How are a family mass-murder in 1983, a string of serial killings in 2014, and a present-day crack house connected? One answer in Dan Chaon's disturbing, amazing, masterful new novel, Ill Will by a prison psychiatrist to the novel's protagonist, Dustin Tillman: "When you've been abused in the way you were, you have a virus. And the virus will demand that you pass it on to someone else. You don't even have that much of a choice."

So masterful is Chaon's command of this story that the character's abuse needs only the roughest of scenes sketched out for readers to know it was horrific. One of the author's lodestones in this book seems to be that even the kindest people can mete out the unkindest cuts. Mothers punish, or ignore, or frighten their offspring. Fathers have no idea what's going on, even when they make an effort. The most reliable friends, the ones who will rescue you from drowning, are also the ones who lead you down the garden path, straight to your friendly neighborhood heroin pusher. The American Dream has turned to dread.

The dread starts early and ratchets up fast: Dustin is a middle-aged psychologist in Cleveland whose seemingly normal childhood was upended one night when his mother, father, aunt, and uncle were killed, purportedly by his cousin Rusty, who is now in prison for the crimes. Dustin and his twin cousins Katelynn and Waverna were sent to live with their maternal Grandmother in a dry corner of Nebraska, where their unhealthy adolescent predilections are allowed too much freedom — Dustin spends too many nights in Kate's bed and Wave (as she prefers to be called) spends too many nights engaging in low-rent Satanic rituals with new friends. Yet even these hijinks turn grim and frightening through the author's pen; he has an incisive perspective on how small acts turn into big terror.

Present-day Dustin has a tough road to hoe. His wife is dying of cancer, one of his sons is experimenting with heroin, and one of his patients keeps pushing him to learn more about a series of strange local deaths by drowning. What Dustin does know is painful, but it's what he doesn't know that will hurt him, and badly. Chaon has such command over the suspense in his novel that even some narrative experimentation doesn't derail the horror: At one point the son's perspective splits into three, and the reader must follow columns on the page, which are a little challenging. Somehow this only adds to the fright.

And there's a lot of fright. Professionally Dustin is the protégé of a famous reclaimed-memories expert, and he wrote his dissertation Satanic ritual abuse. But as his world unravels, his own memories do, as well — even if he could reclaim them, he wouldn't know if they were accurate. When exactly did he wake up on the night his parents died? What does his cousin Rusty know? Should Dustin ever try and find out? Some of the most affecting scenes are the ones in which the widowed Dustin snaps back to life for an hour or two and realizes how much he has lost: No wife, no family dinners, no children to guide through life's troubles.

While Dustin trolls his past for truth and, a more sinister storyline emerges. Chaon fans who have read his previous novels will be pleased to know that, as is his wont, the author waits until the uncanniest moment to loop characters and plots together, providing a frightening finish. Nothing is resolved and not everything is explained, but that matters very little.

Bethanne Patrick is a freelance writer and critic who tweets @TheBookMaven.

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