During the initial onset of Lori’s illness, she likens it and the Voices to demons and the devil. She has repeated fantasies/delusions of the Voices dragging her into the depths of hell to be tortured and raped. These fantasies match the vitriolic violence that the Voices hurl at her, and their constant wish for Lori’s destruction and death. Too, Lori finds herself seeking darkly-themed music and the figure of Charles Manson in her early attempts to both understand and escape her disease. The Devil and Hell therefore symbolize Lori’s early attempts at drawing a corollary between something known and the complete confusion that the onset of her disease causes.

The Quiet Room is both the title of the book and an important motif in it. We first see the appearance of The Quiet Room when Lori is being treated at the White Plains branch of New York Hospital. The Quiet Room is a motif that morphs in its significance through the narrative, in tandem with Lori’s journey toward wellness.

In its first iteration, The Quiet Room is a place of tyrannical punishment and torture. Lori is stripped and administered sodium amytal before being forced to enter it due to extreme behavior, and the staff member who watches her through a window and a rigged mirror acts like a cold jailer.