The following version of this book was used to create the guide: Hogarth, Ainslie. Motherthing. Strange Light, 2022.

Hogarth's novel is divided into 32 chapters and told from the first-person perspective of Abby Lamb, a 30-something-year-old woman dealing with the death of her mother-in-law with her husband, Ralph.

The novel begins in the hospital; Ralph's mother, Laura, has just committed suicide. Ralph is handed a business card from a psychic in the hospital. Abby, his wife, reflects on how she slid a ring off of Laura's unconscious body when they found her. She also narrates on how Laura manipulated Ralph in many ways when she was alive. They drive to the outside of the psychic's house but don't go in, and Abby buries the ring in the yard when they get home.

Abby tells of how Laura had borderline personality disorder, and then reflects on her own childhood spent with an emotionally neglectful mother. She projects mothering characteristics onto her couch when she is a child to fill the void. Later, Ralph wonders if Laura's suicide was his fault, and even though Abby wants to move out of the house, he says he is not ready to do that. Abby calls the funeral director after writing a vulgar, fake obituary for Laura to vent her feelings. Abby and Ralph have sex, and Abby is hopeful they have just conceived.

Abby and Ralph go to the funeral parlor, and Ralph is unnerved by his mother's missing ring and claims the body he saw is not Laura. Abby confirms that it is her, and they cremate Laura without the ring, which causes Abby considerable guilt. Abby returns to work and bonds with Mrs. Bondy, a patient at the nursing home she works at that Abby is very protective over. When she gets home from work, she finds Ralph muttering and crying in the basement with a knife wound on his hand. Abby reminisces about her and Ralph's first night together and how he saved her from things she had picked up from her mother. In the present, Ralph bandages his hand and they go out to dinner, where he tells Abby that Laura is somehow back and in the basement. Upon arriving home, Ralph takes her downstairs, and Abby hears some strange sounds in the basement but seems to play up how much she believes Ralph about Laura because she wants him to feel better.

The next morning, Abby rides the subway to work and thinks about how Ralph is prone to auditory hallucinations as a result of his depression. Interspersed are stories of Abby's unsavory ex-boyfriends and her early encounters with Ralph. When she arrives home, she tells Ralph he does not believe her about Laura.

Ralph later tells Abby he believes he is already dead and that something Laura has passed down to him is contagious; he does not want her to get too close to him. He also voices fears about having a child. Abby hears a voice in the bathroom that tells her she is not pregnant as her period starts. She takes all the knives that Ralph could cut himself with and hides them -- except for one that she takes in her purse.

Abby begins to be tormented by thoughts and voices that sound like Laura. She begins to have violent fantasies about Janet, Mrs. Bondy's daughter who is rude to Abby, and Carol, a coworker who refuses to try the jellied salmon she brings to work. She reflects on horrible memories from her childhood.

Later, Abby burns Laura's old pillow in the yard. She thinks she sees a spot where the ring she buried has been dug up in the yard, and neighbor Irena's dog starts barking at her. Abby yells at Janet at work, fearing that she plans to move Mrs. Bondy to a different, worse facility.

Abby sets out for the psychic whose card Ralph was given at the hospital. The psychic, Joan, and her interpreter, Annie, conclude that something has attached to Abby and Ralph, and Joan seems to be possessed by Laura, who calls her a thief. Annie tells her that she needs to feed Ralph something special to prove her devotion to him and satisfy Laura so she will go away.

Abby is told by her boss that Mrs. Bondy is going to be moved and, in the meantime, she is not to take care of her. She waits outside to confront Janet, who lodged a formal complaint against Abby, whenever she arrives, but is interrupted by Carol before she can.

Abby reflects on how she witnessed her mother beating a boyfriend with a frying pan and then, in desperation, offering the boyfriend both of them when he threatened to leave. Then, she goes to Janet's house. Janet tells Abby that Mrs. Bondy is actually a crook and a bad mother who is spending Janet's money at the nursing home Abby works at, which is why she wants to move her to one she can afford. Abby breaks down and refuses to believe Mrs. Bondy is bad. In a fit of rage, Abby stabs Janet and kills her before taking off some of her skin and bringing it home.

Abby prepares Janet's skin for Ralph, thinking she has found the meal the psychic meant for her to feed him. It seems to restore Ralph to his former self -- he eats it thinking it is chicken -- but he confesses that he almost killed Abby. The two have sex again, and Abby feels like they have conceived their baby at last. She sees a vision of Laura lifting out of the room as she orgasms. The next morning, Irena comes over and gives them the ring Abby took from Laura's body, saying her dog dug it up. Ralph tells Abby he is ready to have a baby, and Abby seems assured that she is pregnant.