Portraying Anxiety Disorders in Picturebooks: An Exploration into Using Picturebooks as an Interface Between Therapists and Young Adults (age 18–34)

In the past, picturebooks were generally comprised of pictures combined with relatively minimal text or no text and aimed at educating or entertaining children, but picturebooks have gradually developed beyond this subject-matter and audience (Nodelman, 2017). Since 2000, picturebooks have been increasingly created to tell stories of more realistic life experiences, and even trauma or mental illness. However, embodying these difficult experiences in picturebooks has rarely been systematically analysed. In contrast, theories of visual metaphor have been utilised in researching the embodiment of illness in comics and graphic novels (Miers, 2017; El Refaie, 2019). For instance, graphic novels and comics about depression have been analysed to explore the effectiveness of visualising depression experiences with visual metaphor theories. Considering the similarities between picturebook and graphic novel formats, this PhD builds on such research by using visual metaphor theory to examine the effectiveness of picturebooks in communicating anxiety disorders.

Anxiety disorders are one of the most prevalent groups of mental illnesses (American Psychiatric Association, 2022) , and it is suggested that younger age groups (18–34) may be more vulnerable to the mental health impact of the pandemic (Varma et al., 2021). Within this age group, generalised anxiety disorder and social anxiety disorder could be the most common anxiety disorders worldwide (Bandelow and Michaelis, 2015; Chang et al., 2019). This research aims at portraying these two anxiety disorders in picturebooks and using them as an interface between therapists and young adults.

The research methods include literature reviews, case studies, critical reviews and illustration practice combined with semi-structured interviews with therapists. Based on the initial research on anxiety disorders and visual metaphor theories, and inspired by my own experience, two picturebooks were created, one examining social anxiety disorders and another generalised anxiety disorders. Their effectiveness of storytelling and embodying feelings has been examined through therapists’ feedback. Eventually, visual metaphor theory has been adapted for picturebooks about mental illness, and practical applications for such picturebooks have been explored.