"I know you're afraid. I know the world feels like a hard place, sometimes. But you've got people who love you. Your dad and I, we have all the faith in the world in you. We'll always be with you. You have got a world of strength in your heart. I know you do. You just have to find it again. Believe in yourself."
Buffy searches newly rented houses for the Trio's hideout. The three discover her on surveillance equipment but she gets too close. While they hide in the basement, Andrew calls on a demon which attacks Buffy and starts a fight. The demon grabs Buffy and stabs her with a needle-like part of its body.In a mental hospital, Buffy cries out as she's held by two orderlies and stabbed with a needle.Outside the Trio's house, Buffy wakes up confused and alone and walks home.Willow prepares to talk to Tara but sees her give her female friend a quick kiss; Willow leaves, wounded. Tara notices her leave but it's too late to catch her.At the Doublemeat Palace, Buffy works like a zombie whilst having brief flashes to the hospital where the doctor tells her it's time for the drugs.Willow and Buffy talk about Xander's disappearing act and Willow's attempt to talk to Tara. Xander surprises the girls by showing up at the house. He wonders about Anya and how to rebuild his relationship with her. The girls tell him that Anya left town a few days ago and that everything will be fine in time.Buffy runs into Spike at the cemetery and they talk about the events at the wedding that didn't happen. A confrontation begins between Spike and Xander and as Willow tries to break it up, Buffy becomes weak and collapses. Xander manages a one punch to Spike who focuses on Buffy.At the mental hospital, a doctor tells Buffy that she's been hallucincating for the past six years and everything she knows about Sunnydale is fake. She's shaken and confused, especially when both of her parents walk in before Buffy falls back into Sunnydale world.Willow and Xander get Buffy home and she tells them about the mental hospital and what the doctor said. While Willow organises a plan to research, Buffy returns to the hospital where the doctor explains to her parents that she's been catatonic from schizophernia for the past six years and her life as a Slayer has been elaborately created.
- Absentee Actor: Anya. Possibly Written-In Absence, as Xander makes mention of it at the start of the episode, asking if anyone has seen her. The others reply she took off after the wedding.
- Adult Fear: Losing your child to madness.
- All Just a Dream: Or Was It a Dream?. Word of God has it that you could make your own interpretation.
- Ambiguous Situation: Buffy is injected with a poison that make her hallucinate... Or is it the other way around? According to a psychiatrist, who may or may not be a real person, she is in fact getting better — She has been sick all along, and now she's finally waking up from years of catatonic schizophrenia. So, the whole series is either This Is Reality or a mad All Just a Dream with a dash of The Schizophrenia Conspiracy. In the end, Buffy chooses her life in Sunnydale over her life in the mental institution, but the ending leaves it ambiguous whether or not the world she settled for is the real one. The fact that Joss Whedon himself has said that either interpretation is just as legitimate as the other doesn't help things at all.
- And You Were There: Buffy imagines her manager at the Doublemeat Palace is a doctor in the mental hospital.Female Doctor: Come on, it's time for your drugs.
[Flash back to the Double Meat Palace.]
Buffy: (confused) What?
Lorraine: I said, if I didn't know any better, I'd think you were on drugs.
Buffy: (confused) Okay. Good.
- Anywhere but Their Lips: Willow is working herself up to ask ex-girlfriend Tara out for coffee and lesbian love when she sees her greet-and-kiss another girl. From her viewpoint it's difficult to see how intimate the kiss was, but she runs off anyway. Willow tries to tell herself later that she overreacted ("I press my lips against my friends all the time.")
- Badass Decay (In-Universe)Spike: It might explain some things, this all being just in that brain of hers. Yeah, whips up some chip in my head, make me soft, fall in love with her. Then, turn me into her soddin' Sex Slave.
- Basement-Dweller: The Trio, though this time it's because they're hiding from Buffy in an empty house.
- Battle in the Center of the Mind, Fighting from the Inside, Mental World: From the Asylum-version reality’s POV.
- Belligerent Sexual Tension / Homoerotic Subtext: Between Xander and Spike — lampshaded in a Deleted Scene where James Marsters gives Nicholas Brendon a mock kiss right after calling him a "pathetic poof" in their graveyard fight.
- Bond One-LinerXander: I altered his reality!
- Bound and Duct-Taped
- Break Them by Talking: Spike delivers this lecture to Buffy. Becomes a "Nice Job Breaking It, Anti-Hero" moment when it causes Buffy to pour away her antidote.
- Continuity Nod: Buffy looks at a family photo of her parents with herself as a child — the same child actress used in Season 5's "The Weight of the World".
- Cuckoo Nest
- Description Cut: Willow says that Xander has help finding the demon; cut to Xander and Spike stalking through the woods. The doctor's description of this years Big Bad as "just three pathetic little men who like playing with toys" to the Trio in their lair.
- Despair SpeechBuffy: (very quietly) I feel so lost.Willow: I know. You're confused. It's, it's that crazy juice inside you.Buffy: It's more than that. (Willow frowning) Even before the demon ... I've been so detached.Willow: We've ... all been kind of slumming.Buffy: Every day I try to ... snap out of it. Figure out why I'm like that.
- Discreet Drink Disposal: Willow asks Spike to make sure Buffy drinks the mug of yummy antidote goodness, but Spike gets into an argument with Buffy and leaves, giving her a chance to pour it away.
- Downer Ending: The Buffy in the asylum goes into permanent catatonia.
