Content Warning: This section discusses graphic depictions of sexual violence and rape; derogatory language toward gay, trans, and women characters; violence against children, including sexual violence; self-mutilation; and suicidal ideation.

The motif of disability figures prominently throughout the text, supporting the themes of Anxiety and the Under Toad and The Intimacy of the Written Word. Garp feels great outrage toward the Ellen James Society, whose members cut off their tongues to protest the rape of an 11-year-old girl who was brutally mutilated the same way. Frustrated by the violence and cruelty of the world (particularly that directed toward children), Garp’s initial loathing toward the Ellen Jamesians likely stems not from the act of self-mutilation itself, but from the visible conclusion that attempts at advocacy are hopeless; the members believe that spectacle is the only chance at achieving change.

Though Garp is a proponent of the written word, he is frustrated with the Ellen Jamesians’ attempt to communicate through notes. Ironically, when he breaks his jaw in the car crash that kills his son, he is reduced to the same level of voicelessness, and from this he derives a new sense of impotence.