BOOK REVIEW

Cutting it Out. A Journey through Psychotherapy and Self Harm

by Carolyn Smith (London & Philadelphia: Jessica Kingsley, 2006). 128 pp. £12.99 (paperback). ISBN 1-84310-266-8.

I was drawn to this book’s title because of the suggestion that it would be tracking treatment over time. I assumed that it was a academic book written by a psychotherapist and was surprised when I found that it is a semi-autobiographical novel written by a patient who has self-harmed.

The protagonist is a young woman who shares a flat with a girlfriend. She is attending therapy three times a week in North London. The story picks up the therapy after a year when the relationship with the therapist is vital to, and consuming of, the patient and her cutting is intertwined with the relationship. It vividly describes about a month of therapy. In this story it is the patient who speaks and who gives (fictional) verbatim extracts of sessions with her thoughts, feelings and reactions to the therapist and what has taken place between them.

As the reader I oscillated between being identified with the young woman and with her therapist. Equally I took a while to settle into this unsettling book, and repeatedly, just as I felt settled something would happen to unsettle me again. Both the powerful identification and the unsettled feelings are, I think, how it can feel being alongside someone who is desperately trying to express themselves but who is only just beginning to know there is someone who is listening to them and is thinking about them. The story makes explicit how the sharing and understanding of pain has a power to engage and hold the therapist and how when a turning point is reached it seems the patient elicits a response from the therapist that is made use of.

The story gives an excellent fictional account of how the words of the therapist are rearranged in the patient’s mind. It makes clear that a therapist has little option but to bide time, hope, and continue to offer understandings while know