Depending on one's point of view, Netsuke, by Rikki Ducornet, is the zenith or the nadir of novels trashing psychiatrists. The main character, who is never named, is referred to as a psychoanalyst, and although we hear a great deal about his work, there does not seem to be a single psychoanalytic patient in his practice. His professional routine is most unusual; he has two “therapy” rooms in his office, one where he conducts what he considers to be mundane psychotherapy and one for highly erotic encounters with patients. Deciding that having the two offices at his own house is too close to home (his wife is an artist who has her studio at their home), he opens a second erogenous den of sex cum therapy in the city.

Dr. X hardly limits his intercourse to patients; he routinely has sexual relations with women he encounters in coffee shops, on the street, and while jogging. His magnetic stare is irresistible, it would seem. These sexual encounters are thrown into the novel as detours from the main theme of sex in the office.

The novel focuses on the doctor's relationship with two “patients”; one appears to have borderline personality disorder and is referred to as The Cutter, and the other is a transvestite who comes to sessions cross-dressed as a beautiful woman. The beginning of the end occurs when the two discover each other. Their chagrin comes from discovering that neither is anywhere near as special as each had assumed.

The end of the novel is the end for the psychiatrist (and for his wife, who is along for the destructive ride). There is no denouement of self-realization but rather a literal and figurative crash when the doctor just cannot pull off his lifestyle any more.

A word about the title: a netsuke is a small figure of ivory or wood used as a button on a Japanese man's sash from which he hangs personal possessions. Dr. X has a collection of these, gifts from his Japanese wife. While she makes art, he makes mayhem collecting sexual conquests.

The irony of all this is that Dr. X's functioning is dependent on fanatical compartmentalization with rigid boundaries. His life, on the other hand, is composed of daily boundary violations. When the internal boundaries dissipate, the only possible outcome is death. Where was his own psychiatrist when he needed one? Not in this novel.