It thematically explores themes of abuse, misogyny, hate, vengeance and violence in its lyrics, inspired by Hayter's own experiences in Providence, and features influences from both classical and extreme music.

In 2017, Lingua Ignota (real name Kristin Hayter) released her album All Bitches Die, which spread through word of mouth as she performed in Providence, where she was based.

"[3][4] She began work on another album at Bruni's request, this time with studio resources and people who she could collaborate with, in contrast to All Bitches Die, which she recorded in complete solitude "in a shed in the woods in Lincoln, Rhode Island.

[11] Robinelli described it as "'kill your rapist' not as self-care, not as political slogan, but as the emotional and physical manifestation of pain beyond self", citing the line "I'm going to throw your body in the fucking river", while Will Gotsegen of Spin opined that "Hayter treats revenge as an imperative, and the death of her abusers as an inevitability.

[10] Robinelli considered it "constructed from the most melodramatic sides of doom metal, noise, and neo-classical traditions" and noted an assistance of bands such as the Body, Full of Hell, and Uniform on the album.

[15] Similarly, Spyros Stasis of PopMatters highlighted her use of noise, power electronics, and dark ambient with her "choral background and neo-classical influences [...] to construct the maze-like anatomy of her work",[21] while Noisey's Leah Mandel further noted the elements of black metal and Baroque music on the album.

called it "by far Kristin's most captivating weapon", describing how "she stacks vocal harmonies [...] before disintegrating into a throat-shredding wail that channels every moment of pain, injustice and powerlessness into a sonic bullet",[24] while Pelly dubbed it "the sound of trauma".

[14] Hayter explained in an interview with Louder that "many many times on Caligula we kept the ugliest take", recalling how she used a recording of her voice for "Faithful Servant Friend of Christ" specifically because of "how shrill it was".

She summarized the album as "a murderous amalgam of opera, metal, and noise that uses her classical training like a Trojan Horse, burning misogyny to ash from its Judeo-Christian roots".

[24] Kim opined that on Caligula "she transforms shattering lamentations into empowered declarations against misogyny, while also complicating the dominant narratives of women's trauma", also commenting that "her thoughtful amalgam of opera, neoclassical darkwave, and death industrial continues to produce theatrical yet still intimate pieces".