The End of Psychtember 2012 and Giveaway Winners!

All good things must come to an end, and so it must be as well with Psychtember. The event is now officially over — I hope you enjoyed the reviews, guest posts, and interviews, and learned something new about psychology along the way! Please keep on adding to this Goodreads list as you discover recent YA books relating to mental health and clinical psychology. I'd love to see it become a comprehensive resource for people looking for YA books about these types of issues!

The winner of the Something Like Normal giveaway is...

...Erin D.!

The winners of the Jennifer Brown giveaway are...

...Lydia and Lissette!

The winner of the Streamline e-book giveaway is...

...Victoria!

Congrats to all of you, and a huge thanks to all of my guest bloggers, the authors who participated, and everyone who visited and commented during Psychtember! 

Psychtember Character Interview with Jason (Freaks Like Us)

I'm excited to have Jason, from Susan Vaught's Freaks Like Us, join us today for a chat!

"When Jason Milwaukee's best friend Sunshine vanishes, Jason knows that something is terribly wrong, but solving her disappearance will require pushing through all the voices in his head and then getting the world to listen to him. His schizophrenia is stopping him from remembering the events leading up to her disappearance, and often he discounts his own memories, and his own impressions. But his deep knowledge that he would never hurt his friend, plus the faith of his parents and a few others in the town bring him to the point of solving the mystery. In the end, it's Sunshine's own love for Jason (Freak) that persuades him of his own strength and goodness. By turns brilliantly witty and searingly honest, Susan Vaught's newest novel is a laugh-out-loud, tear-jerking, coming-of-age story." (from Goodreads)

1.) Thanks for dropping by the blog, Jason! If you could describe yourself in five words, what would they be?

Freak, freak, freak, freak, freak . . .

I know my parents hate that, and Sunshine sort of hates it, but that's what I am. Might as well face it. A long time ago, I figured out that people would call me names, so I beat them to it, and the names don't bother me. My dad thinks I have "poor self esteem" (whatever that means), and my mom thinks I'm being sarcastic or mean to myself. Sunshine thinks I'm not respecting all the good things inside me. I think I'm protecting myself, you know, like using armour, only my armour is made out of a word: FREAK.

2.) Friendship obviously means a lot to you. What do you think is the most important quality to have in a friend?

Loyalty. You have to be there for each other, because everybody else flakes when it's convenient or it gets to be too much for them--and it always gets to be too much for them. Most  people don't have the guts to live lives with problems like we have, or even help us live ours. You should look out for each other, keep each other's secrets, and never ever ever break your promises.

3.) You've had your share of experience with bullies. What's your number one piece of advice about how to deal with them?

Stay away from them and protect yourself. If there are older people in your life who won't flake, tell them and get help. You have to be smart about it, because there's always a time when no one's there to protect you. Bullies are seriously bad news, and each one is just the same as the last one, but also different. I try to figure out what they want, what makes them tick, and most importantly, where they'll be and when, and I make sure I'm somewhere else. People like that are a virus. I don't want them to make me sick.

4.) What is your greatest fear?

Losing Sunshine forever, that's my greatest fear. My second greatest fear is getting lost in my voices and the crazy stuff I see, and not being able to come back. I guess the first fear would happen if the second one did, and vice-versa. They're tied together for me, because Sunshine is just that important.

5.) Where do you see yourself in five years' time?

I hope I'm finished with college and either going on to a higher degree, or working. I'd do okay with a job, if I didn't have to talk to a lot of people. Maybe I'll work on computers, or plumbing. Computer wires and pipes don't have much to say.

6.) If you could have one day where you could go anywhere and do anything in the world, where would you go and what would you do?

I'd take Sunshine to a tropical island where nobody else lived, and there were no bugs and no sharks--but a lot of good food, maybe left by a bunch of rich people on a yacht. We'd eat and swim and talk and rest in the sand, and we wouldn't worry about anything. Everything would be safe and warm and bright, and everything would be okay.


Jason, thanks so much for stopping by and answering all my questions! (And Susan, thanks to you too! :D)

Susan Vaught is the author of numerous YA novels, including My Big Fat Manifesto, Trigger, Exposed, and Going Underground. You can find her online at her website here.

Psychtember Interview with Jackie Morse Kessler

I'm pleased to have Jackie Morse Kessler on the blog for a Psychtember interview! Jackie is the author of the Riders of the Apocalypse series, which includes Hunger, Rage, and Loss as well as the upcoming Breath.

First, a bit about Jackie and the latest in the series, Loss:

"Jackie Morse Kessler grew up in Brooklyn, NY, with a cranky cat and overflowing shelves filled with dolls and books. Now she’s in Upstate NY with another cranky cat, a loving husband, two sons, and overflowing shelves filled with dragons and books (except when her sons steal her dragons). She has a bachelor’s degree in English and American Literature, and yet she’s never read any Jane Austen (with or without zombies). She also has a master’s degree in media ecology. (The living study of technology and culture. Which is cool, but she still can’t figure out how to use Tweetdeck.)  Jackie spends a lot of time writing, reading, and getting distracted by bright and shiny new ideas. (She just came up with a new idea right now.) She has a weakness for chocolate and a tendency to let her cat take over her office chair." (from her website)

"Fifteen-year-old Billy Ballard is the kid that everyone picks on, from the school bullies to the teachers. But things change drastically when Death tells Billy he must stand in as Pestilence, the White Rider of the Apocalypse. Now armed with a Bow that allows him to strike with disease from a distance, Billy lashes out at his tormentors...and accidentally causes an outbreak of meningitis. Horrified by his actions, Billy begs Death to take back the Bow. For that to happen, says Death, Billy must track down the real White Rider—who is lost in his memories.

In his search, Billy travels through White Rider’s life: from ancient Phrygia, where the man called King Mita agrees to wear the White Rider’s Crown, to Sherwood Forest, where Pestilence figures out how to cheat Death; from the docks of Alexandria, where cartons of infested grain are being packed onto a ship that will carry the plague, to the Children’s Crusade in France—all the way to what may be the end of the world. When Billy finally finds the White Rider, the teen convinces the man to return to the real world.

But now the insane White Rider plans to unleash something awful on humanity—something that could make the Black Death look like a summer cold. Billy has a choice: he can live his life and pretend he doesn’t know what’s coming, or he can challenge the White Rider for his Crown. Does one bullied teenager have the strength to stand his ground—and the courage to save the world?" (from Goodreads)

And now for the questions...

1.) The protagonists in both Rage and Loss deal with bullying. In what ways would you say Missy's and Billy's experiences are similar, and in what ways do they differ? How did this affect how you approached writing scenes involving the bullying they face?

