I'm going to go out on a limb here and say that Sunday's episode of Girls was about pain. Physical, mental, and emotional pain, and all three, together. And then there's the kind of pain that comes from having to watch other people inflict pain on themselves, and not being able to stop them, maybe, because they're TV characters. Sometimes it's cringeworthy, sometimes you have to look away, and sometimes it's ear-shatteringly Ouch. This episode was all of the above—viscerally just painful, at the very meta level of the pain of watching people in pain. 

With Adam and Natalia, our promising new couple, all is still roses and sunshine (at first), which is a brief spot of romantic/comedic relief. They have a movie date, and afterward, they go to her apartment, where she tells him, "I'm ready to have sex now ... I've been thinking about it and you've been really nice all week ... We can do it, if you want." She sets some specific ground rules of what she's O.K. with and what she's not. Though it's a bit awkward even here, "I like how clear you are with me," he says. Later, he says he's her boyfriend, and she says, "I know."

Elsewhere, things are also how we left them last week, in that Hannah is still coping with OCD, and it's not going well. She starts out with a meeting with her book editor. He doesn't like what she's writing. "Where's the semen and sadness?" he asks. Instead, she's writing about friendship, all Jane-Austen-y. Hannah is clearly missing her friends; the only people she seems to have to rely on now are her mom and dad. They're the ones she calls after she gets a splinter in her butt, removes it in the bathroom, and then, as a form of penance, maybe, takes to cleaning her ears out so violently with a Q-tip that she pierces her eardrum. (Painful, painful watching moment here; I had to cover my eyes.) She calls her parents, who tell her to get to a hospital; her mom reminds her, too little too late, that nothing smaller than your elbow should go in your ear. (Rhetorical question: But why do they even make Q-tips, then?

If you'll recall from last week, Marnie had decided to follow her dreams and become a singer—now she wants Ray's help laying down a track—and Shoshanna cheated on Ray with the hottie doorman from her friend's building. So we see Shosh "taking care of Ray" (who's suited up in a peace sign snuggie). He suspects something's up: "What's up with all the geisha shit?" he says, but can't figure out what. And we see Marnie heading right back to Charlie, the new Charlie with the big, important new job, the Charlie who's blowing off lunch plans with Marnie because he's too big and important now. When called on his forgetfulness/lack of caring, he tries to make up for it by inviting Marnie to a work party to celebrate the company's success in hitting "20,000 MAUs (monthly average users)" for the app he created. Charlie, suddenly, is the guy everyone wants. As Shosh tells him later in the episode, he could have sex with any girl at the party, including her. But it's possible Shosh is also telling herself—and us—that she really wants to have sex with anyone but Ray.

Hannah gets herself to the hospital, where a no-nonsense doctor gets the Q-tip out (painful again). When she asks him to clean her other ear out, to make them even, he refuses. He lets her keep the offending Q-tip, though. "I suggest you frame it," he says. 

Adam and Natalia take their baby-couplehood to a party celebrating the engagement of her friend. There's some more awkwardness starting to creep in; you can see it on Adam's face, particularly when he's left standing alone. He goes outside for a minute, and who walks by but Hannah, wearing a T-shirt and no pants, on her way home from the hospital. He tells her he's here because "my girlfriend's friend got engaged." It's not ideal timing for her, and Hannah seems surprised and a bit shattered that he's moved on, that he's dating the kind of person whose friends get engaged. He calls her "kid" when she tells him about the Q-tip mishap. (Kid is never a good sign.) She tries to impress him with her book deal, but he just walks right back into the party. It becomes clear, though, that he's hurting, too—more pain, here, more old wounds coming to the surface—and, though everyone knows he goes to AA, gets a drink. The party flashes by, as Adam and Natalia dance and make out and seem to have a good time, though there's an edge here, a sense that things are about to go awry. 

The awkwardness switches to Charlie's company party, as Marnie interrupts the festivities to perform a song in front of everyone. It is painful to watch, and it's painful to watch everyone at the party watch her. When she's done, Charlie drags her away and tells her she's got to get her shit together. "You're flailing; it's like you're manic," he says. "I'm on a journey. Sometimes being really good all the time feels really bad. Don't pity me," she answers. They end up having sex on his desk. 

Ray finally confronts Shosh on her weird behavior and she confesses ... that she held the doorman's hand. "You probably think I'm a whore and you want to break up with me," she says, but he doesn't give her the answer it seems like she wants. "Do you still want to be with me?" he says. "I love you so much." "Oh good," she says, as he hugs her tightly. 

Back in Adam's apartment, Natalia's telling him he might want to change the look of the place a little. "It's depressing," she says. And whether it's the drinking or seeing Hannah or the sudden girlfriending or letting Natalia see his place, or all of the above, Adam is suddenly the guy I remember from Season One. "Get on all fours," he tells her, "Crawl to my bedroom." He's testing her, maybe, to see if she'll like him no matter how he treats her, if he lets the old Adam come out. But she's not Hannah and she doesn't get it, this brand of sexual stuff he's into. Afterward, she says, "I don't think I like that, I like really didn't like that," and he answers, "Jesus, I feel dizzy. Is this it, are you done with me?" There is no answer. I want to know, too: Will the "good girl" who now feels bad stay around for more, or will she hightail it out of there? 

We close with a glimpse of Hannah alone (just as we began). She's still in her T-shirt, sitting on the edge of the bathtub, that place of former female friendship moments, looking impossibly young and vulnerable as she Q-tips her other ear. You might want to watch with your hands over your eyes. Life: It's awkward, and sometimes it hurts. 

Winners: Charlie seems to have come out O.K. in this one. Or will he revert to the same old Marnie-Charlie dynamic? Have the tables truly turned? Props, too, to the unflappable, sarcastic surgeon who works on Hannah's ear, and to Hannah's editor, who's morally indefensible but a great character.

Losers: Oh, gosh. Everyone else, including the Q-tip.