Throughout his narration, Matthew alludes to the deep-seated shame he carries throughout his daily life. Matthew’s deep sense of shame has several origins, one of them being shame about his mental illness. From the start, it is clear that Matthew is intensely fearful of germs, to the point of confining himself indoors to avoid them. Matthew’s germaphobia is later revealed to be the result of obsessive-compulsive disorder. Matthew receives an official OCD diagnosis when he attends his first therapy session with Dr. Rhodes. While an official diagnosis—as well as the subsequent reassurance that recovery is possible—would come as a relief to most people, it seemingly only makes matters worse for Matthew. While Dr. Rhodes carefully explains the specifics of OCD and Matthew’s iteration of it, he feels embarrassed by how his condition has affected his behavior. Though Dr. Rhodes is gentle and informative in her explanation, Matthew cannot help but feel “ridiculous sitting there with [his] stupid plastic gloves” (130). The fear of participating in Dr. Rhodes’s recovery program coupled with his humiliation about being mentally ill in the first place causes both Matthew’s anxiety and shame to increase exponentially.

The shame Matthew feels about his OCD also affects his relationships to those around him.