JK: Both Billy and Missy are victims of horrible bullying. Billy is physically assaulted, again and again, in big ways and in small ways, by people he fears and by people he loves. Missy and Billy are both verbally assaulted and called terrible names, in public in front of their peers. Missy's humiliation is large scale and goes viral; Billy's is more localized and, at times, private. But even though there are differences in how they are bullied, they both suffer greatly.

While I approached LOSS as a story about a very bullied boy -- physically, verbally, emotionally -- I didn't see RAGE as a book about a very bullied girl, even though she is. She copes with her bulling, and all the pressure she's under, by cutting herself; Billy doesn't know how to cope with his bullying. She has reached her breaking point (which is why Death offers her a job); Billy hasn't yet.

In terms of the writing, the bullying in RAGE came across in an organic way - Missy walking in the hallways at school and insulted; Missy at the party; Missy interacting with her soccer teammates; Missy back in school after the party and dealing with more insults and direct attacks, to say nothing of the cyberbullying. With LOSS, the initial scene was planned -- the book begins with Billy getting the snot pounded out of him, again. And from there, events unfold as we see his home life and his terror of going to school, and what happens in school at the gym and in the classroom and in the cafeteria. The bullying is more at the forefront in LOSS because that's everything to Billy; Missy doesn't see herself as bullied -- it's just how things are. It's a very bleak outlook.

2.) It's pointed out a couple times in Loss that sometimes asking a teacher for help with bullying doesn't do any good. What advice can you give to a teen getting bullied who suspects telling their teacher won't improve the situation?

JK: Keep talking - if not to that teacher, to someone else. Your guidance councilor. Your parents. Other teachers. Your friends. Talk. You matter, and your words deserve to be heard. If you still can't find someone willing to listen, call a crisis group or help group like To Write Love On Her Arms, which can help put you in touch with people who can help.

3.) The concept of memory is threaded throughout Loss, and is especially relevant to the characters of Billy's grandfather and King Mita. If King Mita and Billy's grandfather could switch lives for a day, what do you think each of them would learn?

JK: I can't answer that. Billy's grandfather is suffering from Alzheimer's and Mita by the time Billy meets him is insane. If they were both in their right minds, they would see and identify with how much each man loves his family. But neither of them is fully capable of doing that when LOSS takes place.

4.) In Rage, Missy does not have a strong support system at home. How important a buffer do you feel support from family and friends is in preventing emotional distress from developing into something clinical? Do you think if Missy's home situation had been more positive, this might have affected whether or not she began cutting?

JK: It's crucial that people have a support system -- friends, or family, or teachers, or others. We all need someone to talk to. The act of talking can be its own sort of balm. I can't speak to whether a support system would prevent distress from developing into something clinical, but I know from personal experience that Interaction -- knowing that we're being heard and not dismissed -- can help us heal. It's certainly helped me. (I'm a former bulimic and I also used to be on antidepressants.)

5.) Which of your YA books has challenged you the most as a writer?

JK: They each got harder and harder to write. In many ways, HUNGER was the easiest because it had been brewing for 10 years before I wrote it, and I had personal experience with an eating disorder. I think that BREATH (which comes out in April 2013) was the most challenging to write, not only because of the subject matter (writing about depression and suicidal thinking when you're feeling horribly melancholy and possibly depressed is **not** fun) but because of the structure of the book.

6.) Death is one of the most interesting characters in this series, and undoubtedly many readers' favourite  (he's my favourite, anyway!). Can you give us a teaser from the final book, Breath, in which Death finally gets to be the center of attention?

JK: Thanks - he's my favorite too. :) For BREATH, well, how's this? "In the fourth and final volume of the Riders of Apocalypse series, high school senior Xander Atwood has a secret. Death, the Pale Rider, has lost his way. What happens when the two meet will change the fate of the world."

And here's the full back cover copy:

Contrary to popular belief, the Four Horsemen of the Apocalypse aren't just harbingers of doom -- they actually keep life in balance. But what happens when their leader and creator, Death, becomes suicidal? Before the first living thing drew its first gasping breath, he was there. He has watched humanity for millennia. And he has finally decided that humanity is not worth the price he has paid time and again. When Death himself gives up on life, a teenager named Xander Atwood is the world's only hope. But Xander bears a secret, one that may bring about the end of everything. This heart-pounding final installment of the Riders of the Apocalypse series looks at the value of life, the strength of love, and how a small voice can change everything . . . forever.

Thanks very much, Jackie, for stopping by and answering all my questions!

Crazy: A Psychtember Review

Patient: Crazy by Amy Reed

Presentation (from Goodreads):   "He’s falling in love—and she’s falling over the edge of sanity. From the author of Beautiful and Clean, a heartwrenching exploration of a romance marred by mental illness.Connor knows that Izzy will never fall in love with him the way he’s fallen for her. But somehow he’s been let into her crazy, exhilarating world and become her closest confidante. But the closer they get, the more Connor realizes that Izzy’s highs are too high and her lows are too low. And the frenetic energy that makes her shine is starting to push her into a much darker place.

     As Izzy’s behavior gets increasingly erratic and self-destructive, Connor gets increasingly desperate to stop her from plummeting. He knows he can’t save her from her pain...but what if no one else can?"

 

Assessment:

Axis 1. Characters

I didn't particularly like either Connor or Isabel, especially for the first half. Isabel was very annoying in some ways — she's quite self-centered and melodramatic. I suspect that these are aspects of her personality regardless, but that her bipolar disorder intensifies them. She's also creative, and there appears to be some connection between creativity and manic episodes. I thought the difference between "normal" creativity and manic-inspired creativity was actually illustrated quite well here in comparing Connor and Isabel. Connor can be poetic and a bit dramatic when he wants to be, but he doesn't succumb to it the way Isabel does. She throws herself into these fantasies and her imagination just goes wild with it. Still, it's tough to know how much of Isabel's character is just pure Isabel and how much is an effect of the bipolar, especially as she is struggling with the disorder for so much of the book.

Ultimately, Isabel is both self-destructive and destructive of her relationships with others. This is probably mostly due to her disorder, but she actually says at one point that she can blame it on the bipolar, but it's partly herself as well. Indeed, there's at least one cognitive hurdle Isabel needs to get over — that of feeling not good enough for everyone's love and attention, and thinking that she needs to be punished. We don't really see how this attitude has developed, although we're given some indicators in her home life. Her family has ignored her and focused instead on her drug-using brother, and so Isabel has looked for attention in the wrong places (like with Trevor).

I was surprised Connor puts up with Isabel's behaviour for so long, that he keeps trying to help her and be her friend. I didn't really see what he sees in Isabel; maybe back in camp when they first met she acted differently because the bipolar disorder hadn't been triggered yet? Obviously he's not perfect, though, and he does get mad at her quite a bit — not that I blame him, because she says some really out-of-line stuff. It's like she feels she has the right to take things out on anybody.

