further surrounded by bolts of lightning, exclamation points, and electric sound effects like “dzzzt!” “ping!” and “Krak!” (6-7). Soon after, Ellen represents herself in a redrawn photograph that depicts her completed back tattoo in great detail (10). Ellen begins to comprehend her subjective and complex disability experience by collaging these multimedia self-representations, and expresses it to the reader through such means. Each of these multimodal and multimedia representations relies on words, images, and symbols to both visualize and convey the “bright white light,” “the electrical charge,” that she later associates to her subjective experience of BAD (3). These varied visualizations also begin the negotiation process necessary to dismantle the identity imposed by the medical model of disability.

At the end of the diagnostic sequence, Ellen’s medically labelled self is “Othered,” a position typically socially constructed from a heterogeneous dominant non-disability standpoint. Kenny Fries explains the problematic notion that the gaze represents: “Throughout history, those who live with disabilities have been defined by the gaze and the needs of the nondisabled world” (1). By first offering her refined avatar’s image through the focalized perspective of the medical practitioner at the end of the diagnostic sequence, Forney objectifies herself and assumes the disability standpoint as “Other” both for herself and for the reader. However, through subsequent inclusions of her sketch-journal in her autographic narrative, Forney shapes a safe space where she and the reader can examine the rough visual preparations of her changing self-image and disability experience over time. Forney invites both her own and the reader’s stare through her avatar’s representation and the highly diverse representational strategies she employs to compare alternate self-representations throughout her graphic memoir.

Conducting a closer analysis of each medium’s self-representational potential illuminates how Forney uses the sketch-journal in her disability autographic to engage in a transformative empathetic exchange of glances with herself and others. As Dale Jacobs explains, “comics demand that we attend closely to the multiple forms of expression available in the medium, while seeing these forms as interconnected rather than hierarchical” (14). Charles A. Hill and Marguerite Helmers further note how each media signifies something to the viewer: “A daub of paint is essentially different from a stitch with a silk thread, and each has its own mode of conveying meaning” (18). In this same way, the signification of each mode with which Forney embodies herself is meaningful both on its own and in relation to the other media used in Marbles.

As Charles Hatfield notes, the inclusion of redrawn or original photographs in autographics creates an “illusion of volume and a sense of intimacy (as if these found objects have been mounted in a diary or scrapbook)” (64). In a similar vein, Gunther R. Kress and Theo van Leeuwen suggest that we continue to define naturalistic modality based on the standard 35mm color photograph (163); hence, Forney’s redrawn photographic portraits of herself may function to evoke a kind of intimacy with the reader expected of the naturalistic modality associated with the photograph. However, Forney’s photographic self-representation achieves neither intimacy nor naturalism. Her photographs depict a great degree of stylization; through such labels as, “Chorus line #2” and “The Three Graces” (32), they display her as an artificially posed subject.

Figure 2: Ellen Forney, Marbles, page 38.
Figure 3: Ellen Forney, Marbles, page 70.

None of the photographs included in Marbles narrate a genuine embodied moment; rather, they are recreations of fictional embodiments such as Ellen’s photoshoot for Eros Comics, posing as a member of a pretend rock band (34). The reader’s view of Ellen is interrupted by the camera’s eye, the focusing lens to which Forney plays to produce not an intimate connection with the viewer but a projected ideal for the viewer. Like the rock star persona displayed in this image, Ellen is depicted as a glamorous, sex-positive, fearless figure, which may indicate her fantastic ideal of how she would like to see herself, but which is not a robust indication of her complex self-image. However, since Forney includes these photographs only as re-illustrated references of the original image, she subtly subverts the photograph’s authority for capturing her fluctuating identity and experience with mental illness in favour of the self-representations found in her sketch-journal.

