Told in short, repeating stanzas, the poem is about something painful that returns again and again, and the speaker can't make it stop. Each stanza begins with "There it is again," like someone spotting a familiar enemy walking back through the door. The first stanza calls the pain "welcoming," which is a strange and unsettling choice. It suggests the speaker has lived with this feeling so long that it has become almost comforting, a known thing in a life that offers little else.
The pain then grows more violent: screaming, hitting, clawing. After that come "blank stares," planning and lying, which feel quieter and more hidden. The poem doesn't say whether these actions are done to the speaker, by the speaker, or both, and that vagueness adds to the tension. The mood is bleak, numb and exhausted. The final line, "its not gonna leave," drops the list and simply admits defeat, leaving the reader with a sense of resignation rather than hope.