Patrick McGrath’s ‘Trauma’

It will not surprise any regular visitor here to learn I am a big fan of shrink literature.The perspective from the psychotherapist’s chair is one I find particularly fascinating, as it manages to look long and hard at the depths of human suffering and damage, whilst having enough intellectual recoil to make such study curious and illuminating. The warped human mind becomes, if not a thing of beauty, then at least logical and pitiful in its own right, neither an object of shame nor a reason for scorn. Really good shrink-lit will indicate in unsettling ways the very fine dividing line between mental health and illness, will provoke genuine compassion for the struggles of the wounded to heal themselves and might just provide some compelling evidence for all those who would rather deny the power and impact of the darker regions of the mind. Salley Vickers’ The Other Side of You was one of the best novels I read in 1997, and Jed Rubenstein’s The Interpretation of Murder was another excellent example, even if it was a lighter version. The French authors Isabelle Hausmann and Camille Laurens also spring to my mind, but might not be well known to others. Now Patrick McGrath is an author I had never read before. I’d seen his name alongside such uncompromising-sounding titles as Asylum and The Grotesque and assumed he was a horror writer. Having read Trauma, I understand that in a way he is; he works within the shrink-lit genre but lacks belief in the possibility of orderly, viable cure. And so the cool, detached workings of the analytic process on the damaged mind reveal only the depths of a horror that refuses to respond to all manner of loving nurture – it’s what we might call evil, or as McGrath puts it better ‘ what does not kill me lies in wait in my subconscious to ambush me when I am at my weakest and most vulnerable.’ Whatever external enemies we may fear lurking in the shadows, they are nothing compared to the patient and terrifyingly efficient enemies who bide their time within.

McGrath’s novel focuses on Charlie Weir, a psychotherapist working exclusively with trauma cases. It was through his work with Vietnam veterans in the 1970s that he met his first wife, Agnes, whose brother was one of the most damaged men in his support group. And it was Charlie’s indirect responsibility that he committed suicide, thus ending that marriage in acrimony and despair. Now, almost a decade later, Charlie has started sleeping with his wife again, despite the fact she has remarried, and despite the fact that he has embarked on an intense relationship with the beautiful but far from stable Nora. If Charlie’s making a mess of his private life, it’s because his family background hasn’t exactly prepared him for love. The son of a depressive mother and an alcoholic, shiftless father who left home when he was eight, Charlie’s family conflicts get played out in his relationship to his older brother, Walt, a successful artist and a fine family man. Charlie needs his brother and he hates him at the same time. Walt was excused his mother’s bad behaviour, sent away from the worst of her depressions and told to wait until she was patched up again. In the depths of her suffering it was Charlie she leaned on and, precisely because she did so, her toxic combination of shame and guilt prevent her from ever appreciating him. ‘Oh anyone can be a psychiatrist,’ she said, in a quote that comes back to haunt Charlie. ‘It takes talent to be an artist.’ When Agnes’s brother commits suicide and Charlie is wracked with creeping guilt that he provoked him, she’s ready to dig the knife in again. ‘Ah Charlie,’ she said. ‘Always trying to help people who don’t want it.’

And so it’s no surprise that, as the novel progresses, we realize it’s Charlie’s damage at stake here, the wounds he has sustained which, as a good unreliable narrator, he has yet to let the reader see. But that’s mostly because he is not sure where the trauma in his own life is to be located. There are signs and indications, like atmospheric disturbances before a total eclipse, but what lies in the darkness will take the length of the narrative to be revealed. This is the premise of the notion of trauma. We all understand trauma to be the experience of an event so shocking, so horrific, that we have no frame of reference by which to understand it. It cannot be assimilated into the mind and so resists mental digestion, lying as a lump of undigested matter, ready to happen to us over and over again in its shocking, blinding reality, without the merciful haziness of the past. But what most people don’t know is that trauma is itself already a repetition. The experience of the Vietnam vets is beautifully handled in the novel and an excellent case in point. What happened to young conscripts out in Vietnam was atrocious and ultimately pointless; it destroyed many a man who hadn’t needed or wanted to be there. But studies subsequently have shown that there was a staggering correlation between the men who returned with posttraumatic stress disorder and those who had had troubled childhoods. Few vets returned unscathed, but the annihilating effects of trauma were almost exclusively to be found in soldiers who had already suffered hysterical mothers, drunken fathers, family violence, dislocation or abuse. It seems we can experience the worst on one occasion, but to have it happen again, to experience an event that recalls the worst in structure or form, is literally intolerable.

