Dr. Malcolm Avery has spent his life trying to understand the forces that shape human behavior. Once a Catholic priest and now a respected psychologist, Malcolm believes insight can help people distinguish what happened to them from what they choose to do next. But inside his therapy group, that distinction is becoming increasingly difficult to maintain.

The death of one member has changed the room. Everett Shaw's unexplained interest in Malcolm has become impossible to ignore. And the name Michael-someone from Malcolm's years in the priesthood-has reopened a history Malcolm thought he understood.

As questions about Malcolm's past move beyond the therapy room, his professional judgment comes under scrutiny. The people around him face reckonings of their own. Nia must learn that caring for her dying mother does not give her the right to control her mother's choices. Daniel must decide whether protecting the people he loves has become another way of deciding for them. Marcus discovers that understanding the origins of his isolation does not excuse the damage caused when he disappears from relationships. And Grace Kim, the group's newest member, must confront the uncomfortable possibility that generosity can become a form of control when every kindness carries an invisible debt.

Meanwhile, Everett's search for certainty about what happened to his brother leads toward a more difficult truth: the past may contain responsibility without providing anyone a simple verdict.

SUFFERING IN MY ECOSYSTEM is a psychologically intimate literary novel about therapy, grief, faith, family, institutional accountability, moral injury, and the consequences of choices made with incomplete information.