Spoilers are unmarked
- Poor Fran. Her parents died, she lost her only friend, Mr. Midnight, and she is stuck in an asylum where the staff ranges from well-meaning but ultimately useless to outright malicious.
- A couple of times in the asylum, Fran sees some dead animals while on Duotine and has different interactions with them. She wonders if a bunny is asleep and urges it to wake up. On her bed is a dead fox and she’s willing to give it a hug and let it use her hand as a tissue because she thinks it’s crying.
- All the children in the asylum went through terrible things.
- Adelaida was a victim of sexual assault, which almost took her life. This traumatic experience brought on auditory hallucinations and thought disorder. The nurses often tie her up to the bed when she acts out, which resulted in deep rope burns on her wrists while trying to free herself from the uncomfortable situation. Fran's task to receive the green crayon from her is to get bandages to stop the blood.
- Victoria has severe trust and self-worth issues, as demonstrated by her shadow expressing being laughed at and deceived.
- Jason appears to be the victim of isolation and pleads for Fran to kill him when she attempts to talk to him.
- There are not many clues about Isabelle, but the fact that her shadow is stroking her while she's asleep may indicate some form of sexual abuse.
- Damian was the victim of rape by some kind of priest or pastor, was not believed by his mother when he told her, and seems to have issues with delusions of grandeur.
- Robert may have had a gaslighter in his life who gave him kind words while teaching him to hate himself, then had a failed lobotomy in the asylum which may have caused further trauma and behavioral issues.
- Phil is a diagnosed paranoiac, has dark circles under his eyes from lack of sleep, and seems to have been sent down a dark path by his uncle, who supposedly drove him into the death of a bird.
- Clara and Mia may be cruel to Fran, but their backstory of being forcibly stitched together in the horrific twin experiments, as well as both having lobotomies, is a fate that nobody deserves to have. Their anguished faces in the picture inside the mirror are painful to look at.
- Fran cries several times during the course of the game, but one of the worst ones is in Ithersta when after seeing disturbing visions, she breaks down and fears she's simply crazy. It's rather heartwrenching to see her to the point of such utter despair.
- Fran, Mr. Midnight and Itward sharing a hug when the flying ship is about to crash.
- Crosses over with Heartwarming, Dr. Deern was abused by his father when he was a child, which is what turned him to psychiatry, so he could help children who were in similar situations.
- Towards the end, Grace gets rid of Mr. Midnight by dropping him into the Fifth Reality’s void. Fran does not take that well, and attempts to choke her aunt to death. To make things worse, she gets shot by Oswald soon after.
- By the end of the game, very little is actually answered as far as what's happened. Fran seems willing to believe that she killed her parents, but is that the truth or one of Remor's tactics to fuel her despair for him to feed off of? Even if it was the truth, then did she do it willingly or under possession? You never find out, which can leave the player feeling a little empty since Fran only gets told repeatedly that she's not ready to hear the truth. There is no closure, and it stings that there isn't.
