It's hard to know what to say about a book in which the author is so obviously laying out her own personal issues. (As described here.) I can't help but wonder if she would have been better off just talking about some of this with a therapist. It's an interesting (if odd) book, not badly written, but some of the characters who are supposed to be attractive and sympathetic just seem like asses. And the author seems to want us to approve of the protagonist's unkind, even punitive treatment of her brother--which makes some psychological sense given the backstory, but very little sense within the world of the novel.