Twilight Children

PUBLISHERS WEEKLY FEB 7, 2005

Hayden was working as a special ed teacher and needed a break. With her psychiatric training and specialization in "elective mutism," she was cajoled into working for a hospital-based psychiatric crisis and assessment unit. She begins this book with the story of a girl who was only six when she was abducted by her father; returned to her home two years later, she alternated long stretches of silence with lying and sexual accusations. Hayden was then asked to assess a delightful preschool boy whose voice no one had ever heard except his mother; his belligerent grandfather ordered Hayden to "fix" the boy's problem. Then she was called to observe an elderly woman who'd had a stroke that may have rendered her unable to speak. Gradually, the woman began to recount girlhood memories to Hayden who thus knew she was still lucid but would that satisfy the doctors who wanted to send her to a nursing home? Each case unfolds like a detective story, with Hayden piecing together the mystery of the silences from the various clues she gleans. Besides being a delightful raconteur, Hayden is also a very gentle, very sensible therapist. Yes, her patient is dissociating, but that's normal, we all do it the real question is, "at what point on the continuum does it move from being resourceful and helpful to maladaptive and damaging?" This is a compulsively readable book.