Crazy is as Crazy Does: David Small's “Stitches" and the Unspeakability of Mental Health

* I recommend this book for readers 14+.

In David Small’s illustrated memoir Stitches , a mentally ill mother and a complicit father leave Small figuratively and, soon enough, literally, voiceless. This is a haunting portrait of the silence of trauma and the unspeakability of mental illness.

Both the illustrations and the tempo of Small’s storytelling are second to none, and together, they create a storm of movement and restless hurt. It is little surprise that the book was nominated for the National Book Award in 2009—though the category in which it was nominated was more than a little controversial.

Small is so good at making you understand his family’s story from the perspective of a confused child that you can’t help feeling raw and perplexed. In fact, just writing this post, weeks after I finished the book, I feel a terrible tightness in my chest.

A Mother’s Actions

Patriarchy, stigma, and most of all, the healthcare system, leave many women little recourse to get the psychological and psychiatric help they need.

But deconstructing a mother’s malfunctioning brain is beyond the scope of childhood, and from a child’s perspective, crazy is as crazy does. A cruel mother’s actions have no explanatory framework or excuse. They are what they are: confounding.

Small’s mother’s actions are not the kind of cruel that calls in social services, or any kind of rescue at all, but the kind that gaslights a child for years to eventually steal their voice. This kind of voicelessness is a familiar experience among survivors of trauma, but Small’s experience goes once step further when his vocal cords are ruined by a troubling throat surgery. From then on, the abuse he suffers is quite literally unspeakable.

It is only as an adult that Small briefly explores the possibility that his mother was a victim of society (in a very specific way - I won’t spoil it here). That is a sad window for the reader because it feels hopeful yet blocked, too painful for this hurt man to really explore. Who can blame him.

Illustration became a refuge for David Small in his unhappy home.

Stitches Sparks a Familiar Debate

When it comes to children’s literature, there is never a consensus about what is and isn’t appropriate, and tired debates flare up among PTAs, libraries, and of course, morality police.

Still, many, if not most of the books marketed to teens today explore issues such as sex, domestic violence, abuse, addiction, and a whole thorny gamut of controversial topics. These books, however, are fiction, and Small’s autobiographical truth-iness made this book more problematic for adult critics. (Teens, meanwhile, apparently resonate with the book—a crossover appeal that pleases Small.)

Sean Connors, a professor of English Education at the University of Arkansas, specializes in graphic narratives and Young Adult literature (his blog is really fantastic). He has an interesting essay about the controversies that ensued when Stitches was nominated for the National Book Award in the Young People’s Literature.

The other controversy:

An entirely other group of critics also questioned the National Book Award nomination. Graphic novelists felt Small’s work had been dismissed as child’s play and that it should have been included in the autobiography or adult-non-fiction categories. This is an ongoing grievance among illustrators in the literary world. You often hear advocates for illustrated storytelling say:

“The graphic novel is not a genre. The graphic novel is a medium.”

Reading Stitches, you will find it impossible to argue with that sentiment. This memoir, through all its layers of unspeakability, says more in its pages than some of the longest texts.