As her disability narrative unfolds, less and less weight is given to stylized self-referential photographic images as the narrative gives way to a number of sketch-journal images. This shift in medium, which coincides with her transition from a manic state into a depressive one, creates a deepening sense of intimacy and empathy between Forney and the reader. The sketch-journal presents new configurations and understandings of self and her disability experience, allowing both herself and the reader to view her in a way that encompasses the ongoing complexities of BAD. Ellen admits, “After a few weeks, I sensed I had landed, a familiar feeling I’d forgotten…I had a tickle in my throat, and there was pressure in my nasal passages. I’d forgotten this part, too. During a manic episode, depression seemed nearly impossible” (68). This admission marks a crucial change in her desire to (re)view herself, a desire that is uniquely enacted by the sketch-journal. Through acts of spontaneous self-creation, the sketch-journal becomes a vehicle for preserving the moment of the shifting disability experience and an aid for seeing the parts of the self that—unlike the cartoon images of self or the inclusion of the drawn photograph—exist outside polished and composed ideals.

The unpolished self-image may be difficult for both Forney and others to face for what it communicates of self. Ellen remarks that in times of desperation: “I’d take out my sketchbook + look in the mirror—It was jarring. I looked so small and so human—a sad human—not like the horrible monster I half-expected to see” (98). She faces the “demons” of her disability experience by manifesting them “inert on a piece of paper” where they become more “handleable” (98). The sharing of these highly personal, unpolished images of her disability experience with readers can similarly break negative preconceptions of her disability and illustrate the humanity of her disability experience.

The sketches stand apart from Forney’s avatar or the redrawn photographic image in another important way: they are not rendered in a clean line. This is noteworthy for two reasons. First, the starkness of Forney’s ratty-line may be seen to express the inner mental state articulated in her statement: “My head was a cage of frantic rats” (69). Second, the raw line creates a material intimacy between the author and the reader unattained by the redrawn photograph. Scott McCloud suggests that line communicates the artist’s emotion on the page, which in turn arouses an emotional response in the viewer: “The power of line, shape and color can suggest the inner state of the artist and provoke the 5 senses” (123). Hatfield expands on this to specify that the “raw, ‘ratty-line’ approach is at odds with the pristine illusionism of the clear line” (61). The sketch-journal images are executed using a ratty-line style that mimics Ellen’s frantic mental state and her fear of that mental state; both are captured by her embodied sketch-representation. Unlike the clear precise line rendering of the cartoon or photographic self, the sketched self-portrait demonstrates Ellen’s disintegrating identity.

Great detail marks the primary source that establishes and conveys a shared human emotion—the face—in the first sketch included in Marbles (70). Instead of completing the rest of her body, the lines fade away from her face. This is the first time in Marbles that Ellen’s unpretentious image stares back at the reader: the facial expression is one of terror, pictorially conveying the fear she experiences in her shifting mental states. “Karen! I’m scared!,” she admits to her psychiatrist (69). Forney negotiates her disability experience by creating a crude preparatory image that observes and exchanges glances with her self. She endeavors to see her own sensations and, by presenting them to readers in their unpolished state, simultaneously begins building a disability community with the reader through empathy. Through the sketch-journal images, she confirms that in comics, “the gaze/stare is inevitably embodied and transforming to subjects on both sides of it” (Millette).

Forney does not replicate the moment of negotiating her disability experience from a distance, but offers both the physical text and her spontaneous self-created disability image up to the reader for investigation. Unlike the redrawn self-referential photographs, the sketch-journal is included in Marbles as a scanned object or as torn excerpts transposed onto the comics page. The sketch-journal pages provide a texture, depth, and artifact quality to Ellen’s struggle with her changing identity and mentality, a struggle that is not evident in the cartoon renditions of self or in the redrawn photograph’s polished representation. As Hatfield notes “[c]lear line seems to deny the materiality of the comics page” (60). Though many inclusions of Ellen’s sketch-journal are scanned depicting the entire object (93; 95; 97-102; 105-107; 109; 111; 124; 163; 165; 167), when not included in book form, the sketch-journal’s excerpts emphasize the ragged line of having been torn and pasted directly onto the comics page (70; 127; 138-139; 154; 172-173; 176). This ragged scrapbook-like mounting of the sketches generates a sense of materiality and intimacy with the reader that the clean line of the redrawn photographic images does not.

