Transcription of interview conducted by Skype on 21 November 2014. Parts of this interview were used in Farthing, A. & Priego, E., (2016). ŌGraphic MedicineÕ as a Mental Health Information Resource: Insights from Comics Producers. The Comics Grid. 6(0), p.3. DOI: http://doi.org/10.16995/cg.74 DR NINA BURROWES, RESEARCH PSYCHOLOGIST WHO PRODUCES ILLUSTRATED WORK AS THE CARTOONING PSYCHOLOGIST YOU SEEM TO WANT TO ENGAGE WITH PEOPLE VISUALLY, WHY IS THIS IMPORTANT? I want to engage with people Š if I thought using dance would be the better way to do it, I would be the Dancing Psychologist. Visual engagement is the form IÕm using at the moment but I will use others. So my key motivation isnÕt the use of visual, itÕs engagement, and I think using visuals is a smart way to do that. DO YOU CONSIDER YOUR WORK TO BE COMICS? I donÕt know a great deal about the graphic/illustration/comic world. I wouldnÕt personally call it a comic because, for me, comics are smaller and theyÕre a serial and they have a narrative that transcends across them, whereas my work doesnÕt. I call them various things Š illustrated self-help books, illustrated books, non-fiction Š but I donÕt consider them comics. Although if somebody who knew much more about comics was to tell me they were, then fine, that would be OK by me. I use ŌcartoonÕ because I have my books, but IÕll also just do one-off doodles, like a stand-alone cartoon. A lot of the people who read my work, itÕs the first illustrated content theyÕve ever read, itÕs not what they would normally do, so IÕm trying to make it really accessible. IÕm not trying necessarily to communicate with the established graphic-novel sector. DO YOU THINK THE WORD CARTOON IS MORE UNIVERSAL? Yes, I guess so. I mean a comic to me would maybe infer something else. ŌCartoonÕ to me is also definitely playful and I think thatÕs important. But itÕs not like I put a great deal of thought into the word, be it cartoon or comic or illustration. I just thought, well obviously itÕs cartooning and off I go. DO YOU THINK THE COURAGE TO BE ME BOOK AND THE ILLUSTRATION YOU DID FOR IT REVEALED ANYTHING THAT WASNÕT APPARENT IN THE RESEARCH REPORT? I wouldnÕt say anything new came out of the data because I was turning it into drawings, so there is nothing new. But I think the emphasis can be different Š so, yes, I think it reshapes the data and reshapes the emphasis, but nothing especially brand new came up because I was drawing. IN THE BOOK, YOU USE A VARIETY OF ILLUSTRATORS, WHY DID YOU NOT CHOOSE ONE OR DO IT ALL YOURSELF? Originally, I was going to do it all myself but I wasnÕt really a great drawer Š IÕm still not, but I was worse then. I was still working from photographs when I started the book, so I knew I wasnÕt good enough and I wanted it to be beautiful. I knew I wasnÕt good enough to do beautiful myself and I also worked out how long it would take for me to do, so then I thought it would be better if it could be what I want it be in terms of the aesthetic. And working with multiple illustrators was partly pragmatic Š part of that was, I want to do it quickly and six people were going to produce six chapters in the time it takes one person to produce one chapter. It was like spreading the load Š it would have taken much longer to produce if I had only worked with one person. But I also really liked the fact that the book is about a group of different people coming together, and itÕs nice that our process mirrored that. And I love that all the characters are the same, but each illustrator has their own character and all these people look different in every chapter and the counselling room looks different and I like that. I like that it emphasises that we are all seeing the world through our own eyes and it does look different to everybody. I like the kind of subtle messages that you can sew in when you are using a process in that way. HOW DID YOU FIND THEM? I just did a call for illustrators, which quite a few people picked up and helped publicise. I had never done this before and knew nothing about illustration and was a complete novice, so I just literally looked through all the submissions and I just picked people whose work I fell in love with. I didnÕt have any other criteria other than I just think the work is brilliant. So, yes, the whole process was kind of uninformed, if you like Š I didnÕt have anything else to go on, so you may as well love their work if they are going to be a nightmare to work with, or theyÕre wrong person. But as it turned out, it was such an easy experience. I was very hands-on in terms of the message and content of the book, I was very prescriptive in terms of that, but very hands-off in terms of what it would look like. I gave the illustrators as much as a free rein as I possibly could and I think they really enjoyed working on the project Š the feedback I got from them was they loved working on it. I guess they could rely on me to make what they were drawing meaningful and have purpose, but