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"Doctor Psycho" is the fourth episode of the fourth season of Orange Is the New Black. It is the forty-third episode of the series overall. It premiered on June 17, 2016. It was written by Carly Mensch and directed by Erin Feeley.


Nothing stays hidden for long when emotions run high, but Red, Healy and Caputo try to keep the peace. Piper has a business competitor.

Plot []


The episode starts in the solitary housing unit (the SHU). Sophia Burset has gone weeks without her hormones and is experiencing withdrawals. She repeatedly asks the guards if she can speak to Joe Caputo, to no avail. In an act of defiance, she shoves a towel in her toilet and flushes it repeatedly, so her cell floods. Caputo tries to reason with her but she won't budge. The SHU area is flushed out and nothing changes. Sophia then smashes a light bulb to create a flame, lighting her mattress on fire. The guards are forced to evacuate the SHU's inmates and transfer them to Max, where Sophia is seen by Nicky Nichols.  

Frieda Berlin still wants to kill Lolly Whitehill and considers using oleander tea to do it. Alex begs Red to try to talk some sense into Frieda, so Red holds a meeting. However, the conversation only reveals that Lolly doesn’t have the mental capacity to keep the secret. Red agrees, they’ll have to kill her. Amidst a psychotic break about drones and government surveillance, Piscatella grabs Lolly and starts dragging her to Psych A. Sam Healy intervenes, insisting that what she needs is a counselor, not to be locked up with padded walls.

Piper speaks with Maria Ruiz about one of her girls stealing scraps from the panty making room. Maria reveals she's starting her own panty selling business. Flaca Gonzales and Maritza Ramos quit working for Piper to work for Maria.

Healy is so intent on helping Lolly that when she ultimately confesses to murdering Aydin, he completely dismisses it as one of her common delusions, assuring her she didn’t do it.? Lolly believes him and tells Alex she didn't do it. Alex allows her to believe this temporarily, thinking it will ensure she won't confess to the wrong person.

Healy gets jealous when Judy starts spending time with Luschek, and to win her graces back, arranges for her to teach a cooking class to the inmates. Judy, however, wants to take a break from cooking while serving time. Healy is angered by this and insists she do the class. Judy asks for Healy to be removed as her counselor, citing discomfort with his "power issues". Displaying his default misogyny, he tells Caputo "That's just how women talk" but Caputo insists. He tells Healy that another person will now supervise the class but that he should be proud of the high attendance. After Caputo leaves, Healy becomes enraged and smashes a jar.

Aleida Diaz is up for early release due to good behavior. She tells Daya she will get her kids and Daya's baby back. Daya hugs her in an unusually sweet moment and says, “I’m gonna miss you. And you’re probably gonna fuck up my kid”

Doggett finally addresses Coates for the first time since his sexual assault on her. He asks if she’s been avoiding him, she says she’s been busy. Then she asks if he’s “doin’ it” with Maritza. Charlie is confused then asks if she is jealous. Doggett is angered then replies “Just wanna make sure you’re not rapin’ her, is all”. Charlie does not recognise what he did to be rape and is surprised. He reasons that because he said he loved her during the assault, this somehow makes the encounter "different". Doggett becomes visibly upset and replies, “But that didn't feel any different”, before walking away.


Note: Flashbacks are arranged in chronological order, not the order in which they occur on the show.

Sam Healy[]

In flashbacks, we see Sam as a child at a hospital with his father, Dennis, who appears agitated. It is revealed Healy's mother, Margaret, was forced into electroconvulsive therapy (ECT) for her mental illness. Sam mentions the kids at school call him a lesbian because of his haircut. He asks his dad what a lesbian is. Dennis is deeply homophobic and shares his highly negative views of gay women with his son, comparing homosexuality to a mental illness, similar to what his mother is suffering from. Later that night, Margaret tries to assure Sam she is cured now and doesn't want to go back to therapy as it is traumatic. But when she cooks him deviled eggs as a midnight snack, forgetting he is allergic to them, Sam tells her he feels she should continue having her treatment because he doesn't like her "crazy". Unnerved by the idea of undergoing more ECT, Margaret pretends to go outside to turn off the sprinklers and runs away from home. Sam runs outside calling to her, but she is gone.

