HANYA YANAGIHARA’S second novel, A Little Life, features a photo on its cover, a black-and-white close-up of a handsome man who resembles James Franco (but is not). His eyes are closed, squinted tightly shut, his brow furrowed, his cheek resting against the back of a limp right hand. His lips are also closed and yet expressive. It’s a powerful yet perplexing image. At first glance one wonders, what is happening here? Is this man in pain, or ecstasy? It seems it could be either.

The credits reveal the photograph, by Peter Hujar, is titled Orgasmic Man, and with that the mystery seems solved. Here is a man portrayed in the midst of orgasm, and yet even after I learned this I had difficulty reading the image, since the moment it purports to capture looks so painful. Only after finishing the novel did I come to understand how right this dichotomy is. There may never have been a cover that better captures the emotional heart of a story — that is to say the agony and the ecstasy of desire.

A Little Life — the title mocks itself, given that the novel weighs in at an impressive 720 pages — follows the lives, over the course of several decades, of four men who first meet in college and who all move to New York City after graduation to pursue their careers. It poses this question: how does one navigate desire when all pleasure to be discovered in the sexual act has been forever stripped away and turned into the stuff of nightmares, and yet the deep longing for love remains?

The four friends portrayed in A Little Life — two of them white and born in the rural West, the other two African American and raised in the East — have formed a bond so strong it feels as if their worlds are destined to revolve around each other forever. This theme of male friendship, explored by Yanagihara with an intensity that feels claustrophobic, drives the harrowing story.

Jude and Willem — the former an orphan raised by monks in South Dakota, the latter the son of a Swedish couple who work on a Wyoming ranch — eventually emerge as protagonists. The book opens with them inspecting a funky apartment in Chinatown they intend to rent together. Willem is a handsome unemployed actor, temporarily doing restaurant work to earn a living; Jude is a lawyer with an uncanny aptitude for mathematics.

This is in every way Jude’s story, though plenty of characters are pulled into his orbit. He’s a frail, reticent man who walks with a pronounced limp. But where has this limp come from? Immediately the reader wants to know, and Yanagihara hints at the awfulness to come. Jude has always refused to talk about his past, so not even his friends know the origin of this limp, this fragility. We know something terrible (maybe several terrible things) has happened to Jude, but what? It’s part of Yanagihara’s strategy to release the information about Jude’s horrific past so slowly that the book becomes, as one of the author’s friends has said, an emotional thriller.

The secrets Jude carries are writ on his body, encoded not just in the limp but also the scars on his back and arms and legs, which have prevented him from ever daring to appear undressed in front of his friends. He’s not so much shy as removed. There’s an ethereal quietness about his person that makes him seem to shrink into himself, as if he feels unworthy to be alive. He’s like a wraith, eerily intelligent and unaware of his physical attractiveness, and yet also bent on torturing himself.

He’s a cutter, using tape to hide his little bag of razor blades and disinfectant beneath the bathroom sink. Cutting himself is how he’s learned to cope with the agony of being alive. Over and over again, in more scenes than I cared to count, the reader endures not only the detailed descriptions of a cutter at work, as he repeatedly draws the razor blade across his already badly scarified flesh, but also the workings of his mind as he does so. The sanguineous joy he experiences, the desperate relief — the soaring addictiveness of such self-inflicted ecstatic pain — is driven home powerfully.

As shocking, as upsetting as these scenes are, and as difficult as they are to read, they pale when compared to the other stories that unfold slowly, revealing Jude’s past, including his tortuous sexual exploitation as a young orphan. He was dropped off as a baby near a garbage dump behind a South Dakota drugstore and taken in by monks who raised him in their monastery, and who also sexually abused him. And that’s only the beginning of his story.

At one point I found myself thinking, this character can’t possibly have endured all this and emerged as a sane person, not to mention a hugely successful litigation attorney, leading a rather normal life in the dreamily perfect New York apartment he eventually acquires. But that’s just the point. Jude hasn’t overcome anything. Instead of becoming a sadist himself, he has instead turned his anger and despair inward with his cutting. This, we are to believe, allows him to be the loyal and generous friend that he is.