that I was letting them do what they were good at, which was make it look good. They did a great job. DO YOU FOLLOW ANY OF THEIR WORK NOW? I keep in touch with all of them, IÕd like to work with all of them again. I know Jade [Sarson] is making her own book now, which is brilliant. I often see them on Twitter Š Alex [Bertram-Powell] is always very active on Twitter. I get to see where all the referrals coming through into my website are from and I get a lot from the blog by Katie [Green]. I think the first time I actually physically met Katie was at her book signing. WeÕd already had email and phone contact, we knew we were going to work on this project together, but her signing my copy of her book was the first time we actually met. I only physically met everybody once Š apart from Katie who IÕve met twice Š everything was done by Skype and email. ŹŹŹ DO YOU THINK PRACTISING OR STUDENT THERAPISTS OR CARE WORKERS COULD LEARN SOMETHING FROM YOUR ILLUSTRATED WORK? The book has many different audiences. The obvious primary audience is the person who hasnÕt necessarily phoned a helpline, whoÕs been living with this experience on their own. But outside of that, theyÕre their friends and family. And there are professionals as well that IÕm keen to find the book Š basically, anyone who is likely to have someone disclose sexual abuse to them. So that could be teachers, nurses and therapists, people working in drug and alcohol spaces, even prisons Š that kind of professional audience. And within that, obviously therapists, but actually I think itÕs wider than that. IÕm not creating my work for psychologists, but IÕm getting some great feedback from my peers. I think the thing thatÕs really interesting is, when you write a peer-reviewed academic journal article, you use jargon, there is a language and structure, you could waffle a bit, you can hide behind your data a little bit, and you can be ambiguous. But when youÕre cartooning, there is no room for waffling. If you donÕt know your stuff it will be blindingly obvious and everybody will be able to see. So what it forces you to do is get to the essence of the data and the essence of your message. ItÕs actually really hard to do and IÕm getting great feedback from my peers in terms of itÕs unusual to get to the absolute essence of what you are talking about as an academic, because youÕre normally given the opportunity to write something thatÕs 10,000 words long. Whereas, itÕs almost like cartooning forces you to tweet everything, like itÕs giving you a much smaller structure and space. And that forces you to focus and, to me, thereÕs a fantastic academic discipline in that, which I think anybody could learn from. I think some people see it as dumbing down, but I think ŌOh my god, I challenge you to cartoon something you think you understand!Õ It forces you to absolutely strip it down and get to the core. What you would maybe say in 3,000 words, you have 14. And the beautiful thing is, you can say it because the pictures just help you and thatÕs why it works. But if you donÕt know what you are talking about, if you are waffling, if you are unsure yourself, then you wonÕt be able to do it. So to me itÕs been a huge intellectual challenge that IÕve thrived on. I love that my books are relatively short but donÕt underestimate them, itÕs almost like itÕs distilled psychology, concentrated. To me, that in itself is part of the process and why I love it. DO YOU KNOW IF YOUR BOOKS HAVE BEEN USED IN TRAINING SITUATIONS? Yes they are, definitely. IÕm actually going to be making a whole load of material that is specifically meant to be used for training and it will include illustrated content. But my work is already being used. People are buying it for staff training purposes, because I think one of the things is, lots of people get training about sexual abuse, but it can be very medicalised and it can also be just a bit detached from reality. ItÕs very hard to do that training without frightening the hell out of everybody as well. ThereÕs a balance you need to strike between giving people these horror stories, but also just getting the information across in a way that they can remember and engage with. So I think humanising it, making it real Š these characters they feel like real people, although theyÕre not Š and being able to connect with them emotionally helps you not only to remember, but just helps make it human. I think people who disclose are often treated like a hot potato: Ōquick get them to the expert who deals with thisÕ. ThatÕs such a horrible thing to do to somebody. I hope that the book is helping people respond to disclosures of abuse in a more human way and IÕm hoping that they are referring people to the book, like ŌI canÕt help you but please read this book.