1 Making the Invisible Women Seen: The Representation of ADHD Females in Fiction A dissertation submitted by Christa Lee In partial fulfilment of the requirements of the award of BA (Hons) English Department of Communication and Journalism Faculty of Media and Communication Bournemouth University 2019/2020 Submission date: 30/07/2020 Word count: 10000 2 I declare that this dissertation/project is all my own work and the sources of information and the material I have used (including the internet) have been fully identified and properly acknowledged. Student signature ............................................................ 3 Abstract Females with ADHD are diagnosed later than their male counterparts, if at all. Studies and published literature acknowledging and investigating the difference in gender symptomology is limited. Stories have been used across time to explain and teach soci ety’s norms , help people to navigate the world and how they should behave. This use of storytelling has been adapted during the second half of the twentieth century to help advise the medical community, and society as a whole, about the way that illness a ffects a person’s life, in the form of illness narratives. This essay therefore uses the concept of the illness narrative, and the use of stories to educate and inform, to investigate the representation of females with ADHD in fiction. With close reference to Frank’s The Wounded Storyteller (2013), ADHD studies, clinical interviews with those who experienced late diagnosis, graphic medicine, and narratology, it investigates the most effective narrative for portraying the ADHD female’s story across fiction prose, webcomics, and television fiction. This analysis shows that fictional portrayals of ADHD females can be as effective as real patient narratives, and that storytelling, when used widely and regularly, can help the ADHD female to navigate the neurotypical world, and find her place within it. 4 Acknowledgements There is no advice or guidelines for writing the acknowledgements, which I think means that I get to let me and my ADHD run free. I have been thinking about this section for weeks , with my brain jumping to everyone who has made me feel that glimmer of “I’ve got this” over the past year or four. It is to them that I am writing thanks. First and foremost, to Sam Goodman, for a calmness that I have never known in a person before, especially in the face of deadlines hidden in clouds, and me figuratively (and sometimes literally) crying under the table talking about a hamster. My mum, for taking over with endless child taxi services whilst I was at uni, or my desk, or hiding from life. Dr. Phil Wilkinson (I cannot say your name without emphasising the Dr) for so many offers of Zoom support that I always forgot to turn up to. My Uni Babes for being there for all the tears, good and bad – we made it out alive. Suzanne Gotheimer for showing me the kind of woman I want to be if I ever grow up. Mandy, my amazing ALS mentor who I always left feeling like I totally had this nailed. My babies, who have looked at me, and talked about me with such pride that I could never quit: Carys, with her face of unwavering confidence in my ability. Emrys for fixing my Rubiks Cube every time. Bronwyn, for all the tea, lunches, and “no, you can’t ask people that” . Charley (the Donovan fan), and the BlurStans on Twitter who I offended, yet they still sent support. Astra, for always being with me in hideous unicorn form. The many “strangers” who live in Narnia my computer who have supported me and dragged me through so many meltdowns. Messrs Beam and Daniels, without whom many drafts would have been far shorter. But finally, and most importantly – Adam. Stacey Turis says that everyone with ADHD needs that one person in their life who is their cheerleader, who will always pick them up regardless of whatever insane thing they have done (or done again) this time. Ok, he’s more like one of Marilyn Manson’s cheerleaders , or the Al to my Sam Beckett (that will make sense soon), but he’s that for me. He’s given me a mix of love, sarcasm, alcohol, and endless sacrifice (not the literal slaughter kind) to get me through this part of my quest, and I can never thank him enough. 