The sketchbook is thus imbued with both weight and importance as a material object that allows Ellen to negotiate her disability and its narrative, and subvert the authority of the DSM-IV. The scans transcribe the texture of the journal cover itself and the shadow it creates, further accentuating its importance as a material object. The page composition also features the journal prominently; the journal takes up most of the page, unlike its drawn portrayals on previous pages. Both the sketch-journal’s size and its realistic inclusion in the autographic demonstrate the importance of the sketch-journal to Forney’s expression of her subjective identity as an artist and the negotiation of her disability experience.

Figure 4: Figure 4: Ellen Forney, Marbles, pages 92-93.

Changing the Reader/Viewer Relationship

Sketch-journal images in Marbles draw attention to Ellen’s transforming embodiment, enacting a reader-viewer relationship that extends the work of resymbolization taken up in Marbles. The reproduction of the intimate sketch-journal invites readers to partake in her experiential understanding of mental illness; it helps the creation of what Rosemarie Garland-Thompson calls “an arc of empathy” that can “leap across the breach opened up by staring” (qtd. in Wheeler 342). This empathic arc transforms staring into what Garland-Thompson terms an “exchange of glances” that creates a mutual reciprocity built on the reciprocal stare that allows the individual inside the disability experience to identify with the individual outside of the disability experience (qtd. in Wheeler 343). An exchange of glances helps to resymbolize not just the individual experiencing disability, but also the outside viewer’s relationship to the individual inside the disability experience. It thus inducts the outsider into the disability community.

Through the sketch-journal, Ellen faces the social stigma or “ugliness” (85) of her disability experience, which initially leaves her unable to speak back to the social stigmatization of mental illness and partake in social self-activism (143). In drawing the rough images, she finds a voice, however unpolished; in sharing the images, she communicates this unpolished side of her experience and herself with others, thus promoting an empathic understanding. The material inclusion of the sketch-journal invites readers to see Ellen and co-construct the narrative with her. Furthermore, it resymbolizes the reader into the disabled individual; it positions readers as Ellen is. They can thus intimately interact with the sketch-journal as Ellen might, opening its cover and flipping through its pages, and imagine her disability experience.

As the reader views the sketch-journal cover, Ellen describes the image within: “A tall, leafless tree, with a thin trunk + long, thin branches bending in the wind, and at the end of one branch a nest perched precariously” (93). While the reader imagines the described image on the reverse side of the page, the reader flips the comic book page in a way that mimics Ellen’s experience of opening her journal. This mirroring brings readers to imagine the disability experience, emotionally and physically. The reader’s active participation generates an intimacy through empathy, which bridges the gap between the individual inside and outside of the disability experience, thus cultivating a disability community.

By incorporating different visual media into her autographic, Forney creates a disability narrative that is not easily consumed but requires active and communal (re)thinking, (re)imagining, and (re)symbolizing. The double-page spread following the opening of the sketch-journal, which portrays images of the redrawn polished and rough sketch of the tall leafless tree side by side, indicates the difficulty of applying one image, label, or identifier to mental illness. Just as the verbal description of the leafless tree activates a variety of representations in the individual reader, multiple versions of self-representation confront readers. Though the image is not of Ellen’s body, it is an embodiment of her disability experience. The use of visual metaphor manifests an attempt to visualize the sensation of mental illness, and convey that shifting image to self and to the reader.

