Lyric discussion by spds 

Cover art for Turnin' On The Screw lyrics by Queens of the Stone Age

The title may refer to the ghost story "The turn of the Screw" by Henry James. I think that at least part of this song refers the development of an unstable mind and the silence of the lambs quote on line 2 can only further describe it. Just the various sounds of this song hint at something slowly growing, like maybe one's insanity. He has rejected all chance of reason or sense because of inconsistency or even complete absence and instead he is satisfying his mind in another way.