Nearly 20 years after his exposÇ on anorexia, The Best Little Girl in the World (1978), Manhattan psychotherapist Levenkron tackles the subject of the self-mutilation syndrome, offering less of a novel than an awareness guide for troubled teenagers. Katie Roskova, a 15-year-old figure-skating hopeful, has a grueling schedule of early morning and after-school practice, plus the pressure of maintaining high grades to retain her scholarship at a private school. Despite all the strain, though, Katie's an angel, pleasing all; in reality, of course, it's a ruse. To deal with the confusion and insecurity of teenage life, Katie maintains her calm facade at a grisly cost: She ritualistically cuts herself when she feels out of control. There are numerous passages here, unsettling in their quiet terror, describing the slow precision with which Katie takes a pair of sewing scissors to her arm until the cut is deep and bloody enough to satisfy her compulsive urge. Eventually, her arms are covered with scars, hidden by her long- sleeved shirts. This is compelling, even shocking, material, but Levenkron's approach is generally one-dimensional, making the narrative seem more case study than a work of fiction. Katie's background is predictable: Her mother is abusive and domineering, her father absent, and everyone drives her to succeed at all costs. When Katie is finally caught abusing herself (repeatedly slamming her locker door shut on her hand), she's sent to Sandy Sherman for therapy. The predictability is further reinforced when Sandy enters the picture--he creates a safe space within which Katie can confront her hostility toward her mother. The psychopathology of the illness, though, and the methods for treating it, will scarcely be new or surprising for many readers in our psycho-savvy age. Undoubtedly helpful for anyone having to deal with the self- mutilation syndrome, but as fiction it sadly lacks deftness either in plotting or in character.