Trauma BY Patrick Mcgrath. Knopf. Hardcover, 224 pages. $24.

The cover of Trauma

Like the internal combustion engine and the Internet, the psychiatrist is one of those revolutionary inventions that no one embraces as an unalloyed gain for humanity. Psychiatry renders fatuous any attempt to imagine its absence from our world; even so, might not we be better off without it? Such a reflection is hardly the stuff of idle speculation for Charlie Weir, the therapist-protagonist of Patrick McGrath’s Trauma, who at one point voices the psychiatric “heresy” that “it is often by means of simple courage and a good woman that psychological problems are overcome, and without any help from people like me.” In the midst of a lengthy personal crisis, Charlie might well wonder about psychiatry’s ef­­ficacy. Once lionized for his work on post-traumatic stress, he now finds his professional life to be crumbling as part of a more general crack-up. In earlier novels, McGrath has explored the psychic disintegration of his characters by exulting brilliantly in the grotesque and the demonic. A sparer, far less outrageous tale, Trauma is by comparison a surprisingly lukewarm production.

Charlie is haunted by a failed marriage, which fell apart after the suicide of his ex-wife Agnes’s brother, Danny, a Vietnam veteran whom he had been counseling. Charlie’s grim discovery of Danny’s corpse in a squalid East Village apartment is an event he can’t put behind him—he’d pushed Danny to open up about his war horrors and so feels responsible for the suicide—and in its wake, he walked out on Agnes and their infant daughter. Agnes, for her part, shows more generosity after the death of Charlie’s mother; she resumes a sexual relationship with him seven years after their breakup. The melodrama of their affair, conducted furtively because she has remarried, balloons into a full-blown soap opera when Charlie begins a relationship with a woman named Nora Chiara, “famous . . . for destroying men.” And she confirms that reputation by in turn launching an apparent affair with Charlie’s hated brother, Walt, a successful painter. Suspicion of that affair plunges Charlie into the real despair lurking behind his distress over his brother-in-law’s suicide: the dark hatreds that suffused his relations with his family—not just with Walt but with his parents. His father is a shiftless petty criminal, while his mother lorded tyrannically over the “suffocating domestic atmosphere” of his childhood home.

Charlie tells his tumultuous story with a sort of measured equanimity that is conspicuously out of joint with the turmoil engulfing him. We all know that first-person narrators aren’t to be trusted, but to say that any one of the narrators of McGrath’s novels (all told in the first person) is “unreliable” would be redundant. McGrath has shown an abiding preoccupation with the way monstrous distortions masquerade as truth; his narratives undergo dramatic transformations akin to those that so often affect—and afflict—his characters’ bodies. The slippery, ambiguous tales told in his books range from the grisly story of a murder filtered through a schizophrenic’s fevered mind in Spider (1990) to the tautly controlled account, in Asylum (1997), of a woman’s erotic obsession given by Peter Cleave, a self-serving doctor seeking to rise through the ranks of a sprawling English psychiatric facility (one that closely resembles Broadmoor, the institution where McGrath’s father long served as medical superintendent). But Cleave spoke assuredly, even suavely, using the language of psychiatry as a means of exerting power over his patients and associates (and the reader). Charlie, while cautioning us not to assume that therapists are “uninterested in power,” resorts to the clinician’s vocabulary in the throes of desperation, as he mounts an increasingly vain attempt to hold his collapsing world at bay. The therapist’s language comes naturally; when we speak, McGrath suggests, we perform a desired version of the self. “Every psychiatrist,” Charlie observes, is “a writer manqué.”

Whatever their value as general principles, Charlie’s psychiatric insights do little to assuage the inner deadness that has left him an “emotional isolate,” a sick soul no less tormented than the Ancient Mariner or the Underground Man. By rotely pronouncing his profession’s talking points—“the child has no confidence in his ability to withstand rage, and believes it will break him into fragments”—Charlie only makes his detachment ever more tenuous and inadequate, as he gradually succumbs to a zombielike dissociation from himself and spirals into an existential maelstrom. He owes this fate not to any gaps in his knowledge, but rather to his habit of holding the things he knows at arm’s length: “Falsification of memory—the adjustment, abbreviation, invention, even omission of experience—is common to us all, it is the business of psychic life, and I was never seriously upset about it.” He should not be so cavalier about such psychic “business” because, as we eventually find out, his troubles have much to do with his own memory’s revisions of the past. McGrath strews these sorts of matter-of-fact, al­most dis­­missive—and thus neutralized—invocations of psychiatric concepts throughout Charlie’s monologue so as to point up his narrator’s fatally flawed self-regard.

