Hands are a common feature of the landscapes in Yume Nisshi. Most hands found in the game are posed as if they are cupped or if they are holding something. Usotsuki is able to walk between and appear held by many of these hands.
These areas all display images reminscent of the ancient Egyptian art style. Perhaps these images reflect Usotsuki's past, heritage, or tastes. Perhaps these images hold only references to Yume Nikki's usage of ancient Aztec art styles.
Perhaps the abundance of sharp objects conveys a fear Usotsuki has. This could just be fear of being cut and bleeding or it could be a fear of needles. The Nail World presents an example of imagery from a medical office. It entrance is within the Office and a figure made of a thermometer transports you there. The area is inhabited by not only giant spikes but also by red ooze (blood), corpses, and Aura who wears a hospital gown. So perhaps Usotsuki associates all of these things and fears them.
However, Usotsuki also wields these sharp objects with the usage of the Nail Bat and Thorns effects. So maybe Usotsuki doesn't have a fear, but instead admiration or obsession.
Lack of a Face
In the Doll Room there is a giant doll with no face that is near the pink Porcelain Doll. In the Face Alleys, every time Usotsuki sees her reflection, a dark hole takes the place of a face. The room the Proto effect is found identically matches Usotsuki's Dream Room with the exception of an extra bookcase and that a different girl besides Usotsuki resides there. These all support the notion that Usotsuki has some form of identity issue.
It may be that she feels she has lost her identity and is searching for it in her dreams. It could be that she dislikes her identity and prefers to not have one at all. Perhaps she has stolen the identity of the girl in the replica of her room and that is weighing on her conscience and is reflected her dreams. After all, Usotsuki's name means Liar, so maybe she lies to others about her interests, personality, beliefs, or herself in general.
Another perspective on Usotsuki's lack of face is that it is a reference to the blue witches found in Yume Nikki. The witches' faces become dark holes when bekoned by Madotsuki's cat effect. So Usotsuki could just be implied to be related to these characters. Though this theory seems to be less popular.
Many entrances to areas in Yume Nisshi are one way. (The church doors, the candle under the hanged girls, crystals, white building in the NES World and the entrance to the Nail World) Even the door in Usotsuki's room while she is awake obviously is an entrance that she at some point used, but it is only one way. This implication comes from the fact that Usosuki's door is locked when she tries to leave. It has nothing to with her will; she simply can't leave the room.
The one way transports in Usotsuki's dreams most likely symbolize her locked door in real life. It is unclear whether that door has been locked by someone (or something) on the out side, or if Usotsuki just forgot her keys downstairs.
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