For Elisabeth de Mariaffi, the process of writing a story starts with a single scene that eventually evolves into a full narrative. It was no different for her latest novel, Hysteria.

The book follows a young German woman, Heike Lerner, who escapes Dresden and the perils of the Second World War and finds herself in the 1950s living in Upstate New York with a husband and four-year-old son. But the eeriness of her idyllic life becomes hard to ignore when a mysterious little girl appears one afternoon at the pond and vanishes just as quickly. Things take a turn for the worse when her son disappears.

Below, she discusses the writing process and inspirations that led to Hysteria, her second thriller novel.

"One of the most fun and engaging parts of writing Hysteria was how all these other elements showed up to be a part of the story and they all made sense. The fairy tale piece was really interesting to weave in with Heike's German background and growing up with fairy tales, then telling stories to her little kid, but living in a time in the States that was marketed as a fairy tale. We use that word to mean something delightful, like a utopia, but in fact that is not what the U.S. was actually like in 1956. It was a deeply unequal time and not particularly good for lots of people. Also, fairy tales themselves are very dark and they actually explore our fears.

"The character of Leo Dolan, whose work is very strongly based on the work of the Twilight Zone creator Rod Serling, is creating these teleplays that are kind of like Twilight Zone-style modern fairy tales that depict the fear of the unknown that 1950s American culture was exploring. All those things started to work together, so you could have this character in the woods in upstate New York with a husband who was on the vanguard of developing a new industry around psychotropic drugs and classic fairy tales from hundreds of years ago and the Twilight Zone. Pulling that all together was deeply satisfying."

"With Hysteria, I started with the character. I was really interested in Heike, in that time period, as someone who's being very independent and is now living in one of the least emancipated moments for women in the 20th century and what the friction is there. I almost always have a really visual scene in mind and in this case, Heike and her son Daniel at the pond when the little girl arrives was the one that came to me. I knew I wanted to write a story about it and, at first, I thought it might be a short story; but once I sat down to write, it just all started to fill in. All of a sudden you've got 100 pages and you think, 'OK, now I must go on.'

"There was a great amount of motivation to get to that scene. And often those first 50 pages can feel the most challenging because you don't really know what's going to happen. But aside from that, what's really important to me is to allow myself to really be expansive in that imaginative phase of writing a first draft and not question myself too much, especially in a book like this that was a fairy tale and involves lots of imaginative work. So the trick is to just allow yourself that space."

"I went through a whole bunch of possible titles and nothing ever felt really good. I become so close to a story and a character that I always feel uncomfortable naming it. Once the book was already largely polished, we were talking about the Hitchcock feel to the story. I picture Heike as a 1950s Hitchcock blonde — very much like Grace Kelly in those party scenes. The story is set at that time and it's a psychological suspense thriller. I was riffing back and forth with my husband and he actually said 'hysteria' and I went, 'Oh my god, that's the name of the Hitchcock movie.'

"It is also a word with a long history for women and mental health. The diagnosis of hysteria moves with women through time from the Victorian era right into the 1950s. She's married to a psychiatrist and one of the ways that he diminishes her is by saying, 'You're hysterical.' That is still something we say — that women react emotionally and not logically. There is an undercurrent of devaluing or diminishing women's contributions."

Elisabeth de Mariaffi's comments have been edited and condensed.