The experiences and concepts of guilt and grief arise repeatedly throughout the text. These are profoundly affecting emotions that fundamentally change the people who experience them. Much of the decision-making in the text is driven by guilt and grief: John-Paul’s lifetime of penance, Connor’s years of therapy and self-sabotage, Cecilia’s disassociation when she decides to keep John-Paul’s secret, and Rachel’s poor relationship with her son and ultimate decision to hit and kill Connor with her car. Tess, too, is driven by grief initially and later by the guilt of her sexual affair with Connor. Moriarty reveals the depth of grief and guilt and their power to overwhelm more positive emotions like happiness and love. 

The larger framing devices of the Berlin Wall and, early in the text, The Biggest Loser serve to reinforce the idea of the individual who is actively engaged in their own life at any given moment. Moriarty makes this clear in the first few chapters; she has each woman hear the same moment in the television program to make it clear to the reader that these moments of personal crisis are happening simultaneously. All three women struggle, initially, to see people as individuals rather than as parts of their own stories.