Plumbing the Deep, Dark Secrets of a Psychiatrist’s Mind : DR. NERUDA’S CURE FOR EVIL by Rafael Yglesias; Warner $24.95, 694 pages

“Slow hands,” according to one memorable pop song, can be a praiseworthy quality under certain circumstances. Novelist and screenwriter Rafael Yglesias allows us to see that the authorship of a psychological thriller is one of them.

“Dr. Neruda’s Cure for Evil” opens with the idle musings of its protagonist and narrator, a psychiatrist named Rafael Neruda who describes his experiences as the son of an adventurous Cuban father and a troubled Jewish mother. At first, Dr. Neruda’s richly observed memoir of childhood is slow, stately, even solemn.

And then, suddenly, the heads begin to roll--not quite literally, but close enough to startle and even shock.

Dr. Neruda, as we learn, is a psychiatrist with enough dark secrets of his own to keep a shrink hard at work. Thanks to a cluster of traumatic experiences--a vicious assault, a grotesque seduction, a particularly gruesome suicide--his bruises are both physical and psychological. “Use your peasant brain” is his rogue father’s only advice, and the words obliquely predict what Neruda will become, a celebrity shrink who writes best-sellers and appears on “Nightline.”

Not until halfway through Yglesias’ big book, however, do we begin to see how the various threads of Dr. Neruda’s private life and his professional practice have become hopelessly--and treacherously--entangled. Suddenly, the boundary between doctor and patient begins to disappear, and Dr. Neruda finds himself through the looking glass into a world of violence.

“I can tell you lots of nightmares,” says another patient, an abused young man who has become an abuser, as if to seduce Dr. Neruda--and the psychiatrist readily succumbs to the seduction. “. . . Real nightmares. That what you want?”

The flash point is Dr. Neruda’s apparently successful treatment of an unremarkable guy who suffers from what appears to be nothing more than low-level sexual repression. To the psychiatrist’s shock--and ours--Dr. Neruda discovers that his patient is a ticking time bomb only when he explodes.

“You can’t get rid of all the evil in the world by swallowing it yourself,” Dr. Neruda is cautioned by his girlfriend, but he insists on putting his patient’s ghost--and, in a real sense, himself--back on the couch in a desperate effort to search out what he missed the first time around, and why.

So the last third or so of the book turns into a breathless psychiatric whodunit as Dr. Neruda backtracks into the real life of a man whose most intimate fears and desires he thought he knew. He finds his way to the very woman who had beguiled his patient in the first place, and he puts her through one punishing ordeal--”You just like to play mind games, is that it?” --but sometimes it is not quite clear who is manipulating whom when Dr. Neruda embarks on one of his elaborate (and treacherous) psychosexual games.

The climax of “Dr. Neruda’s Cure for Evil” is one thundering chord of psychological dysfunction that resolves itself into a pure note of revelation, the psychoanalytic equivalent of Grand Guignol.

“I’m bad!” blubbers the real villain when unmasked at last.

“OK,” deadpans Dr. Neruda. “At least that’s a start.”

The intimate first-person narrative of “Dr. Neruda’s Cure for Evil” is punctuated with short asides that allow us to hear Neruda’s public voice, the glib words and phrases of the media-wise therapist. Eventually, we begin to suspect that the book is an elaborate satire on psychiatry as well as an eccentric love story and a razor-edged psychological thriller.

“We are animals,” sums up Dr. Neruda, as if shrugging off all of his elaborate psychoanalytic speculation about himself and his patients, “although we expend so much effort convincing ourselves that we aren’t.”