Sacks (Dresden Dolls, Willard Grant Conspiracy) "drove up from New York [to Montreal] on a day’s notice" to contribute cello to "Bone," whilst Newman (Mudfish, Sackville) added lap steel guitar to "Evil Hand".

[12] Whereas her prior solo releases had included many covers—Leonard Cohen, Luiz Bonfa, and V; in 2001's Been Here and Gone, The Velvet Underground and Bob Dylan in 2003's You’re a Big Girl Now EP, not to mention the self-released Live at Tonic, NYC January 16, 2000 which consisted entirely of covers— Trust Not Those in Whom Without Some Touch of Madness was composed wholly of original material.

The album is dedicated to the memory of the late Laura Carter, Bar-B-Q Killers’ vocalist and guitarist, friend and former girlfriend of Zedek's.

[21] In his review for AllMusic, Johnny Loftus remarked that "[t]hroughout this record as it's been since the old days, Zedek never fails to put her very soul into each syllable, and her commitment is matched by the instrumentation,"[22] whilst Mike Joyce, writing for The Washington Post, described it as "somber, poetic and sometimes unnerving, […] cutting and dissonant"[23] In his praising review for Pitchfork, Matthew Murphy remarked that, "[t]hough the musicians occasionally make overt references to traditional blues, C&W, or Appalachian folk, the proceedings here generally breathe in the same nebulous, turbulent atmosphere that has fueled groups like the Bad Seeds or The Dirty Three.

"[24] Tiny Mix Tapes’s review of the album stated that "[w]hat surprises [...] most about Trust Not in Those… is the willingness on Thalia's behalf not to retread much of her past work," whilst also praising "the strength of the actual songwriting"[25] In his positive review of Trust Not Those in Whom Without Some Touch of Madness for Out, Matthew Breen characterised it as "truly challenging, beautiful, dark music inspiring something akin to desperation",[26] while, opening his complimentary review the album for Neumu, Anthony Carew stated that "Thalia Zedek should be so well acclaimed by now that she's reached some sort of venerable status.