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Those working with adolescents and young women in mental health settings, in children's homes, in the NHS, in social services or in the voluntary sector, will find this book an invaluable and thought provoking resource. Gardner presents clinical material which explores and throws light on the internal worlds of a small group of young women seen or assessed for individual psychotherapy during her work in a counselling setting and in private practice, yet it is her own much broader and long experience of social work with very marginalized and damaged young people which forms a solid foundation to her therapeutic knowledge.
Reading Gardner's account of cutting, the particular self-destructive behaviour which provides a focus for the book, I was reminded of a young woman who presented herself immaculately made-up and smart in T-shirt and jeans; the jeans were decorated with a fine tracing of silver lines crisscrossing the denim fabric to create a series of delicately drawn spider's webs. These silver lines seemed to me to be a visual reminder of the razor cuts drawn across her arms and legs, which lay hidden beneath her mask and which she could not yet speak about directly. The careful cover-up seemed to reflect the multiple layers of meaning underlying such disturbing behaviour which Gardner elucidates so clearly.
The cutting is paradoxical; devastatingly self-destructive, it is also experienced by the young women as creative, as a release of unbearable tension, and as a means of continuing to live. It is also metaphor, expressing a conflict which cannot be communicated in any other way, and in so doing, offering ‘a route into contact with the world of words’ and hope of a new beginning. The conflict is firstly one of adolescence, for the behaviour typically occurs among adolescent girls or in young women who remain stuck in an adolescent state of mind. The developmental task of adolescence is that of individuation and separation from dependent ties to the parents. This