Trauma [Paperback]

Almost without exception, Patrick McGrath's novels are about intense, violent affairs, their inherent melodrama underplayed by the author's beautiful, clear prose which takes a detached (sometimes unhinged) analytical view of the subject, usually from a medical or psychiatric perspective. Like Asylum, which this latest novel perhaps most resembles, (not least of which is in its admirably concise and self-explanatory title), Trauma throws a lot of complicating psychological and behavioural complications into the mix - sibling rivalry, damaged people, Oedipal and Electra complexes and more Freudian analysis than you can shake a big stick at. It's lucidly insane, which is as concise a description of McGrath's work as I can find.

Essentially then, there is no dramatic shift in subject matter or style for McGrath in Trauma, with a flawed or unreliable narrator (this one being a psychiatrist who obviously has a tendency to be over-analytical of others' motives and behaviour), and clashes between rational analysis and sexual passions, between seemingly rational-minded individuals and artistic creative geniuses - so it's not just Asylum that comes to mind here, but also Port Mungo.

What is different in Trauma, and confirmed in the author's previous (fabulous) collection of three short novellas Ghost Town, is the growing influence and importance of living in New York that is playing a greater part in McGrath's work, the author managing to channel both the passionate seething of life with the isolating factors and anonymity of living there. Slowly but surely then, the depictions of madness in McGrath books is extending from the individual to the collective madness of America, without losing any of the riveting personal drama of his work.

This is a sharp focused book that stays with you for days after you have finished reading it. It appears disarmingly simple and economically written but is layered and resonant. Like all literature that contributes to our knowledge of the human condition it will be around for a very long time to come.

Patrick McGrath's 2008 thriller Trauma, which was shortlisted for The Costa, revisits a theme that has long fascinated him, psychiatry.

McGrath's fascination with mental illness stems partly from the fact that when he was growing up, his father was Medical Superintendent at Broadmoor psychiatric hospital in London. His fiction, dark and brooding, haunted with unmentionable secrets, forbidden desires and repressed memories, teams with the mentally unstable, from the disturbed Spider in 1990 and Dr Haggard in '93, through Peter Cleave, the psychiatrist in Asylum in '96 and the disturbed father of Martha Peake in 2000, to the frighteningly volatile unreliable narrator of Port Mungo in 2004.

The third novella in his trilogy Ghost Town, in 2005, featured a psychiatrist who showed signs of being as unstable as her patients. The pattern continues with Trauma, which centres around Charlie Weir, a New York psychiatrist approaching forty.

Charlie is haunted by demons. There are the memories of his mother, who he spent his childhood protecting, but who always unfathomably favored Charlie's older brother, Walt, who seemed indifferent to her suffering. There's Charlie's estranged father Fred, who deserted his family when Charlie was eight. There's Charlie's ex wife Agnes who Charlie pushed away seven years before after a catastrophe for which Charlie and Agnes both blamed him. And there's the glowering relationship Charlie has with Walt - the brothers goad and resent each other, but keep circling each other like prowling beasts about to attack.

Into this maelstrom comes the fragile and disturbed beauty Nora, with whom Charlie starts a relationship. But his personal life becomes entangled with his work when he finds that Nora's problems are deeper than he insitially believed.

McGrath spins a gripping, compelling story that enmeshes the reader inexorably. His prose is punchy and potent and often devastating in its understated power, as in this sentence on Charlie's mother :

'If she was typing then she wasn't crying, although later she was able to do both at once.'

Or this one on his ex-wife Agnes:

'Could I read her like I used to? But no, a new layer of emotion had silted and hardened upon what once had been a virgin bed of trust.'

There are sections of stunning, acute perception, where McGrath perfectly nails experiences most people have had but never articulated, such as this account of the exhausting, restless and broken sleep that haunts the disturbed and anxious:

'I slept in my mother's bed that night and was badly disturbed. I grappled through the hours of darkness with intensely frustrating problems of logic, or so it felt, but had a waking memory only of repetitive circular movements of the mind that allowed no resolution or escape, like being trapped inside the mechanism of a clock. Of the specific content of these dreams I had no recall, but I woke in a state of dread.'

And McGrath's insight into psychiatry and the reasons doctors become psychiatrists is chillingly astute, as evidenced by this aside of Charlie's:

'It is the mothers who propel most of us into psychiatry, usually because we have failed them.'

The only slight let-down in this wonderfully compelling, dark thriller was the way in which the novel ended fairly suddenly, with a few loose ends left dangling. Not only are questions left unanswered - why was Nora so disturbed? Why didn't Fred shed some light on his ex-wife's psyche, either at the end of the novel or during the previous 40 years? Why did Charlie's mother behave as she did? - but those answers that are provided seem inadequate: the reason for a recurring nightmare Charlie has is given, but the rationale for that event is never explored. The ending thus seems rushed and unfinished.

But then, clean, tidy endings to a McGrath novel would lessen the dark, bitter thrill, the lingering taste left haunting the palate. I've changed my view on McGrath. When I read Port Mungo and Martha Peake, I thought him an accomplished but not sufficiently unusual novelist to rate as one of my top twenty choices. But his last two books (this and Ghost Town) have convinced me that I was wrong.

****0 1/2