Ultimately he’s a deeply damaged person who cannot shed his sense of unworthiness and shame. His past is a cancer eating away at him. Others simply can’t see the depth of his disease because he hides it. Only one person eventually breaks through to his secrets, and that’s the actor Willem, his dearest friend, who halfway through the novel becomes his partner. Yanagihara depicts the transformation from loving friends to devoted lovers, an evolution that takes place over the course of many years, in such hallowed terms it amounts to reverence.

In Jude and Willem, Yanagihara has created men who are so kind and empathetic, whose affection and devotion run so deep, over so many years, one can only envy such a relationship. In this area, the world depicted in A Little Life is too broadly drawn. The devotion and love is perfect, the forgiveness always forthcoming. The gatherings of friends, the parties and Thanksgiving dinners are inevitably warm affairs. There are fabulous apartments, successful careers, enviable country houses — a doctor completely devoted and available to Jude at all hours, and an older couple, a professor and his wife, who adopt him as an adult in an attempt to give him a family. It’s all so lushly drawn — even the horrors, especially the time young Jude spends (Lolita-like) on the road with the renegade priest, Brother Luke, who pimps the boy out and becomes, in the priest’s mind, the boy’s lover. A reader may begin to feel guilty about wanting to continue to read to find out the rest of Jude’s story — the details of which are unveiled so slowly and tantalizingly that the violence can feel like porn. The extremity of the hardships Jude endures pushes the book to the very edge of believability.

In a conversation with her editor, Gerald Howard (full disclosure: Howard was my first editor), posted on Slate earlier this year, Yanagihara responded to the idea that she might have taken things to an extreme, heaping too much suffering on Jude, as Howard initially suspected when he read the manuscript in progress (he has described the novel, not unkindly, as a “miserablist epic”).

Yanagihara flatly stated that she didn’t regret the amount of abuse she had required Jude to endure. Everything in the book, she said, is a little exaggerated — “the horror, of course, but also the love.” She added, “I wanted it to reach a level of truth by playing with the conventions of a fairy tale, and then veering those conventions off path. […] I wanted the experience of reading it to feel immersive by being slightly otherworldly, to not give the reader many contextual tethers to steady them.”

Perhaps this is why the novel feels rather claustrophobic for all its length. There is no context other than the one created by these men’s lives and their relationships. One might be forgiven for thinking there was no homelessness in New York, no poverty or crime, no political shenanigans or artistic failures, only successes and rather pampered lives, the taste of uni to be discovered in a Soho restaurant, paintings to be admired at openings — and of course all the bloody scenes of cutting and rape. Past horrors drive the story forward even as the present becomes ever more dreamy. And yet this insularity works in terms of achieving the author’s stated goal of drawing us into the singular realm of the emotional lives of these men. Reading A Little Life is indeed an immersive experience.

The novel, as Howard suggested in the interview, was devised to “trouble a soul.” And who could say this is a bad thing? Yet what I found most troubling were the book’s main flaws — the idealization of the romance between Willem and Jude and the agonizingly slow revelations of horrific abuse. In some unseemly way they feed off each other and represent counterbalance — this ideal love, impossibly pure, and this terrible evil, so grindingly evil. One can certainly play with conventions of a fairy tale, but I’m not sure Yanagihara took us far enough off path to shake off the idea of princes and ogres.

Yanagihara wrote her first novel, The People in the Trees, in 1996 and for many years kept it a secret from even her closest friends (she has said she doesn’t want to be the sort of writer who “announces her hopes and ambitions”). It was finally published in 2013, and in its wake she wrote A Little Life rather quickly, over a period of 18 months — an impressive feat even if she had been thinking about the book and its themes of “love and friendship, repair and salvation” for a very long time.

Perhaps in her mind this justifies its length. Like another very long novel, Donna Tartt’s The GoldfinchA Little Life would have benefitted from pruning. And like The Goldfinch, it falls apart at the end: the only thing surprising about the tragic conclusion is it took so long to get there. Still I read it compulsively, often moved by its grave intelligence and storytelling power.

There is no happy finale here, only redemptive acts. In the end, the novel asks us to consider the possibility that love really isn’t enough: even if it’s perfect, it can’t save us from ourselves. Some pains are too enormous to be erased or even meaningfully soothed for long.

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Judith Freeman is the author of a collection of stories and several novels, including The Chinchilla Farm and Red Water. Her most recent book is the nonfiction work The Long Embrace: Raymond Chandler and the Woman He Loved.