Katie is a promising figure skater whose divorced mother drives her relentlessly to perfect her skills, at almost any expense. What her mother and coach don't know, but her English teacher begins to figure out, is that when Katie gets to an emotional edge, she hides and cuts herself; the pain and blood help focus her mind. Not until she goes over that edge one day at school and begins slamming her locker door on her hand and then banging her head on the wall does she begin to get the professional help she needs.

After a couple of false starts, she finds a psychiatrist experienced in working with teens in trouble who enables her to tell truths she hasn't for years been able to admit to herself or speak of to anyone else. Her mother resists other adults' help and almost succeeds in getting her out of therapy, especially group therapy with girls her mother labels "delinquents." But Katie finally manages to make some choices against her mother's wishes--an immense step out of the depths of years of co-dependence.

As the story ends, she has come to realize the girls in the group are capable of being real friends--something she hasn't had for a long while--and she is capable of making choices toward her own healing, the first of which is to seek and accept real help and to distinguish it from pleasing adults who are using her to assuage their own pain.


Like his novel about anorexia, The Best Little Girl in the World (see this database), this one takes on a very delicate and difficult topic and treats it with skill, clarity, and complexity. Self-mutilation is not yet as widely or publicly discussed as anorexia, and for that reason this novel could be an important help for groups where young people are dealing with this particular problem.

It might be heavy going for personal reading, but the honesty with which it acknowledges a frightening condition and the confidence with which the psychiatrist character assures Katie (and therefore readers) that healing and real mental health are possible to retrieve more than offset the jarring effects of the first chapters where Katie's practice is described in disturbing detail. Certainly people who work with teens could benefit from reading it, and teens themselves, where there's an opportunity to talk about it along the way.


Steven Levenkron is a psychotherapist who has written about treatment of anorexia nervosa and obsessive-compulsive disorders.



Place Published

New York



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