The doctor provides anti-depressants and tranquillisers, advises that time will heal all and allows Helen to stay on in hospital. This sojourn permits her to reflect on her pre-second-baby self. In Sydney Helen’s prestige and potential were evident; in London, however, she does not so readily stand out. Feeling worthless, she progresses to feeling guilty for not being as happy as is required of young, privileged mothers by society and Dr Spock.

Earlier incidents recounted in the novel (a holiday in Greece and the disastrous effects of the prestigious nursery on her first child, Kate) announce some of the major themes. Kate’s nursery captivity prefigures Helen’s experiences with hospitals and other institutions. The themes of isolation, containment, powerlessness and abandonment are sounded.

The birth of the second baby is induced to suit the obstetrician’s holiday plans (an important episode in Coombs’ s first book, Regards to the Czar). By allowing the induction Helen precipitates the ‘crack-up she’d been pregnant with’, which she was ‘sick of waiting for’. In hospital Helen endures the false cheer and officious attentions of the nursing staff and when she fails to buck up she is referred to a psychiatrist.

The core of the novel is the relationship between Helen and the psychiatrist, Dr Dougal Argyle, but to say that the relationship is one-sided is an understatement. Helen expects salvation at the hands of Dr Argyle, despite the fact that, in the Australia she grew up in, ‘good girls didn’t go to psychiatrists’:

Psychiatrists were people who testified in court on behalf of murderers or who nannied film stars. They were them­selves charlatans, ratbags, sex­obsessed, evil and/or mad. Where Don and I grew up people who went to psychiatrists were either criminally self-indulgent or criminally foolish or criminally pretentious or criminally loony.

Conscious of the enormity of my planned transgression, I felt childish excitement, daring, relief, doubt, immense curiosity, happiness, hope.

Heralded as magician, authoritative sorcerer, priest and father figure, Dr Argyle seems, on first appearance, worthy of such high-sounding titles. However, like his Harley Street flat (which has an impressive drawing room but is otherwise cramped and dingy), Dr Argyle is deceptive and empty. Before long, Helen learns how uncaring and ineffectual he really is.

Dr Argyle’s sheer incompetence creates some hilarious moments; glorious lapses of memory and the repetition of the same shallow advice enhance his absurdity. Some events show a more sinister side to his buffoonery. But his experience has not prepared him for Helen who, while sexually aroused by him, actively rejects his counsel. And yet, one of his suggested ploys does provide help. When he advises Helen to ‘just jot down the story of your life’, her voice is released and her need for recognition and empowerment is heard (but not of course by Dr Argyle). One of the many ironies of the novel is that Dr Argyle’ s failure to provide any support or understanding stimulates Helen’s growth. His very banality provides opportunities for her to comment more and more brilliantly on her condition, the myths that surround it and the society that supports her oppression.

The relationship with Dr Argyle becomes increasingly intense on Helen’s side as she feels compelled to exhibit some of the symptoms of puerperal depression in order to continue consulting him. In due course Helen knows that Dr Argyle has persuaded others to treat her as mad. Several of the most engaging episodes in the novel occur at this stage. A visit to Dr Argyle’s clinic titled ‘Shangri-La at last, or She’ll be apples when we get to Harrow House’ sees Helen arriving groomed to perfection:

Anyone can see I am no ordinary nut case! I have just had my hair cut by Annie Russell herself at ‘Annie Russell’ in the King’s Road and I am wearing my very expensive, very plain, very trendy, black Cacharel skirt and top (French) bought from Brown’s in South Molton Street. My eyebrows are plucked, my legs shaved right up to the crotch, my nails are manicured, my (subtle) makeup is on. I am done up as carefully as a Darling Point bride.

This novel has a startling appearance. The printed page is scattered with lengthy quotations from Charlotte Bronte, William Blake, George Eliot, Flaubert, as well as extracts from encyclopedias, Ms magazine and medical texts and calendars. Pages are also plastered with exclamations and large bold type indicating rising hope, rage, despair or lunacy. Book One comprises a series of chapters with extraordinary titles like ‘ourfather hallowbethyname thywillbedone’ and ‘The Magician who performs by rote will not be able to adapt to the unexpected’.

In Book One particularly, events are not merely allowed to unfurl. The narrator does not hesitate to address the reader and to interpret experience, but the humour and vigour of these intrusions are welcome, to be relished for their subversive comedy and honesty.

Book Two comprises a sequence of documents mainly dating from 1971. The narrator ostensibly abandons us here as the content is too painful to bear direct comment and yet, despite this withdrawal, the second part is as unified and strong as the first.

Throughout, Margaret Coombs exploits the comic clash between Helen’s attempt at social conformity and the clarity of her gathering perception. She becomes more and more aware of the absurdity of the roles she and others are expected to play. But part of Helen’s problem is that she cannot stop acting inter alia the part of blissful mother, extraordinary woman and immaculate hostess and the comedy serves a very serious purpose in illuminating the pain and torment of establishing identity in a pressured setting where understanding, privacy, role models and time are in short supply.

In the end, the novel makes no attempt at tying up the threads – in fact it deliberately closes with Helen adding further drama to her life. I hope that Margaret Coombs intends to let us see more of Helen Ayling.