Why the Characters in "The Pitt" Season 2 STILL Need EMDR Therapy
⚠️ Caution – Major Spoilers Ahead!
If you read my earlier blog post, Why So Many Characters in "The Pitt" Could Use EMDR Therapy, you already know that I can't watch a show like this without my EMDR brain kicking in. Honestly, it's a curse that happens now during every show I watch where the negative impact of a character's traumatic past is clearly evident. For all of you EMDR therapists out there reading this, I know you can relate! EMDR is so effective at processing traumatic memories that it feels like a missed opportunity for someone not to get help. Well, it inevitably happened again for Season 2 of The Pitt. During every episode, whether it be a character revelation or emotional overreaction, my mind is quietly noting that (of course) they need to do some EMDR! Season 2 definitely gave me a lot of material to work with.
For those just joining us: The Pitt is an award-winning medical drama on HBO Max that follows the staff of a Pittsburgh trauma emergency department. Each episode corresponds to each hour of an intense shift on the unit. In my humble opinion, it's one of the best-written, most medically-accurate, and emotionally-honest shows on television right now, and the second season continues to deliver complex characters carrying very real psychological wounds.
And for those who don't know much about it, EMDR (which stands for Eye Movement Desensitization and Reprocessing) Therapy is an evidence-based therapy for trauma and PTSD that works by targeting maladaptive, insufficiently-processed traumatic memories from the past that are the root of a person's current psychological and emotional symptoms. It is a first-line treatment for PTSD on many national and international guidelines and very effective at resolving a person's trauma symptoms.
So, let's take a look at Season 2 of The Pitt and how EMDR can help!
Louie Returns with the Same Wounds
Fans of Season 1 will of course remember Louie (played by Ernest Harden Jr.). He was the friendly, smiling man who kept coming back to the hospital despite everyone encouraging him to address his alcoholic drinking. In Season 2, Louie returns, but unfortunately the news is still not good. His alcoholism has continued to take a serious toll on his body, leading to repeated medical crises and hospitalizations. In this season we see the doctors draining gallons of fluid from his abdomen. And then, later in the season, we find out the missing piece - that years ago, Louie's pregnant wife and their unborn child were killed in a car accident. Everything makes sense all of a sudden.
The truth, as pioneers like Gabor Maté have been saying for years, is that no one drinks themselves into oblivion if they are truly okay inside. I'm sorry, but happy and emotionally-healthy people just don't engage in self-destructive behavior like that. As with many of our clients at Mangrove Therapy Group, Louie wasn't just someone who "liked to drink." He was a man carrying an unimaginable loss, thus medicating his grief and pain with what we assume is the only thing that seemed to ease it. Underneath his warm smile and friendly demeanor has been a deep wound that never healed. EMDR is extraordinarily effective at addressing the kind of deep trauma and grief that fuels the addictive process.
The Tree of Life Shooting Survivor
In one episode, we meet a woman who we learn is a survivor of the 2018 Tree of Life synagogue shooting in Pittsburgh which was one of the deadliest antisemitic attacks in American history. During this event, 11 people died while many more were injured and/or traumatized. The woman had severe burns from dropping a scalding urn of hot liquid onto her leg after hearing firecrackers outside. The sound triggered her.
Unfortunately, this is textbook PTSD hyperarousal. Examples of hyperarousal include feeling keyed up all the time, hypervigilance, difficulty sleeping, and a startle response. Basically, traumatized individuals have a nervous system that never fully comes back to baseline after a life-threatening event as their brain and bodies remain primed for threat and danger. Eight years after the shooting and her body is still responding to a loud pop as if she's back in that synagogue. EMDR is particularly effective for exactly this kind of traumatic memory, reprocessing the original traumatic memory so that her body can relax and is no longer triggered.
The Patient with the Eating Disorder
This season introduces a woman admitted with aspiration pneumonia secondary to an eating disorder. When the staff talks with her, she's quick to note that things had been "a lot more controlled" lately until a recent breakup kicked everything back up. In her presentation (i.e., overworking, neglecting self-care for the sake of meeting responsibilities) are hints of perfectionism and a clearly self-critical voice.
This is a story we've heard many times at our practice. As with Louie and his alcoholism, eating disorders rarely exist in a vacuum and are also fueled by unresolved trauma. Underneath the surface are often deeply held negative core beliefs such as "I'm not good enough", "I'm not worthy", "I have to be perfect", or "I'm not in control". And we know that these trauma-related beliefs were formed long before the eating disorder behaviors (such as food restriction, purging, or compulsive exercise) ever started. A breakup doesn't "cause" an eating disorder; rather, it reactivates the underlying wound that the eating disorder was managing in the first place.
EMDR is particularly well-suited for the kind of deep, shame-based material that underlies many eating disorders. People find they have far less need for the coping behavior when the emotional root is effectively addressed.