Also, I didn't find Connor that authentic as a teen guy. He's unusually thoughtful and sensitive (which is pointed out a few times), and while I got used to his voice I never ended up liking him much.

Axis 2. Premise/plot

I wasn't that into it for the first half, but then later as Isabel's bipolar started to worsen, things got more emotionally intense and I became more interested. Crazy is a fantastic portrayal of someone's downward spiral into serious bipolar disorder. Isabel begins oscillating, first just a little, and then more and more as her highs and lows start getting really high and really low.

After the climactic scene there's a fair bit of denouement where not that much actually happens, but it was neat that the author offers a glimpse of the beginning of recovery for her, and we see her start to gain a perspective of "normality".

Axis 3. Writing Style

The writing was quite good, especially once things got going. Isabel's sections come off as overly dramatic, yes, but that's because Isabel is overly dramatic, so the writing is merely reflecting her personality/mood. In fact, this quality of the writing is particularly well-illustrated in one of her e-mails, which is just one long run-on sentence, like there are all these words bubbling over that she has to get out. This "stream-of-consciousness" kind of style works well to portray what's going through her head, and also functions as a written version of the pressure of speech symptom some individuals with bipolar experience.

Axis 4. Psychological Accuracy

"Fast Facts" about bipolar disorder: Did You Know?

• Bipolar disorder is recurrent — over 90% of people who experience one manic episode will have another in the future.

• Bipolar symptoms can be mimicked by medical conditions like thyroid problems, neurological diseases, and vitamin deficiencies.

• Antidepressants can trigger manic episodes in people predisposed to bipolar disorder.

• For a long time, nobody knew why lithium worked as a medication for bipolar disorder. We still don't know for sure, but recent research is suggesting that it could be due to a link with circadian rhythms.

Crazy does an exceptional job of showing what a person with bipolar disorder is going through mentally and emotionally. In fact, I don't think I've read a better portrayal of the perspective of someone who has bipolar disorder.

Mania is often associated (by the general public) with being really happy, but with Isabel, this isn't often the case. She's happy for very brief moments at the beginning of a manic episode, but this quickly turns to anger/bitterness — but still with all the energy a manic episode brings. Then this progresses downhill into depression. It's good to see the portrayal in Crazy doesn't fall prey to stereotype, as I suspect what happens with Isabel is a much more likely scenario for many individuals with bipolar, rather than a black-and-white, "happy" or "unhappy" sort of divide. It's better to think of bipolar as alternating between energy levels. Also, it's possible that Isabel sometimes experiences a mixed state — either mania with some depressive symptoms, or depression with some manic symptoms.

While I wish we'd seen a little more of Isabel's manic episodes, bipolar disorder cannot be neatly separated 50-50 into depression and mania; the frequency of each type of episode depends on the individual. During her manic episodes, though, she definitely "acts out" in ways one might expect (spoilers, highlight to read: for example, having sex with a random guy, burning stuff, and shredding her mom's records). She's also obsessed with sex at some points, and hypersexuality can occur with manic episodes. And we see elements of psychosis in Isabel at times — she hears voices and holds what could be interpreted as a delusion about her "evil twin". Psychosis certainly can be present in some individuals with bipolar, particularly in a manic episode. Overall, I'd diagnose Isabel with Bipolar I disorder, rapid cycling (since the book doesn't take place over a very long period of time, and by the end she's already shown a few episodes of both mania and depression).

I thought it was very realistic that Isabel resists treatment for such a long, long time. She really digs her heels in, turning against everyone who tries to help her, thinking they're the enemy. Indeed, she almost starts acting a little paranoid schizophrenic (perhaps part of this is her psychotic symptoms?). We're not told exactly why she doesn't want to get help, though — whether it's the stigma of having a mental disorder, that she's in denial, that she's naturally stubborn, that it's an effect of the bipolar disorder itself, that she's worried she'll lose part of herself, or a combination of these factors.

As for Connor, he didn't strike me as being really codependent — a term brought up briefly in Crazy — but he certainly lets her take center stage in the relationship. It's all about her, and he doesn't put his foot down very much in terms of making her pay attention to him. It's a one-way relationship — he's trying to save her and she's not giving him anything in return, which she acknowledges at one point.

Validity Score: How psychologically accurate was Crazy?

Patient shares symptoms with: A Note of Madness by Tabitha Suzuma, The Unquiet by Jeannine Garsee

Patient's statement:


I am a parasite on this world. I suck the life out of the things I love. I multiply and spread until I've consumed you. And even when you're gone, even after I've licked up every last crumb of you, I'm still hungry. I'm starving, Connor. I'm empty and lonely and lost and I'm starving, and there isn't enough in the whole wide world that could make me feel whole.

Diagnosis: 4 shooting stars.

 

For more information about bipolar disorder, see here.

Note: this book contains some coarse language and mature content.

This book counts toward my goal for the Just Contemporary reading challenge.

Psychtember Interview with R.J. Anderson!

I'm happy to welcome R.J. Anderson to the blog for a Psychtember interview! Rebecca is the author of several YA novels, including Ultraviolet and the upcoming companion novel, Quicksilver, due out in spring 2013 (from Carolrhoda Lab).

First, a bit about Rebecca and Ultraviolet:

"R.J. Anderson (known to her friends as Rebecca) was born in Uganda, raised in Ontario, went to school in New Jersey, and has spent much of her life dreaming of other worlds entirely.

As a child she immersed herself in fairy tales, mythology, and the works of C.S. Lewis, J.R.R. Tolkien and E. Nesbit; later she found inspiration in books by Ursula LeGuin, Patricia A. McKillip and Robin McKinley, and learned to take as much pleasure from their language as the stories they told.

Now married and a mother of three, Rebecca reads to her sons the classic works of fantasy and science fiction that enlivened her own childhood, and tries to bring a similar excitement and timeless wonder to the novels she writes for children and teens. She currently lives in the beautiful theatre town of Stratford, Ontario." (from her website)

"Once upon a time there was a girl who was special.

This is not her story.

Unless you count the part where I killed her.

Sixteen-year-old Alison has been sectioned in a mental institute for teens, having murdered the most perfect and popular girl at school. But the case is a mystery: no body has been found, and Alison’s condition is proving difficult to diagnose. Alison herself can’t explain what happened: one minute she was fighting with Tori—the next she disintegrated. Into nothing. But that’s impossible. Right?" (from Goodreads)

And now for the questions...

1.) a) Frequently in YA we see a character displaying symptoms of a mental disorder, but the story doesn't actually show us the treatment of it. Why do you think that is?

