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  • Written by Patrick McGrath
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  • Written by Patrick McGrath
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List Price: $11.99


On Sale: April 08, 2008
Pages: 256 | ISBN: 978-0-307-26870-9
Published by : Vintage Knopf
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Charlie Weir is a man who tackles other people's demons for a living. He has seen every kind of trauma during his years as a psychiatrist in New York.Yet he hasn't found a way of resolving his own conflicts, particularly the fatal mistake that caused his wife and daughter to leave him condemning him to corrosive loneliness and restless anger.Years later, he meets a beautiful but damaged woman who promises to restore his dwindling faith in both his profession and himself. But as he realizes that she has become more of a patient than a lover, events conspire to send him reeling toward the abyss. Addictive and enthralling, Trauma is Patrick McGrath's most riveting work to date.


My mother’s first depressive illness occurred when I was seven years old, and I felt it was my fault. I felt I should have prevented it. This was about a year before my father left us. His name was Fred Weir. In those days he could be generous, amusing, an expansive man—my brother, Walt, plays the role at times—but there were signs, perceptible to me if not to others, when an explosion was imminent. Then the sudden loss of temper, the storming from the room, the slamming door at the end of the hall and the appalled silence afterward. But I could deflect all this. I would play the fool, or be the baby, distract him from the mounting wave of boredom and frustration he must have felt at being trapped within the suffocating domestic atmosphere my mother liked to foster. Later, when she began writing books, she fostered no atmosphere at all other than genteel squalor and heavy drinking and gloom. But by then my father was long gone.

In those days we lived in shabby discomfort in a large apartment on West Eighty-seventh Street, where my brother lives with his family today. I never contested Walt’s right to have it after Mom died, and have come to terms with the fact that to me she left nothing. Indeed, it amuses me that she would throw this one last insult in my face from beyond the grave. It was more appropriate that Walt should have the apartment, given the size of his family, and me living alone, although Walt didn’t actually need the apartment. Walt was a wealthy man—Walter Weir, the painter? But I don’t resent this, although having said that, or rather, had I heard one of my patients say it, I would at once detect the anger behind the words. With consummate skill I would then extricate the truth, bring it up to the surface where we both could face it square: You hated your mother! You hate her still!

I am, as will be apparent by now, a psychiatrist. I do professionally that which you do naturally for those you care for, those whose welfare has been entrusted to you. My office was for many years on Park Avenue, which is less impressive than it sounds. The rent was low, and so were my fees. I worked mostly with victims of trauma, who of all the mentally disturbed people in the city of New York feel it most acutely, that they are owed for what they’ve suffered. It makes them slow to pay their bills. I chose this line of work because of my mother, and I am not alone in this. It is the mothers who propel most of us into psychiatry, usually because we have failed them.

Often a patient will be referred to me, and after the preliminaries have been completed and he, or more usually she, is settled comfortably, this will be her question: Where would you like me to begin?

“Just tell me what you’ve been thinking about.”


“What were you thinking about on your way to this appointment?”

And so it begins. I listen. Mine is a profession that might on the surface appear to suit the passive personality. But don’t be too quick to assume that we are uninterested in power. I sit there pondering while you tell me your thoughts, and with my grunts and sighs, my occasional interruptions, I guide you toward what I believe to be the true core and substance of your problem. It is not a scientific endeavor. No, I feel my way into your experience with an intuition based on little more than a few years of practice, and reading, and focused introspection; in other words, there is much of art in what I do.

My mother did eventually recover, but there is a strong correlation between depression and anger and at some level she stayed angry. It was largely directed at my father, of course. I have a clear memory of the day I first became aware of my parents’ dynamic of abandonment and rage. Fred had taken Walter and me to lunch, a thing he did occasionally when he was in town and remembered that he had two sons living on West Eighty-seventh Street. For me these were stressful events, starting with the cab ride to an East Side steakhouse, though in fact any time spent with my father was stressful. One summer he took us on a road trip upstate to a hotel in the Catskills, a journey of pure unmitigated hell, the endless hours sitting beside Walter in the back of the Buick as we drove through the endless mountains, and the atmosphere never less than explosive—

Fred Weir was still handsome then, his dark hair swept back from a sharp peak in a high-templed forehead, a tall, athletic fellow with a charming grin. He wasn’t a successful man but he gave the impression of being one, and when he took us out to lunch I marveled at the peremptory tone with which he addressed the waiters, brisk unsmiling men in starched white aprons who, in that adult room of wood paneling and cigar smoke, thoroughly intimidated the lanky, nervous adolescent I then was. My anxiety was not eased by the presence of steak knives with heavy wooden handles and sharp serrated blades, and a sort of diabolical trolley that was wheeled, steaming, to the table by a stout man with a pencil mustache who with the flourish of a gleaming knife indicated the meat and demanded to know where I wanted it carved.

