Ottessa Moshfegh is adept at creating difficult, even occasionally repulsive characters: the eponymous sailor of her debut novella McGlue struggles, drunk, to remember if he killed his lover, whilst Eileen (shortlisted for the 2016 Man Booker Prize) tells the story of frustrated prison-guard who refuses to wash, is addicted to laxatives, and attempts anything to repress her own sexuality.

My Year of Rest and Relaxation doesn’t deviate much from that ethos. The unnamed narrator is a superficially perfect Upper East Sider, Columbia educated, and ‘tall and thin and blonde and pretty and young’ with this stock description repeated so often her physical appearance becomes meaningless; nothing more than another indication of perceived societal worth. The novel starts mid-2000, with the narrator newly graduated and dissatisfied with her life, despite her wealth and apparent perfection. Yet, struggling with the legacy of her dysfunctional family and the death of both her parents, she turns to a dubious psychologist and a catalogue of medication to exercise her somnophillic fantasy to sleep round the clock.

She becomes quickly exasperated with the politics and pretension of the art gallery she works in, finds the status-seeking brand-worshipping tendencies of her best friend Reva ridiculous, and cruelly dissects the habits of the wealthy New Yorkers she is surrounded by. Her listing of drug names that she acquires from her impossibly liberal psychologist Dr Tuttle as a part of her attempt to achieve unending sleep become a repeated motif in the novel: ‘Neuroproxin, Maxiphenphen, Valdignore, Silencior, Secnol, Nembutal, Valium, Placydil, Notec, Miltown’ and the ‘Infermiterol’ that causes three-day blackouts and unremembered sleep-adventures; these drugs act as a chemical barrier between the narrator and the world she can no longer bear. Yet, these repeated fictional and alien names also come to symbolise the synthetic nature of the world she is desperate to leave.

This is a conflict Moshfegh draws attention to: the narrator wants to leave this world of appearances, but her only route it is a purely artificial chemical high. Even in a state of delirium, she cannot resist commenting on her good looks, her fashionable status, describing herself as a “Kate Moss” look-a-like.

By allowing appearance, deception, and pretence to be so central to her sense of malaise, Moshfegh builds a fundamental sense of unease into the developing structure of the novel as our narrator lets the artist Ping Xi, previously derided as (in)famous for ejaculating onto canvases, use her hibernation as substance for art. Observation is inescapable in Moshfegh’s world – in becoming the classical figure of the female Muse, she opens herself up only to a different form of observation.

Moshfegh is tackling head on 21st century obsession with appearances, images, and how self-consciousness about scrutinizing of these façades. This fixation reaches a climatic moment at the end of the novel when Moshfegh describes the wholly materialistic and execrable Reva, who works in the Twin Towers, as one of those famous for jumping from the windows during 9/11. The narrator recognises Reva is still dressed in her discarded designer clothes in flight; one shoe hasn’t fallen off in her fall because it ‘doesn’t quite fit’. Reva acts as a paradigm of a capitalist, superficial lifestyle throughout the novel and her death is a cruelly ironic comment on the catastrophe.

Thousands died in 9/11 – it’s an emotive image and to use it as a comment on the perceived amorality of the consumer society feels enormously clumsy.

Indeed, whilst Moshfegh is able to balance sympathy, comedy, and repulsion, there are other moments where My Year of Rest and Relaxation falls flat. The narrator’s pathological self-obsession flattens out the power of her acerbic commentary on modern politics. Rather than marvelling at Moshfegh’s ability to create such a destabilising and disconcerting series dream-scapes, I was left unmoved by her fate and her prospects of recovery from her condition.

Yet, despite these failings, My Year of Rest and Relaxation remains a compelling read: Moshfegh does make a radical challenge to the excesses of American capitalism and forces into a profound reckoning with a complex female lead who embodies some of the paradoxes and trade-offs associated contemporary womanhood.