Sometimes YA novels include mental illness as part of a character's background or present struggles, but the main plot of the story isn't about MI so we don't get a lot of details about the disorder or how it's being treated. I don't think there's anything wrong with that per se, because I think it's possible to respectfully acknowledge the existence of mental illness and the challenge it can present without going into a lot of details.

But if the main plot is about the character dealing with a mental illness, either their own or someone else's, I think treatment ought to come into it eventually. Maybe some authors don't want to tackle the treatment angle because it demands too much research, or maybe they're afraid it would bog down the story and bore the reader. I don't know. But I feel that if you're going to write about MI at all, you need to be prepared to do a lot of research; and I think anything can be written in an interesting way if the author cares enough to do it.

b) A significant part of your book takes place at a psychiatric facility. In what ways do you hope Ultraviolet addresses this gap in the literature?

Part of what made me want to write about life as an inpatient at a psychiatric hospital was my frustration with the stereotypical, sensationalized and downright misleading portrayals of MI I'd seen elsewhere, TV and movies especially. On one hand I saw portrayals of people with mental illness as loveable eccentrics or unorthodox saints, and on the other hand they were portrayed like wild animals or dangerous criminals, and there wasn't a lot in between. Similarly, psychiatric hospitals in these stories tended to be either sunny halls of hope and healing, or dismal prisons full of people in straitjackets locked up in isolation. I wanted Alison's experiences of psychiatric care, and her interactions with her fellow patients, to be more nuanced. Within any health care system there are all sorts of different personalities and approaches to the giving and receiving of treatment, and sometimes the combination of caregiver and patient is a positive and healing one and sometimes it's disappointing or painful, but it's not that easy to sort everybody into heroes and villains. With Ultraviolet, I've tried to reflect that.

2.) For authors attempting for the first time to write a character dealing with mental health issues, what are some "must-haves" for their writing and what pitfalls would you recommend they avoid?

I'd say the first thing to do, if you don't have firsthand knowledge or experience of dealing with mental illness, is to throw out all your preconceptions about what mental illness is like and how it is treated today. Read memoirs by people with MI and by their family members, look up blogs written by nurses and aides and psychiatrists, watch educational videos about schizophrenia and bipolar disorder and depression. Try to build up a detailed picture from all angles, instead of relying on just one source or point of view -- which is where I think a lot of stories about mental illness go wrong.

3.) How would you suggest a teen reader gets the most out of a book focusing on psychological issues? For example, are there any strategies a reader might use to detect when an author is portraying a mental disorder or treatment clumsily or inaccurately?

I don't think there's any way to know that unless you have firsthand experience with mental illness or have been doing your own research into the subject, because as I mentioned before the portrayals in TV and movies are so misleading. Because of that influence, I think it's easy for a lot of readers not to notice when an author does a poor job of portraying mental illness, because the mistakes and wrong assumptions the author's making are probably similar to their own.

The best an author can do, I think, is try to be responsible, respectful, and thorough about their research in all areas, even those that don't involve mental illness. Because if the reader finds that they are reliable in one aspect of the story that they do know about, they're more likely to trust the author to be reliable in other areas as well. But if the author botches up other facts, it's hard for the reader to trust them after that. And rightly so, because that's often a warning sign that the author hasn't really done their research.

4.) There's a paranormal element to Ultraviolet. How challenging was it to blend this with the fact-based psychological aspects of the book? Were you concerned about tackling two genres in this way?

Fantasy and Science Fiction are my first love, and my original concept for this story was very strongly rooted in the SF element. I was actually more worried about pulling off the contemporary aspect than anything else, because it was less familiar territory. And I always knew that there were going to be some readers who didn't want to come all the way on Alison's particular journey -- in fact I worried at first that no editor would buy it simply because of that cross-genre aspect. But at the same time, I knew I couldn't tell this particular story any other way. If I took out the paranormal and science fiction elements, I'd have to write a totally different plot, or else turn it into a "But she was really crazy all the time!" story or a "Then she woke up and it was all a dream!" story, and neither of those options were interesting to me. So I was very relieved and grateful to find two editors -- Andrew Karre at Carolrhoda Lab US and Sarah Lilly at Orchard Books UK -- who loved the manuscript and got what I was trying to do.

My editors also did me a great favour by encouraging me to drop more hints about the SF aspect of the story earlier in the book, so that when the twist came at least some readers would feel that it made sense. I wanted Ultraviolet to be a book that would reward re-reading -- where people could go back and say "Aha, I see what you did there!" even if they hadn't caught it the first time around. So even in the early sections of the book there are plenty of SF in-jokes and allusions from Star Trek and Star Wars, The X-Files and Doctor Who, Blade Runner and Hitchhiker's Guide to the Galaxy -- plus blatant references to SF classics like War of the Worlds and The Day The Earth Stood Still. I don't know if any of my readers picked up on all of those little easter eggs, but I had a lot of fun putting them in.

5.) Stigmatization is still a big part of mental illness in North American culture. What tips would you give for incorporating stigma into a story to realistically reflect our society, without coming across as demeaning to individuals with the mental illness?

It's a difficult issue, because no matter how you handle it there's so much potential for offence. Some readers are going to be upset if an otherwise likeable character behaves badly, or says something insensitive or ignorant. They may even mistake that character's point of view for the author's, unless that character gets an immediate smackdown that makes plain the author doesn't endorse such behaviour. But real life doesn't work that way -- people say insensitive things without getting called out or punished all the time -- and if the author tries to fix everything their characters do wrong, you end up with a preachy, unrealistic story.

I think the best way to handle it is not to eliminate or ignore the insensitivity, or have some Voice of Authority step in to immediately correct the misbehaviour, but to realistically portray how that kind of stigma affects the people who are subjected to it. To put the reader into that person's position, even if only for a moment, and make them understand how inaccurate and unjust the stigma really is.

6.) If you could ensure that readers take away one fact or message about mental health/psychology from Ultraviolet, what would it be and why?

I think it would be the same lesson that Alison gradually learns over the course of the story -- that people with mental illness are struggling and suffering in some very obvious ways, but that doesn't mean they're some strange alien race, or otherwise essentially different from the rest of us. We're all human beings with our own hurts and fears and temptations to overcome, and we need to be compassionate to one another, because none of us can make it alone.

7.) Can you recommend some other YA books dealing with synaesthesia (or one of the other psychological issues involved in Ultraviolet)?

I didn't discover this book until well after I'd started writing mine, but Wendy Mass's A Mango-Shaped Space is a contemporary novel about a girl with synesthesia, and also deals with issues of grief and depression. It's beautifully written and I'd recommend it to anyone who's interested in learning more.