I thought this was a cracking book. It is absolutely beautifully written, with such clear, elegant prose that it made other narratives look florid and strained. McGrath doesn’t waste a single word and he moves from past to present with great fluidity and control. The big revelation at the end was perhaps a little bit of an anti-climax, but I mention this only out of a concern for complete accuracy, and not because it bothered me as a reader in any way. The journey getting there, like all therapeutic journeys, was always the point. This is a chilling, unnerving read, possibly not for people who want a happy ending, but a fine thriller for those who fear that it is the power of the mind that really threatens our safety, our wellbeing and our ability to sleep easy at night.

24 thoughts on “Patrick McGrath’s ‘Trauma’

  1. This is an excellent review of what sounds like a compelling book. All I can say is that humans only have so much resilience we’re born with, and as it gets worn down over time, from the time we are born, without replenishment, it gets harder and harder to recover from the traumas that sever attachments to the world.

  2. I’ve always been curious about Patrick McGrath. I wonder if all his books are as good as this one, as I have a cople of others by him (but not this title). I love it when authors get into the character’s mind like this, and you always have such a knack for writing about these sorts of books. I’ll have to give him a try, though you’re right some of his titles are a little disconcerting. Also I have no idea that soldiers with difficult childhoods were/are more apt to suffer from post traumatic stress. Interesting.

  3. Yes, very interesting (and am intrigued to check out that behind the couch blogger too!) I’ve heard PTSD described uncharitably as “borderlines in crisis” which suggests that it’s the vulnerability to trauma rather than the trauma itself which is crucial. As you say, it’s repetition. Would be interested to read this but it’s perhaps a bit dark for my current state. But thanks for another excellent suggestion to add to my research project.

  4. I’d never heard the term “shrink lit,” but I know I’d love it. The inner workings of the mind are fascinating. This book definitely goes on my list 🙂

    I just read “The Other Side of You” last year. It was a marvelous example of the type of work you describe.

  5. Behindthecouch – thank you so much! I think he ought to be compulsory reading for all therapists! 🙂 You have a lovely site, btw, and one I’ll be back to visit at my leisure.

    Q-Squirrel – It is a very good book indeed, so wonderfully written. Interesting what you say about trauma. You’d think age and experience would help, but it doesn’t seem to be that way, neither with the traumas of childhood nor with what comes later. I once spoke to a therapist who said that they’d discovered trauma could be aided enormously if the victim was allowed to speak what had happened without any time limit. He said it took up to five or six hours for the analysand to talk themselves out, but that it seemed to have encouraging results. I do hope that’s a way forward.

    Danielle – I really do love this sort of book. It’s probably my favourite of all. And I love all psychoanalytic literature, hence I pick up these things about trauma sufferers. Mental breakdowns and problems are so awful and yet I can’t help but find them fascinating. Couldn’t sit through a whole medical drama, though! 🙂 But I will definitely be reading more McGrath now, titles notwithstanding!

    Pete – I was going to come over and recommend this to you, if you hadn’t seen it yourself. It might be a bit dark for you at the moment, but it is very cooly written, it holds itself off from expressing any really terrible pain, so, maybe… Borderlines in crisis is a fascinating term (if a bit offhand, I agree), but very evocative.

    Becca – Aren’t those inner workings fascinating? I do find so myself and would love to know what you think of this book if you read it. It is much darker than the Salley Vickers, but it has that same emotional intelligence and the same piercing apercus into the human condition.

    Anne – I think you’d really like this – or at the very least find it an interesting comparison to your own work. I could see interests that the two of you would have in common! 🙂 And I’d love to know what you think if you do read it. Big hugs!

  6. This sounds good. I have his Asylum on a bookshelf somewhere and was excited to read it when it entered the house but ot got pushed back. Your review makes me want to go rescue it to see if it is aas good as this one seems.