When Fred grew bored with us and showed signs of calling for the check, Walt would ask him for investment advice, claiming to have considerable funds stashed away. Walt was always more curious about our father than I was. As a boy he was intrigued as to what went on in our parents’ bedroom, when they shared a bedroom, that is. He wanted to get in there and find out what they did.

Mom was distressed when we returned from these outings, having in our absence awoken to the possibility that Fred might exert a stronger influence over her boys than she did and that we too would then be lost to her. It fell to me to assure her of our love and loyalty. Then she lavished her affection on me for a while, until she grew distracted and drifted off down the hall to her study. Hearing the door close and the tap-tap-tap of the typewriter, I knew she would not come out before it was time for a cocktail. I was comforted by the sound of the typewriter. If she was typing then she wasn’t crying, although later she was able to do both at once.

But I remember one day when we returned to the apartment and she wasn’t waiting in the hallway as we came up the stairs. This was unusual. We let ourselves in and at once heard her crying in her bedroom. It was pitiful. Walter said he was going out again, I could do what I wanted. I see myself with great clarity at that moment. The choice was simple. I could walk out of the apartment with him and spend an hour or two in Central Park, or I could go and knock on my mother’s bedroom door and ask her what was wrong. I remember sitting down on the chair in the hallway, beside the low desk with the telephone on it, where she always left her keys on the tray and fixed her hair in the mirror on the wall above it.

“I’m not waiting,” Walt said from the front door.

A sudden fresh gust of misery from the bedroom.

“I think I’ll stay.”

“Suit yourself,” he said, and the front door closed behind him.

For another minute I sat on the chair in the hallway, then stood up and walked slowly toward her room. This is how psychiatrists are made.

Much of my later childhood and adolescence followed this pattern. I did not make friends easily, and I was more content by far with a book than with the company of my contemporaries. Walter by contrast was a gregarious boy and often brought his friends back to the apartment. This was a source of pleasure to my mother, although if she was depressed she would withdraw to her bedroom. At times like this it was a cause of concern to me that Walter’s friends made so much noise. I remember I stood in the doorway of the living room once and asked them to be quiet, as Mom was resting. They were dancing to Bill Haley. Walter would have been about seventeen; I was three years younger. I remember he turned the record player off and they all stared at me, six or seven of them, older kids I’d seen in the corridors of the high school we attended on the Upper West Side.

“What did you say?” said Walter.

If it hadn’t been for the fact that Mom was trying to sleep I would have fled.

“I said, I think you should turn it down.”

They all stared at me in silence. It was a form of mockery. “What did you say?” said Walter again.

“Turn it down! She’s trying to get some sleep!”

He looked at the others and solemnly repeated my words. They started laughing. They slapped their thighs, they yelped like hyenas; they lifted their heads and howled, all to humiliate me. Then Mom’s bedroom door opened down the hall. She shuffled toward the living room, yawning. She was in her robe, barefoot, and she hadn’t brushed her hair. It was the middle of the afternoon and I felt embarrassed for her in front of Walter’s friends, who had fallen silent. She stood in the doorway and asked what was going on, and Walter told her. She was still half asleep. She turned to me.

“Don’t be silly, Charlie, I was only reading. You people have fun, I don’t care.”

She went back to her room with a wave of her hand and I left the apartment feeling angry and ashamed.

When I returned to New York after my residency at Johns Hopkins, I didn’t move back to Eighty-seventh Street. Mom told me she didn’t want me in the apartment. She said she needed silence in order to write. I understood what she was telling me. It was not a rejection, though it was framed in those terms, because she also gave me a new set of keys. Don’t abandon me, she was saying. She was stabilized on antidepressants but there were still times when she would suddenly, precipitately go down, and then it was me she needed.

