I really loved The Things We Do to Our Friends, so I was looking forward to A Sharp Scratch and I was not disappointed. From the first few pages of I was hooked by the subtle, creeping sense that something was deeply, unsettlingly wrong. Heather Darwent’s novel is psychological suspense at its most insidious, with echoes of The Stepford Wives and The Retreat by Mark Edwards, but with a colder, more clinical core.
Betsy, the protagonist, is not your typical unreliable narrator. She’s exhausted, raw, and sharp in the way only someone who’s been struggling for years with severe sleep deprivation can be. Darwent crafts her voice with care—at times surreal, at others distinctly unstable and therefore unreliable. She is unable to recognise what’s real and what’s in her head . Through Betsy’s eyes, we’re taken on a jagged journey through mental illness, societal expectations, and the grotesque commodification of wellness culture. Her time at Carn is written with such tension that I found myself holding my breath more than once.
The characterisation here is first-rate. Betsy is layered and heartbreakingly real, but even the secondary characters pulse with motivation and ambiguity. Harry, her husband, is particularly well drawn. He’s not overtly villainous, but his actions and emotional withdrawal sharpen the knife Betsy already carries inside. Betsy’s decision to marry Harry seems, at first, like a misguided act of hope. But Derwent gradually peels this back to reveal how his personality may have accelerated Betsy’s psychological deterioration. Her sense of self begins to fray, not because she is innately unstable, but because Harry treats her instability as inconvenient. His desire to “fix” her becomes a quiet form of violence.
Carn, the wellness retreat where Betsy goes to “heal,” is rendered with unnerving beauty. It’s serene, expensive, full of soft furnishings and even softer threats. Elise, the founder, is a fascinating creation—a woman who, on the surface, champions acceptance, but underneath curates conformity with an iron will. The more you listen to Elise, the more you sense she doesn’t want to heal women so much as repurpose them. Her motive seems rooted in personal trauma—perhaps a need to regain control over a life that was once out of her hands—but there’s also a chilling sense of cultish pride. Elise believes she knows best, and that belief becomes dangerous.
Betsy has a fragile grip on reality. When she gets to Carn and meets the other female guests, the atmosphere tightens. The pacing is slow-burn but deliberate—tension builds like a low-frequency hum, and by the final third, it’s almost unbearable.
Darwent writes with a really strong atmospheric tone. The Carn is A Scottish retreat in a stately home in the countryside miles away from anywhere. The appointments are luxurious and the food is superb. But there’s no such thing as perfection, and the whole confected bliss begins to unravel. As Betsy has her first blissful sleep in a long time, Darwent begins to ratchet up the Gothic angles and what seems like a blissful escape turns into a horror of nightmare proportions.
What Darwent does so well is layering—not just in structure, but thematically. This is a novel about control, identity, and the weaponisation of wellness. Carn promises salvation, but at what cost? And who defines what “healing” looks like? The final twist isn’t a shocking reveal, but a devastating realisation. What’s really broken are the systems, relationships, and ideologies around her.
VERDICT: A Sharp Scratch is very dark indeed and also slightly surreal. The slow pace certainly won’t be for everyone but it does really create the tension and atmosphere that the book needs. This is terrific modern psychological fiction—claustrophobic, compassionate, and darkly terrifying in equal measure.