This is a case where I need to separate my personal enjoyment of the book (as reflected by the four-star rating) from my critique of the book.

There is a line earlier on in the book: "For a family, schizophrenia is, primarily, a felt experience, as if the foundation of the family is permanently tilted in the direction of the sick family member." Although Kolker is an outsider, the book is written from the perspective of the two daughters of the Galvin family. They are the youngest two of the twelve children, Lindsay (née Mary) and Margaret, and neither is diagnosed with schizophrenia. They both suffered sexual abuse at the hands of the second oldest brother diagnosed with schizophrenia. Robert Kolker took up writing this book at the request of Lindsay and Margaret, which is to say that this book is about their victimhood and trauma. As a result, the sick brothers appear as mindless monsters and the parents as their enablers. The latter is unavoidable given the connotation throughout the book that the couple kept bearing children beyond their means.

I enjoyed the book because someone very close to me has been diagnosed with a psychotic disorder. Having grown up with them, I understand the longing for normalcy that Lindsay and Margaret had their whole childhood. I enjoyed reading this book because exposing a family sickness is vindicating when you are a) not one of the sick ones and b) a victim. But I must admit that my vicarious vindication comes at the price of portraying the sick as a monster.

The book is praised as empathetic, but it is empathetic to the extent that it is very hard not to empathize with victims of domestic sexual abuse. What's harder is to write a book that is wholly empathetic to patients of schizophrenia whose lived experience is out of reach from ours. The book fails in that regard.