In a heart-wrenching scene, Ben calls his mother for help during a breakdown, but she dismisses him, telling him to "find a yellow pages" and hangs up, leaving him to the voices.

It’s a deeply sad episode, highlighting that the true monster isn't just the illness, but the lack of support. Ben’s struggle is treated with a surprising amount of empathy compared to other Criminal Minds episodes, especially in the final scenes with Ashley Seaver, who grapples with the remorse Ben showed.

Spencer Reid is deeply affected by the schizophrenic unsub, fearing his own mental health issues and struggling with the team's loss of Prentiss.

Early theories suggest a "pack" of killers, but Hotch quickly realizes it is one single, highly disturbed individual leaving the same shoe prints at every crime scene. The unsub is Ben Foster (played by Bug Hall), a paranoid schizophrenic who believes he is being pursued by the ghosts of three friends he killed in a fire when he was a child. These "ghosts" (Matt, Tony, and Yolanda) now haunt him, acting as "imaginary foes" that force him to kill to get them to stop nagging him.

The BAU is reeling from the loss of Emily Prentiss (who they believe is dead), but they must focus on a series of violent murders in Portland, Oregon. The victims are bludgeoned and stabbed, with high levels of overkill—up to 71 times in one instance.