5 Contents 1. Title Page 2. Author’s Declaration 3. Abstract 4. Acknowledgements 5. Contents 6. Introduction 10. Chapter One: Prose Fiction 17. Chapter Two: Webcomics 26. Chapter Three: Television Fiction 30. Conclusion 33. Bibliography 45. Ethics Checklist 6 Introduction Stories play an “ essential role in the evolution of human cooperation by broadcasting social and cooperative norms to coordinate group behaviour” ( Smith et al. 2017), they teach us how to navigate our world, and how we should be. There are many benefits to using stories to show and enforce social norms, including tales 1 such as The Boy Who Cried Wolf to encourage honesty, or The Emperor’s New Clothes to encourage critical thinking, and not being held back by pride or a fear of speaking up, but not all lives fit into the “norm”. Sometimes they once did, but changes occurred during their lives, and now they are no longer the norm. Changes in health have an impact on a person in both physical and mental ways, these changes mean that they must learn to live their new life. The traditional stories and guidelines are often for the healthy person, but for the ill, or “wounded” (Frank 2013) a different set of norms are necessary. Medical sociologist, Arthur W. Frank talks of the “wounded storyteller” as someone who can shift the concept of illness from passive, to active. They can change their personal narrative so that rather than illness being something that happens to them, over which they have no control, it becomes something in which they are participating and can influence. By sharing stories, they can both recover the power that they have lost due to illness and help the audience use that story to recover their own power. Charon (2006) states that when we want to understand “particular situations that unfold over time”, human s naturally turn to storytelling. As scientific advancements have been made in medicine, illness has become something taken over by overwhelming technical expertise and terminology (Frank 2013). By combining medicine with the narrative skills of “recognising, absorbing, interpreting, and being moved”, Charon believes that the stories of illness can be used to not only help medical professionals become more effective treating the patient rather than just the illness, but also that those experiencing the illness can understand how it affects their lives. Judith Zaruches (Frank 2013 ) introduces the concept of an individual’s view of their life as having a map and destination. We roughly understand our destination, in part due to the stories that we have experienced showing what “successful” happy endings are within our culture. It is then up to us to choose the pathways and routes to follow to reach that destination. Serious illness affects this, so that none of the 1 Fables such as The Boy Who Cried Wolf , which originated from Aesop, and The Emperor’s New Clothes (Andersen 1837) have been repeated and adapted throughout time, ensuring that their message remains consistent and heard. 7 pathways will get you to your planned destination. By telling the story of an illness, or by listening to a wounded storyteller who has experienced the same, a new map can begin to make sense, and a new path can be plotted. This map analogy works for illnesses that have occurred during a person’s lifetime, having learned to read society’s map, but neurodevelopmental conditions that have been present from birth or a young age, yet not recognised until a later stage in life, do not fit into this concept. Disorders such as Attention Deficit/Hyperactivity Disorder (ADHD) and Autistic Spectrum Disorders (ASD) are often not recognised until later in childhood, or into adulthood. These disorders present individuals who do not always understand the map reading norm. Focusing on ADHD females allows us to see how increased representation in fiction could help with this navigation. According to the Diagnostic and Statistical Manual of Psychiatric Disorders Vol. 5 (DSMV) approximately 5% of children, and 2.5% of adults have ADHD, with a gender divide of a ratio of 3:1 in children, and closer to 1:1 in adults, male to female (Holthe and Langvik 2017), suggesting an underdiagnosis in girls and/or the increased likelihood of girls presenting differently to boys. Although the differences between gender in symptomology and neurobiology is being acknowledged (Nussbaum 2011), there is still limited published literature about women (Fuller- Thomson et al. 2016). The DSMV defines ADHD as “a persiste nt pattern of inattention and/or hyperactivity- impulsivity that interferes with functioning or development” (DSMV 2013), and can also feature low frustration tolerance, irritability, and mood lability. It is divided into subtypes of primarily hyperactive, primarily inattentive, and combined. Rather than being a deficiency in attention, as the name suggests, the ADHD brain takes in too much incoming stimuli, making it difficult to focus attention due to becoming overloaded (Oscar Berman et al. 2008). It is also suggested that ADHD brains suffer from low dopamine function (Gold et al. 2014), which, when unacknowledged and untreated, can lead to substance abuse to self-medicate. A study by Hinshaw et al. (2012) showed that from teenage years and throughout adult life ADHD females have higher rates of suicide attempts, self-injury, and major depression, being more than four times as likely to seriously consider suicide (Fuller-Thomson et al. 2016). The stereotypical cultural representation of ADHD is of the overactive boy flinging rubbers across the classroom, unable to sit still. As they often display hyperactive and impulsive behaviours, this leads to referrals for ADHD