The connection between pleasure and pain features in the novel’s romantic relationships. The title, Ugly Love, embodies this theme. Hoover explores the duality of pleasure and pain through physical intimacy. While Tate and Miles physically derive pleasure from their acts, they always end in emotional pain, as Tate longs for something more while Miles desperately fears it. The novel’s explicitly sexual scenes build out this theme by showing the double-edged experience of pain and pleasure. Tate’s sexual experiences with Miles evoke both feelings, mimicking the way her overall relationship with Miles feels for most of the story.

The duality of pleasure and pain is the novel’s primary theme, which Hoover solidifies with the title and explores through the characters’ interactions and conversations. As the mentor, Cap encapsulates the novel’s crux: “I know the thought of confronting your past terrifies you. It terrifies every man. But sometimes we don’t do it for ourselves. We do it for the people we love more than ourselves” (293). To have pleasure with others in the future, it’s important to confront the pains of the past. Cap encourages Miles to face his traumatic pain because the joy of the people he loves will be worth it in the end.