The album focuses on semi-fictional accounts of band leader John Darnielle's years as a teenager, particularly his friends' and acquaintances' experiences in California and in Portland, Oregon, as methamphetamine addicts.

As The Mountain Goats' official website puts it: "All of the songs on We Shall All Be Healed are based on people John used to know.

The song "Cotton" was featured in an episode of the television series Weeds.

One of the provisional titles for the album was New Age Music Will Save Your Wretched Soul.

[1] We Shall All Be Healed was generally liked by critics, but divisive in some circles regarding the different direction taken in the album's creation, with a new production style and a band playing alongside the typically solo John Darnielle.