Anyone who doesn't really know Katie Roskova would think she was a model teenager: studious, smart and attractive, and a talented, hard-working athlete to boot-even if she is quiet and doesn't socialize much with her classmates. But who really knows Katie? She appears to be the luckiest girl in the world. The truth, as Steven Levenkron points out, is that she is desperately unhappy. Driven by her mother to achieve unrealistic goals in her junior skating career, Katie is both angry and ashamed at her inability to meet her mother's-and her own-expectations. With her father out of the picture and no close friends at school, Katie has no one to whom she can express these overwhelming feelings. Her solution, internalizing her anger and turning it against herself, has devastating consequences.

Young people like Katie are more common than you might think. There are currently an estimated 1.9 million "cutters" in America. This practice generally begins in adolescence but can continue for decades if not treated properly. Adolescence is a particularly difficult time for many, when social pressures to be "normal" can make just about anyone feel awkward and incompetent. For those without the emotional support of parents or some other adult to turn to, or whose home situations offer only further psychological and physical distress, the bad feelings can become intolerable. It's natural to turn these feelings inward, but for some kids, that can be psychologically harmful and physically dangerous. Repressing emotion can lead to a kind of numbness. As a result, many kids find that cutting themselves forces them to feel something, and reminds them that they are alive. For others, cutting presents a challenge to withstand pain-a chance to prove to themselves that they can handle just about anything. But of course, nobody should be expected to handle pain alone. Unfortunately, that's just how many adolescents feel-isolated, ashamed, and unwilling to trust anyone enough to share their anger and fear.

What do we learn from Katie's story? Perhaps she is lucky after all. Finding a therapist sensitive enough to let Katie tell her own story and yet persistent enough to keep her in therapy isn't easy. Many therapists are hesitant to take on clients who cut themselves; they find the practice abhorrent, and frequently refer these patients to mental hospitals because they are afraid of the possibility of suicide. Books like The Luckiest Girl in the World will help many adolescents and adults alike understand that cutting is actually a symptom of an often highly treatable problem, that it is more common than people think, and that by ignoring or refusing to acknowledge the problem we are not only endangering the welfare of the cutters themselves, we are also reinforcing the feelings that lead them to harm themselves in the first place.

Just looking at Katie Roskova, you’d think she had it all: she was pretty, popular, an A-student at an exclusive private school, and on her way to becoming a champion figure skater. But there was another Katie—the one she hid from the world—who was having trouble dealing with the mounting pressures of her young life. And it was this Katie who, with no other means of expression available to her, reacted to her overbearing mother, her absent father, her unforgiving schedule, and her oblivious classmates by turning her self-doubt into self-hatred. And into self-mutilation.

In his previous novel, The Best Little Girl in the World, Steven Levenkron brought insight, expertise, and sensitivity to the painful subject of anorexia nervosa. Now he applies these same talents to demystifying a condition that is just as heartbreaking, and becoming more common everyday. Through his depiction of Katie’s self-mutilating behavior—she is called "a cutter" by her peers—and her triumphant road to recovery, he offers a compelling profile of a young girl in trouble, and much-needed hope to the growing numbers who suffer from this shocking syndrome.