  7. I think mine is going to be a dissenting opinion here. Books like that–at least by the sound of it–make me laugh. Not because I think trauma is laughable. Not at all. But because trauma is so common. Scratch below the surface and most people I’ve met have come from painful families of origin and yet they are living ordinary lives and doing their best not to pass along the legacy. Maybe it’s the fact that there were two generations completely messed up by world wars. The scope of it is mind boggling. (72 million people died as a result of the 2nd world war, for example). Not to mention the depression between them. That legacy has reverberated through the next couple of generations along with whatever else gets passed down: neglect, abuse, alcoholism. There are many other varieties of messed up shit as well. So I see that sort of plot as carrying on with a caricature of therapy rather than the real thing, and a caricature of trauma and its aftermath. The after-effects of childhood trauma are painful, but most families have some degree of that. Either we are all mad (yes that is possible) or a lot of us are carrying on and trying to make the world we give to our kids a better one. Therapy is one way to heal and so make the next generation’s lot better. But the lessons of therapy are crucial for our whole society: acceptance, respect, listening to each other.

  8. Stefanie – I really liked the look of Asylum when I read about it on amazon (alas, I have been there already!). I’d love to know how you get on with a McGrath novel if one looks like the right thing to you!

    Lilian – a few thoughts. First of all, to be fair I do think you’d have to read the novel. It could come across very differently to you. Secondly, I do feel there should be some distinction respected between trauma and the undoubtedly troubling, distressing and often damaging consequences of bad stuff happening. I’m not commenting on the level of distress, (it’s not for me to judge other people’s degree of suffering, and different people are traumatized by different events), but because trauma is a particular psychic disorder requiring a particular form of therapy. Finally, I don’t understand what you mean by ‘carrying on a caricature of therapy’. This is an informed novel, and not one that intends any comedy or commits any disrespect. Nor does it follow through an account of a particular therapeutic interaction. It does deal with trauma in many forms, but there are parts of the plot I wouldn’t wish to reveal. I’m just not quite sure what you are getting at there.

    Finally, of course I agree that the lessons of therapy would, in an ideal world, be incorporated into multicultural life. Let’s hope one day they are.

  9. You’re right–I should read the novel before commenting on it. I’ve never heard the word trauma used to mean a psychic disorder. I wonder if the North American usage is different. Here trauma refers to things like child abuse, war, being witness to a violent crime, in other words bad stuff. That was the context of my comment. The description of the book touched a nerve for me because I know many people valiantly living ordinary lives despite surviving very bad stuff (ie what we would call trauma). Some of those people have ptsd (the reverberating aftermath of bad stuff). And there is so much misinformation circulating about that. I thought that the “warped mind” in the review referred to people who have lived through bad stuff, described as having a mind that “if not a thing of beauty, then at least logical and pitiful in its own right.” That to me would caricature survivors (I am not referring to caricature as comedy, but to exaggeration of features) and their healing process. On the contrary, the people I know healing from ptsd and traumatic experiences like child abuse and life with alcoholic parents have families, jobs, friends. Most people have no idea that they are living ordinary lives while carrying the extra weight of nightmares, hypervigilance, and so on. And I would say that they are not pitiful but heroes for doing so, and that there is great beauty and dignity in it. However…it sounds like all of this came from different usages of the word trauma. And that what you were writing about was something else. Perhaps I need to read the book.

  10. To add to litlove, there are degrees of trauma, loss, resilience, horror, length and depth and submersion. Yes, everyone in certain generations were exposed to certain wars from certain distances whether at tea parties or in battlefields or in concentration camps or in the middle of the night being sexual abused by depraved uncles and each of these people had different capacities — inborn capacities — to cope, to hide, if you will, the effects of their trauma, to get on with their lives with no help at all, and others were crippled and needed all the help they could get and still couldn’t judge them and to offhandly lump them all together is to me, at the very least, puzzling. Litlove, you handled that with greater aplomb than I ever could have or am. This is why I don’t review therapy books. Or write therapy posts. They bring out such rage in people about suffering contests and who gets to win and lose the suffering prizes.

  11. Mmmmm … this sounds like a good book. Your description reminded me a teensy bit of the Anne Perry book “Face of a Stranger,” which is of course nothing like the McGrath book in subject, but has a similar theme of the main character haunted by a past just out of his line of sight.