Õ CAN YOU TELL ME WHY YOU CHOSE TO SELF-PUBLISH YOUR BOOKS AND DESCRIBE WHICH METHODS HAVE BEEN MOST EFFECTIVE IN DISTRIBUTING THEM AND GETTING THEM READ? I was originally going to just have The Courage To Be Me online, fully free on my website. I wasnÕt even thinking about publishing it all, but then the process of creating the book was quite public because of crowdfunding. So I already had an audience before I had a book, and then a lot of people began to ask if theyÕd be able to buy a copy. I didnÕt really know why someone would buy a book that they can read free on the internet, but if people want it then great. I knew a publisher would never let me try to sell a book that you can read for free on my website, they just wouldnÕt be up for that. I also knew they would slow me down horribly, so I looked into self-publishing, got some advice from people who were already doing it and they made it sound like it was doable and easy. IÕve been so super impressed with the technology that is available. The technology on Amazon is kind of awesome and I wouldnÕt be able to do what I do without that platform. You can buy my book anywhere in the world, it hasnÕt cost me a penny to make that book available, and IÕve made some money out of it. I went through a stage of thinking ŌItÕs a shame I canÕt work with a publisherÕ, to actually thinking ŌIÕve no idea what a publisher could offer me that IÕm not already doing myselfÕ. And importantly for me, as this is now how I make my living, I assume if I was with a publisher I would probably get 30p every time I sold a book. I donÕt get loads of money now, but the book is mine, which means if it does get very popular, that asset is 100% mine, not 10% mine. So, just as an entrepreneur, I was thinking ŌWhy would you give away your asset?Õ And my understanding also, talking to other people who had worked with publishers, is you end up doing a quite a lot of the work. You have this idea that they are going to sell the book for you, but you end up doing a lot of the marketing yourself anyway. So maybe one day IÕll have a conversation with a publisher, but my first question will be ŌI have no idea what you can offer me, so can you explain what it is you can do that I canÕt already do myself?Õ IÕve just published another book [Eyes Open to Sexual Abuse. What Every Parent Needs to Know]. I literally finished drawing it on a Friday, I ordered my own copy of it on a Sunday, and I had it in my hands on a Tuesday Š thatÕs how quick the process is. And if I want to change anything, I take it off, itÕs offline for about 36 hours, then itÕs back and my changes are live. I think thatÕs incredible. If I sell many, many copies then IÕll have earned enough money to have a proper print run and then do it more conventionally Š have 10,000 copies sitting in a warehouse somewhere. But at the moment I donÕt, there are no copies sitting anywhere, they are all just printed one at a time. So itÕs a nice business model because itÕs like the book has to earn its keep and, if it does, it raises its own funds for a print run. So that means its a low-risk way of creating a book Š sink or swim, although the sinking doesnÕt actually cost me any money, it just wastes my time. But youÕre always going to sell some copies. Ź DO YOUÕVE NEVER DONE ANYTHING LIKE BOOK FAIRS? No, IÕve never tried to sell there. I do talks Š for example, I did one in Sheffield the other week, it was with a charity who buy my books from me. So books were available for sale afterwards, but they were selling them which is great. IÕm making a bit of money because I sold them the books, theyÕre making a nice wad of money, too, and people are getting signed copies, so that works for me. I havenÕt yet gone to bookshops, I havenÕt pushed it out in any of the conventional ways at all. I donÕt have any budget for marketing so IÕm doing all the free things, like social media. The field I work in, the sexual violence world, nobody has really done anything like this. But people love the books, so I really like hearing other people talk about it Š they are my sales team and they do such a better job than I possibly could. ThatÕs the wonderful thing, having met lots of these people, there are hundreds of helplines or counsellors out there who are recommending my book to their clients, who have bought multiple copies themselves and are recommending it. And I like that they can say you donÕt have to buy it, itÕs for free on the internet if you canÕt afford it. So yes I have an awesome sales team, IÕve just not met them all yet! But IÕm slowly meeting them and itÕs really reassuring, but the big market for this book is beyond survivors of abuse: itÕs like victim support, the prison service, the NHS. It will take some time, but I donÕt see why I wouldnÕt eventually get that kind of customer, theyÕre just going to be slower to come round to the idea that actually handing out this book might be a good idea. DO YOU READ PSYCHOLOGICAL WORKS IN COMICS OR ILLUSTRATED FORM? IÕve read Couch Fiction, which is a graphic novel about therapy, and IÕve seen a few websites, I forget their names Š most of them arenÕt written by psychologists, but by people who have experienced mental-health