ABSTRACT
Rachel was a petite, wan, twenty-year-old young woman with blond hair over her face when I first saw her on the psychiatry ward, after her third hospitalisation in eight months for serious suicide attempts, self-mutilation, and psychotic behaviour. As she had been after the other suicide attempts, she was withdrawn and hallucinating; she looked blank, her attention on inward preoccupations. On two previous occasions she had overdosed; this time she had been found, dazed and confused, wandering on the Golden Gate Bridge. There were reddish lines on her forearms from cutting at herself with a safety pin.
