This cover went around and around.  The first developed concept was a shattered plate on a kitchen floor.  I knew I wanted a bleak anonymous feel, but the broken plate pieces said "desperate" it was too forced, somewhat cliche, and didn't represent the book in its violent overtone.  

The anonymous theme carried over still and the clear solution was capturing a desperate moment of leaving the life you set up for yourself; leaving something that was once a positive but is now negative.