conditions. I donÕt actually consume loads of graphic novels or comics myself, but people send me stuff and there was Dragonslippers. When I started The Courage To Be Me, everyone was like you must read Dragonslippers, which is one womanÕs story of domestic violence. I got in contact with the author and weÕve been Skype pals for a long time now. ThatÕs what I love about the comics world, itÕs so accessible, people are so friendly and welcoming. I donÕt get any sense of competition, everyone is very inclusive because I guess you donÕt go into comics thinking you are going to make loads of money. Although, I have to say, there is in self-publishing, if you are smart about it, there absolutely is. What I encounter a lot when I meet illustrators is, they have an amazing talent for illustration Š they are probably better than IÕll ever be, and definitely better than I am now Š but they donÕt have a story to tell. Whereas IÕm the opposite, IÕm absolutely overflowing. I think IÕm going to be prolific, IÕve published three books this year, almost finished my fourth. I think IÕm going to produce tens of books, if not getting close to a hundred in my career, because IÕm bursting with content. I just canÕt draw fast enough, thatÕs why itÕs nice to collaborate with illustrators. HAVE YOU HAD MUCH INTERACTION WITH THE GRAPHIC MEDICINE GROUP?Ź Yes I have. I been along to Laydeez Do Comics a few times and IÕve spoken there. IÕve met Ian Williams [author of The Bad Doctor graphic novel and founder of graphicmedicine.org], as he goes there, so IÕve been introduced to him, but donÕt know him. They had a conference last summer in Brighton but I wasnÕt in the country so I couldnÕt go. But, yes, IÕm aware of them, nurses who are cartooning and these kinds of things, and I think itÕs brilliant Š it makes total sense to me. I think the NHS can really benefit from that kind of contribution. I think our ability to communicate to one another is terrible Š I think as a psychologist IÕm particularly tuned into it. I think psychologists are pretty bad at it Š people donÕt like being told what to think and what to do. The way you communicate different things is really, really important, if you think about what kinds of messages people are able to hear, what they can understand. I think comics is such a human form, thatÕs why it works and I think it works especially well with something that is emotionally difficult or intellectually challenging, definitely something where there would normally be a power dynamic. I love that in my work. Yes, IÕm Doctor Nina Burrows, but look IÕm cartooning, IÕm obviously not taking myself too seriously. IÕm not trying to put myself above you, IÕm not the expert. My cartoons are kind of a bit crap, and I like that, theyÕre kind of vulnerable, and thatÕs a fantastic way to meet somebody on an equal footing, to have a conversation with them. I donÕt think medicine always excels at that kind of communication. I have quite a few doctor friends and weÕve always tentatively talked about how we should probably work on something together at some point, because there are so many health conditions where itÕs essential the patient understands whatÕs happening to them, and I really donÕt think they do at the moment. The Courage To Be Me has been a fantastic proof of concept as far as IÕm concerned, it makes stuff that people have never understood about themselves easier to understand. So, yes, I think graphic medicine has got a great future. HAVE YOU EVER USED ILLUSTRATED WORKS OR COMICS FOR ACADEMIC STUDY TO UNDERSTAND SOMETHING? Yes, IÕve always drawn Š badly Š so I always mind map when IÕm studying. I donÕt practice as a counsellor but I have trained as a one because I thought it would make me a better psychologist, so when I was writing up client notes, which you do after every session, my notes were always cartoons. It just came naturally to me that I would draw that interaction rather than write sentences. And as a researcher, I would probably be doodling while I was listening to someone and if I was writing up field notes, it would probably be cartoons. But even now I still like to use them, just really rubbish matchstick people, so very low quality, but still able to say a lot more than my words. IÕve also worked quite a lot with young offenders in my research work and it can be quite a nice ice-breaker to say ŌShall we draw together? Shall we draw how this feels?