An underage boy is introduced to sex in a relationship with a man in his thirties. A girl, likewise, mentions having her first sexual experience at thirteen years old with a forty-year-old man.

A girl wears skimpy outfits through the duration of the film. This includes booty shorts, miniskirts and halter tops.

A woman is seen fondling and kissing another woman in what is revealed to be a lesbian relationship. No nudity here, only mildly revealing nightgowns that cover up their private parts.

A psychiatrist pairs a molested teenage girl up with another of his (much older) patients in a lesbian relationship. It is mentioned that the girl's father "showed her his penis in a rowboat".

Women sexually fondle each other with blades of grass on their lips and chests.

A man writes a poem about a nun menstruating; the poem calls the titular nun a "whore".

A boy mentions and discusses being gay.

A girl tells a boy to "be sexier and make them want you" to a boy as they both dance in go-go boots.

An unethical sexual relationship is implied between a woman and her psychiatrist.

An elderly psychiatrist has a room in his office which he calls his "masturbatorium".

A woman becomes aggressive in a hotel bar, shouting and swearing and splashing water down a man's clothes.

Characters break down a door to rescue a woman in the room on the other side, who is having an apparent hallucination.

A man writes a poem about being beaten and sexually abused by a nun in his childhood. He then loudly bellows out the poem verbally to a crowd of shocked women.

An electroshock therapy machine is brought out and hooked up to a boy's head. The machine in shut off before it can be used.

A cat is starved to death and killed. The corpse is later seen on-screen with matted fur and an emaciated body.

A man holds a knife over another man's head at night.

Dierdre often is verbally and physically abusive to her husband. In one scene she tells him that she can smell manure coming out of his ears. In another scene, she knocks him unconscious after hitting him.

Natalie confesses to Augusten that when she was thirteen, she had a relationship with a 43-year-old man who constantly beat her up until one day he broke her collarbone and she passed out while hitchhiking to the emergency room because her own father wouldn't drive her to the hospital.

Augusten overdoses on pills to "fake" a suicide. His mother drives him to a hospital and he has his stomach pumped, after which he starts barfing and screaming at the same time.

Uses of sexual slurs and terminology.

Scatological humour, including a psychiatrist analyzing his own poop in the toilet by its shape and "duplicoils", uses of the word "turd" and "shit". He tells his wife to get a shoehorn so that they can let the poop "dry in the sun" outside, which they then build a shrine around.

One disability-related mockery; a girl furiously scratching at her head while making pig-like faces is told that she looks like she has down's syndrome.

Frequent vulgar references to sexual anatomy. This includes proper terminology and also slang, including "cunt", "whore", "masturbate", "tampon", "twat", "anal", "oral", "dick", "cock", "fuck" and other words.

Multiple uses of "shit", "fuck", "bitch"; one usage of "svengali", milder words including "poop", "manure", "old maid", "Jesus Christ", "God/oh God" and others.

One of the characters is named Poo. He is a little boy and his teenage mother named him Poo for his habit of defecating on the floor and saying, "I just pooped!" He isn't corrected or punished, rather, the older kids tell him they're proud of him for his behavior.

Cigarette smoking

A woman accuses her children of using pot.

A boy purposely overdoses and is given anxiety medication to experiment with.

A woman becomes drugged up on sedatives and tries to take a bite out of a wax birthday candle, mistaking it for the birthday cake itself.

Various pills, including apparent sedatives, Quaaludes, antidepressants and more, are shown on-screen.

Alcoholic beverages are served at a hotel bar.

One of the main characters is an alcoholic. Another is a pretentious drug addict with delusions of literary grandeur; she gets high at one point and hallucinates a snowstorm in her bedroom, spinning around under the "snow" that does not exist.

Frequent drinking and drug use.

The film deals with severe childhood trauma, vulgarity, psychiatric abuse and the intentional killing of a domestic cat, all things which the writer of the story claims to be nonfiction (this has since been legally disputed since the release of the film). These events are often shocking and sensationalistic.

A scene from the 1970s television show Dark Shadows is shown on a TV in the background. A vampire appears in full white skin with sharp teeth, causing a female character to scream.

scene occurs in which every character screams very loudly, the volume of which is heightened dramatically during the scene to override the soundtrack playing in the background. May startle/upset some viewers.

Talk of human feces, vomit, manure, masturbation and other bodily fluids may gross out and sicken some viewers. This includes an incident where a woman is ordered to dry a man's poop in the sun after retrieving it from the toilet with a shoehorn and building a shrine around it. (NOTE: no actual feces is ever shown on-screen).

The film's ending scene is quite emotional and upsetting.

The theme relates to insanity and perverse behavior among almost all characters. Child abandonment and isolation is central to the story. One episode of anticipated murder.