Despite the mental horrors Alice endures, her mind stays somewhat resilient and her diary becomes her true sanctuary, not only as a place to describe her feelings but now as a proof of her own sanity. Her physical self-abuse is a manifestation of all her previous bouts of self-loathing and morbid anxiety. Her old nightmares of worms and maggots eating away at dead bodies now haunt her imagination, yet the worms and maggots now take on a new significance. In her acid episode, the "dead things and people" that were trapping her in the casket intermingle, becoming one entity that seeks Alice's harm. While not explicit symbols, the maggots and worms stand for all the destructive impulses of society that Alice has internalized into low self-esteem. Just as society is "pushing" her inside the coffin, it pushes her into drugs, pushes her away from her family, and pushes her into a lonely corner at school. She comments on the symmetry of her first and last drug uses, both of which were without her knowledge. In another way, though, all times were without her full consent. the drugs were pushed on her by a society that was cold and harmful and only gave her love and self-esteem when she was high. Again, Alice meets an extreme example in Babbie, another exploited, abused victim of society's cruelty.

Society again rears its hypocritical head. Alice is sentenced to an asylum, while the real villains—Jan and the other girl—get off scot-free. As Alice puts it, the "whole world is crazy," and, while some of the inmates at the asylum are insane, the outside world is just as incoherent. The theme of defining insanity versus sanity has been prevalent in literature from Hamlet to One Flew Over the Cuckoo's Nest, and the reader can see that Alice, while mentally shaky from her episode, deserves freedom. Even her inability to understand whether the worms are real or not is partially a product of her vivid imagination that confuses fact and fiction.