- Dramatically Missing the Point: Buffy tells Spike, "You're not part of my world" because vampires aren't real. Assuming she's referring to him no longer being her boyfriend, Spike goes off on a rant instead of ensuring Buffy takes her medicine.
- Education Through Pyrotechnics: Willow mentions that her previous attempts at making the antidote "went boom twice" before she got it right.
- Foreshadowing: For "Entropy" — Spike threatens to tell the Scoobies about their affair if Buffy doesn't do so.
- Frying Pan of Doom: Buffy hits Xander with one, then drags him to the basement where he and Willow and Dawn can be eaten by the Monster of the Week.
- Group Hug: Xander gets a hug threesome when he returns home.
- Hell-Bent for Leather: Buffy changes into the Black Leather Jacket Of Ass-Kicking while searching for the Trio, but not the Red Leather Pants of Death — she's not quite her old self yet.
- Homoerotic Subtext / Les Yay: Buffy is once again fed up with work.Buffy: I could wrestle naked in grease for a living and still be cleaner than after a shift at the Doublemeat.Willow: Plus, I'd visit you at work every single day.
- A House Divided: The Trio are starting to fray.
- Idiot Ball: Even if her life did seem more unrealistic in comparison to the Asylum-containing version, Buffy still decided to start killing her friends without running any Litmus Paper tests on both “realities”. If she’d have researched her condition she would’ve discovered some neet mind tools like the Brain in a vat thought experiment and would’ve found some rationally stable strategies for dealing with such conditions (checking information inflow level, for example, in regards to which the Slayer-reality was winning over the Asylum-one so far). Which she might have done...if the poison wasn't making her completely delusional.
- I Just Want to Be Normal
- "I Know You're in There Somewhere" Fight: Dawn tries this, but Buffy is too far gone by that stage.
- Leaning on the Fourth Wall: Plenty of this.Doctor: Buffy, you used to create these grand villains to battle against, and now what is it? Just ordinary students you went to high school with. No gods or monsters ... just three pathetic little men who like playing with toys.
- "Leave Your Quest" Test
- Lotus-Eater Machine: In the asylum Buffy has no responsibilities, and her parents are alive and still together.
- Mind Screw
- The Nicknamer: Xander calls Spike "Willie Wannabite", and Buffy "Sane Girl" — right before she clonks him with a frying pan.
- No Mere Windmill: Buffy reveals that her parents had her sent to a mental clinic for two weeks after she first told them about seeing vampires.
- Out-of-Genre Experience / Slasher Movie: The scene where Psycho!Buffy stalks her sister through their home.
- Person as Verb: Jonathan says he's "going Jack Torrence" cooped up in the basement.
- Retcon: Buffy is revealed to have been briefly institutionalized when she first learned about vampires, which makes Joyce's Weirdness Censor in the first couple of seasons rather implausible. The common explanation is that this is part of the timeline that was altered by Dawn's creation. Another possibility is that it's merely a side effect of the demon's venom, since it's never referenced again after this episode and Dawn never confirmed the story. The non-canon (but canonically plausible) comic interquels that cover the time between The Movie and Season 1 show she actually was institutionalized.
- Rousing Speech: Joyce gives one to Buffy, that ironically has the opposite effect of what she intended.
- Saying Too Much: Spike vents about how his Badass Decay led to Buffy using him as a sex toy. Fortunately Xander thinks it's just some stupid Spike fantasy.
- Schrödinger's Butterfly: Is Buffy the Slayer dreaming she's insane? Is she insane dreaming she's the Slayer? Are both true? GOD DAMN YOU JOSS
- Shout-Out: When the Trio are planning a heist Andrew says, "I still think we need eight more guys" and Warren replies, "I should never have let you see that movie."Xander: Friends, Romans, anyone?
- Smash Cut: From the demon injecting Buffy to Buffy being injected in the mental hospital.
- Staircase Tumble: Tara's Big Damn Heroes moment is stopped by Buffy tripping her up from beneath the staircase.
- Summon Magic
- Surrogate Soliloquy: Willow rehearsing asking Tara out.Willow: "Hello, Tara. Would you like to go out with me for coffee, food, kisses and gay love?"
- Teens Are Short: Buffy notes that she should be taller than her 'little' sister.
- Teeth-Clenched Teamwork: Spike and Xander capturing the demon.
- Testosterone Poisoning: Spike and Xander work out their frustrations over their recent relationship cock-ups on each other.
- That Came Out WrongBuffy: Some kind of gross, waxy demon-thing poked me.Xander: And when you say poke...Buffy: In the arm.
- Thousand-Yard StareBuffy: (vacantly) I'm okay, Dawn.
Dawn: The, uh, thousand-yard stare really helps sell that.
- Tranquillizer Dart: The anti-Oz rifle makes a reappearance. Instant Sedation is averted — the Glarghk Guhl Kashma'nik demon takes several darts, plus Xander and Spike bashing away at it, before it's subdued.
- Twisted Echo CutWillow: Dawnie, you can help me research. We'll hop on-line, check all the—[Smash Cut to Buffy in the asylum. A doctor is talking to Buffy's parents.]Doctor: —possibilities for a full recovery, but we have to proceed cautiously.
- The UnpronounceableSpike: Oh, balls! You didn't say the thing was a Glarghk Guhl Kashma'nik.Xander: That's 'cause I can't say Glarma— (demon hits him)