From the Hardcover edition.
Patrick McGrath|Author Q&A

About Patrick McGrath

Patrick McGrath - Trauma

Photo © Elena Seibert

Patrick McGrath is the author of six previous novels, including Asylum and Spider, and two collections of stories. He lives in New York.

Author Q&A

A conversation with


author of


Q: You've used psychiatry and psychiatric disorders to great effect in you work. Using therapy as a storytelling device to get into the drama of characters' lives can be an intersting tool—something that the new HBO series IN TREATMENT also takes up, for example. What are your inspirations in using therapy in your fiction?

A: I use psychotherapy in my fiction as a way to reveal and explore my characters’ emotional predicaments, from which stories will always emerge. There is also a story to be told about the relationship of the therapist and the client, which is rarely straightforward. So in other words this is very rich, dense, human territory for a novelist. I should also say I’m a big fan of IN TREATMENT. Gabriel Byrne in fact played the father in David Cronenberg's film of my novel SPIDER...

Q: What gave you the idea for this novel? And did it take long to write?

A: Trauma took quite a time, almost 3 years, as I began it as a post 9/11 story. In this early draft, Charlie is a man in his 60s, a sad lonely figure estranged from his grown-up daughter. When she’s badly traumatized on 9/11 he's able to help her, having spent his life as a psychiatrist treating trauma. But before I wrote all this, I wanted to describe his early days treating Vietnam vets as a young man, and that part of his story, the prelude really, became the story itself. But it took a long time to figure all this out.

The family elements arose as the book developed. Key to this process was me being told by a NY shrink that most shrinks he knew were in the profession as a result of failing their mothers. That gave me a way into Charlie’s psyche, and I was able to create his family background, relationships with his parents, brother, etc. What he doesn’t know, of course, is what happened in the old Western Hotel when he was a small boy…

Q: The idea of trauma therapy is especially interesting now that we’re seeing a lot of soldiers coming home from war missing limbs and suffering emotional turmoil. Did this influence your decisions about your main character’s professional discipline? Do you think therapy can truly help people with severe post-traumatic stress disorder?

A: It did occur to me of course that the trauma suffered by American soldiers fighting unpopular wars overseas wouldn’t be so different whether it was Vietnam or Iraq, and in that sense I thought, or hoped, rather, that it was timely.

Yes, I do think therapy can help people with severe PTSD. My research while writing the book (Robert Jay Lifton’s “Home From the War” was very helpful, as was Judith Herman’s “Trauma and Recovery”) convinced me of this. As for traumatized Iraqi vets influencing my decision to make Charlie a trauma doctor, it was rather that I wanted Charlie to be a young man recently qualified in psychiatry in the early 1970s, which then led to him working with Vietnam vets, which in turn suggested parallels with what’s happening today as another generation of young Americans comes home physically and emotionally damaged from an unnecessary and immoral war.

Q: Your books often have, at heart, a fairly unreliable narrator and in this case it seems to be a psychiatrist who can’t quite see himself or his own psyche very well. Is the Unreliable Narrator something you’re fascinated by and plan ahead of time or does it just naturally evolve?

A: The unreliable narrator starts to evolve the moment I ask myself, who is telling this story? One character has to be given the task of narrating the events, and almost at once I start asking, why is he or she telling the story in this manner? What is being left out, denied? What is being distorted, exaggerated, falsified? I believe we all do this, we can’t help it, we have to bring bias into the accounts we give of our experience. For me it’s the only way to tell a story properly, to see it as the expression of a flawed and unreliable human being. I’d say unreliable narration is more a philosophical principle than a narrative technique.

Q: We’re used to the gothic settings and dark British mystery of your earlier work, yet this novel is set in the New York City of the ‘70s and is quite a vivid depiction of the city itself. Was that easy to write about/imagine a different city then?

A: It was not hard to evoke New York in the 70s. I arrived here in 1981 and it was still a pretty dangerous, dirty, edgy, conflicted city, and exciting as a result of all that, at least to a young guy come to be a writer here. How it didn't descend into utter chaos and anarchy seemed a daily miracle. It echoed nicely the breakdown in the mind of Charlie Weir.