diagnosis. However, ADHD females show fewer disruptive symptoms and more inattention. Girls 8 are twice as likely as boys to present as inattentive type and keep their hyperactivity internalised (Biederman et al. 2002). When hyperactivity is externally present, it is more likely to present as hyper-talkativeness, (Quinn 2005) or in emotional reactions. Whether this presentation is due to gender differences in ADHD neurobiological function, or from women being traditionally conditioned to be quiet, is unclear. It does, however, lead to the condition being less obvious, and more likely to be missed for diagnosis until later in life, or completely. This delay leads to a far longer period of struggle before being able to understand themselves, often contributing to a range of co-morbid mental health issues. In addition to this struggle for diagnosis, there is the issue of emotional dysregulation, a symptom of ADHD that affects all areas of the individual’s life, but since being removed from the diagn ostic criteria during the 1970s (Shaw et al. 2014), is often not acknowledged as a symptom, and is left unaddressed. This all combines to the map/destination analogy becoming more complicated for ADHD. The stories that are told, and the social norms which are learned show that map reading comes naturally and easily. For the ADHD child, it is as though they missed the stage of learning to read maps, but they do not realise this, as no-one talks about reading the map as it is something that is seen as natural. Robin Hobb (1997) refers to this in terms of describing a horse when they are commonly known “[b]ut who amongst us would see the need to devote the labour and time to writing out exactly what a horse is? “(p.255). Society is currently designed towards the Neurologically Typical (NT), and as such does not explain what comes as the NT norm to the Neurologically Divergent (ND). ND individuals can thus feel confused, frustrated, and stupid for not being able to do it. They wonder if they are lazy. Diagnosis is the equivalent of sitting them down and explaining that they do not know how to do it, and need to learn, or find a different method of navigating, rather than that they have the skills within them and just are not using them properly. We have gradually begun to move past using the disease metaphors that Sontag (1988) suggested led to stigmatising tropes for conditions such as cancer, yet there is still stigma surrounding ADHD. It is blamed on food, environment, poor parenting. The book Why French Kids Don’t Have ADHD (Randall 2016) states “social and spiritual context” as one reason for ADHD. It is seen as a character flaw rather than a neurodevelopmental condition. Diagnosis is the stage in which the process of telling their stories, and hearing those of others could help them to understand themselves, and learn to read maps, or follow tracks, or whatever navigation methods are available to them. They can find the truth behind the metaphors and misinformation. They can find their power. Their storytellers are not so much “wounded” as opposed to “other”. As the diagnosis of 9 ADHD females is often delayed (Holthe and Langvik 2017) there is a much longer period of struggle before being able to understand themselves and their position within their world, making their representation in stories to help them to understand their norms even more vital to this understanding. There are representations of ADHD males across all forms of fiction, yet the depiction of ADHD females is very limited. It is therefore necessary to consider the portrayal of ADHD females as their voices and stories are currently overlooked within popular and critical discourse. By looking at the medical humanities, with close reference to Frank’s The Wounded Storyteller (2013), ADHD studies, clinical interviews with those who experienced late diagnosis, graphic medicine, and narratology, this essay will examine works of prose, including The Adventures of Phoebe Flower (2010) by Barbara A Roberts, and Focused (2019) by Alyson Gerber; graphic semiautobiographical fiction such as the ADHD Alien (2019) webcomics by Pina Varnel, and televisual fiction series Mom (2013). This analysis will show whether fictional portrayals of ADHD females are as effective as real patient narratives, and if storytelling can help the ADHD female to navigate the NT world, and reach her destination. 