Liz Atkin is a visual artist, educator, and mental health advocate. Her work, which has recently been acquired by Wellcome Collection, explores the lived experience of compulsive skin-picking, a body-focused repetitive behaviour disorder. Fiona Johnstone, visual culture editor at The Polyphony, visited Atkin in her studio in south London.
This conversation took place in early January 2020. Since the COVID-19 outbreak, Atkins has stopped creating and gifting the #CompulsiveCharcoal drawings.
Fiona Johnstone: I first came across your work in an article in Metro; you’re best known for giving away free #CompulsiveCharcoal newspaper drawings to fellow commuters, to raise awareness about compulsive skin-picking (or excoriation, as it is termed in the DSM-5). Having done a little more research, I now know that this is just one aspect of your practice. Can I start by asking how you first began making work about skin-picking?
Liz Atkin: I did my first degree in drama, followed by a Masters’ degree in dance. At the beginning of the MA we were asked to do an exercise recording ourselves with a video camera. At the time my skin-picking was horrendous: under my clothes, I had wounds down my arms, down my back, and all around my hairline. When I did the exercise, I saw that I was picking at my face and body the whole time, but what occurred to me as I sped the footage up and down was that the flow and movement of my hands was actually rather beautiful; it looked like dance. I thought that there might be something in this; I spoke to my tutor and I started to research skin-picking online. I discovered forums of people sharing their experiences, and realised that I was reading my own story coming out of other people’s mouths. That was the moment I decided to do something creative with it.

Fiona Johnstone: Can you tell me a little more about making the #CompulsiveCharcoal drawings?
Liz Atkin: About six years ago, I had a nervous breakdown; that’s when the charcoal drawings started. It began as a way of looking after myself on my commute; I’d draw in a notebook or on the free newspapers to distract myself from picking. Nowadays people often ask if they can buy them, but it’s never been about that; it’s not about creating an object to sell, but about starting a conversation and initiating an encounter with people.
Fiona Johnstone: It’s about the performance and the interaction.
Liz Atkin: Definitely; I sit on a train with a line of people opposite me and two people either side of me, and it’s like invisible theatre. There’s that moment of starting to draw, and people witness it, and wonder what is going on. There are little moments of eye contact when I am able to invite people in, and then the conversations start, the interaction happens as I draw, and then they take away the finished artwork.
After a person has taken home one of my drawings, I’ll sometimes get a message saying “My friend got a drawing from you in the train, she said that you do this because you pick: I’ve picked all my life, but I didn’t know that it was a recognised condition and that there are other people who also do this.” That was how I initially felt about the condition, but now I know that it’s really common. Being part of an expanded community of people that share the same condition makes it inherently more manageable. It’s not just about breaking down the stigma of skin-picking, but about connecting with other people and finding a community.
Fiona Johnstone: It started with self-care, and it has developed into advocacy…
Liz Atkin: Yes, although it continues to be self-care as well. The picking is what my body does, and so I have to manage it by drawing, whether that is in a sketch book or on a newspaper. If I get on a train and I don’t draw – whether that is in my sketchbook or on a newspaper – I will pick. And the newspapers are the things that start the conversations, so that’s what I use deliberately now.
Fiona Johnstone: There’s something about the materiality of charcoal that seems significant here. It’s the mess, the texture, the fact that it stains your hands…
Liz Atkin: My friend gave me my first box of charcoal as a present; the joke was that all my artwork is very messy. There’s a peculiarly tactile, textural quality to my condition: it’s very much about touch, about scanning my skin with my fingertips and finding the place where I want to pick… I quickly discovered that once my fingers are covered in charcoal, I’m much less likely to be picking at my face.
Fiona Johnstone: Shall we talk about the works that Wellcome have recently acquired?
Liz Atkin: I’ve been affiliated with the Bethlem Gallery since 2013; Bethlem started dialogue with Wellcome about eighteen months ago. I was put in touch with the acquisitions team, who did a studio visit. They wanted to capture the whole story from the beginning, so they took a series of work from each part of my practice; they also took an archive dating back fifteen years, tracing the evolution of my advocacy work; digital files; and a large charcoal drawing.

