Oof, Virginia's mom. Let's look at what Anaïs has to say about her, shall we?
"Let me guess. On your thirteenth birthday, Mom left It's Perfectly Normal on your bed with a note that said"—Anaïs crooked her fingers like quotation marks—"'Come to me with questions.' But then, of course, she never has a spare minute to talk because she's too busy helping other teenagers figure things out and, anyway, who wants sex advice from someone who considers Dad an ideal mate?" (2.8)
In other words, Dr. Shreves can listen to the people to whom she gets paid to listen, but heaven forbid she listen to her own kids. Partly it's because she's busy, but mostly it's because she's "Cleopatra, Queen of Denial," as Anaïs calls her.
When Byron gets busted for date rape, Dr. Shreves doesn't sit down with the family and discuss it. Nope—instead she suggests everyone carry on as they always have, going so far as to cook Byron a fancy dinner to boost his spirits (read: ego). When they sit down to eat the first meal she's cooked in years, she says:
I thought a home-cooked meal would cheer everyone up. (17.40)
Because after you rape someone, you should totally be cheered up a.s.a.p. Oh, wait… no you shouldn't.
One thing Dr. Shreves is more than happy to discuss, however, is Virginia's weight. In fact, she discusses it ad nauseum—it's one of her favorite topics. One reason for this is that she wants her family to appear perfect, and Virginia's the only imperfect Shreves (by Mom's measure, that is). There's more to it than that, though. As Virginia tells us:
Mom is so together that it's hard to imagine she used to be Phyllis Nutford, Fat Girl from Ozark, Arkansas. Her classmates used to call her Phyllis Nutcase. I only know this because I once discovered her old yearbooks stashed in our storage space in the basement. (5.48)
A-ha… So in other words, she's not just in denial about her family, she's in denial about herself. She wants to think she's always been a wealthy New York shrink, but in fact:
[…] her high school's mascot was a hillbilly… Barefoot, overalls, a corncob pipe, the whole bit… She wants to put as much distance as possible between her Ozark past and her Manhattan present. (5.48)
Sorry Dr. Shreves, but we're pretty sure a shrink would have a field day with you.
Dr. Shreves's major turning point, like so many turning points in the book, comes as a result of too much alcohol. Still, it's a turning point. On the cab ride home from the Lowensteins' holiday party, she says to Virginia:
I wish I'd had the nerve to dye my hair purple when I was your age. (27.41)
Coming from her, that's like a bear hug and a Model Brewster Student award. It's also an admission that though she tries to pretend everything is perfect in her life, Dr. Shreves has some regrets about the way she's led her life. It's just one little sentence, but it's a major admission for Virginia's mom—a crack in the façade she so carefully maintains—that allows Virginia to understand her mother differently than ever before.