10 Chapter One: Prose Fiction Since the beginning of mankind, we have told stories. An Indonesian cave painting from 44,000 years ago depicts scenes of a pig and buffalo hunt, believed to be the world’s oldest recorded story. The Epic of Gilgamesh , c1800 BC, is known as the first written fictional story, and covers many aspects of storytelling as we use them today; a hero facing challenges, learning about love, life, and developing as a person. Paintings, oral storytelling, moving onto the written word shows us that stories have always been important, and they have been used to communicate the values, perspectives, and experiences which are of importance to society. Some tell of a history, some, the mythology, and beliefs of the time. Brody (2003) describes the purpose of stories as to relate individual experiences to society and culture. Greek mythology was told as oral stories, with the lives of the gods explaining the world, and displaying positive and negative behaviours and consequences Aesop’s work c600 BC used fables to portray moral lessons. In 375 BC Plato’s Republic discusses the use of stories to “mould [the children’s] minds and characters” (Lee et al. 2007). Moving forwards, we come to A True Story (Lucian of Samosata 2 AD), where Lucian uses satire to educate against mythical events being taken as fact, once again, using fictional storytelling to explain the world around him, to help inform his society how their current beliefs have evolved. Women who seek diagnosis for ADHD as adults often do so after recognising themselves in articles about ADHD (Holthe and Langvik 2017). If they were represented across all forms of narrative this recognition could potentially occur earlier, leading to earlier diagnosis and possibly reducing some of the problems associated with late diagnosis. Frank (2013) refers to “wounded storytellers” as those who tell their illness narrative. This concept of illness as a wound is accurate as something previously healthy that is damaged, and eventually heals. Jamison (2014) refers to a wound as an injury from the past which has not finished healing, “t he present tense of its immediate aftermath”. The tale of the wounded storyteller is of that wound as it progresses through to the full aftermath. Neurodivergence such as ADHD however is neither wound nor illness. Nothing is damaged to cause it, and there is no previously healthy state. He also argues, however, that the initial need to tell the illness story is not the illness itself, but suffering, which Cassel (1982) states covers three points. S uffering affects “the person” (Cassel 1982), the body and mind combined. ADHD has body symptoms such as physical restlessness, sleep disturbances, poor 11 proprioception. The mind struggles with executive dysfunction, mood swings, impulsivity. These combined, plus the effect that these things have on mental health, lead to the suffering of the person. Cassel’s second point states that “suffering occurs when an impending destruction of the person is perceived” (Cassel 1982). The uncertainty that ADHD brings leads to a constant feeling of threat to the person. Those with ADHD are often rejected by their peers, and struggle with social skills, which links to the third point of suffering, that it can affect any aspect of the person, including their role in society, how they identify, and their view of their self. By acknowledging this suffering, it is clear that neurodevelopmental conditions are still part of the illness narrative, but that it is the suffering who are speaking as opposed to the wounded. When looking at the different narrative styles for the suffering storyteller, Frank observes three types, the restitution narrative, the chaos narrative, and the quest narrative. When looking at these narrative styles for the ADHD storyteller, none of them truly fit. The restitution narrative centralises on the concept that a person is healthy, becomes sick, then gets better, utilising the concept of Parson’s (1975) sick role, in that it is a change in a person for a time, understood by society. It is a narrative that works for illnesses that can potentially be cured. For chronic or neurodevelopmental conditions however, it is unrealistic, as the best that can be hoped for is learning to live with the condition. The person essentially remains separate from the illness, even with a condition as pervasive as cancer, the sufferer remains a person with cancer, rather than is the case with neurodevelopmental conditions, an ADHD person, or an Autistic person. The chaos narrative is useful for ADHD stories, due to the inherently chaotic nature of ADHD. There is a lack of genesis to the condition and the story, and as a result, to the co-morbid conditions, and reactions. There is no way to tell if the anxious ADHD person has anxiety due to the chaos of ADHD, or if the anxiety causes the chaos, or if trying to do multiple things prevents focusing, or if not focusing leads to doing multiple things. There is no reliability in medication for ADHD, with women often trying various medications and doses, and then dealing with the additional challenge of hormonal changes leading to a change in effectiveness of medication. In Here’s to Not Catching Our Hair on Fire (2012) Stacey Turis writes in a chaotic way about her life with ADHD, ignoring the traditional linear narrative, and instead writing in blocks of work, school, people, relationships. Writing about how one thought leaps to another with ADHD shows the chaotic nature of the condition, which leads to writings about it to be just as chaotic, thus illustrating the overwhelming nature of the condition. 