Reality and fiction
In his play, Caden attempts to recreate reality as closely as possible, even casting actors who look like their real-life counterparts. As the film goes on, Caden becomes more committed to this cause, blurring the lines between reality and fiction, to the point where they are almost indistinguishable. Compounding this is the fact that Caden's play is set within the fictional representation of the film, meaning that there is a further blurring of reality and fiction for the audience of the film.
Artistic endeavour
Both Caden and his partner Adele are artists, and this film explores the relationship between an artist and their work. After he is awarded a fellowship and financial help, Caden directs his time and energy towards his play, which becomes his obsession for years. Caden attempts to depict reality so closely that lines become blurred, giving it a disturbing quality. Ultimately, Caden becomes too committed to the play, leading to conflict in his personal life as his own issues are unresolved.
Physical illness
Throughout the film, Caden suffers from a strange disease that is slowly shutting down his body. Ultimately, this adds another facet to his suffering. This illness causes him a lot of physical pain, and reflects his emotional and spiritual pain due to his unsettled personal life.