Last year, Halsey revealed that approaching NIN to work on the LP was "the scariest moment of my life" and like "writing a letter to Santa being like, 'I’ve been a very good girl’”.
"I was just really honest and said I was a huge fan and I’ve been plagiarising you guys for years – badly – and I’m not arrogant enough to believe that I have anything new to offer you, but this album is about pregnancy, gender identity, body horror," the singer explained. "The most important thing to me is that this album has tension – it needs to be visceral, or I’m doing a disservice to the message."