Mental Illness
The key theme of the novel is mental illness, although the author does not seem to differentiate between emotional conditions and full blown 'madness'; Jackrabbit is admitted into a mental asylum because he is having trouble making decisions, whilst Connie receives visits from imaginary friends and seems to have schizophrenic episodes. Not all of those suffering from mental illness in the book are violent, but Connie is, as is the father of her child. These violence episodes are considered more than anger, and are likely caused by some level of sociopathy. Degrees of madness are not really compared in the novel; Jackrabbit's condition is most likely some kind of anxiety disorder that could be assuaged with therapy and the addition of an emotional support dog; Connie would be less easy to help.
The book is also not as interested in the nature of mental illness as it is in the way that people considered to be mentally ill are treated. Like Connie, they lose all privileges and are not allowed to make decisions for themselves. Connie is treated like an experiment and surgeons cannot wait to operate on her brain. This raises the question as to who really is the insane one - Connie, for wanting to be in a better world, or the people in the real world who think that experimenting on someone is actually perfectly acceptable.
Class System
Mattapoisett is Connie's imaginary place of the future where there is no class system, and by definition, no class discrimination. Nobody is above anyone, or more important than anyone, because everyone is equal. Connie feels very strongly that she is treated badly because she is lower class; an example of this is the way in which her daughter is taken away from her. She feels that although middle and upper class people spank their kids, only the working class and the poor are investigated if they do so.
The issue of poverty is also wrapped up in the theme of class. Connie has no money but believes her life would be much different if she did. She would certainly have more power and would be able to hire an attorney to represent her, and enable her to possibly fight the removal of her daughter, and even fight her forced incarceration in the mental asylum.
Unethical Medicine
The doctors at the asylum seem far more interested in using their patients as lab rats than they are in helping them get well. Connie has to fight both the doctors' intentions to do brain surgery on her, and remove the part of her brain that they believe controls violent impulse, and she also knows that they are drugging her. We also learn that her friend was killed in jail after being injected with a trial hemophilia vaccine that reacted badly and eventually killed him.
By contrast, in Mattapoissett, medicine is ethical and at the cutting edge of science which all has a purpose and is intended to benefit everyone.
Love
In the real world, Connie is very unlucky in love. Her first two relationships are based in violence. When she does eventually meet someone who loves her wholeheartedly, and demonstrates this with his actions, they are separated by his incarceration. She loses most of the people she loves to violence, and she loses her daughter due to violence that she herself commits.
By contrast, in Mattanpoisett, she is able to experience loving relationships, and to be in a place where she is able to receive love, which also makes her realize that she knows how to give love as well.
Utopia
In the novel, Utopia is actually the imaginary futuristic location of Mattanpoissett. It is Utopia in a theoretical sense, in that everyone is equal, which means there is no crime, no war and no poverty.However, it is also more simplistically Connie's dreamworld. In the real world, she feels powerless, but in Mattanpoissett, nobody is more powerful than anyone else. In the real world, she has lost everyone she loves, but in Mattanpoissett she finds love and is able to heal her heart to a certain degree. Every area in her real life that brings her the most pain is surprisingly easy in Mattanpoisset. The imaginary place corrects everything that Connie feels is wrong with her life, and the way in which the world is allowed to treat her.
