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.