Paul's car
Paul's car (and his subsequent car accident) is a powerful symbol of rebirth. The moment after Paul steps into his car to return to Los Angeles, his life enters a new phase. Drunk and disoriented, Paul crashes and injures himself. Shortly after the crash, Annie finds him and portends to nurse him back to health. She pretends to care for him, but she doesn't at all. She exerts coercive control over him, injuring him both physically and mentally. Paul is forever changed by this experience; his car accident is the turning point in his life and will always be the demarcation point between something "normal" and something other than that.
Annie's chainsaw
Towards the end of the novel, Annie obtains a chainsaw and nearly uses it to kill Paul after he makes her life difficult. Her chainsaw is symbolic of her madness and childishness; because she doesn’t get her way, she will use a blunt instrument that is capable of violently separating people from their limbs. Children act in a similar way: if they don't get what they want, they throw a fit.
Pill
The painkillers that Annie gives Paul represents the hold she has on him. Very shortly after his accident, Annie starts to give Paul addictive painkilling pills. And Paul, naturally, gets hooked on the drugs. Without them, he starts to go into withdrawals, lessening his will to escape and making him dependent on Annie, who is his only source to get his fix.
Paul trying to escape
One of the most common motifs in the novel is Paul trying to escape. Invariably, after Paul gets a burst of courage or starts to feel better, he tries to escape from Annie. Unfortunately, most of his attempts fail for one reason or another, but these escape attempts show Paul to be an intelligent person who wants to avoid the pain and heartache he is going through.