The visual metaphor also highlights that mental images are incomplete or misleading. This is particularly relevant to stereotypical depictions of mental illness. The sketch-journal images, while representative of Ellen’s inner state, are still in need of revision through acts of self-observation and self-creation, through layerings of images and words. The polished cartoon image of the tree is labelled “extremely but indeterminately tall” because it is impossible for Forney to show the indeterminable height that accurately captures the image of the disability experience (94). The comics medium is limited by its physicality, unable to fully capture the indeterminate nature of the disability or its depiction. Even though the cartoon version of the tree is more polished and a somewhat more accurate portrayal of Ellen’s mental image than the initial image she attempts to capture in the sketch journal, it is still not accurate enough. The label enhancing the reader’s understanding of the cartoon tree acts in a way that explains the limitations of any one mode or medium’s affordances to accurately represent or convey the disability experience. The adjacent images of the sketch-journal and comics page demonstrate the necessary co-creative process of layering multiple, multimedia, and revised images of disability to communicate the complexity and plurality of the disability experience.

Lastly, the temporal difference between the spontaneously rendered sketch-image and the polished cartoon image suggests the importance of comparing reflections of disability over time. The sketchbook’s presence emphasizes that all images of self and identity configurations in autographics of mental illness are provisional because of the unknown and unseen experience of mental illness. As Ellen engages with changing understandings of self through her sketch-journal, she also discovers her own humanity (98). Ellen not only sees and expresses the humanity of her experience of BAD through the sketch-journal; she also shares it with others, thus exposing a shared humanity: “I gave one of my drawings to a non-English speaking local in a second-hand shop….It felt like an intense cross-cultural moment, perfect and profound – a glimpse of the dazzling network of connections that bind the universe” (164). This transitory image transcends language in an act of reciprocal understanding that is ultimately communal. By including her sketch-journal in her disability autographic, she resymbolizes her disability experience as one not to be hidden but embraced and shared. She creates a network that “binds the universe,” “perfect and profound” (164).

Figure 5: Ellen Forney, Marbles, pages 94-95


The sketch-journal offers a malleable, unpolished, non-instantaneous, and internalized space; it is a holistic platform of self-representation that can embrace multiple, complex, figurative, and transitory self-images. In this way, the inclusion of the sketch-journal in disability autographics has the potential to transform the way the public creates and negotiates representational images of invisible disabilities like BAD in a way that both affirms and shares subjective identities and that ultimately reimagines the socio-cultural context.

In Marbles, the sketch-journal functions as a third textual construction created by and for Ellen that contrasts the prominence of the DSM-IV text. The sketch-journal acts as a material object that fortifies and authorizes the subjective experience and self-representation of mental illness. By creating and observing multiple media manifestations of herself, such as refined cartoon or photographic images and preparatory sketch images, Forney gains the ability to view herself comparatively from multiple points of view and construct a cohesive identity for herself.

The inclusion of the personal sketch-journal in Forney’s text engages in a form of activism by deriving new lenses to view self and thus initiate processes of resymbolization. Marbles challenges the polished self-image of other media such as cartooning and photography and creates an empathetic bond with the reader by inducting them into the shared disability experience. Forney begins her comic by presenting the standard invisibility or silencing narrative of the diagnosed persona and the disability experience through her autobiographical cartoon avatar. She then turns to the creative and documentary medium of the sketch-journal to re-evaluate herself in relation to her personal experience with BAD and the normative medical model. The drawing and reproduction of unpolished sketches of self executed in the unadulterated space of the sketch-journal grants her the ability to retain her subjective identity outside of the disability diagnosis, share her experience with others to create an empathetic disability community, and speak back to the curative narrative.


[1] Here, avatar is used to indicate the author’s self-reflexive visual embodiment as a character. As Charles Hatfield describes, the author “[d]raws the character…in his own image, but gives him a unique identity that is separate from his own” (273).

[2] Arthrology refers to Thierry Groensteen’s notion of braiding, the idea that “every panel exists, potentially if not actually, in relation with each of the others,” responding to the text as “not that of a strip nor that of the chain but that of a network” (146). Repeating images such as the labelled patients at the beginning of this sequence and Ellen’s same self-representation at the end of this sequence are an example of this kind of relational connection.

[3] Pathography, as defined by Newman, “refer[s] to narratives written about illness, [which] is a recent term based on equally recent definitions of illness” (9).

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