In group therapy, Casper asks the girls who their friends and community are “on the outside” (68), the people who keep their secrets and make them feel safe. For most of the story, Charlie does not feel safe with anyone. Part of her journey in the novel is figuring out how to establish trust and build healthy relationships with people who will see and value her and who can support her recovery.

After her father’s suicide, Charlie was not safe with her mother, who was physically and emotionally abusive. Though she romanticizes her friendship with Ellis, Charlie was not safe with her either, as Ellis sold her out to her parents to protect her boyfriend. Losing Ellis to brain damage fills Charlie with guilt, but their friendship was not always healthy for her. Evan and Dump cared about Charlie because they prevented her from being raped but were the reason she ended up in Frank’s sex house: They wanted drugs, and Frank promised them. After Charlie’s suicide attempt, they brought her to the hospital and followed up to make sure she was okay, but their addictions made them unreliable.

By the time she wakes up at Creeley, Charlie feels alone, and she is terrified of being discharged because she has no one “outside” who she feels safe with and who she feels will keep her secrets.