Dolls are an important symbol in the novel, signifying the uncanny—a feeling of discomfort upon seeing something which makes no sense on a deeply psychological level. Since toys are associated with childhood, the horror genre often repurposes them to evoke revulsion by perverting of innocence. In particular, dolls are often used for this treatment because they are made to resemble humans. The idea of a possessed doll is inherently disturbing. It is no surprise then that Edgar is spooked by Reba, the anger management doll, having a nightmare of her as a child with a blood-smeared mouth, another dissonant image that distorts purity with rage and violence.

King transforms this standard horror trope by presenting the novel’s dolls as vessels that can be filled either for good or ill. Reba helps in Edgar’s recovery, and Elizabeth’s ragdoll Noveen helps defeat Perse by recording and playing Elizabeth’s memories of her. However, Perse’s porcelain doll manipulates little Elizabeth, allowing the malevolent entity to have a corporeal host.

The horror that dolls evoke in the text therefore is more complex, associated with the body horror fear of being powerless. Perse treats the dolls as her puppets; later, we learn that she uses the humans aboard her ship the same way.