Charlie’s blind spots alternate with expressions of candid self-exposure. Acknowledging at one point that “I was not a normal man: I was a psychiatrist,” he feels himself keenly estranged from normality, whatever that might mean, and proceeds to make a fetish of family life, whose mundane forms of happiness are missing from his own conflict-ridden past: “Such ordinariness struck me as the very acme of human achievement.” But Trauma’s “physician, heal thyself” parable does not paint Charlie as a hypocrite or even as much of a morally culpable figure—the psychic forces in play are cast as too fundamental for that. The novel never disavows or discredits the ability of psychiatry to shed light on human behavior. On the contrary, it endorses an orthodox view of our early years as the crucible of adult strife: “We see nobody clearly. We see only the ghosts of absent others, and mistake for reality the fictions we construct from blueprints drawn up in early childhood. This is the problem.” Fully invested in Freud’s conceptions of repression, memory, and transference, Trauma takes a decidedly Oedipal view as well of the sexual entanglements within Charlie’s family. Charlie finds himself drawn to Nora because she is a patent surrogate for his mother—they both are heavy drinkers prone to depression—and the linkage is driven home none too subtly when the couple have sex in his late mother’s bed, the centerpiece of a bedroom that he has made “a monument to the past, a shrine to the presence that still imbued it.”

The psychologizing is so doctrinaire in Trauma that one enjoys the novel only to the extent that one can accept its insistent Freudian diagnoses of personality, family conflict, and, of course, trauma itself. I’ll refrain from giving too much away, but the story concludes, inevitably, with the unearthing of the buried childhood secret that long ago set Charlie adrift. This late revelation causes Trauma to read like a psychoanalytic whodunit: The solution to the puzzle of Charlie’s malaise has indeed been there all along, in a nightmare that, it turns out, was not in fact a dream but rather a displaced recollection of parental brutality. And so, with the root of Charlie’s difficulties thus excavated, each family member takes on a new and pre­sumably more authentic cast—and in the novel’s concluding scene, Charlie himself can grapple with his newfound knowledge in a life-and-death struggle with his darkest impulses. As a narrative device, this sort of closure is undeniably satisfying. But is there any more to it than a way to bring the curtain down? Ultimately, there’s something reductive about the way McGrath stage-manages the novel’s conflicts so that they neatly resolve themselves as products of an underlying primal blueprint.

McGrath is a writer of estimable gifts, but Trauma is not a book that showcases his strengths. Despite certain parallels to Asylum, the novel comes across as if he set out to create something far more austere and un­­embroidered than usual. Although there are few of his signature gothic touches—the book’s ’70s-era Manhattan setting registers as an underworld of decay and degradation, and for the denouement, the scene shifts to an American variant of the decrepit Victorian psychiatric institution used to such powerful effect in Asylum—the lurid, rank lushness that permeates his most memorable novels has been dialed down. Mostly what we are given in Trauma is Charlie’s troubled mindscape, expressed through a voice quixotically trying to talk its way out of its nutshell until the confrontation with sorrow’s wellsprings makes all talk irrelevant. What I miss in Trauma is the cinematic sort of grotesquerie that McGrath so handily brings to life—the harrowing fogbound ambience of Spider, the teeming density of detail that made eighteenth-century England ooze with vitality in the first half of Martha Peake (2000). Over the past twenty years, in his invigoration of what we might have thought to be stale gothic conventions, McGrath has consistently offered up irresistible entertainments executed with fiendish verve and seductive wit. Here, alas, these qualities are not enough in evidence. In Trauma, the psychiatrist is told, “You’re just not all there anymore, Charlie. Something’s missing.” The same might be said of the novel as a whole—a recognizably McGrathian effort, but with a curious lack at its core.

James Gibbons is associate editor at the Library of America and a frequent contributor to Bookforum.