Õ And for me to show them how shit I am at drawing, that can be a great way of communicating with younger people, trying to make yourself less intimidating and make the whole thing a bit more owned by them. THE WAY YOU WERE SPEAKING ABOUT GRAPHIC MEDICINE, AND ABOUT THE WAY THE NHS COULD USE THINGS LIKE TO INTERACT WITH PEOPLE, IS THAT UNDERPINNED BY NARRATICE THERAPY CONCEPTS? It depends, I donÕt know if it would have to be so obvious as in Ōthis is a therapeutic toolÕ. I think graphic medicine has a lot to offer just in simple communication, but also in terms of helping people make meaning. I think people could find meaning and create meaning through illustration as much as words. I think for some people, talking therapy really suits them and they almost enjoy having a semi-intellectual conversation about their emotional state. But theyÕre not really doing the work, itÕs a comfortable space for them. But for other people, that isnÕt a good fit, they need and can benefit from therapy, but talking therapy might not be ideal. IÕm quite keen that people who are therapists recognise there are many ways to do therapy and that talking therapy is not the only way Š itÕs a common way, and a default way, but not the only way. And in terms of the wider NHS stuff, I just think understanding how important it is to humanise this scary thing, this scary health condition, and how empowering knowledge is. One of my motivations for making the book is, we go to these conferences on sexual violence and all these academics already know each other. They have conversations about their last yearÕs work and theyÕre are at the cutting edge of research and they know this, that and the other. So this small group of academic elites get together, and they make their stuff publicly available in that they publish it in a terrible language, in a journal article that you have got to pay money to get hold of. But there are people out there suffering, and the stuff that you know, the stuff that is basic knowledge for you, could actually change their experience of their day-to-day life. You can help them realise that actually what they are experiencing is totally normal and theyÕre not insane and there is a reason. ŹAnd when you understand the reason why you are a certain way, that can be half of the journey changing it. So itÕs tragic that such a small number of people have all of this knowledge that could help so many other people. If thereÕs a problem that somebody else is living with and you are the academic expert on that problem, your job is not done when you have published it in academic journal article. I think you should feel somewhat obliged to make your content accessible to that 16-year-old girl who thinks sheÕs gone mad Š thatÕs what our work is about so we should make sure that person can access it. IS THERE ANYTHING ELSE YOU WOULD LIKE TO ADD? To me itÕs like, ŌThis is so important, we must cartoon itÕ Š thatÕs how I feel. Whereas I think other people would be like, ŌThis is so important, we must get a professor in and put it an academic journal article.Õ As I said earlier, for a lot of my audience, if you asked them if they would like to read a comic, they would think ŌNo, thatÕs for kidsÕ. I find that you have to put it in front of them and get them to start reading. I think people have a prejudice against comics, simply because they donÕt realise how adult the genre is and theyÕve never engaged with it. They think itÕs for children or they think itÕs just Batman and Superman, which of course is a big part of the space and thereÕs a big lovely history there. But I find if you stick it under their nose, and let the work do itÕs magic, it will because itÕs so human. So itÕs almost like the job is get it under their nose and let the work speak for itself. Ź IÕm sure initially a few people might dismiss what I do and think ŌCartoon psychology? That sounds gimmickyÕ. But to me, I feel like IÕm practising hardcore psychology and IÕm making it accessible to Joe Public Š there is no gimmick here. The trick is, if I was to ask people, I think they would say I no donÕt want to read comics, but if I was just to put one under their nose, IÕm pretty sure they would read it. IÕve created peer-reviewed academic journals, but nobody reads my academic work Š even I donÕt read it! Most of the stuff I havenÕt read for years, and if you asked me to read my article from 2000 and whenever, IÕd be thinking ŌOh god, do I have to?Õ like itÕs boring, and thatÕs such a shame. If you actually talked to me about whatever project it was, IÕll have some passion about the actual research Š itÕs just like ŌOh my god, the journal articles?Õ They have to exist, thereÕs an important function that they perform. I donÕt think IÕm a terrible writer, I think IÕm Źgood writer, I think I do good research, but I think my journal articles are boring because they are supposed to be. But my cartoons, I read them hundreds of times and I read them differently Š even I see different things and I drew it. ThereÕs something absolutely magical about making it fun. TheyÕre also short Š you can read most of my books within 15 minutes Š itÕs kind of beautiful but itÕs also really damn clever. And I think itÕs that bit that people need to cotton on to and they will do. I reckon if you were to illustrate their work, they would fall in love with it and they would totally get that this is a way to go forward. IÕm not suggesting getting rid of academia, but IÕm saying if you want to communicate with people, really communicate, this is an excellent way to do it. ENDS