Augusten’s home life as a child was dysfunctional and violent, and this eventually leads his mother to seek the help of a strange psychiatrist named Dr. Finch. Dierdre has always had a mental health condition and mood swings that overpower the family atmosphere. Dr. Finch advises her to divorce Norman, which she does, but this doesn’t seem to improve her state. Instead, Augusten notices that Dierdre slowly starts to seem faded and distant, her eyes glossed over. This comes to a head when Dierdre’s concern for Augusten reaches its lowest point and she abandons him, forcing him to live with the Finches. In the conclusion, Dierdre confesses that Dr. Finch was overmedicating her for years and that he not only took advantage of her financially and emotionally but also raped her at one point. Augusten immediately senses that Dr. Finch isn’t a normal doctor right, but it takes years for either him or his mother to realize just how damaging Dr. Finch’s practices truly were.

Dr. Finch is a psychiatrist who works out of his home and also houses several patients there. Some have lived with him for years yet don’t appear to be improving at all, such as Joranne, who has obsessive-compulsive disorder and never leaves her room.