Content Warning: This section of the guide contains discussion of mental illness, substance use, death, graphic violence, and emotional abuse.

Gather initial thoughts and broad opinions about the book.

1. How did your perception of the narrator’s “hibernation project” evolve from the beginning to the end of the novel? Similar to Moshfegh’s novel Eileen, did you find yourself simultaneously repelled by and drawn to the protagonist?

2. What role does dark humor play in the novel? How does Moshfegh balance the serious themes of isolation and depression with moments of absurdist comedy, particularly in scenes with Dr. Tuttle?

3. The novel ends with a striking image of the 9/11 attacks. How does this conclusion affect your overall interpretation of the story’s message about sleep, awakening, and being “wide awake” in life? How does its representation and use of 9/11 compare to that of other novels—e.g., Jonathan Safran Foer’s Extremely Loud and Incredibly Close?

Encourage readers to connect the book’s themes and characters with their personal experiences.

1. The narrator uses sleep as her preferred method of escape. What coping mechanisms have you observed people using to deal with emotional pain or disconnect from reality?