When Sue Miller began plotting Family Pictures, her novel about a family's devastating experience with an autistic child, she didn't need to think too long about its setting. ''Chicago in the 1950s was the worst place in the world for an autistic child to be born,'' she says. ''Bruno Bettelheim was at the University (of Chicago). He believed that mothers caused their children's autism by subconsciously rejecting them. He called them schizophrenogenic mothers, and for a long time the theory was extraordinarily influential. I thought it would have been extraordinarily bad luck to have had an autistic child in Chicago then but that it would be very interesting fictionally. We fiction writers are always interested in bad luck. We pick the worst scenarios and watch our characters weasel around them, triumph over them, or be destroyed by them.''
With bad luck as a modus operandi, Sue Miller has set out to untie the Gordian knot of motherhood. Her first novel, The Good Mother, published in 1986 when she was 42, told the wrenching tale of a single mother's unsuccessful battle for the custody of her daughter. It hit a nerve, went straight to the best-seller list, was made into a movie starring Diane Keaton, and marked Miller as a literary star. Family Pictures takes on a more ambitious and painful subject a mother's and a family's bondage to a damaged child. (Four children in 10,000 are born with autism, a poorly understood disability that mimics retardation.) ''It was very brave of her to pick such a severe case,'' says Clara Claiborne Park, author of The Siege, a chronicle of her own daughter's autism. ''Autistic characters appear quite often in science fiction, for some reason, but, besides Rain Man, few popular works have dealt so powerfully with the subject.'' The New York Times concurred, calling Family Pictures ''virtuoso a work whose cumulative insight blossoms into wisdom and whose steady focus on a single family reveals much of what there is to know about the American middle class in the middle of our century.''
Miller's fictional family, the Eberhardts, are ordinary enough until they realize that their third child, Randall, is autistic. David, the father and a psychiatrist, won't say so but he blames his wife, Lainey. A master of unspoken aggression, he suggests to Lainey that the problem originates ''at home'' and proposes sending Randall away to Bettelheim's Sonia Shankman Orthogenic School. Lainey, a loving, adept mother of two healthy children, Mack and Nina, passionately resists. ''He's mine. He's ours. He belongs with us. I work with him night and day.'' Worse, Lainey is driven to prove her innocence by bearing three more healthy children. Not surprisingly, this remedy does not work.
It is when David begins to keep a journal about Lainey that Miller displays the depth of her understanding of this family. The only way the psychiatrist can cope with the diagnosis is to keep a clinical record of his wife's and son's behavior. In David's notebook, Miller captures the blind confidence, the maddening certainty that characterizes psychiatry even at its most misguided. ''I make the mistake of labeling R. autistic,'' David writes. ''I say we know what causes it, that she has to come to grips with it. She tries to hit me. I hold her. L., weeping, 'Don't dare to say we to me! We! we! I am not your patient. I am your wife.'''
Miller's ability to hit the emotional notes with perfect pitch is partly a result of the year she invested reading medical and psychological reports from the '50s. ''I had known a few families with autistic or schizophrenic children,'' she says. ''I wanted to get inside the mind-set of what people thought in the '50s.'' A friend gave her a pass to the Harvard medical school library near her Boston home and she pored over 1950s medical journals about autism.
Since Bettelheim's The Empty Fortress always pointed to the family as the root of the problem, Miller began to read widely in personal accounts of families coping with autistic children. ''A book by Helen Featherstone called A Difference in the Family got me started,'' she says. ''I read the three books by Josh Greenfield about his son Noah. Then I read Clara Claiborne Park's The Siege. That was extraordinarily important to me.''
But it was an obscure book in the Harvard medical library that unlocked an emotional puzzle for Miller and let her write. ''It was a wonderful book called My Son, an account of a couple during the '50s who had an autistic child and ended up institutionalizing him. It was written by the father, who had the most wonderful, kind, loving attitude toward his wife. On the other hand, he was completely condescending, protective, and paternalistic toward her. He very much felt that since she had carried the child in her womb, she wasn't to be part of the decision. What was wonderful for me was that it was an account of the way people thought in their roles. I kept him in mind, not as a model for David but for the way men thought then. It made me believe I could write the book.''
Miller had a more personal reason for wanting to set her novel in Chicago. ''I wanted to have an element of it lifted from my own childhood,'' she says. ''I grew up there. It was a very weird place, a place that saw itself as unusually bohemian and radical.'' Miller's father, James Nichols, was a professor of church history at the University of Chicago. ''There were four children in my family. Everybody was a real achiever. My parents were quite different from David and Lainey, but I wanted to convey the sense of the way kids in a big family bounce off each other and change in relation to each other.'' Miller's mother was the quintessential faculty wife, giving parties and writing plays. ''Now I think we would say she was quite chemically depressed. At times she had lots of energy; other times I remember her being in bed for days. Still, parents in that place and generation embraced the notion that they were raising their children differently.''
But child-rearing techniques of the Spock generation weren't always effective, either for Miller or for the children in her novel. ''I very much felt the energy of the kids when I was writing,'' Miller says. How? She laughs. ''I was full of adolescent rage myself for a while about life, about rules, about not being loved enough, the same things every kid is angry about.'' Miller also called on the experience of her son, Ben, a senior at Harvard. ''He's just pulling out of that, and I tried to remember his genuine, passionate feelings of being misused, of family members not being able to communicate with each other.''
If Family Pictures is a story about the crime of blaming a mother for her damaged child, it also is very much about the vulnerability, unspoken pain, and understanding that can emerge from family relationships. ''Once you love, you're exposed,'' Miller says. ''In a family, as a child, you're exposed and you have no choice about it. All of us yearn for a pure, unqualified love, most of all from our parents. But most of us don't have to deal with the specter that exists in the novel watching our parents love another child the unconditional way that Lainey loves Randall. It seemed to me that it would be very difficult to watch a parent forgive someone else everything when you aren't forgiven everything.''
Family Pictures doesn't end neatly. David can't manage his wife's acceptance of Randall, and in the end, he and Lainey are too altered by the pain they've endured to forgive each other. ''I think the pain that parents feel at lack of perfection in a child whether it's a normal child or whether it's a child like Randall is among the most intense kinds of pain in life,'' Miller says. ''Yet families are also about opportunities. Opportunities for joy, opportunities for understanding.''