12 “You’re in a room with flickering lights. A wall of screens, each showing a different channel. Radios play, all different stations. You catch sight of an image on one of the screens reminding you that you need to write an essay. Looking around for a pen, an advert for washing dishes plays, you move to the sink and turn on the taps. Your stomach rumbles, have you eaten today? You check the fridge and freezer for something to eat, the leftovers that you forgot three days ago need throwing out. You walk out to the bin. A movement catches your eye... Oooh squirrel! An hour later you walk back in. The freezer has been left open and is defrosting whilst the sink overflows onto the floor. You sigh and turn off the taps and close the fridge. You move to get a towel to dry the floor. You spot a pen. What did you want a pen for?” (Lee 2016) 2 One of the problems with chaos narrative for ADHD is that it can be impossible to truly document the chaos during the experience, it is something that can only be seen after the immediacy has passed, which then makes the sense of “horror” (Frank 2013, p.109) less real. The chaos narrative can be problematic as a method for learning however, as the listener does not want to listen and acknowledge the reality. “We all lose our keys” and “just focus” are two of many dismissive responses that those with ADHD face when telling their story. The listener asserts how they would break out of the chaos. This leaves the storyteller feeling unheard. Frank’s third illness narrative style is the quest narrative. This is the style which is most often displayed in ADHD storytelling. In the quest narrative, the illness becomes something to be accepted and used. There are things to be gained by the 2 During one of my earliest units on my BA English course, we were tasked to write a blurb for our autobiography. I chose to write this to give a glimpse into both my mind and my life with ADHD. 13 illness. The storyteller has a “quest” to live with their condition, use it, and often to help others, to pass on the “boon” of knowledge. It makes ADHD a social issue as well as a personal one and seeks to make changes to the NT society to ensure fewer challenges to for the ND to overcome. The quest for those with ADHD does not lead to one defining moment, it is a process. The storyteller in the quest narrative is seen as the conquering hero, but ADHD is less conquering, more learning to cope as best they can in the chaos. Having studied Frank’s na rratives, ADHD does not truly fit into any of them, as a result, I propose a fourth illness narrative, that of the Chaotic Quest. Chaotic Quest narrative is the most relevant for ADHD storytelling. The chaos can never truly be conquered, the quest never ends, yet the “boon” of passing on insight gained from surviving in an NT world is always present. The television series Quantum Leap (Bellisario 1989) seems the best example of the ADHD “ Chaotic Quest ”, there is always new confusion, and a new battle to be won, but never a way to end. The Chaotic Quest narrative will be the one used during analysis as it is the only way to accurately represent the experience of the ADHD female. Non-fictional illness narratives provide ways for ADHD females to learn about themselves and others, but this does not solve the problem of needing to see representations of ADHD females as part of the social learning stories, to allow them to recognise themselves as they develop. By having ADHD females appearing in fiction they can become visible, both helping them feel seen, and the NT to recognise them within society. Looking at the representation of ADHD females within fiction, however, requires a different lens. The illness narrative still plays its role, but it is not enough to just focus on the condition, it requires the whole life, and the way in which the ADHD female interacts with it, both positively and negatively. When looking to prose fiction that offered representations of ADHD females, there were very few, with just two having a female with acknowledged ADHD: The Adventures of Phoebe Flower by Barbara A. Roberts and Focused by Alyson Gerber. The Adventures of Phoebe Flower is a series of short stories, originally divided into four books: 8-year-old Phoebe encounters many problems in life, without really understanding what she has done wrong when her intentions were good. Eventually she is diagnosed with ADHD and begins treatment, and we see how her life changes. Phoebe Flower follows the restitution narrative. We meet a child who does not want to go to school, and see her difficulties because of her ADHD symptoms, and ultimately diagnosis and medication which makes her able to focus and work. This only fits for 14 the four parts combined, however. If read as individual books, two of them show Phoebe trying to live through her chaos narrative, with no understanding as to why she cannot do what