49 pages • 1-hour read
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Phantom Limb is grounded in the established psychological principle that severe trauma can trigger dissociative disorders. Dissociation is a mental process in which a person disconnects from their thoughts, feelings, memories, or sense of identity. When dissociation is severe and persistent, it is diagnosed as a dissociative disorder, of which there are three main types: dissociative amnesia, dissociative identity disorder, and depersonalization/derealization disorder. The novel’s protagonist, Emily, experiences a rare and extreme manifestation of dissociation, known as a dissociative fugue. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a fugue state involves amnesia about one’s identity, often combined with sudden travel and the adoption of a new identity (Sharma, Pradesh et al. “A Case of Dissociative Amnesia with Dissociative Fugue and Treatment with Psychotherapy.” The Primary Care Companion for CNS Disorders, 2015). After causing the car accident that kills her twin sister, Emily unconsciously assumes Elizabeth’s identity as a way to escape the unbearable reality of Elizabeth’s death and her own guilt.
The novel’s clinical verisimilitude is rooted in the author’s professional background, as Lucinda Berry holds a PhD in clinical psychology and specialized in research about childhood trauma. Her depiction of the twins’ codependency, the graphic descriptions of self-harm, and the methodical exploration of Emily’s fractured consciousness draw from this professional experience. While specific cases of prolonged fugue states are rare, the connection between trauma and dissociation is a well-documented clinical reality. Berry uses this connection to construct a fictional case study, illustrating how the human mind can construct an alternate reality to survive an annihilating truth.
Phantom Limb employs an unreliable narrator, a narrative device central to the psychological thriller genre. An unreliable narrator is a protagonist whose credibility is compromised, forcing the reader to question the version of events being presented. This unreliability often stems from mental illness, memory gaps, or deliberate deception, creating suspense. In Phantom Limb, the narrator, who is presented as Elizabeth, is actually her twin, Emily. Her unreliability is a product of her dissociative fugue; she is not intentionally lying but genuinely believes she is her dead sister. This technique fully immerses the reader in her fractured consciousness. The narrative is built on memories that are vivid but entirely fabricated, such as the climactic scene where “Elizabeth” discovers her sister’s suicide. The narrator recalls, “Emily’s body lay crumpled up next to the toilet […] She was dead and I had killed her” (54). This detailed memory is a delusion created by Emily’s mind to process her grief and guilt. Because of this delusion, nothing the narrator says throughout the novel, at least until the final chapters, can be taken at face value. The revelations that arrive at the end of the novel force reconsideration of everything that has gone before. This device is common in the psychological thriller genre, seen in novels like Paula Hawkins’s The Girl on the Train, where the protagonist’s alcohol addiction causes blackouts that obscure her memory of a potential crime, and Gillian Flynn’s Gone Girl, in which the narrative shifts between the points of view of husband and wife Nick and Amy Dunne, with events gradually revealing that each is hiding secrets both from each other and from the reader. In all these cases, the reader must piece together the truth from a damaged narrator’s account. By using this trope, Berry crafts a plot twist that is not just a surprise but a psychologically coherent revelation of the narrator’s deep trauma.



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