The human mind can be a very strange place. Nobody knows that better than psychologist and forensic examiner Dr. Kelly Moreno, whose debut novel, A Duty to Betray, explores the relationship between therapist Rick Ruiz and his troubled patient Mr. Tran, who’s bent on revenge after Dr. Ruiz’s diagnosis of malingering landed Mr. Tran in prison rather than the cushier mental hospital he’d hoped for.

Released after his two-year sentence, Mr. Tran concocts an elaborate plot to punish Dr. Ruiz—all set amidst the final three weeks of the Camarillo State Mental Hospital, which is now the site of California State University, Channel Islands.

In addition to his private practice, Moreno oversees the Marriage and Family Therapist Masters of Science degree at Cal Poly, but he’s also called upon to render diagnoses in criminal cases.

“A forensic examiner is the interface between mental health and the law,” Moreno explained. “Is someone incompetent to stand trial? Should they be found not guilty by reason of insanity? Those are the questions we answer.”

The novel is filled with the sort of detail only someone who’s worked in the field would know and follows in the footsteps of the famed Stanford psychologist and novelist Irv Yalom, whose popular books are also “teaching tales” to help his students better understand clinical psychology.

“He calls them teaching novels to educate trainees as well as the public, and that’s certainly one of the aims of my book,” Moreno noted. “There are a lot of legal and ethical issues at play, and there are a lot of good examples of pathologies and psychotherapy as well as a look at a mental hospital and what the dynamics between patients are like.”

Moreno was an intern at Camarillo State Hospital between 1987 and ’89, where he did his residency and post-doc work on his way to state licensure. The experience enabled him to render the novel’s setting in intimate detail.

“Not only did I work there, but I went back in ’96 or ’97 while no one was there and wandered through the old wards, basically helped myself to the place, exploring rooms where electroshock therapy was once used. It was really spooky,” Moreno admitted.

Once Mr. Tran gets himself admitted to Camarillo and requests Dr. Ruiz as his therapist, his plan begins to unfold as he adopts the female persona of Camille, a beautiful Asian volunteer at the hospital. With the right clothes, makeup, and a black wig that obscures his eyes, Mr. Tran, as Camille, suddenly has access to the hospital and Dr. Ruiz’s colleagues—none of whom suspect that Mr. Tran and Camille are one and the same. The novel quickly begins to play out like a twisted Brian De Palma film—think Dressed to Kill.

The story itself is very cinematic, and Moreno confirmed that was his intent: “I definitely thought in terms of scenes and film. Early drafts were criticized for being too elliptical or moving too fast. I needed to provide enough backstory.”

The novel was certainly a long time in the making. He started it in the 1990s, worked on it for years, brought it to a number of writers’ workshops, and even shopped it around, and while early drafts got some interest, a lot of publishers felt a core element of the story—AIDs and a psychologist’s “duty to warn” others if a patient is a danger—was passé. Moreno abandoned the novel.

Fast forward to 2011, when he decided to take one more shot at revision. Cambria resident and Pay it Forward novelist Catherine Ryan Hyde suggested he write part of the novel in second person—perhaps a prologue or epilogue. Moreno took the idea and ran with it, penning a good portion of the novel from Mr. Tran’s point of view. The idea was brilliant. Not only did it make it easier to follow the shifting points of view of the various chapters, but it also puts the reader in the shoes—and mind—of Mr. Tran/Camille. 

“Catherine was a very important teacher to me,” Moreno said, “and her advice in that 2011 writers conference was pivotal.”

Once again, Moreno took his revised story to publishers and rediscovered just how difficult publishing a novel can be. 

“Writing is the easy part, the fun part,” he laughed. “Finding an agent is the next part, and after trying for awhile, I gave up on that. I didn’t want to self-publish, but another local writer, mystery novelist Sue McGinty, suggested trying some smaller publishing houses.”

Moreno finally found a publisher in Oak Tree Press and its Dark Oak Mysteries, and he also discovered that small publishing houses have small budgets for promotion. He’s been trying to market the novel himself.

“It’s a ton of work,” Moreno lamented, with lots of travel and bookstore readings at his own expense, but it hasn’t stopped him from continuing to write. He’s almost finished with his next novel, Reality Testing, about a psychologist and his wife who have a premature baby who ends up in a hospital ward. After the baby continues to have a series of problems, the psychologist suspects that someone working on the ward is suffering from Munchausen syndrome by proxy, a mental illness and form of child abuse in which a caretaker makes a child sick.

If it’s as richly observed and insightful as A Duty to Betray, it might finally put Moreno on the literary map.  

New Times Staff Writer Glen Starkey has a therapist named Dr. Jameson. Contact him at [email protected].