she intends. The second two books follow her diagnosis and eventual treatment. For this essay, the combined book is used in four parts. Part One shows Phoebe experiencing rejection sensitivity disorder, difficulty making friends, literal interpretations of language, struggles with decisions, disorganisation, distraction, inability to work on something of no interest, hyperactivity, time blindness, hyperfocus, a lack of awareness of surroundings, impulsivity, and a determination to “try” even though it isn’t that she is not trying. It also shows the effect that her condition is having on her family, with her mum repeatedly being shown as “ worn out”, “stressed”, and “exhausted” (Roberts 2010). Part Two covers the same aspects of ADHD but also the view from the people surrounding her, including their teasing, and reminders of the things that she does wrong, such as losing things regularly, and emotional dysregulation. We see a child struggling with shame and a fear of disappointing people. She begins to find coping techniques for herself such as studying in the bathroom to avoid distractions. It is in Part Three that the adults in her life discuss diagnosis. Phoebe is still struggling with friendships, so she begins to act the class clown – a common path for those with ADHD (Young et al. 2008). She struggles with social conventions and understanding when things are appropriate. Part Four shows Phoebe's life changing with medication, and her teachers making accommodations for her at school. Her mother is now in a “good mood”, reinforcing the concept that ADHD hurts those around them by causing extra stress within the family (Miranda et al 2007). The Adventures of Phoebe Flower appears to be a book for children to show that ADHD is why some children act in certain ways, and that they can be helped to succeed with medication and a sticker chart. In this sense, it may be seen as a positive restitution narrative for ADHD. Throughout the book, however, are the phrases that are said by NT people. Phrases such as “work hard” and “try harder” are scattered throughout the book, alongside “think”. Even on one of the final pages, once diagnosed, Phoebe repeats her doctor’s words as being “right” - “I just needed to concentrate”. There is a dichotomy of the book understanding all the symptoms of ADHD, yet somehow still dismissing them as though it was a lack of effort all along. Focused follows the story of 12-year-old Clea who is struggling in school due to her symptoms of ADHD. She is then diagnosed and given medication and coping strategies. Focused fits the quest narrative most closely, as Clea is learning about 15 herself, and how to overcome her obstacles along the way to be able to keep the most important thing in her life: chess. Written from Clea’s perspective, it shows the issues of emotional dysregulation, rejection sensitivity disorder, time blindness, impulsivity, low proprioception, friendship struggles, disorganisation, forgetfulness, hyperfocus, sensory issues, and distraction. We see Clea’s internal struggle as she tries her hardest to overcome these issues without understanding where they come from. She voices the concern that many do prior to ADHD testing (Young et al. 2008), that she is not smart, that she is dumb, that it is not ADHD, it is just her not being good enough. She also states that she cannot have ADHD as she does not present in the stereotypical way, “I’m not really like them. I can sit still. I don’t blurt our answers all the time or get out of my seat.” (p.86). The doctor explains about the different types of ADHD presentations to explain how she might present differently to the ADHD children she knows. She shows feelings of shame at testing and diagnosis, reflecting the low self-esteem of ADHD females (Young et al. 2008). Plans are put into place to help her learn to manage her life, and medication is tried, with the emphasis that medication is trial and error, and it needs other changes as well, rather than the magic solution that it appears in The Adventures of Phoebe Flower. Clea is seen living her life and being able to see how her ADHD has affected everything in it. By the end of the book, her resilience is discussed as being “like your superpower” (p.287), and she thinks that she is beginning to see ADHD like that. Focused presents a strong, resilient ADHD female. Running throughout the book is the emphasis that increased resilience is a result of ADHD. Although this is a positive message for those with ADHD, and it seems logical that the more struggles that have to be overcome, the more resilience is built, studies are conflicted on the truth of this assertion, with Wilmshurst et al. (2009) finding that ADHD college students are an especially resilient group, yet Regalla et al. (2019) suggest that ADHD leads to lower resilience. The increased suicide rates in women with ADHD suggests that this need to be resilient can become overwhelming (Balazs and Kereszteny 2017). A common feeling by those diagnosed at an older age is one of grief and anger, anger that no-one noticed their condition as a child, and anger that their life has been so hard, (Murphy 1995) which Focused clearly represents “it’s okay to for me to be mad that no - one noticed I needed help for way too long.” Clea asserts regularly that she will be different, will be better, she “promises”, which are also phrases associated with ADHD females. “Another participant reported, “I got so angry with myself because I used to go to bed at night and think ‘Tomorrow I’m going to be really good’ but I actually didn’t know what I was doing wrong.”” (Young et al. 2008). 