Thanks very much, Rebecca, for these thoughtful responses to my questions!

Readers, I'm curious — have you read many YA novels that highlighted the treatment of a mental illness, not just its symptoms/diagnosis? What have been your impressions of the portrayals of psychiatric facilities in YA?

All You Never Wanted: A Psychtember Review

 Patient: All You Never Wanted by Adele Griffin

Presentation (from Goodreads): "With my eyes closed and Alex's core friends all around me, it was like I'd become my big sister, or something just as good. And so who cared if they were calling it Alex's party? One thing I knew: it would be remembered as mine.Alex has it all—brains, beauty, popularity, and a dangerously hot boyfriend. Her little sister Thea wants it all, and she's stepped up her game to get it. Even if it means spinning the truth to win the attention she deserves. Even if it means uncovering a shocking secret her older sister never wanted to share. Even if it means crying wolf.

Told in the alternating voices of Alex and Thea, Adele Griffin's mesmerizing new novel is the story of a sibling rivalry on speed."

Assessment:

Axis 1. Characters

Adele Griffin is just so good at writing complex characters. Characters who do the wrong things for the right reasons, the right things for the wrong reasons, and the wrong things for the wrong reasons...but not so often the right things for the right reasons. Her characters are so flawed — but in All You Never Wanted at least one of the two main characters is one you can root for. 

The sisters: Alex is obviously the more sympathetic, likeable sister; she has a whole host of issues to deal with (which will be discussed below) and certainly shows some less than honourable behaviour, but she is definitely easier to like than Thea.

Her sister, on the other hand, is a real pain in the neck. She's the 'bratty kid sister' taken to an extremely toxic level. I never felt like she truly cared about Alex (even though she said she did), because she went around sabotaging her sister — trying to take her friends and boyfriend, be "better" than Alex, and capitalize on the fact that Alex is struggling. Thea is never satisfied; she always wants more, and the only reason she wants it is because Alex has it. This life of luxury she's been given has opened up a realm of possibility. Suddenly there's all this stuff that she never wanted that she has now, and it's almost like she doesn't know what to do with it exactly, but it makes her want more. And she begins treating people like objects, stuff for her to accumulate. I suspect something clinical is going on with Thea as well, so her behaviour will also be addressed in detail on Axis 4. 

I wasn't strongly connected emotionally to either sister, although I found Alex easier to relate to than Thea, but they're very flawed and multi-dimensional. The story is kind of irresistible anyway, though, because it's clear that these two sisters are heading for disaster.


Xander and Joshua: Xander is the one person here who's sensible, the voice of reason/sanity. He's Alex's "rock" in a way. He's pretty awesome and the day he and Alex spend together is cute. While he's not perfect (he does get angry at times), he's pretty steady, and certainly preferable to Joshua. I couldn't get a read on Joshua for a long time, but basically, he's a jerk. I never liked him that much and I don't think we're supposed to!

Other side characters: We don't really get to know Alex's friends, "The Blondes," that well, but they're pretty much there just to show us that Thea is trying to steal them away from her sister. Honestly, I don't know why Alex wants to hang out with them anyway, because they don't seem that nice; I guess Alex and Palmer in particular have a long history and a strong connection. I wish we'd seen a little more about the mom (and Thea's and Alex's connection with her) as well as Arthur. At one point it's mentioned that Alex feels so bad about disappointing Arthur and I was like, "Really? Because you didn't seem to care about him for most of this book..."

Axis 2. Premise/plot

I was really confused for the first few chapters, but then it started making more sense as I got further into it. The whole story takes place in this glitzy glamour world of money, that Thea and Alex were pushed into when their mom remarried. It's almost soap opera–ish in a way; you can see it playing out kind of like the TV show 90210 with all these really rich teens. It conveys that vibe very well, and it's difficult to stop reading (especially towards the end) because you can't tear your eyes away from this glittery, frothy life of these rich people — and how destructive they are in their opulence. This kind of life is tearing Alex up inside, even as she weakly tries to rebel, and Thea is just destroying herself. 

It would have been interesting to have seen more flashbacks to when the mom first remarried, and been shown the effect (as it happened) of the money on Alex and Thea. As Alex acknowledges at one point, the whole thing does seem very "poor little rich girl". I couldn't feel that bad for people who have so much, but on other hand, I guess I can kind of understand how it would completely change your world and how you live, messing with your values and making you doubt yourself. I think how much it changes someone would depend on the character of the person, though. Thea didn't have a strong enough personality to resist it, and was tempted by the money and everything it gave her. It's pathetic how concerned she becomes with what people think of her. I have a hard time buying it's just the money's fault; you can point your finger at the fact that her stepdad's so rich, but really, it's how she reacts to that — the money is just an excuse. 

Plotwise not that much happens here, but it doesn't really matter — it's rich in social drama. Plus, there's the party at the end, and you know that's where everything's going to go down. And does Adele Griffin ever know how to end a book! It's exploiting some shock value, yes, but there's a sickening sort of ambiguity at play here; you don't really know what happened, but you are certainly left to suspect. The very last couple of pages gives us a brilliant dose of irony by being juxtaposed with what just happened previously.

Thea is a mess at the end, and Alex's behaviour really says something about how much Thea has torn apart their relationship (although Alex is a little to blame as well for that). However, I had to feel bad for Thea in a way (that is, given a particular interpretation of events), because she is pretty young and doesn't know exactly what she's doing. She's cluelessly reaching for fire, thinking she wants it...and then she finds out that she doesn't. There's definitely a message of "reap what you sow" with this book, and Thea cannot for the life of her figure out that there will be consequences to her behaviour, and that she'll just wind up hurting herself.

Unfortunately, we don't get much resolution about Alex's psychological problems. It looks like she's taking the first steps to getting herself back on track and getting help, though.

Axis 3. Writing Style

I just get so impressed by Adele Griffin's books because she's a really good wordsmith and the quality of writing is always high. In particular, I have to commend her talent for subtlety. She's excellent at insinuating twisted things; it's almost like the spaces where she doesn't say something are as important as all the words she does say. It's masterful writing technique when you can make those blank spaces mean as much (or more) than the actual words.

Alex's chapters are written in third-person and Thea's in first-person, which is interesting, because I feel like I couldn't understand Thea's perspective and attitude as well as I could relate to Alex's. It took a bit for me to switch between the viewpoints for the first little while, but this approach works to separate the two perspectives and keep them distinct.

Present-tense is not usually my favourite, but here I think it really gives the reader that sense of immediacy; the time passing is important because it all happens over a fairly short period. In particular, Xander's and Alex's relationship develops very quickly, and yet despite that we see they share a meaningful emotional (and physical) connection.

