1. James frequently turns to bravado or isolates himself when dealing with hard times at the clinic. What other coping mechanisms does he use? Which of these seems most effective?

2. How does James’s relationship with Lilly differ from his relationship with the Girl with the Arctic Eyes? How does each relationship relate to each part of his life?

3. Frey’s writing style has been called “gritty,” “raw,” and labeled as “stream of consciousness.” What does this style say about his state of mind during his stay at the clinic? Is it an effective vehicle for his thoughts?

4. How does James’s relationship with his family change throughout the course of his stay at the clinic? In what ways does James show the changes? Why is this change important to James’s recovery?

5. What role does Leonard play in James’s recovery? What does Leonard stand to gain from making friends with James? What is the significance of Leonard accepting James as a son?