I totally agree with irisange101's interpretation. I think it's significant that all love shown to him, finally proves to be empty.
His Father (Step Father?) despises him, at best he has unrealistic hopes for his future?
His Sisters show little more than contempt for him (although at the end, one sister does show some emotion whilst joining him on the white sofa, but this may represent remorse to the oncoming coffin?
His friend Kenny, initially innocent, young and full of ideals, but is soon turned by the cynical mob. That same group of older 'Lads' at first befiend James, but later revile him.
His 'girlfriend' shows him some intimacy, but either acts like a prostitute, or is defiled by the older lads.
Most significant is his mother, who's only real display of mother to son love was when she thought he had been the one who drowned.
The final turning point was his realisation that Kenny had seen him drown Ryan. Now he is caught like a rat, and as he now views himself as vermin, he too must drown.
The end is a surreal dream.
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