“Cutters don’t have words for [their feelings]. Cutting is their language. Cutting is like a diary in blood on their skin,” explains Steven Levenkron about the self-mutilating behavior that involves cutting open one’s own skin. Levenkron’s 1997 novel, The Luckiest Girl in the World, examines the situation of one teen “cutter,” Katie Roskova, whose story, although fictional, reads much like a psychological case study. Bright, talented, and attractive, Katie appears to be ‘the luckiest girl in the word,’ but she endures unrelenting pressures in her life, and has no trusted confidant with whom to share her feelings. Internalizing her overwhelming anxiety and anger, she cuts herself when her emotions become too intense. No one in Katie’s life knows her secret until her psychological pain becomes so unbearable she harms herself at school, for all to see. Katie, age 15, lives in New Rochelle, New York with her divorced mother, Katherine, who harbors a good deal of unresolved anger which she directs at her daughter. A promising figure skater, Katie follows a strenuous practice schedule as she trains for her junior competition. Each morning she wakes at 5:00, travels to Connecticut for skating practice, goes back to New Rochelle for school, then returns to the ice for more practice. Katie excels academically as well, and has a full scholarship at her private school, yet this is an additional source of stress as she’ll lose the funding if her grades slip. The wellspring of pressure in Katie’s life, however, is her ambitious, overbearing, even verbally abusive mother. She expects nothing short of excellence in everything from Katie. Cue the opening scene of the novel: Katie is at skating practice and fumbles a jump. Her mother explodes in fury, although her coach, Ron, responds with kindness and encouragement. It is times like this that Katie’s feelings of fear and anxiety overpower her, and she starts to “space out” trying to repress them. Then she retreats to a private spot with a pair of scissors, and sedulously cuts at her arms until the pain and the sight of blood anchor her in reality once again. Afterwards, she regains enough composure to force a smile, and return to the task at hand with the pleasing personality she requires of herself. Katie has been self-mutilating since she was 13. Her arms are covered in scars, but a wardrobe of long-sleeved shirts conceals them from everyone. Her coach and her English teacher, Jenny Moran, worry that something is amiss. Katie’s mother, however, ignores any troubling signs, while inflicting more distress on Katie by constantly accusing her daughter of falling short. Because her time is consumed by practices, competitions, and otherwise studying to maintain good grades, Katie’s social life has suffered. She has no close friends to turn to when fears of failure swamp her. The strain on her mental health reaches a snapping point, and one day at school she begins slamming her hand in a locker door and hitting her head on the wall. Not pleased with the prospect of having a psychologically unsound student at his exclusive academy, the school’s headmaster considers expelling Katie. Jenny Moran and the school nurse convince him they should provide assistance instead, and they connect Katie with a psychiatrist, Dr. Sandy Sherman. Initially, Katie stubbornly refuses to cooperate with Sandy’s attempts to help her. Having strived to please her mother most of her life, Katie is loath to go against her wishes. And her mother Katherine vehemently objects to her daughter receiving therapy, saying that “shrinks” are for “crazy” people. Over time, Katie’s resistance weakens as she finds comfort talking with someone who sincerely cares about her welfare. When Sandy invites Katie’s divorced parents to attend a family session, and they end up shouting insults at one another, it’s clear that the family dynamics of blame and shame have contributed to Katie’s condition. The most therapeutic sessions for Katie turn out to be those she shares with other troubled teens. Group therapy brings her together with five girls who suffer from a variety of psychological disturbances. Her mother calls them “delinquents,” and Katie herself balks at being classed with such a crowd, but she soon discovers that the girls can relate to one another’s experiences with uncommon understanding. Eventually, she develops close friendships in the group. Katie’s mother continues to rail against the therapy, and against Katie’s shortcomings in general. After a drunken joy ride with a fellow student lands Katie in police custody, her mother verbally attacks her. More outrage from her mother follows when Ron decides to stop coaching Katie. Katherine recklessly concludes Katie should drop out of school to work with a new coach in Connecticut. The pressure of Katherine’s punishing demands and criticisms finally compels Katie to cut herself in full view of her mother. At last, Katherine acknowledges her daughter needs help. With Sandy’s ongoing care, Katie learns how to make decisions that are in her own best interests, even if they conflict with her mother’s ambitions. The novel ends with hope that Katie will recover and begin to thrive. It’s estimated that 1.9 million Americans practice “cutting.” They often begin the self-destructive behavior during their teen years, but without proper intervention, cutters may continue to harm themselves for decades. Like Katie, many teens feel isolated, fearful and ashamed, and they find relief from their internal pain by externalizing it on their flesh. Levenkron, who is a practicing psychiatrist himself, says, “because these people don’t have a language with which to express themselves it’s important to help them put these feelings into words.” Indeed, that’s just what he’s done with this novel, which was named a 1998 ALA Best Book for Young Adults.

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