"Ænema" makes lyrical references to Bill Hicks' set Arizona Bay, in which the San Andreas fault collapses, purging the continent of Southern California and the Baja Peninsula which would give Arizona its own oceanfront. This is further illustrated in the lenticular map under the CD tray. The alternate spelling for the song emphasizes the "enema" portion of the combined title also used for the album; in this way, it differentiates the meaning of the song (with California's collapse seen as a 'flushing out' for the country) from the meaning of the album (the "anima" emphasis indicating a spiritual, Jungian focus for the album in its entirety) while retaining the song's placement as the title track, though the differing spelling and pronunciation marks a different approach from other Tool albums that are named directly after songs ("Opiate", "Undertow", "Lateralus" and "Fear Inoculum)" or sections of songs ("10,000" "Days)."