A very intriguing book overall, and enjoyable for me because I enjoy unreliable narrators. Regina's carefully-constructed world unravels, with two main "revelations" to the reader about how she's been lying to us about her past. I liked the juxtaposition of these revelations with her continued day-to-day work in the psychiatric hospital and with her private patients. Despite her struggles, life goes on around her.

I thought this book would have been stronger if it were shorter; the revelations would have packed more punch if we got to them more quickly. But overall, a worthwhile read with interesting characters. People who like unreliable narrators, books about psychiatry, and uncovering family secrets will not be disappointed. ( )

When I first started this book, what really stood out was how witty the lead character, Regina, a psychiatrist, was in her thoughts. Many of which she does not speak outloud, though there are some she does. I thought from the very beginning was she was using this as a defense mechanism. See she was a psychiatrist so I was thinking in psychiatry speak. This book is very different and extremely innteresting, because it is in essence the unraveling of a psychiatrist's psyche. As the reader learns more, uncovering Regina's past, we watch as she interprets and reacts to these events. This book also shows how little we actually know about the people we love, that everyone keeps things hidden and everyone reacts to and see the events f a trafgedy deifferntly. Very well written, also and maybe a bit mean to say but it was entertaining reading about some of the patients in the psychiatric ward. The whole time thinking "there but for the grace of God", well you know the rest. Anyway, I was right about the defense mechanism, I think. Read it and see for yourself. ( )

egina Moss is an emotionally distant mother whose daughter Anna is struggling in her freshman year at college. What makes Regina's inability to meaningfully talk to and connect with her daughter so surprising is that Regina is also a psychiatrist. She not only works in a psychiatric hospital but she also spends hours listening to her private clients as they try to work through the things that are weighing on them and to face reality, something Regina seems incapable of doing herself.

At first glance, Regina is a completely trustworthy narrator who is still grieving the tragedy in her past. She and her daughter have a difficult relationship. She is immersed in her professional life almost completely and developing an interest in one of the new, young techs on her ward. But as facts about Regina's life come to light, she has to expand or alter her backstory, peeling back the sanitized and imagined past layer by layer to reveal the truth that still haunts her and drives her present no matter how deeply she's tried to bury it in her subconscious.

This tale of a manipulated truth, slowly revealed only through necessity, showcases a classic unreliable narrator. Separated into three sections: Lunacy, Hysteria, and Bedlam, each section is told in short numbered passages which serve to make each bit feel self-contained although they clearly build on one another. Everything about the book, Regina's life, the revealing truths, her relationship with Anna, and her feelings about everyone in her life past and present, grows incrementally. And as the shifting sands of Regina's story cover over the previous layer, the reader can't help but be caught up in wanting to see past the obfuscation to the uncontestably true core, to finally know the whole story. A fascinating look at the many ways in which we compensate for guilt and grief and living after a major loss and how we lie to ourselves and others, this was a surprisingly riveting novel. ( )