Cartoonist Raina Telgemeier illustrates what anxiety feels like in 'Guts'

Raina Telgemeier is an author and illustrator based in San Francisco, California. She’s a “YA rock star”, beloved by millions of readers of all ages — but especially tweens who feel seen and supported by her work. Her most recent graphic novel, Guts, is a New York Times bestseller and explores how her own anxiety manifested in the fourth grade — as a fear of vomit, or “emetophobia.”

The story of Guts is obviously very personal. How did you come to decide that it was time to share this story?

It’s a true story I’ve been telling for many years. When friends get to know me well, they hear about my guts! At this point in my career, my longtime readers knew me pretty well, too, so it felt like the right time to share.

What do you think it is about comics that allows you to tell this story in a way that truly resonates with readers?

The medium of comics allows the storyteller to play with words and images, as well as wordless images. For a story about something taboo (anxiety and IBS), it was important to be able to show how things feel, how heavy thoughts are, even when the character isn’t able to properly describe or express them. It took many years for me to learn to talk openly about anxiety. Creating *Guts* was part of that journey.

In Guts young Raina is, at first, afraid to tell her friends that she is going to therapy. Do you have any advice for people, of all ages, who might want to go to therapy but are intimidated by the attached stigma?

I love therapy; I’m a huge fan! I think wanting to go is an extremely positive first step. Therapy is about working on your own self, so what other people think is very secondary to how much you might get out of the experience. Go for you.

Young Raina also shares with her classmates her strategies for coping with fear, including deep breathing and concentrating on her feet. Do you have any other strategies you use that help during moments of stress?

Breathing and focusing on my feet are two that I use routinely! I also use body scanning and a few techniques I’ve learned in cognitive behavioral therapy and EMDR (eye movement desensitization and reprocessing). I’m not a trained psychologist, so I don’t want to be too specific in my recommendations, but these things are fairly easy to look up, and a lot of therapists specialize in helping patients cope with anxiety and stress.

I was very struck by the imagery that accompanies how young Raina experiences her fears — standing on spiderweb, falling through the floor. How do these images come to you? When you experience stress and anxiety, do you process those emotions in your mind’s eye?

My own experiences are less visual and more physical. My body reacts viscerally: shaking, heart pounding, cold limbs, stomach in knots. I tend to worry out loud and become obsessive. I don’t have a great vocabulary for talking about it, but comics allow for visual metaphors to push these ideas forth. Using scale, color, pattern, lines, panels, and facial expressions to describe fear felt accurate to me, in a way that lets the reader imagine how these feelings might register in their own bodies.

The character of Raina asks herself, “Can you be healthy even if you hurt?” How would you answer that?

Most of my life, I’ve been healthy “on paper.” Tests show nothing, my blood work is great, I don’t get sick very often. But … I frequently feel unwell! Stomachaches, headaches, sore muscles, fatigue. It’s unclear whether there is a psychological basis for any of it, or if my body is dealing with some underlying issue like an autoimmune disorder. I feel very fortunate that nothing is “wrong,” and yet, a lack of answers can be frustrating!

Are you interested in tackling any other mental health topics in upcoming books?

All of my stories deal with feelings and emotions, both in interpersonal relationships as well as feelings within one’s own self. I’ve been interested in psychology for most of my life — I find people and their minds endlessly fascinating! I’m not yet sure what my next works will hold as far as discussing mental health, but whether it’s overt or covert, it will always be there.