Some of the description in here may seem somewhat unnecessary, but it balances out some of the really important things that happen "off-screen" (otherwise it would be really short and simple!). There's also a fair bit of brand name–dropping (they are rich people, after all) which didn't do anything for me, since I didn't get most of the references; some of the slang was lost on me as well.

Griffin is great at creating meaning with fresh or unusual analogies/metaphors, and her writing feels quite powerful; it's not really a book to skim, because you could miss something important. She writes warped behaviour so effectively. I don't know how she does it, but somehow she manages to pull it off really well, so that instead of interpreting the characters as so unbelievable or unlikeable you don't want to read about them anymore, you're sucked in, wondering what they're going to do next. She also uses the unreliable narrator technique to good effect a couple of times, tricking the reader very nicely (spoiler: there are a couple scenes when Thea thinks up a lie, but you don't realize at first she's making it all up in her head, because it's written as though it's real, woven right in there).
 

Axis 4. Psychological Accuracy

The psychology here is mind-boggling — there are so many issues that both sisters are dealing with.

Alex: she definitely has some kind of anxiety disorder, specifically related to the fact that she's worried she will lose control of her bladder in public. While she does appear to have something akin to panic attacks, I don't think she'd qualify for full-blown panic disorder. She certainly displays some symptoms present in a panic attack — pounding heart, trembling, jumbled thoughts — but I don't know that she has enough, or to the extent, that they would meet the criteria for a panic attack.

What I suspect may be going on with her is agoraphobia without panic disorder. Symptoms of anxiety can still occur with this, but they are not at the same level as panic disorder. This page about the disorder states that the individual is afraid of something embarrassing happening in public, and gives a loss of bladder control as an example. Of course, it might also be possible Alex has a form of social phobia or a specific phobia — it's difficult to say without a diagnostic interview! Regardless, what happened to her at the internship was absolutely humiliating, and I can see how that would make her feel ashamed and set off an anxiety disorder that snowballs.
 
Alex also shows hints of obsessive-compulsive personality disorder (OCPD). She has a need for perfection; she was always the admired, sociable sister that everyone looked up to, and while she didn't excel academically the way Thea did, she was planning on going to college. Now she's scared of losing control again and being imperfect. I doubt she is at the clinical level of OCPD, though.

Alex's phobia has led to other difficulties in her life. For instance, she barely eats at all now, because she wants to keep herself "void" to decrease the chance that she will have a repeat of the previous incident. I don't know if it would be classified as an eating disorder — it certainly isn't a typical case of anorexia, as Alex doesn't have body image issues — but it has similar effects. She's unhealthily thin and her menstrual cycle has become irregular. These kinds of problems are not touched on in most YA "issue books", so it's refreshing to see something more unusual being focused on.

Thea: she is such a weird, twisted character. I suspect she might have histrionic personality disorder. She craves attention, going so far as to invent the most outrageous stories and spreading hurtful rumors. Pathological lying can be associated with histrionic disorder. It seems like she does a lot of rash, self-flaunting things, including flirting with her sister's boyfriend.

This behaviour particularly happens when she's being "Gia", this "alter ego" of Thea's who makes her feel like a sexier, more confident person. She's aware of Gia, so I wouldn't classify it as dissociative identity disorder, but there are moments with hints of dissociation, and she certainly feels like she's playing two different roles.

It's creepy that Thea can be so cold and ruthless, and yet she has her innocent, naive side as well. We very occasionally see glimpses where Thea's real self (or at least her old self) comes back — for instance, when she feels guilty about something. A lot of the time, however, she just wants to be a manipulative Queen Bee. I wish we'd seen more of Thea before and witnessed the change in her; it's pretty sad what she's become. I think I would have liked her a whole lot more back when she was "bookworm Thea".

Validity Score: How psychologically accurate was All You Never Wanted?

Axis 5. Miscellaneous 

The girl on the cover doesn't look like either of the sisters, in my opinion. (But it is a striking image!) Also, I think All You Never Wanted is a really good title for this book, as it works on a few levels.
 

Patient's statement:

"Everyone knows your written story is a lie. But if you're going to get people to believe your lie out loud, then you have to muffle them in your breezy, shocking, junky, juicy, sexy, needless words. As for your darlings? That's the goo of anticipation. What sticks 'em to their seats. And the whole entire point of the project is that you're launching yourself into the void. Spitting in blood and crossing your heart to vouch for an experience you'd never known. That you couldn't feel, touch, or taste until the moment it was on your tongue and you realized — Everyone is buying this crap. Even me.

It pumped me up just to think about."

Diagnosis: 4.5 shooting stars. 

This book counts towards my goal for the Just Contemporary challenge. 

Disclaimer: I received this book as an ARC from the author for review.

Note: this book has some mature language/references. 


Read my Psychtember interview with Adele Griffin here!

Identical: Guest Review

Najela from Brave New Adventure is back with one last guest review for Psychtember! This time she's reviewing Identical by Ellen Hopkins.

Summary: Kaeleigh and Raeanne are identical twins trying to live in the abusive house of their parents. Their father is a district attorney and he has turned his attention to Kaeleigh while their mother is absent. Raeanne has turned to drugs and alcohol and men to get the love she can't get from their father. An accident that happened years ago is starting to take it's toll on the sisters, but with their Raeanne spiraling out of control, can Kaeleigh help her sister take control of her life before it's too late? Or will both sisters hit rock bottom with no way out? 

Likes: This novel was chilling, the amount of tragedy these "girls" endured. Had this story been in another format, like a straight prose novel, it would have been heavy handed and overwhelming, but Hopkins expertise with verse serves the novel well. The brevity of the verses serves the novel well and allows for the twist to be woven in seamlessly. I honestly didn't see the twist coming, but when you do get to that point, you see all the subtle hints Hopkins drops along the way. I've read quite a bit of Hopkins novel and this one is by far one of my favorites.

Psychological Aspect: The psychological aspect of this story is done so well that you don't see the twist coming. When you get the twist it doesn't come off as a gimmick, but something that you could honestly see happening. I'm trying not to give any spoilers, but the psychology behind this story is fascinating. If you read this story, I urge you to look up the disorder that one of the sisters (again, no spoilers) has and tell me that you didn't see that twist coming. I think I've said too much already. Seriously go read it.

Writing Tip: There are several ways a story can deal with a mental illness. It can something that is a known illness and newly diagnosed with people learning how to manage it. It can be something that the character has known for a while and is just dealing with it. Or it can be unknown, as in the case with Identical where a character is dealing with the symptoms of a disorder without being diagnosed. If you are going to write about a charcter dealing with any type of illness, you'll have to determine how far they are into the illness. That'll determine how much you should emphasize this. Here's a fabulous post for more advice on how to write about a mental illness.  http://atapestryofwords.blogspot.ca/2012/09/guest-post-how-much-should-you.html

Another Book to Read: Any Ellen Hopkins book!