16 Authenticity in the representation of ND characters has previously been problematic. When Mark Haddon’s The Curious Incident of the Dog in the Night-Time (2003) was published, it received great acclaim, receiving several awards for its content as both a novel with very clear plots, but also having a character on the autistic spectrum. It has later been criticised by the autistic community due to Haddon’s lack of research into the condition, stating “imagination trumps research” (Haddon 2009), therefore basing Christopher on myths and some harmful ASD stereotypes (Kelly 2016). In contrast, works such as Neil Hilborn’s poem “OCD” (Hilborn 2017) portrays the rawness of a relationship whilst having obsessive compulsive disorder, with a feeling of it being more trustworthy as the author has the condition. Alyson Gerber was diagnosed with ADHD as an adult, allowing her first-hand experience to be expressed through Clea in Focused. Roberts is not publicly said to have ADHD, yet her books are written to help educate children on ND conditions, ensuring that the research is thorough to provide accurate information. An author having experienced what their characters experience is not an essential requirement - we do not, expect murder mysteries to be written by murderers, or detectives - but by looking at Haddon, it is clear that research is vital if it is to provide a meaningful portrayal of an experience or condition. Reading The Way (2018) investigated the way that disabilities are portrayed within children’s literature, but their findings are valuable for all literature. They emphasise a need for extensive research or personal experience when depicting a character with a with a disability, and also a need to avoid sensationalising the condition, or showing only the extremes. Both The Adventures of Phoebe Flower and Focused are written specifically to address the issue of ADHD and diagnosis, which although is useful in terms of giving those with ADHD a voice, it is still focused on the condition rather than the person. Despite the issues with Haddon’s The Curious Incident of the Dog in the Night-time , featuring Christopher, a character strongly implied to have ASD, the novel itself is not about that. It is about an autistic boy solving a murder and dealing with his relationship with his father. This blending of an ND character with a plot not relevant to that diagnosis helps to normalise them within society. This is what is currently lacking with representations of ADHD females in fictional prose. 17 Chapter 2: Webcomics As noted in the introduction, storytelling in the format of pictures predates history (Versaci 2007). Cave paintings showing hunt scenes, hieroglyphics, caskets engraved with the Passion cycle, and the Bayeux Tapestry show stories and histories in pictorial format. This use of images for narration has never left us, but the “modern” comic strip began with Rodolphe Töpffer in the 1800s (Kunzel 2007). Since then, it has continued to evolve in both style and readership until the present day, when technology allows for it to be shared in digital format online. During this chapter, the word comics or webcomics will be used to describe the medium: the panelled comic form, traditionally with word and thought balloons. The past 20 years has seen a surge in the production and sales of graphic novels (Salkowitz 2019), whilst there has been a decline in other print book sales (Sweney 2019). This is due in part to the growing acceptance of comics as a narrative medium, but also a turn away from superheroes towards stories about the common man. When Art Spiegelman published his Holocaust history and memoir Maus (1991), first as a serialisation, and then in its entirety in graphic novel form in 1991, he brought the graphic novel format out from the shadow of comic books, and into the world of literature, being the first and so far only, graphic novel to win a Pulitzer prize in 1992. In 2018, Sabrina (Drnaso 2018) became the first graphic novel on the Man Booker Prize long list. Classic novels including Margaret Atwo od’s The Handmaid’s Tale (2019) and Harper Lee’s To Kill a Mockingbird (2018) have been reimagined in graphic novel format. In an interview, Mark Siegel explained that people do not think by words alone, it is a visual and verbal process (2017 cited by Terrill 2017), and the combination of pictures and texts that comics provide allows for enhanced understanding and processing (Mayer and Sims 1994). Comics are able to make some subject matters easier to tolerate and process. Taking Maus as an example, there is a level of emotional safety when reading the horrors of the Holocaust as depicted by animals (Cavna 2016). This makes the move towards using comics for educational purposes an understandable process. Graphic memoirs have been able to show the past more clearly than writing in some cases, and those same processes can be used to explain the present. 