Alice's best skill is her talent for putting her thoughts and feelings into words, but time and again she concedes defeat when it comes to explaining the hallucinogenic and emotional effects of drugs. At first, this untranslatable quality is the main appeal for drugs, but ultimately it conspires to alienate Alice from even her escapist reality—she needs to communicate with others, and drugs only create temporary and shallow relationships based on hedonism. Her dislocation from writing and words while on drugs becomes explicit when, under the influence of acid, Alice stares at her right hand for hours—her writing hand, in effect, becomes no longer a tool but an object of study.

One of the main factors behind Alice's move to the counterculture is the competitive, harsh world of bourgeois life, with its premiums placed on appearance, skill, and ambition. It leaves little room for the less quantitative attributes of love and openness, and Alice seeks such values in drugs and the counterculture. Even within her family, Alice is jealous of her better- performing younger siblings and resents her father's concern over himself and his career more than with his family. Nevertheless, her frequent returns to her family always refuel her middle-class desires for marriage and education, and her father shows his true colors in dropping work to help her.

What forms the counterculture is not only drug use, sexual abandon, rebellious fashion, and subversive politics, but the adaptation of a new language, one derived partially from minority slang. Alice rebels from her middle-class upbringing when she introduces words like "dig" to the family and identifies her father's academic vocabulary as "his" words. Just as each group of the population belongs to a different sphere, such as wealthy drug users and poor drug users, as Alice observes once, each one has its own specific language to reflect its lifestyle and values. In part, Alice's use of counter-cultural language is simply an offshoot of her own natural facility for expressive language, but it is also an attempt to try and describe her new experiences. As she learns, words are generally unable to describe drug trips, but this holds true for the counterculture as a whole; it is not a world based on communication, and she struggles to relate to the near-comatose drug users she meets. She eventually returns to the language she was brought up with, one that suits her and helps explain herself but with the memory of other languages she has spoken.

Alice's recurring nightmares of maggots and worms eating at corpses turns into explicit hallucinations during her overdose and hospital stay. Since it is supposed to be a true diary, Go Ask Alice does not have any overt, artificial symbols, but the maggots and worms do take on two meanings for Alice. The loneliness of the individual mind, hidden from others while it is being destroyed, is one possible analogy for the maggots and corpse; no one knows what happens to a body underground, hidden from sight, while predators scavenge it. A second meaning indicts society more. The "dead things and people" that "were pushing" her into a casket become one mass entity that seek Alice's harm. The maggots and worms are the destructive impulses of society. Society is "pushing" her inside the coffin, as it has pushed her into drugs and away from other people.

The quest in Go Ask Alice is for communication; Alice finds it first only with her personified "Diary," and not with other people. The diary fools Alice into thinking that she is corresponding with someone who reciprocates her feelings, opening up to her as much as she reveals herself to it. Through conversations with other runaways, Alice gains an interest not only in sharing herself with others, but in letting themselves share their stories with her. Alice learns to trust others, taking risks while opening up to Joel about her life, and she finds that her relationships deepen that much more when she is open. Discarding the diary is her victory; she has finally applied her skills at self-communication to a newfound intimacy with others, one that she hopes will eventually help them as much as it does her.