Consisting of 10 songs, this album deals with issues with relationships, issues with childhood, issues with drugs, and even incorporates some optimism with the song "4 Degrees", a song seemingly about reaching a higher consciousness/letting go of oneself through sexual intercourse.
Although frontman Maynard James Keenan doesn't use a wide variety of pitches, he certainly uses a lot of tones. His tones range from angry to hopeful to possessed, all within the span of one song. Danny Carey's drumming is especially noticeable in the 5+ minute anger-fest entitled Crawl Away about a relationship falling apart; one person fading, or "crawling" away, and the other trying desperately to hold it together.
Guitarist Adam Jones and bassist Paul D'Amour work well together on the song Prison Sex, to create a strangely melodic and peaceful atmosphere amidst a barrage of disturbing vocals from lead singer Keenan.
The atmosphere of the album is topped off by depictions of large naked women and the band members posing with pins in the sides of their heads in the liner notes, which caused quite a controversy across The United States and North America, and was removed from the shelves of most large retail chains.
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