A central theme of the novel is that most of the families portrayed have been damaged or are threatened in some manner. Marc’s family was severely disrupted by his father’s strokes. While Marc does not blame his father’s illness for Stacy’s addiction issues, her depression was likely left untreated for longer than it would have been without the focus on her father’s health, which may have contributed to self-medicating through drugs. Marc’s new nuclear family implodes in spectacular fashion when his wife attempts to kill him, and Tara disappears. Monica and Marc share a failure of communication that results in Monica’s insecurity overwhelming their family. It is a joint failure of their responsibility to Tara.

The Portmans have also irreparably damaged their family. Monica believed, before her death, that her brother committed suicide on purpose, and she blamed her father. While there is no concrete evidence that Edgar is at fault in the death of his son, Dina can vouch that Monica’s mother actually did physically and emotionally abuse her. This abuse primed her to believe she was unloved by everyone except Tara. Monica’s decision to attempt to kill Marc is a result of her mother’s prior actions. As the reader can see, not only are children damaged by their parents, but they can grow up to become adults who damage their own progeny as well.