Najela is a graduate from UC Riverside with a dual degree in Psychology and Creative Writing and finally making the most of both degrees. She works with kids and is currently pursuing a Master's Degree in Exceptional Student Education. She is also working on several writing projects including a Beauty and the Beast retelling webcomic coming in late October 2012. You can follow her at her website or her tumblr.  



I'm glad to hear you were impressed with Identical, Najela — thanks for sharing your thoughts!

Psychtember Interview with Adele Griffin

I'm happy to welcome Adele Griffin, author of numerous YA novels including Tighter, The Julian Game, Picture the Dead, and the upcoming All You Never Wanted, back to the blog! (Adele also participated last year in Psychtember, with a character interview of Isa from Tighter.)

First, a bit about Adele and All You Never Wanted:

"Adele Griffin, a two-time National Book Award finalist (Where I Want to Be and Sons of Liberty), is the acclaimed author of Tighter, The Julian Game, Picture the Dead, the Vampire Island series, and many other books for young readers. Adele lives with her husband and young daughter in Brooklyn, New York." (from book)

"With my eyes closed and Alex's core friends all around me, it was like I'd become my big sister, or something just as good. And so who cared if they were calling it Alex's party? One thing I knew: it would be remembered as mine.

Alex has it all—brains, beauty, popularity, and a dangerously hot boyfriend. Her little sister Thea wants it all, and she's stepped up her game to get it. Even if it means spinning the truth to win the attention she deserves. Even if it means uncovering a shocking secret her older sister never wanted to share. Even if it means crying wolf.

Told in the alternating voices of Alex and Thea, Adele Griffin's mesmerizing new novel is the story of a sibling rivalry on speed." (from Goodreads)

And now for the questions...

1.) Many of your YA books deal with some psychologically twisted stuff. What draws you to write these kinds of complex, flawed characters who are often in need of professional help? What would you say the appeal of these kinds of stories is for the reader?

I don't know why I go dark but it always feels right! I think it's because I myself always felt like a peripheral person-- if not exactly a disturbed one. My father was in the military, and I grew up being called "new girl" -- an uncomfortable and yet familiar role.

2.) Alex's perspective is written in 3rd-person and Thea's in 1st-person. How challenging was it as a writer to switch not only from one girl's voice to another, but from one POV style to another? Are there any writing tips you can give for making these kinds of transitions work?

Oh so happy you asked that question! I made that choice to underline who these girls are. Thea is truly manipulative, and I wanted her cozy 1st person to draw in the reader because 1st is more intimate-- but ultimately then you are trapped in her skewed reality-- and her total insistence on it. Whereas Alex is holding us at arm's length in 3rd person, while her narrative is an unwinding, and a painful raw reveal of who she really is.

3.) Alex and Thea are sisters, but they really couldn't be more different in personality. If you could give Alex one personality trait of Thea's, and Thea one of Alex's, to help balance out both girls, which attributes would you trade?

I'd give Alex a dose of Thea's self-esteem, and I'd make Thea a bit less tone-deaf, so that she could share Alex's ease in social situations.

4.) Envy is one of the prominent themes throughout All You Never Wanted. Who is one YA author you envy and/or one YA book you wish you'd written?

I have real envy of HOW I LIVE NOW by Meg Rosoff. and I have some Patrice Kindl envy because I love her variety of concepts.

5.) If you were suddenly thrust into the lap of luxury, would you react more like Alex does, or more like Thea? Why?

My guess would be I'd have an Alex reaction only in that she is a bit of a control freak-- though I wouldn't make my rules so spartan or self-destructive. I did relate to Alex-- I think it would be awful suddenly to live a life where nothing is special, or a treat, or has to be earned.

6.) Alex is the more obvious candidate of the sisters for therapy, but I rather suspect Thea could also use a good dose. Who do you think would respond better to treatment (either in the form of psychotherapy or medication)? Or is either of them a "lost cause"?

When Thea needs it most, she lacks conscience, which always signals a little bit of "lost cause." But in most of the book, she's floundering, and her story in many ways is about how she is surrounded by resources-- by caring people who unfortunately are not caring about her. She's kind of like that adage: "water water all around and not a drop to drink."

7.) Xander's character works very well as a foil for Joshua. What's one thing you feel Xander can offer Alex that Joshua can't?

Ah, Xander! This is the first male character I ever wrote who I got a crush on myself. What I like best about Xander is that this guy has no secret agenda. He's fallen for Alex, boom, the end. While Joshua is just trouble eight different ways.

8.) Books can change a fair bit from first draft to final copy. Did All You Never Wanted undergo any major changes (scenes, characters, etc.)?

Yes, big time. Early drafts had a lot less Alex-Xander, and then I realized that part of her reconnection had to be about physical delight, about not punishing her body but rewarding it. So pages got sexier. And Thea was more flat-out awful. I had some great reads on the book, and the big note from my peers was to give Thea more vulnerability and history-- moments for the reader to empathize with her.

9.) All You Never Wanted works as a title for this book on several levels. Was this the working title from the start, or did you have to go through an arduous brainstorming process before you came up with the perfect choice?

It was called WOLF when it came it. I was thinking of "the wolf at the door" and "the girl who cried wolf" but it got nixed-- everyone said YA readers would be hoping for a werewolf. I love this title, it's very on-point.

10.) Imagine Thea from All You Never Wanted, Raye from The Julian Game, and Jamie from Tighter somehow all end up at the Figure Eight lunch table. What happens?

That's the scariest lunch table ever. I think Thea the bully would enlist Raye the hench-woman to gang up on Jamie the victim-- and from there all hell breaks loose.

Thanks so much, Adele, for giving us some more insight into the writing process and characters of All You Never Wanted!

Rage: A Psychtember Review

Patient: Rage by Jackie Morse Kessler

Presentation (from Goodreads):  
"Missy didn’t mean to cut so deep. But after the party where she was humiliated in front of practically everyone in school, who could blame her for wanting some comfort? Sure, most people don’t find comfort in the touch of a razor blade, but Missy always was . . . different. That’s why she was chosen to become one of the Four Horsemen of the Apocalypse: War. Now Missy wields a new kind of blade—a big, brutal sword that can cut down anyone and anything in her path. But it’s with this weapon in her hand that Missy learns something that could help her triumph over her own pain: control. A unique approach to the topic of self-mutilation, Rage is the story of a young woman who discovers her own power and refuses to be defeated by the world."