In a later flashback, a now adult Sam is on a date. The woman is not interested in Sam because he is her therapist, and excuses herself. As Sam heads home alone, he spots a homeless woman across the street. He believes her to be his mother. They share a coffee and a hot meal but Sam sees her hospital bracelet, revealing her to be someone else who had escaped a nearby psychiatric ward. She becomes panicked and tries to leave. Sam begs her to stay longer, becoming violent and grabbing her arm whilst forcefully asking her who else is gonna help her, but she breaks away and runs.

Memorable Quotes[]

"Poison is beneath you, Frieda. It's for witches and bored housewives, not badass biker chicks with octopus tattoos."
Galina Reznikov





Main Cast[]

Guest Starring[]



  • First appearance of Michelle Carreras
  • Nicky Nichols reappears after being missing from the show for 13 episodes.
  • The sign on the door of the movie theater Healy and his date exit through advertises an Ingmar Bergman film festival, and the film he describes having just seen is 'Fanny & Alexander'.
  • The "loafing and shirking" comment in Aleida's file is another term for being unproductive and without a job. 


  • Out of My Head - The Fling (Credits)


Healy's Flashbacks
Mother's Day  •  Trust No Bitch  •  Doctor Psycho?
Episode Navigation
Season 1 I Wasn't Ready  •  Tit Punch  •  Lesbian Request Denied  •  Imaginary Enemies  •  The Chickening  •  WAC Pack  •  Blood Donut  •  Moscow Mule  •  Fucksgiving  •  Bora Bora Bora  •  Tall Men with Feelings  •  Fool Me Once  •  Can't Fix Crazy
Season 2 Thirsty Bird  •  Looks Blue, Tastes Red  •  Hugs Can Be Deceiving  •  A Whole Other Hole  •  Low Self Esteem City  •  You Also Have a Pizza  •  Comic Sans  •  Appropriately Sized Pots  •  40 Oz. of Furlough  •  Little Mustachioed Shit  •  Take a Break From Your Values  •  It Was the Change  •  We Have Manners. We're Polite.
Season 3 Mother's Day  •  Bed Bugs and Beyond  •  Empathy Is a Boner Killer  •  Finger in the Dyke  •  Fake It Till You Fake It Some More  •  Ching Chong Chang  •  Tongue-Tied  •  Fear, and Other Smells  •  Where My Dreidel At  •  A Tittin' and a Hairin'  •  We Can Be Heroes  •  Don't Make Me Come Back There  •  Trust No Bitch
Season 4 Work That Body For Me  •  Power Suit  •  (Don't) Say Anything  •  Doctor Psycho  •  We'll Always Have Baltimore  •  Piece of Shit  •  It Sounded Nicer in My Head  •  Friends in Low Places  •  Turn Table Turn  •  Bunny, Skull, Bunny, Skull  •  People Persons  •  The Animals  •  Toast Can't Never Be Bread Again
Season 5 Riot FOMO  •  Fuck, Marry, Frieda  •  Pissters!  •  Litchfield's Got Talent  •  Sing It, White Effie  •  Flaming Hot Cheetos, Literally  •  Full Bush, Half Snickers  •  Tied to the Tracks  •  The Tightening  •  The Reverse Midas Touch  •  Breaking the Fiberboard Ceiling  •  Tattoo You  •  Storm-y Weather
Season 6 Who Knows Better Than I   •  Shitstorm Coming   •  Look Out for Number One   •  I'm the Talking Ass   •  Mischief Mischief   •  State of the Uterus   •  Changing Winds   •  Gordons   •  Break the String   •  Chocolate Chip Nookie   •  Well This Took a Dark Turn   •  Double Trouble   •  Be Free
Season 7 Beginning of the End   •  Just Desserts   •  And Brown Is the New Orange   •  How to Do Life   •  Minority Deport   •  Trapped in an Elevator   •  Me as Well   •  Baker's Dozen   •  The Hidey Hole   •  The Thirteenth   •  God Bless America   •  The Big House   •  Here's Where We Get Off