As in his previous work of fiction, The Best Little Girl In The World, Levenkron explains a disorder away with family problems, in this case a father who left and a mother who physically abused her child in order to "encourage" her. This girl is conveniently surrounded by people who care about her, in particular "Sandy Sherman", the ever-so-wonderful psychologist (featured previously in The Best Little Girl...) who jots down notes about her progress, letting the reader know how well our Katie is coming along. It simplifies a complex disorder into "family problems and too much pressure make little girls want to cut themselves". Levenkron, in the guise of Sandy Sherman, explains that Katie has a personality disorder which triggers her moments of "spacing out", something which is *not* common to self-injurers and should not be used to explain it. A final word of warning to anyone who hurts themselves, or has recently stopped - this book is *extremely* triggering, and should be avoided.