The Chequerboard Boy tells the story of Robert, a 15-year-old boy and the psychotherapeutic relationship he entered into with child psychiatrist, Dónal J. Cotter. Robert was born with spina bifida and endured a series of procedures in early childhood to enable him to walk. Robert’s mother was protective of him but struggled herself with depression. His parents fought, sometimes violently, and finally separated when he was about 13. Despite his physical disability Robert managed to make friends and succeed academically in school. However, in adolescence he found himself feeling increasingly disconnected from the world around him and expressed the wish ‘to talk to somebody’.

What followed in the course of therapy with Dr Cotter is a wonderful journey into Robert’s unconscious mind. On the verbal surface Robert was cagey and intellectually defensive but in a series of pictures that he produced spontaneously and brought with him to the sessions, he revealed much deeper conflicts. The book reproduces and analyses these pictures as they were presented and thus neatly takes us through Robert’s therapeutic journey.

This is a beautifully produced and most eloquently written book. The images are stark, arresting and beautiful. Dr Cotter opens with a brief but fascinating account of working psychoanalytically with children. He notes that James Joyce had described some of the key defence mechanisms of childhood long before Anna Freud. Each of Robert’s drawings is accompanied by a short description of the complex and hidden meanings being communicated and how their interpretation enabled Dr Cotter to foster meaningful and lasting change. Many of the pictures are genuinely horrifying and convey Robert’s fears of being misshapen and cast out. This is in stark contrast to the relative blandness of his verbal and body language all the while. The black and white checkerboard is a recurring motif signifying order that becomes distorted, just as with his spinal column. Robert’s anger and sadness jumps out of image after image but towards the end colour and playfulness convey progress and maturity.

Robert later reflected that his time attending Dr Cotter had been the best thing that had ever happened to him. Now in his 90s, Dónal J Cotter, was one of Ireland’s earliest child psychiatrists, working at St James’s Hospital until his retirement in 1990. Robert was indeed fortunate to have encountered Dr Cotter when he expressed his need to talk to somebody. In an age when psychiatrists are rarely trained to deliver psychotherapy and spend too much of their time focussed on risk and medical management, it is refreshing and stimulating to read such an empathic and insightful account of a different way of working. It is valuable reminder of the unparalleled potential of painstaking psychological work. This book is a gift and should be of interest to everyone.