*Note: there are spoilers discussed in this review, particularly the Axis 2 and Axis 4 sections. You have been warned!
 

Assessment:

Axis 1. Characters

You have to feel pretty bad for Missy, because she doesn't have a lot of support. Still, I never really fully understood why she started cutting. We know she was being teased and bullied, but we don't see a specific trigger that sets it off. I also had some trouble getting a clear picture of her relationship with her parents; she mentions at one point that they neglect her most of the time and only pay attention to her when she's their "perfect" daughter, but at another time she says they would hound her if they found out about the party. This seems to be a bit of a conflicted portrayal — are they interested in what's going on with her or not?

For a sister, Sue really sucked. She acted very cruel towards Missy most of the time, more like one of the bullies at school. Sue tried to offer Missy help in the way she knew how, but really, it probably did more harm than good.

Side characters like Trudy, Erica, and Becky could have been fleshed out, as we don't really get to know them. I also wish we'd gotten more from the horse Aries' perspective, and been shown more of his personality — he seems nice enough to Missy most of the time, even though he's a war horse! It was interesting to see a different portrayal of the character Famine than in Hunger, though. 

As for the romance that develops between Missy (as War) and Death, it is admittedly pretty cute. The whole idea of Death and War "working well together" makes sense, but it's kind of funny that it's being used romantically as well. I thought it was a little out of character for Death to get involved in a relationship (I don't know if Death would make himself vulnerable...does he even have a heart?) but at the same time I suppose it rounds out his character more. Jackie Morse Kessler's Death is an unusual take on "Death" to begin with — but he's the best character in the series so far, in my opinion! And he gets most of the good lines in this book, as usual.

Axis 2. Premise/plot

I felt that the pacing of this one was a little more sluggish than Hunger, and not a lot actually happens. The same internal struggle Missy faces comes up again and again (just prompted by different things). This struggle of whether she should give into her brutal impulses, or whether she can accept/control them without resorting to violence, is the crux of this book. 

It follows a similar storyline structure to the first in the series. Our protagonist has reached a fairly low point in her life. She receives and accepts Death's offer and begins to figure out her role as a Rider. She meets another Rider, has some more trouble with her problem, travels and sees how bad things are in another part of the world. Then she hits an even rougher spot, there's a big conflict scene, she wins out, has a large realization, and then things get better. The major difference between Hunger and Rage in terms of plot is the ending (spoiler, highlight to read: Lisa resigns from being a Rider, whereas Missy stays War). 

I thought Missy accepted the existence of the Riders of the Apocalypse and her role as War way too easily, like she understood it intuitively. It felt unrealistic that she took everything pretty much in stride. I suppose the author didn't want it to be same as how Lisa reacts in Hunger, but you'd think Missy would have demanded a bit more explanation. 

The ending also didn't seem that believable, in that Missy solves the problem in the abstract, but then this is translated immediately to the real world. Just because she has resolved things cognitively doesn't mean it will have an impact at once on her behavior. I feel like there would have been more of a learned behavioral pattern that she'd have to try harder to break (spoilers: after her "revelation" she just doesn't feel the need to cut anymore, and I'm not sold on that). However, the approach the author took to showing the battle between Missy and War was pretty cool.

The epilogue wrapped up the story too neatly, although at least it's not all resolved in a happy manner for Missy. However, it seemed like the author was trying to jam-pack everything into this epilogue, when it could have been included in the actual story instead. I would have been interested to see the guidance counselor sessions and Missy's parents' reactions, and I feel like we got cheated out of seeing that because it all happens in the epilogue!

I did like the last paragraph, as it perfectly ties together the concept of War with Missy's difficulties. I think it's important that the author acknowledges it's an internal conflict Missy is dealing with, and that just as Famine starves herself, War wars with herself.

Axis 3. Writing Style

The writing in Rage is quite repetitive. A lot of the same analogies and metaphors are used again and again (for instance, "razor kisses," blood imagery, and the idea of a glass jar around Missy's heart). However, Jackie Morse Kessler definitely does a good job of descriptions, managing to give the reader a flavour of things with powerful imagery and combining words together in interesting ways.

In particular, I enjoyed the scene where Missy wanders through a party and causes havoc. The way this was portrayed really conveyed the power of War's presence in influencing people in ways they weren't even aware of.

Axis 4. Psychological Accuracy

Rage very effectively shows the horrible cruelty that teens can inflict on each other. It's ruthless and vicious what Adam does to Missy, and the level the other girls stoop to is despicable. The worst part of it is, Missy is a girl who so clearly needs help, but instead she becomes a pariah because of her cutting. It feels so wrong that this girl, who needs all the support she can possibly get, is being tormented because of evidence demonstrating how emotionally distraught she is. Rage also realistically shows how cellphones and technology can exacerbate the problem further. 

At first, you might wonder why Missy is chosen as War, because she's not violent with others, just herself. But the author takes a broader viewpoint of War, and part of War is passion; as I understand it, Missy has difficulty handling emotion, and in order to deal with it, she cuts. This seems to match the motivation for many individuals who self-harm in real life. We're given some good descriptions of how Missy feels about cutting — what it does for her, how she feels after, how it gives her clarity and relief. Despite this, though, I never truly understood why she was feeling like this and why she would cut. 

What I think is less accurate in this portrayal is the quick resolution to Missy's self-injurious behaviour. We're told in the epilogue that she starts spending time with the guidance counselour at school, and then ends up telling her family about her cutting. This is certainly a step in the right direction for Missy, but I am still very doubtful that she could break this pattern of behaviour so easily. It is acknowledged that she could cut again in the future, but the whole thing seems a little too "cold turkey" to be believable. Indeed, self-injury can become something of an addiction — and addictions are notoriously difficult to just quit.

Validity Score: How psychologically accurate was Rage?

Axis 5. Miscellaneous

I was a little disappointed with this one and didn't find it as good as Hunger. Of course, with the first in the series it was a new world and concept we were being introduced to, whereas Rage doesn't have that novelty aspect. Personally, I also identified a bit better with Lisa from Hunger, finding her character more sympathetic and her problem (specifically, an eating disorder) more interesting.

Patient shares symptoms with: Scars by Cheryl Rainfield, Willow by Julia Hoban

Patient's statement:

"She lifted the razor in her right hand, holding it between her thumb and first two fingers. She heard Adam and the others call her names and accuse her of horrific things, laughing at her all the while. She felt her soul crumple, squeezed into pulp. She tried to breathe and failed. 


In her mind, Adam's voice whispered: Freak.

Tears stinging her eyes, she sliced down."

Diagnosis: 3 shooting stars.

For more information about bullying and self-harm, see here and here.

Note: this book contains some coarse language and mature content (both sexual and violent).