1. In the opening chapter of UNDER THE INFLUENCE, Helen catches sight of Ava in a passing car, years after the events that take place in the rest of the novel. What is the significance of this fleeting glimpse? How have both Ava and Helen changed in the intervening time?

2. Both Helen and Elliott had difficult and painful childhoods, and each found different ways of coping with their childhood memories. Is one a healthier approach than the other? How have their childhoods shaped the adults they are today?

3. Helen describes being drawn to “one small odd thing…the thing you don’t expect. That fragment in the landscape out of keeping with the rest.” Is it ironic that, given Helen’s talent for photography, she is oblivious to so many warning signs? What blind spots does Helen possess despite her photographer’s eye?

4. Helen blames herself and her actions for the loss of her son. Do you think Helen should or could have fought harder to regain custody? What factors play into her acceptance of the custody agreement?

5. What initially draws Helen to the Havillands? Do you think she would have been so readily attracted to them at a less vulnerable time in her life?

6. When Helen considers why Ava picked her as a friend, she reflects that “maybe it was simply that I needed rescue, and Ava had a habit of taking in strays.” What role do the Havillands’ dogs play in the novel? How does Ava’s attitudes toward animals compare with how she treats people like Helen, Carmen and Estella?

7. After she meets Elliott, Helen finds happiness, but she worries that she is missing out by “opting for simple, uncomplicated contentment over large and extraordinary passion.” Why does Helen second-guess her relationship with Elliott? Do you agree with Ava’s romantic advice: “Don’t settle”?

8. When Helen tells Elliott about the Havillands, she says, “I owe them so much.” What, if anything, does Helen actually owe the Havillands at this point in the novel? Are her feelings of indebtedness justified?

9. Late in the novel, Ava and Swift befriend another woman, Felicity. What role does Ava’s new protégée play in the story? How does her introduction into the Havillands’ inner circle hint at the events to come?

10. Ava’s planned 60th birthday party for Swift is a bold, public romantic gesture. How does this over-the-top statement compare with Elliott’s much more private gesture of his love and loyalty for Helen, one that she learns about only afterwards? What do their actions reveal about their characters?

11. What did you think of the revelation about how Ava came to be paralyzed? Did you give thought to how it happened?  

12. During her last visit to the house on Folger Lane, Helen takes the small sculpture of the “joyful fornicators.” What is the significance of her decision to take this piece in particular?

13. When Helen reflects on Ollie’s accomplishments in swimming, she notes, “This, at least, we owe to Swift Havilland.” Are there any other positive outcomes from Helen and Ollie’s time with the Havillands? How has the experience changed both Helen and Ollie?

14. UNDER THE INFLUENCE closes with some ambiguity about Helen and Elliott’s relationship. What do you think will happen next? What do you hope will happen?