Community and distress
Although typically, a community is a sign of comfort and belonging, the setting of the novel causes Adam to be at odds with himself and others. He is often uncomfortable, and thus attracts the wrong kind of attention. Angry kids pick fights with him because he is dealing with emotional issues that make him an easy target, and this makes his experience of community highly distressing. When distressed, there is a feedback loop, because the community misunderstands him and afflicts him.
The family imagery of home
Adam's life is shaped by a nostalgia for a home life that was never really what he hoped for in the first place, but he carries that disappointment through nostalgia for the past. He wants another chance at childhood, shown through the concrete journey through his hometown (literally toward his father), and abstractly through the prose of his point of view. He is painfully aware that he is damaged by the past, but he has a hope that something familial might save him.
Paranoia
Adam remembers events from his childhood that were strange and traumatic. He was attacked by a dog once with his father, he recalls. He struggles to make sense of his reality, because he feels people are sneaking up on him, using him for their covert purposes, and he often believes there are government entities pursuing him because of his father. We learn that as a child, they were in a witness protection program which explains the paranoia; another explanation might be that Adam is correct—the novel shows a world to the reader that is ambiguous, but suggestive. Who is Mr. Grey, and why does the doctor push him so much about the past?
Memory and belief
The issue of memory is clearly shaping Adam's world. For one, he struggles to make sense of disturbing childhood memories that remind him that his personality is fabricated by a witness protection program, which was jarring and puzzling for him as a child. There is the phone number that he dials hoping to reach his girlfriend, and then a man answers and says he's owned the number for years. He is asked by a doctor to recall what he believes about the past. His experience of consciousness is tainted by his incomplete memory.
