1. Abby provides a number of examples of early compulsive behavior. Are these innocent childhood habits or do they indicate a predisposition to OCD? Do you think her father's and aunt's deaths in some way led to her OCD?
2. Discuss Abby's experiences with death as a child, a teenager, and an adult. How does David's death make the imagined accidents more real? How do her ideas about guilt and responsibility evolve with each new experience?
3. Discuss the role of prayer in Abby's life and the different things she prays for. How are her fears of death and danger related to what she prays for? In what ways do her prayers help her and hinder her?
4. Abby's various compulsions/obsessions evolve and take shape over the course of her life. From singing the cement mixer song to picking up sharp objects to kissing her bike to pounding her head. List and discuss her rituals and compulsions. How do these rituals relate to the circumstances of her life at different times? What are the motivations behind each of them?
5. After going on medication, many of Abby's compulsions are eased but, she writes, "I had the sense that G-d was not pleased with my decision to medicate." Why does she feel that acknowledging her OCD undermines her piety? Is her faith distinct from her illness, or is it connected? Does the medication make her less devout?
6. How does Abby's intense friendship with Ruthie challenge her notions of self? How is their relationship similar to that of Abby and Ellyn or Abby and her mother? Consider the ways that Ruthie both broadens Abby's horizons and becomes an unhealthy obsession.
7. What does Abby relish about being on stage? How do her feelings about performing change over time and why?
8. What factors contribute to Abby's progression from counting calories to over-exercising to self-mutilation? Why do you think her adult compulsions are more self-directed than earlier ones? How do her prayers change as these behaviors manifest?
9. Consider Abby's romantic relationships with Will, Tristan, Mark, Ben, and Jay. How does her reverence for G-d, and for her father, complicate these romances? What expectations does she have of the men she loves and what expectations does she have of herself? Ultimately, she and Jay find happiness together; what compromises and epiphanies allow them to make it work?
10. Abby relies on and adores her mother, but their relationship isn't always close. How does it shift over the course of the book? Which events draw them together or pull them apart? Does her mother help with or enable Abby's illness and her compulsions? Discuss the significance of the chapters "the incredible shrinking truth" and "start spreading the news."