It was a conscious decision to move my stories to my country of adoption (some 30 years ago I got to the US–I began to write in NY), and then more specifically to set my work in New York. This was difficult, as I felt far more comfortable writing about England, despite having been away so long. But Trauma feels like a New York novel, at least to me.

Q: The women in this book really stand out as both simultaneously strong and vulnerable. Is it any harder or more of a challenge for you to write a female character than a male?

A: I don’t find it harder to write a woman than a man. The effort of imaginative identification with the character, which comes about slowly in the course of the writing, is no different. There’s always a moment of feeling—Aha!—now I know who this is, and from then on you’re at home with the character, and this’ll happen with men as well as women. Children are tougher.

Q: You grew up literally near/around a hospital for the criminally insane in England and later worked in an asylum in Ontario, Canada. Do you think you’ve drawn much inspiration in your fiction from what you witnessed in those years? Was it at all traumatic?

A: Growing up close to the mental hospital where my father worked gave me an early, very basic understanding of the problems of institutional psychiatry as experienced by my dad. I discovered to my surprise when I started writing that I wanted to tell stories about the distressed and the insane, and this must be where it came from. My childhood was not in the least traumatic. Kids of shrinks don’t get exposed to the horrors or violence of their parents' more wildly psychotic patients.

Q: This book also deals with hidden trauma that one can experience in childhood, yet push away from their memory. Do you think it’s always bound to surface later, the buried trauma of the past?

A: If deeply buried trauma isn’t brought to the surface in therapy, it will continue to blight and disturb and diminish the life of the person in all sorts of ways, largely by coming to the surface in the form of disguised feelings and behaviors. These are the symptoms of trauma, and they should lead the therapist to uncover the buried trauma that causes them, and so help the person come to terms with the trauma.

Q: Are you working on any new projects yet?

A: I have a new novel cooking, another New York story, this one set now, in the present. I have the outiline of a story, a number of characters, not too much else.

Q: You've been traveling a lot lately—is travel important to you?

A: I would prefer never to travel. I am perfectly happy in my study writing a book and whatever hunger for new experience I may have, reading satisfies it.

Q: Can you recommend some good books you've read recently?

A: Recently I’ve read Philip Rot's Exit Ghost, Denis Johnson’s Tree of Smoke, Anne Enrigh's The Gathering, Peter Carey’s His Illegal Self, Patrick White’s A Fringe of Leaves and the stories of Katherine Mansfield. I recommend them all, particularly the Patrick White. He was Australia’s greatest writer, won the Nobel Prize, but many of his books are sadly out of print today.

From the Hardcover edition.



“McGrath at his dark-hearted best.” —O, The Oprah Magazine“Beautifully crafted and paced, Trauma [is] either a superb psychological thriller or a masterly evocation of modern alienation and despair. . . . A terrific literary entertainment, one that will keep you on edge.” —The Washington Post “Full of sensitive, well-observed touches [and] elegant when it needs to be. . . . McGrath makes us see that our own minds are the most haunted of houses.” —Los Angeles Times“Ambitious. . . . McGrath uses his potent storytelling powers to draw us into [his narrator's] fevered brain and convey his emotional distress.” —The New York Times"The inversion of roles, the blurring of the boundaries between the rational and the irrational, the violence, the twisted sexual passions, the slipperiness of memory: these are familiar themes in McGrath's fiction. Here they are recombined in powerful and imaginative ways. Trauma is a gripping psychological thriller. McGrath's prose is taut and lean; his way with characters is deft; and his explorations of the dark side of human nature are disturbing. And at the novel's centre, the descent of its narrator from a false sense of superiority into a pit of madness and despair is handled with great skill." —Andrew Scull, The Times Literary Supplement“Tortuous, often gripping…The novel is aptly titled, since trauma can be said to be the origin and the end of its insidiously uncoiling developments.” —Sven Birkerts, The New York Times Book Review“A haunting story of a man in the grip of a painful and beautifully articulated spiritual malaise.” —Publishers Weekly

  • Trauma by Patrick McGrath
  • April 07, 2009
  • Fiction - Literary; Fiction
  • Vintage
  • $14.95
  • 9781400075492

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