The novel is a poignant exploration of a young African-American man's journey through life, where he grapples with issues of race, identity, and individuality in mid-20th-century America. The protagonist, who remains unnamed throughout the story, considers himself socially invisible due to his race. The narrative follows his experiences from the South to the North, from being a student to a worker, and his involvement in the Brotherhood, a political organization. The book is a profound critique of societal norms and racial prejudice, highlighting the protagonist's struggle to assert his identity in a world that refuses to see him.

The novel follows the story of a young woman who wins a guest editorship at a magazine in New York City and, after a series of personal and professional disappointments, suffers a mental breakdown and returns to her family, where she continues to struggle with depression and suicidal thoughts. The protagonist's experiences in psychiatric institutions and her attempts to reclaim her life are depicted with brutal honesty, making it a poignant exploration of mental illness and the societal pressures faced by women in the mid-20th century.

The Butcher Boy is a dark and disturbing tale set in small-town Ireland, following the life of a troubled young boy who descends into madness and violence. The protagonist's life is filled with neglect, abuse and mental health issues, and his increasingly erratic behavior and gruesome fantasies lead him down a path of horrific actions. The novel provides a stark exploration of the effects of societal neglect and the failure of mental health systems.