18 Medical humanities and the use of storytelling to explain patient journeys has allowed not only the “wounded” to find their power and tell their s tories, but also medical professionals to become better at treating the person rather than just the illness. Graphic medicine is the “use of comics in medical education and patient care” (Williams 2007), and as Squier (cited by Glazer 2015, p.18) states, comics create a “richer and more resistant voice”, giving strength and clarity to both those speaking and reading, making them an ideal format for patient narratives. Comics can show multiple events occurring at once, such as a patient and a doctor, and it is through this multiple event scene perspective that graphic stories can teach observational skills (Green and Myers 2010). In the image from Mom’s Cancer (Fies 2011) we can see the patient thinking that everything is anything but ok, and the doctor paying attention to her computer – this depiction of the scene allows us to recognise that the patient feels a lack of attention, and can remind medical students that turning away from their screen fully could help relax their patient. This is especially suited as a medical teaching tool, but also as a reminder for people to look at situations in their entirety. As seen with Phoebe, the thought processes that lead to actions for those with ADHD are often not readily decoded by others, leading to them being incorrectly described as impulsive. Increased observation can assist with seeing the why of “impulsive” actions. Due to the nature of comics, it is possible to convey more richly the metaphors (Rice et al. 2020) which are often used to explain the feelings and emotions of illness for which we have limited words. Alongside this ability to give voice to the words which have been lost, comics are good for looking “under the surface” of a situation (Glazer 2015, p.17). In prose, it can be difficult to convey when conflicting words and thoughts are occurring, yet different bubbles above one person can tell two stories at once. In The Bad Doctor (2014), Williams shows Iwan’s physical situation, whilst also showing his obsessive thoughts spiralling across the pages as he discovers that the girl he likes is a Black Sabbath fan. Williams created GraphicMedicine.org as a way to bring together these graphic medical narratives and to ensure that they are taken seriously as a way 19 to enhance patient care, perceptions of medicine, enable easier discussion of difficult subjects, and to help others. As well as Williams’ academic efforts, GraphicMedicine.org works to combine these comics into one location, and to provide news, links, and critical analysis of graphic medicine. The internet has provided a unique platform for artists to share their work, publishing graphic narratives can be expensive, and online communities such as Twitter and Tumblr provide more influence and function than in publishing any other form of book (Farthing and Priego 2016). One of these online communities is @adhdartists on Twitter for those creating graphic medicine comics for ADHD. It is used for sharing artist’s work and offering advice and support. Comics are a un iquely efficient medium for the portrayal of the ADHD narrative in that they allow for a clear representation of an immediate plurality of messages and concepts. The chaos narrative that represents the life of the ADHD person which cannot be adequately represented in prose can be much more efficiently articulated through the graphic format. When examining ADHD webcomics, it is important to note that the fictional portrayal of ADHD females is less prevalent due to the educational or autobiographical nature that they tend to take. Williams (2012, p.22) describes comics as being able to “articulate experiences in an immediately engaging way”, and it is this immediate engagement which makes them suited to this analysis, as it allows for them to increase the understanding of the ADHD female in society without requiring reading long complex pages of documentation. Illness webcomics are usually short, concise aspects of life, rather than the full narrative as examined by Frank. As a result, they tend not to fit a full narrative framework. It is more suitable perhaps to look at them with a view towards Hawkins ’ (1999) categories of pathographies, or medical autobiographies. ADHD webcomics are