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Case Study: A cod psychiatrist for the ages

John Boyne happily immerses himself in Graeme Macrae Burnet’s tale of a fictional therapist

Case Study
Case Study
Author: Graeme Macrae Burnet
ISBN-13: 978-1913393199
Publisher: Saraband
Guideline Price: £14.99

One of the more tedious questions a writer can be asked is “where do you get your ideas?” but Graeme Macrae Burnet, the least tedious of novelists, opens his new book with a playful take on this by suggesting that they come first in an email from a stranger, and then in a series of notebooks that have come into his possession.

Twenty pages into reading Case Study, I confess that I googled the name Collins Braithwaite, the central character of the novel, to reassure myself that he was, in fact, fictional and not “a contemporary of RD Laing, and something of an enfant terrible of the so-called anti-psychiatry movement of the 1960s”, as stated by the author in his preface. But such is Burnet’s skill that he immediately convinces the reader that everything he is about to say is based on historical fact, a conceit he used to brilliant effect in his earlier, Booker-shortlisted novel His Bloody Project.

This novel is divided into alternate sections, the first producing a mini biography of Braithwaite, the second a memoir by a young woman grieving the suicide of her sister Veronica, a former patient of the therapist.

Burnet portrays Braithwaite as a narcissist, a priapic seducer of women, and someone so convinced of his own intellectual greatness that, even before publishing a single book, he invites the more celebrated members of his profession for drinks to inform them why he is their superior in every way.


He’s rather brilliantly described as “although not of great physical stature, he is like a small country whose empire extends beyond its borders”. Encumbered by a chip on his shoulder over his humble beginnings, he hot-foots it to London to become part of a social and cultural elite, while considering himself utterly above it all.

And yet, somehow, he’s a rather attractive character and his loucheness is part of his appeal. With his patients, or his “visitors” as he terms then, he makes no bones about his complete lack of qualifications, believing that if they want to spend their money on his observations, then that is very much their own choice.

The grieving sister is a more disturbing presence. Adopting the pseudonym of Rebecca Smyth, she signs up for sessions with Braithwaite to discover whether his approach might have pushed Veronica over the edge. In doing so, however, she discovers that her own mundane life gains some much needed colour, for her alter-ego is far more coquettish and worldly than her real-life persona. She parries with Braithwaite, challenges him during their sessions, and, outside of his consulting room, gains both a handsome suitor and a taste for gin, after a lifetime of frigid, teetotal spinsterhood.

Although Rebecca’s voice dominates the narrative, she remains a cypher, and the gradual schizophrenia brought on by her deception is brilliantly depicted. Her life at home seems like something out of a Victorian novel – an ageing, benevolent father, a dominant housekeeper, darkened rooms with unappetising meals – while her new existence resembles the kitchen-sink drama of the 1960s that are referenced throughout. It’s impossible to tell whether Braithwaite is taken in by Rebecca’s deception or whether he’s complicit in it, drawing her towards a place of dark self-awareness, just as he might have done with her suicidal sibling.

Most intriguing is Rebecca’s desire to understand what happened to her sister when, as she reveals herself, they were not exactly close. Indeed, her reaction to Veronica’s death is almost comical in its cruelty. “(One) shoe, along with her other clothing and the contents of her handbag, were later returned to us. The second shoe was never recovered, but as her feet were two sizes larger than mine, I could not in any case have worn them.”

Case Study makes for compulsive reading as both an examination of how psychotherapy was viewed in the 1960s and an indictment of those who popularised it. It reads like a thriller, and while the encounters between Rebecca and Braithwaite might lack the humour and frisson of those between, say, Clarice Starling and Dr Lecter, they nevertheless have a tension that sometimes hints at violence, sometimes at sexual malevolence, and sometimes at each other’s ennui.

If, like me, you feel that most of us are just barely hanging on for dear life, then Case Study provides an account of a descent into madness with which many readers may identify.

John Boyne’s latest novel is The Echo Chamber (Doubleday).

John Boyne

John Boyne

John Boyne, a contributor to The Irish Times, is a novelist and critic