Sharp Objects, the new limited series based on Gone Girl author Gillian Flynn’s debut novel, premiered last night on HBO. Created and written by Marti Noxon, the series stars Amy Adams as a troubled reporter who returns to her small hometown to cover a local tragedy — and re-open some old wounds in the process. The debut episode, “Vanish,” is a dark, gorgeously-shot and dreamlike introduction to Sharp Objects and its central mystery (who killed these girls?), courtesy of series director Jean-Marc Vallée (Big Little Lies). And if you haven’t read Flynn’s novel, you probably have a fair amount of questions, particularly about that final shot.

Having read Sharp Objects, I’ll try to keep this relatively spoiler-free regarding future plot developments, but be warned that this explainer will absolutely include major spoilers for the premiere episode of the HBO series. The basic premise: Camille Preaker (Adams) returns to her hometown of Wind Gap to cover the disappearance of one teenage girl and the murder of another. Camille has plenty of skeletons in her closet; she’s an alcoholic, for one, and her relationship with her mother (Patricia Clarkson) is fraught with drama, to say the least. Below, I’ll dig into some of the biggest questions and developments in “Vanish,” including the surprising PSA that appeared at the end of the episode.

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1. Camille’s Past

Camille’s past comes back to her in fragments, and Vallée beautifully weaves those scenes into the present to evoke the slippery, surreal nature of repressed trauma and pain. Given Vallée’s reliance on music and imagery and his approach to letting the past bleed into Camille’s present, there may have been some confusion over what exactly happened to her as a child. We witness a few important moments from the life of young Camille (Sophia Lillis from IT), notably her relationship with her sister, Marian, who became ill and eventually died. We see Camille at Marian’s funeral, trying to forcibly remove the bright pink lipstick on her sister’s mouth — undoubtedly chosen by Adora.

There’s also a scene in which Camille runs through the woods in a cheerleading uniform as boys chase her, and in another memory, she comes upon a shack filled with animal carcasses and BDSM pornography on the walls. Later, Camille visits Marian’s room, which her mother, Adora (Clarkson) has kept exactly as it was when the younger girl died. Honestly, it’s the least creepy thing in that house, which looks like it was manufactured by V.C. Andrews.

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2. Amma

Camille runs into her teenaged half-sister, Amma (Eliza Scanlen), a couple of times around town. Amma is seen with a couple of other girls on roller skates; they’re all sort of superficial and bratty, so it’s a surprise when we meet Amma again later at Adora’s, wearing a preppy cardigan and a bow in her perfectly-styled hair. She gushes over her doll house in front of her mother, then quietly commiserates with Camille about living under Adora’s rule. In Flynn’s novel, we don’t learn who Amma is until much later, but Vallée and Noxon clearly want us to keep an eye on this troublemaker.

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3. Adora

To say that Adora is a real piece of work is an understatement. Camille’s mother is a fragile, melodramatic woman who seemingly lives in an extravagant pink nightgown with a drink firmly attached to her hand. One minute with Adora is all it takes to explain much off Camille’s upbringing and her psychology: This woman is intense. Her husband, Alan, would probably get along really well with Gabriel Byrne’s similarly useless and aloof patriarch in Hereditary. We’ll learn more about Adora in the weeks to come (there are eight episodes total, FYI), but the most important things to note for now are her dependence on alcohol, her determination to remain ignorant of anything remotely unpleasant (including the story her daughter is writing), and her obsession with delicate, pretty perfection.

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4. The Disappearance, the Murder, and the Dead Body 

Camille is originally sent home to Wind Gap by her editor to cover the disappearance of Natalie Keene — but, as we learn early on, another teenage girl named Ann Nash was murdered several months earlier. It’s not long before Camille draws the attention of Detective Richard Willis, a fellow drinker and, let’s be honest, total babe. Although Willis is evading most of Camille’s questions (for now), “Vanish” answers one by episode’s end when the brutalized body of Natalie Keene — missing all of her teeth — is found in an alleyway. Keene’s brother John is an early suspect, as well as Ann Nash’s dad (Will Chase), but if you’ve spent any time watching crime stories (of the true or fictional variety), you’re likely already thinking that these two are red herrings. Still, it’s difficult to rule anyone out just yet, no matter how obviously volatile Ann’s dad is.

For now, Bob Nash is probably our most viable suspect.

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5. The Final Shot and That PSA

“Vanish” ends with Camille getting into a bathtub at her mother’s house. It’s a scene lifted from chapter four of Flynn’s novel: Camille, naked, sinking into the water, her body covered in the physical evidence of a lifetime of internal trauma. There are scars all over her skin, each spelling out a different word: April. Inquiry. Nude. Branch. Fraud. Vanish. To help shed some light on Camille’s startling form of self-harm, here’s an excerpt from Flynn’s book:

I am a cutter, you see. Also a snipper, a slicer, a carver, a jabber. I am a very special case. I have a purpose. My skin, you see, screams. It’s covered with words—cook, cupcake, kitty, curls—as if a knife-wielding first-grader learned to write on my flesh.

As a journalist, Camille has a penchant for the written language — one that extends to her cathartic approach to coping with trauma. For some people who engage in self-harm, the act is a way to make inner-pain visible. Flynn confirmed as much in an interview with The Hollywood Reporter:

The reason I wrote about the scars, about Camille writing on her skin, was because I felt that [misery] of, like, ‘Why can’t anyone see how much pain I’m in?’ I wished I could bear witness somehow. I had these fantasies of being mangled—of showing how much pain I was in.

It’s an unsettling reveal, particularly as a closing shot, and one that might be personally upsetting for some viewers. After the credits finish rolling, a PSA appears on screen that reads:

If you or someone you know struggles with self-harm or substance abuse, please seek help by contacting the Substance Abuse and Mental Health Services Administration (SAMHSA) 1-800-662-HELP (4357).

It’s rare to see such PSAs attached to TV shows, though The Handmaid’s Tale recently opened an episode — “The Last Ceremony” with a trigger warning. That was somewhat surprising for regular viewers, given that rape and abuse are recurring elements on the series, but the episode in question did indeed feature a rape scene that was more disturbing than most.

As confirmed by Deadline, the self-harm and substance abuse PSA will air at the end of every episode of Sharp Objects — similar to the video trigger warning that aired at the beginning of each episode of 13 Reasons Why, which Netflix incorporated into the second season in response to viewer backlash over the show’s depiction (and possible glorification) of teen suicide. It might just be HBO’s way of avoiding potential backlash, but it’s also the right choice considering the subject matter of Sharp Objects, which will almost certainly hit a little too close to home for viewers who struggle with issues similar to Camille.