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As a young college graduate a year into treatment with a psychiatrist, Cree LeFavour began to organize her days around the cruel, compulsive logic of self-harm: with each newly lit cigarette, the world would drop away as her focus narrowed on the fierce, blooming release of pleasure-pain as the burning tip was applied to an unblemished patch of skin. Her body was a canvas of cruelty, each scar a mark of pride and shame.

In sharp and shocking language, Lights On, Rats Out brings us closely into these years. We see the world as Cree did-turned upside down, the richness of life muted and dulled, its pleasures perverted. The heady thrill of meeting with her psychiatrist, Dr. Adam N. Kohl-whose relationship with Cree is at once sustaining and paralyzing-comes to be the only bright spot in her days.

Lights On, Rats Out illuminates a fiercely bright and independent woman's charged attachment to a mental-health professional and the dangerous compulsion to keep him in her life at all costs.