A young man sits in a kitchen with a blue felt-tip pen. He can see his reflection in a chrome toaster: tousled black hair, Oxford shirt. He sketches out a grotesque figure, a human body with a contortion of tentacles where the neck should be, then a giant cauliflower-like red growth in place of a head. “It takes me a while,” he says, “but at some point I realise I’m drawing a self-portrait.”

This is the opening scene of Final Cut, Charles Burns’s first new English-language graphic novel in a decade (it brings together three serialised comics previously published in French). A body-horror toaster self-portrait is quintessentially Burnsian, his work being inked in the blurred space between humdrum American adolescent life and a monstrous, otherworldly unconscious. But it’s also about a real thing that happened to Burns, half a century earlier. “I was in this kitchen,” he says. “It was 1974 and I was very high, at a party, drawing my self-portrait in a toaster. Actually, I think I’ve got a copy. Let me grab it real quick.”

Burns, now in his late 60s, heads off, giving me time to nosy around the studio of probably the most celebrated graphic novelist of his generation. He built his name in the alternative comics scene of the 1980s, where he buddied around with a young Matt Groening, drew for Art Spiegelman’s revered Raw magazine, and created the artwork for early Sub Pop mixtapes – including one that featured the first ever recording by Nirvana (Kurt Cobain was reportedly a fan).

Throughout the 1990s, Burns published a series of comics about a group of teens who circulate a sexually transmitted disease that turns them into monsters. Collected in graphic novel format in 2005, Black Hole became a watershed moment in comics for adults. It was taught on university literature courses and made Burns a cult hero, cited as an influence by everyone from the Knife to Kristen Stewart.

We meet at his home in the Northern Liberties neighbourhood of Philadelphia, a once run-down and crime-ridden industrial area that has become a beacon for artists and hipsters. “When we moved there 30 years ago, it was all we could afford. But because there was affordable studio space, other artists eventually moved in,” he says. His home, like his work, is ordered, visually arresting – and filled with monsters. The living room is covered in eerie papier-mache masks while its bookshelves heave with rare independent and horror comics. On the top shelves sit hundreds of charming grotesque figurines, with saurian tongues and tumescent scales on their every surface.

Burns, tall and softly spoken, returns to the room holding a copy of that 1974 pencil drawing. It’s rougher and more playful but the connection between that moment and Burns’s new work is obvious. Rediscovering it shook him out of the writer’s block that set in after his last big work a decade earlier, the X’ed Out trilogy. “I had three false starts. Each time I got into a project I started thinking, ‘This is shit, I hate doing this.’ I reached a point where I thought, ‘I don’t know if I can do comics any more.’”

As a final attempt to break the block, he made a seven-page comic about that party. “Suddenly it opened up,” he says, and half-joking continues: “I just started thinking, ‘What if this beautiful girl came in and realised what a magnificent human being I was?’ I liked the idea of revealing myself through my artwork. I had this awkward, stumbling personality, but I was able to express something on paper. Someone’s going to see that and understand, ‘Oh, there’s this depth.’ Then you go off and discover things.”

It all resulted in the story of a young comic artist, Brian, who struggles with depression and lives with his alcoholic mother. Brian makes Super 8 monster films with his best friend, Jimmy – smearing lipstick on their friends’ faces to simulate blood. Subject to mood swings and a short temper, Brian becomes enraptured by a beautiful girl called Laurie, and they set off for the woods to shoot an 8mm horror flick inspired by Invasion of the Body Snatchers.

Brian’s lurid fantasies, combined with Burns’s playfulness and the camera trickery of the moviemaking teens, means the book is constantly putting Vaseline on the lens of reality. When Laurie asks Brian what the film is going to be about, he screams: “It’s about all the fucked-up shit going on in my head.”

As in most of Burns’s work, the protagonist is an obvious avatar for himself. He even interchanges “Brian” and “I” during our interview, and says: “There’s a part of me in every single character.” In the story, which focuses on a group of attractive young people in the US in the 1970s, it’s never quite clear what is fiction, memory or imagination.

Burns knows he’s on familiar territory here. “One of the problems was that I was thinking, ‘I’ve got to do something different. I can’t do young adults again. I’ve got to have this middle-aged guy as a character.’ But I thought, ‘Fuck, I hate him. I don’t want to hang out with him. I want to think about passion and intense emotions instead of everything dampened down.’ So I said, ‘Fuck it. I’m just going to do what I enjoy doing.’”

It’s good that he did. Final Cut is among Burns’s best work, its huge full-page drawings pushing your buttons in the moonlit American outdoors. Still, even though the characters are young, they’re layered and uncomfortable – particularly in their responses to Brian’s depression – another element of Burns’s own life he wanted to include. “I went through real depression. It was three, four, five years of struggling. So I wrote that in.”

Burns became obsessed with monsters at a young age. His father had “every kind of hobby”, which meant the house was always full of art tools and Indian ink. Burns would try to recreate comics he found around the house but his awakening came in early 1969 when a kid at school introduced him to Zap Comix, helmed by the godfather of underground comix Robert Crumb. “Suddenly, here’s this thing with intense drawings! I wasn’t interested in Captain America and Iron Man – but I would imitate these psychedelic comics.”

Burns disappears again and comes back with some of his early examples. They have a beautiful, frantic quality – a kind of professionalised bedlam – with all the hallmarks of his current work, from weird monsters to attractive adolescents. The cartoonist Lynda Barry once wrote of his style and the standard he reaches: “You can’t believe a person could do it with regular human hands. It’s the kind of drawing that would have scared the pants off you in grade school, not only because the images are so eerie but because they are too perfectly done, and not good or evil enough for you to tell what you are supposed to think about them.”

That eerie perfectionism is right there in his earliest work. It’s this style that excited Spiegelman, who agreed to publish Burns in Raw in the 1980s. It’s why the cult literary magazine The Believer, founded by Dave Eggers in 1998, used Burns for every cover until 2014. It was also a style that brought Burns together with his wife, the artist Susan Moore, whom he married in 1982, and who died two years ago.

“She was a painter,” he says. “So we would always be looking over each other’s shoulders. Very early on, when I had just moved in with her, I was struggling to letter a comic. I was trying as hard as I could to do really tight, good-looking lettering but my hand felt like a claw. She walked in and said, ‘Oh, that doesn’t look very good.’ So I said, ‘Oh, yeah? Let’s see you try! I’m going to set you up at the desk.’ And she did this perfect, perfect lettering. She got the job. She was a painter, so I stretched her canvases and that sort of thing and she did all the lettering for me.” Final Cut is his first book to use computer-generated lettering, although in a font based on Moore’s style.

With such a prolific career in comics, you might expect Burns would be adapted for film, like his fellow graphic novelists Daniel Clowes and Alan Moore. He made one animation short in 2007, for a French horror anthology called Fear(s) of the Dark. And he says Hollywood has come knocking many times, but nothing ever seems to lead anywhere.

“There was an option for Black Hole,” he says. “I signed on the dotted line 15 years ago and got paid very well. But I don’t know how Hollywood works and it’s not something I’m pursuing. If it happens, I don’t want to be a consultant. I don’t want to be involved. Because with comics, you have pure control over everything. If you fuck up, it’s you. I like that kind of control.”

Burns has certainly had a life of unlimited creativity: working constantly, publishing rarely and compromising not a jot. “I know there’s folks that are thinking about what’s going to sell. If I was smart, I would do Black Hole 2, Black Hole 3. That is what people buy. That is what people want. For me, that would be a dead end. The minute I’m done with a book, it’s in a distant space.”