The album showcases the addition of drummer Jeff Gretz and bassist Martin Lunn.

Some pre-ordered copies of the album came with a separate sheet of paper with easier-to-read lyrics for each song.

Topics throughout the album include death and loss of everything you have ("Everything You Love Will Soon Fly Away"), politics ("American Sheets on the Deathbed", "Kingdom of Thieves"), frustration with false interpretations of the band's purpose ("It's Hard Not to Shake with a Gun in Your Mouth"), that we can't do it all alone ("Physician Heal Thyself"), American priorities ("Pudgy Young Blondes with Lobotomy Eyes") and zombies ("My Love, My Love (We've Come Back From the Dead)").

Dan Weyandt's vocals are given the same treatment as he sang with a hand-held microphone through an amplifier to simulate an over-driven P.A.

Instead of adding the melodic elements that were introduced on the album The Funeral of God, it takes a somewhat raw, black metal-influenced sound.