I immediately read this as it brought to mind the barrier island off the coast of Virginia's Easter Shore. The story is actually referencing an Island in Maine, but I'm still glad I read it.

The central idea involves expanding traditional talk therapy into custom made virtual realities. The narrator deals with layers of trauma that echo the issues dealt with in the VR games created for patients.

There's a sort of Kafka vibe and I dig it. There's also an interesting effect where the most import aspects of the story float around the edges.