When the severed hands of young girls with numbers tattooed on them are found in the sewers of Houston, Texas, profiler Audrey Macleah (Ally Walker) is brought in to help investigate.
On a tip from a psychiatrist, she goes to interview Jordan Thomas (Tara Subkoff), a teenage orphan who has been institutionalized for the last decade. He has never spoken a word, and every year on July 16, his birthday, he has a seizure, his wrists bleed, and he carves hands with numbers on them into the wall.
Macleah believes that if she can get through to Jordan, she can learn the identity of the killer.
When the Bough Breaks contains examples of:
- Abandoned Hospital: Macleah goes into the hospital where Jordan was born, which has been closed for a decade, to read his records.
- Alone with the Psycho: Macleah breaks into the killer's house, and is still there when he arrives home. The two teenage girls he's imprisoned are also there, but they're in no condition to defend her.
- Bridal Carry: The killer carries Jenny to a bed this way, where he prepares to rape her. Macleah carries her to a window the same way.
- Clue of Few Words: Jordan borrowed Macleah's lipstick to write "Two Rivers" on the wall of his Room Full of Crazy. Two Rivers turns out to be the killer's hometown.
- Copycat Mockery: Jordan mimics Macleah's movements, using a crayon as her cigarette and mouthing along with everything she says, to her irritation.
- Couldn't Find a Pen: Jordan borrows Macleah's lipstick to write "Two Rivers" on the wall. Two Rivers is the town where the killer lives.
- Cry into Chest: Jordan cries into Macleah's chest after one of his seizures.
- Day Hurts Dark-Adjusted Eyes: When Macleah starts unboarding the windows of the killer's cellar, Jenny, who has lived there since she was an infant, covers her eyes.
- Don't Make Me Take My Belt Off!: A heroic example. When Macleah is cornered by the killer, she grabs a belt and hits him with it.
- Evil-Detecting Dog: One girl is abducted while walking her dog. The dog barks as the kidnapper approaches, but the girl is listening to her Walkman and doesn't hear him until it's too late.
- Flipping the Bird: When Jordan becomes annoyed at Macleah, he lifts up his doll's hand and bends down all the fingers except the middle one.
- Freeze-Frame Ending: Of Jordan's face as he reunites with his long-lost twin Jenny.
- Lens Flare: Shown while Macleah is unboarding the kidnapper's windows.
- Man on Fire: After some flammable chemicals spill on the killer, Macleah sets him on fire with her lighter. While he blunders around screaming, Macleah leaves the room and ties the door shut, giving the two girls time to escape before the killer kicks his way through the door.
- Quiet Cry for Help: Jordan whispers "Help me, help me," the only words he utters in the movie.
- Room Full of Crazy: After Macleah gives Jordan some crayons and a drawing pad, he fills in all the hands carved on the wall, writes "Yes" over and over again, and makes drawings of things like a piano and stairs leading up to a cellar door. Those turn out to be objects in the house where Jenny and the latest kidnap victim are held.
- Security Blanket: Jordan keeps a baby doll with "Jenny" written on her forehead in his cell. He becomes violently upset if anyone else touches her. The doll is a substitute for his lost sister.
- Single Tear: Jordan sheds one when he is finally released from his cell and reunited with Jenny. She wipes it away.
- Soft Glass: Macleah breaks into the killer's house by punching out the glass in a window with her bare hand.
- Special Thanks: "The producers gratefully acknowledge the following," followed by a list of people and organizations.
- The Speechless: Jordan can make vocal noises like humming and screaming, and is capable of writing in crayon, but virtually never speaks.
- Title Drop: Jordan writes the "Rockabye Baby" poem on his wall in crayon.
- Title In: The movie starts with "Houston, Texas." After that, several scenes have a caption showing the date, from July 4 into the middle of the month.
- Toplessness from the Back: When Macleah undresses for bed, the camera stays focused on her back, where scars are visible.
- Vehicular Kidnapping: The kidnapper's latest victim is lured into an ice cream truck with a sign telling her to help herself and leave the money in the jar. As she looks at the selection, the kidnapper comes up behind her and grabs her. He drives off in the ice cream truck, leaving the dog by the side of the road.