George's Health Anxiety and Phobia
George is the guy who was waiting a long time in a hospital bed in the hallway who we learn comes to the emergency department periodically for medical reassurance that he is okay. This is the guy who was working with Dr. Mohan, and who quickly reveals a significant amount of anxiety such as worrying intensely about his health despite repeated reassurance from Dr. Mohan that he's going to be fine on his current medication (Eliquis). He also alludes to having a very difficult time leaving his house.
George seems to be describing some long-held patterns of health anxiety (previously called hypochondriasis), possible agoraphobia, and a nervous system that stays in hypervigilance mode. Fortunately, this is the kind of presentation that responds beautifully to EMDR Therapy because these fears are often rooted in earlier experiences such as witnessing illness in the family, a past frightening medical event, or even early experiences of feeling unsafe or out of control that are totally non-medical related. Unfortunately, with people who have unresolved traumatic stress, verbal reassurance only helps temporarily but it doesn't address the underlying issue. EMDR helps people process those root experiences.
The Cancer Patient (and Her Family)
This season features a woman in the late stages of cancer who is in so much pain that she wants to die. We see various members of her family who show up and, naturally, are incredibly distraught. What caught my eye was her older son who was visibly struggling in the hallway and unable to bring himself to go back into her room. He mentioned that "she didn't always look like that" which reminded me of numerous versions I've heard in my clinical practice. There is a particular kind of trauma that comes from watching a loved one deteriorate from illness, whether rapidly or over the course of many years. People who witness this often carry lasting traumatic imagery, grief, and a deep feeling of helplessness.
EMDR has been very effective at treating this type of trauma. And there is actually a growing body of research on EMDR as an effective treatment for cancer-related PTSD. So, treatment is really for both for patients themselves and for family members. The surviving sons and husband in this episode are person who, with the right therapeutic support, could move through this experience effectively.
Dr. Mohan
Dr. Mohan has a difficult season. We see her visibly stunned and overwhelmed following the deaths of several patients, moving through her shift in what looks like a dissociative fog. This is a normal response to an abnormal amount of acute loss and distress, so I don't want to pathologize it. Emergency medicine clinicians are exposed to death and suffering at a rate that the human nervous system was simply not built for. But normal doesn't mean it doesn't need attention. When the distress accumulates without adequate processing, it becomes cumulative trauma. We see this in Dr. Robby, who we will discuss very soon and who we know has been experiencing this over the course of multiple decades. EMDR can help clinicians like Dr. Mohan metabolize distressing experiences so they don't compound over time.
Our Beloved Dr. Robby
And then there's Dr. Michael "Dr. Robby" Rabinavitch (played by Noah Wyle), the captain of the ship and attending physician for the department's day shift. Wow, does he have a season.
We already knew from Season 1 that Dr. Robby was impacted by significant work-related trauma (many years in a high-acuity setting watching many people die). In Season 2 it quickly becomes clear that none of that has been resolved. A colleague describes him as "living on the edge." He is clearly tightly wound and high-strung, snapping at colleagues and underlings, being sharply critical, and at times publicly shaming people in moments of frustration.
In a heart-to-heart with Dr. Abbott, it becomes clear that Dr. Robby struggles with self-reflection and doesn't know what to do with himself when he's not working. Unfortunately, work itself, the proverbial "scene of the crime", has become unbearable.
And then in Episode 13, in a moment of raw disclosure with charge nurse Dana, Dr. Robby shares that his mother left him as a child. We later learn that she abandoned him at the age of 8. And in a conversation with his friend the motorcycle guy, he reveals that he is really struggling to the point of being suicidal. And that the only thing that used to keep him going (the distraction and purpose of work) is doing more harm than good.
So, Dr. Robby is carrying two distinct trauma presentations. On one hand, he has the cumulative trauma of decades in emergency medicine, while also (likely on a deeper level) the early abandonment wound of a child whose mother left and never came back. Both need treatment! EMDR can address both layers, working with the recent traumatic memories and the early developmental experiences that probably makes everything harder to bear and likely puts more pressure and responsibility on himself to prove his worth and value.
If Dr. Robby were a real person walking into my office, I'd want to start EMDR as soon as possible.
Ready to Start Working With an EMDR Therapist in Palm Beach County, FL?
The Pitt is extraordinary television. It doesn't look away from the psychological toll of what its characters carry. These stories resonate with the show's viewers as we can empathize with what they are going through and what they are likely carrying. The good news is that healing is possible!
If any of what you read today feels familiar, Mangrove Therapy Group is here. Follow these simple steps to get started:
- Contact Mangrove Therapy Group
- Meet with a caring therapist
- Begin reprocessing the past — and find lasting relief
Other Services Offered With Mangrove Therapy Group
EMDR therapy is not the only service that Mangrove Therapy Group offers. Our team is trained to offer support in a variety of mental health services. We also offer care for:
- Trauma, EMDR intensives, PTSD, and Complex PTSD
- Substance use and process addictions
- Eating disorders and body image concerns
- Grief, loss, anxiety, depression, and self-esteem challenges
- Anger, shame, emotional dysregulation
- “Failure to Launch” issues and life transitions
- CBT and DBT-based support
If you have additional questions, feel free to learn more from our blog or FAQ for more helpful info!