BOOK REVIEW / A rare talent to abuse: 'Hotel 167' - Jane Solomon: Picador, 4.99

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'MAUD worked down her arm until there were four or five cuts and a steady flow of blood. Soon the cuts became something edifying, a visible embodiment of her feelings. She was able to nurse her arm as she would like to have nurtured her brain, to apply a tissue to mop up the blood, to massage in antiseptic cream.' Maud is 19, has dropped out of Bristol University, and is being treated for psychosis in London. She wants help, yet is convinced she won't get it: no therapeutic alliance for Maud, rather a therapeutic battlefield. When the psychiatrist, Grumer, makes unethical advances to her, she takes him on and humiliates him, but it's a Pyrrhic victory.

The novel comes with editorial assurances that it is 'intensely autobiographical'. In fact the text is seeded with clues. Solomon's insertions of 'you see' break the cold analytical tone, address the reader directly, beseech understanding. Just as Maud has to transfer her pain to her arm before she can care for it, so Solomon has had to transfer it to Maud before she can write it down. The third-person narrative is a device, the confiding asides are a lure. And yet Solomon is ruthless with her alter ego. She undermines Maud, lays bare her manipulative game-playing but is unequivocal about the despair behind it: 'There was no help.' The novel's description of NHS care and authoritarian attitudes is depressingly convincing: 'She wished that she could say something, make her feelings known. At the same time, however, she felt that this attitude would be interpreted as presumptuous.' Maud, dealing with doctors, is a mouse trying to play games with a cat. The hospital passes her on from one doctor to another, from one form of medication to another. They don't listen to her. She can't speak to them.

To Grumer, she offers an exotic-erotic narrative centred round an older couple, Yasmin and Alan, who - she says - have involved her in their relationship. Bewildered, salivating and appalled, he trails her to the cinema where the three made love while watching Last Tango in Paris, to the restaurant where they masturbated each other with oysters, to the graveyard where they smoked cannabis, and where Maud cuts herself in his presence. At last he tries to have sex with her, confirming what Maud expects: her thoughts, 'that had been her friends during her enforced solitariness', are of no value to him, need to be suppressed with pills or answered with sex.

Hotel 167 describes its looking-glass world with remarkable artistry and unsparing black humour. Deliberately, it challenges its readership. Self- mutilation, like anorexia, is common among young women. Are we listening? Do we want to understand? And then comes the most disturbing question: does Solomon want us to understand?