    Every book you read sounds so delicious and wonderful that you make me wish I could lounge around all day long, drinking tea and reading. How pleasing it would be to swoon from an excess of fiction!

  12. Lilian – thank you for the clarification; very helpful. I wondered what part of my post triggered your response, and I’m sorry I wrote something that provoked a strong reaction like that in you. To think that one’s mind had been warped by events would be by no means incompatible to me with heroism – far from it. My perspective is that the damaged of the world are themselves often misunderstood and told to ‘buck up’ or ‘get over it’, which simply isn’t possible with clinical trauma. I understand it to be a particular condition in which the events of the past recur in flashbacks, nightmares and somatic responses, none of which are controllable, and which return the past to the present as if it were happening again. This is certainly part of PTSD. I think we are both on the side of the sufferers here, though, and the confusion is only over terms.

    QS – Thank you for the helpful distinctions there concerning trauma. I haven’t got any clinical experience the way you have, but I read a fair bit about the way that two people could go through the same bad experience (a bomb on the underground, for instance), and whilst one person would be deeply upset and badly shaken, the other would be properly traumatised. I should read more, though, as I’m sure I have much to learn. You’re right these topics are difficult to discuss and I’m really grateful that everyone who comments here remains polite. I would deal very badly, I’m sure, with a personal attack, but then it’s unlikely that kind of a comment would make it through moderation! 😉

    Doctordi – lol! Yes, it is certainly creepy. But it isn’t depressing, or at least I didn’t find it so. Still, not the book to give you belly laughs.

    David – I have never read Anne Perry. Now there’s something I could rectify. I think I’ve spent my entire life trying to arrange matters so I can maximise loungeing, tea-drinking and book-reading; work still gets in the way a bit though. I am certainly up for all fictional excesses! 🙂

  13. Squirrel and Litlove–I hope that I haven’t given the impression that people who have endured terrible things should buck up and quit whining. Yikes! That wasn’t my intention at all. I was reacting to what I perceived as way of categorizing people and making a judgment about people who have been wounded. I know so many people who have been abused or neglected by both sober and alcoholic parents that I’ve wondered whether that generation, ie the parents and their parents, might have been a traumatized generation. I didn’t intend that as a statement that everyone is messed up so buck up and forget therapy. If anything I think that it means that most people could use therapy and that if there was less of a stigma about suffering, and more support and recognition from friends and family, then it would make it easier for people to get the deeper healing that therapy can provide. I’m sorry I reacted so quickly in posting. This is how it felt to me after reading the review. “People who have been seriously harmed as children are damaged goods not like regular folks.” And my response was: “People who have been seriously harmed as children are regular folks who have an extra burden to carry and should be respected for that.” While I agree that warping is not contrary to heroism, people who have seen a lot in life also can see some things more clearly than those who haven’t, even though they may also have greater sensitivities in some areas. The word “warp” implies a distortion and has a negative connotation that I react strongly to. There are people who have delusions because of brain chemistry that has nothing to do with any prior experience of traumatic events in their lives. There are people who have experienced traumatic events who would classify themselves as mentally ill and find in that classification validation for their perception of themselves and their lives. But a lot of people I know who are survivors don’t perceive themselves that way and the possibility that somebody would call them mentally ill is just an added bit of stigma they don’t want. For those people then it means covering up and concealing something that shouldn’t be any shame to them but becomes so in order to avoid stigma. Both of those different positions deserve respect, I think.

  14. I’ve enjoyed, if that’s the right word, the few examples of shrink-lit I’ve come across, but there’s always been a slightly scared part of me. There seem to be lots of commonalities between the unfortunates in the books and myself. This is the source of some of the ‘pleasure’ in reading these books (I’m not alone!), and also the source of the discomfort (eeek, I AM insane!).
    I’m thinking specifically about The Bell Jar and Hurry Down Sunshine by Michael Greenburg.

  15. Lilian – you end there on a note I’m sure we can all agree with.

    AndrewL – I know exactly how you feel! You should try reading psychoanalytic tomes – it’s far worse for arousing symptoms than your average medical dictionary! I haven’t heard of Michael Greenburg, so thank you for that tip – I’ll be checking the novel out.

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