Part of the acquisition is a big Pouring Mountains drawing; I create these works as performances in front of an audience. Each performance typically takes about ten to fifteen minutes, resulting in an energetic and densely textured large-scale drawing; their size usually responses to both the physical space of the wall on which I am working, and to the ‘reach’ of my own body. The process connects to the visceral physicality of the disorder, but also to notions of privacy, shame, and of not wanting to be seen.
Wellcome also took a whole early series of images made on scanners – I call them ‘anti self-portraits’. These were the first evolution of a repetitive practice; over the course of a year I would make these scanned images every day. I started making them at points in the day where the skin-picking energy was very tense; for example, at night, when I’m getting ready for bed, I’ll often want to skin-pick, as I’m tired and near a mirror; I wanted to redirect that energy. I didn’t have a good camera but I had a document scanner for my coursework; I made a series of scans of my face, picking up all the wounds and scars and marks. I would move at the same time at the scanner, so the skin distorts and stretches; they’re very abstract and kind of violent, and became a useful way of rethinking my face.
Fiona Johnstone: Do you know what Wellcome are planning to do with your work?
Liz Atkin: No, it’s all very mysterious! They are working with lots of Bethlem artists at the moment and they have acquired work from quite a few of us; perhaps there will be something coming up, but there hasn’t been a conversation about that yet.
Fiona Johnstone: I wanted to you about the term ‘outsider artist’. How do you feel about that label, and do you relate to it in any way?
Liz Atkin: I don’t term myself as an outsider artist but I suppose I am; it’s quite a useful place to be because the usual rules don’t apply. I actually prefer a lot of outsider art, because there’s feeling in it which has come through working in a way that is very real: that feeling doesn’t come through training, but through thinking and being.
Fiona Johnstone: You’ve often shown your work in spaces outside of the white cube gallery system – hospital space or the Bethlem Gallery, for example.
Liz Atkin: It makes sense to me to be visible in those kinds of places. It was a huge thing to put the work up at the Bethlem Gallery, and to make that direct connection. I remember having a conversation with Beth Elliott (the director of the Bethlem Gallery at the time), where I couldn’t bring myself to describe my work as being about skin-picking! The shame of the condition felt so enormous: it was a real tipping point in my life to be able to write it into my biography, because for a long-time I hid it. But the work only really makes sense once you know that it’s about skin-picking, or about anxiety. I would never remove that information now, it would be unthinkable.
Now I feel proud of it. There’s such a power in taking back control. I can recognise that I have this condition, but it’s not a secret anymore; I have made it a visible and valuable part of my life. I ironically now get employed because people know about this! It’s still part of me, but it’s not the same relationship any more. It now fuels something that is useful, not awful.

Fiona Johnstone: I have two big questions before we finish. First of all, what is art for?
Liz Atkin: I know it sounds big, but I think that art has saved my brain and saved my life. I don’t often find it easy to say some things in words; sometimes the language for what I need to say just doesn’t exist. But if I can make a mark on a piece of paper, or capture something on a camera, I can access an immediacy that is not available in language. This is what art does all the time: it is present when I see a small child pressing paint into a bit of Play-Doh and making a big mess, and equally when I am trying to think about that is something really challenging. Art is a human interaction, an emotional response to something; it’s about a landscape that doesn’t necessarily have a language; it’s unique to the person that is doing it, and read uniquely by whoever sees it. I think that art is vital – it’s just a huge part of being a human, right?
Fiona Johnstone: That brings me to my final question. What does the term ‘medical humanities’ mean to you (if anything)?
Liz Atkin: I think it comes back to learning about patient experience through creative mediums, and valuing what that dialogue can open up. It’s about looking for a richer, rounder type of knowledge, and of finding another kind of language that will facilitate the sharing of different knowledges and experiences. If you’re a clinician treating a person with a condition that is particularly difficult to grapple with, then there are multiple ways of understanding the lived experience of that condition. For me, the tension of skin picking has a very particular jittery energy to it; if you are just talking to me, you don’t hear those nuances, but they might be something that I can communicate in another medium.
Fiona Johnstone: So for you, the intersections between art and visual culture and medical humanities include creative self-expression; therapy; communication; advocacy; and also research.
Liz Atkin: Yes! But are the two fields intersecting enough? How can we make those connections happen?
Fiona Johnstone: I think we need to develop a more effective shared language to make those connections happen!
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A number of works by Liz Atkin are on display in the exhibition Constraint Restraint at the National Justice Museum in Nottingham, from 15 February to 31 May 2020.