The Breaking Point is the ninth episode and mid-season finale of the fifth season and the 85th overall episode of Private Practice.

Short SummaryEdit

Amelia makes the hard decision to enter a rehab facility, and finds strength in an 18 year-old girl, as they both go through the painful detox process. Meanwhile, Cooper's strengthening bond with his son is tested by his allegiance to a patient in need, Pete and Violet's marriage reaches a tipping point, and Addison collapses from her rigorous fertility treatments.

Full SummaryEdit

Amelia and Addison enter the Pacific Serenity Treatment Center. They take a look around and see some of the patients in a therapy session. Amelia freezes when she sees the reception. Addison knows she's scared, but it's the best thing. They walk to the reception and Amelia tells the receptionist her name and that she's checking in.

Day 1

The receptionist gives her some documents.

Addison is with her therapist and tells him that Amelia's mother is as good as a mother gets. It's hard to fathom that you can do everything right and still you can't control what happens to your kid. He writes down "distracted?" and "control" in his notes. Addison says your kids might end up in a rehab fighting for their life and it's hard to wrap you head around that when you think you're pregnant. He writes down "fear?". 

An employee tells Amelia her recovery experience is their top priority. She starts explaining things about the program, but Amelia only has eye for a guy searching bags and finding a package of pills. The employee gets through to her and asks if she can hear her. "It's gonna get worse before it's gonne get better, but I swear it gets better," the employee says. She advises Amelia to give any other drugs she's hiding, as they'll find them anyway when she hits the detox bed. She takes a small package out of her bra and tells the employee that the man she loved died. She lies the pills on the table and the employee takes them away.

At Violet's house, Pete comes downstairs. Violet tells him Lucas said pancake. It wasn't really perfect, but she knows what he was going for. Pete gets ready to head out and she asks if he's heading to... "Yeah," he says, before she can finish.

In the kitchen of the practice, Violet tells Addison they only talk about Lucas. They're good and warm with Lucas. They're themselves with Lucas. She asks about Addison and Sam. Addison says they're good, as long as they don't talk about pregnancy or anyting baby-related. They laugh and Violet makes sure Addison will tell her when she's pregnant. And if she ever wants to complain to someone, she is just down the hall. Addison thanks her for that and touches her belly.

Cooper is examining a kid in an exam room. Cooper asks Jim how long Toby's pain has been going on. It started just after dinner, and a few hours later, the night attended reported he developed a fever. Cooper tells Toby to get dressed while he talks with Mr. Davies outside. Outside, he asks Jim why he didn't call her as the group home is only a few miles away from his house. He could've come over. Jim says he has 43 other kids like Toby, so it's not doable to call a doctor every time one of them sneezes. He wishes he could do more. He's placed Toby in 9 foster families in those 4 years, but nobody wants a sick kid. He says Toby deserves more. Cooper says that Toby was diagnosed with lupus 4 years ago, which could explain the dominal pain and the fever, but he'll have to do more tests. Toby comes out of the room and says he doesn't feel too good. He has a nosebleed and Cooper asks Jim to hand him some tissues, but the nosebleed only gets heavier.

Addison is flipping through a magazine as she waits for Jake in a hospital lounge. Once he comes in, she tells him to just say it, whatever the results are. She's not pregnant. He knows she's a doctor, but he's still going to give her the speech because even though she knows this stuff intellectually, she needs to process it emotionally. She says he doesn't need to give her the speech, but he says he does. So here it goes. Something like 6% of women her age get pregnant using IVF. It's a small number, but between her commitment and his experience, they can make this happen. There are a number of other options, so when she decides she's ready to do this again, they'll get into it. She smiles. "It's not over, Addison. Unless you want it to be," he says. He pats her back while she stays silent.

In the serenity center, Amelia and another girl are both suffering in the detox bed. Amelia tries to get through to the girl, who seems to have more difficulties than she does. Amelia asks her name and she replies that it's Hailey. She introduces herself to Hailey, who wants her mom. So does Amelia. Suddenly, Hailey freaks out and starts scratching every inch of her body, yelling that there are bugs on her. Amelia says there aren't and as Hailey continues to freak out, Amelia says she's a doctor and that there are not bugs, it's just her body withdrawing from the drugs. Her nerves are firing on their own and it feels like itchy bugs, but there are no bugs on her. It's just a hallucination and it's gonna stop. Amelia manages to get through to Hailey and asks if she sees any bugs on her, as her skin is crawling too, so bad that she wants to rip it off. She proposes a deal to call a nurse when they see any bug on the other one's body. If they don't see any bugs, it's just their nerves healing from all the crap they shot in them. Their nerves need to heal, just like them. They hold each other's hand.

Day 10

Amelia is sitting in the garden of the treatment center. Hailey comes over with a candy bar and sits down with her. Hailey asks if she's thinking about Ryan. She is, all the time, and she can't and doesn't want to stop doing so. Hailey understands. She's also had a best friend and a boyfriend die. They best friend was worse for her, as the boyfriend was a bad influence. Amelia thinks that with Ryan, it was the other way around: she was a bad influence for Ryan. A staff member from the center comes over to inform Amelia that Sheldon Wallace is at the center to visit her, but Amelia asks to tell him she's busy. Hailey asks about Sheldon. Amelia doesn't want to see him because of all the things she said to hurt him. Hailey points out that despite of that, he's still coming to visit her. She should let him in. 

Addison joins Violet, Charlotte, and Cooper in the kitchen. Cooper's figuring out the camera he bought to film Mason's school play. Violet jokes a camera is only basic equipment, but he takes it seriously and walks off. Violet repeats to Addison, who looks whistful, that a lot of women don't get pregnant the first time. Addison knows, but still she feels a little sad. Charlotte reminds her that there are also other ways to start a family if she doesn't want to try again herself, naming her own life at this point as a perfect example. While she's getting used to Mason now, at least Addison has choices. Violet asks if Addison's gonna try again. She is. She says Sam looked relieved when it didn't happen the first time. Violet says Pete looks relieved when she leaves the house, but that doesn't stop her from coming home. Violet says she'll hold Addison's hand if she decides to try again and Sam doesn't wanna do it. Addison thanks her.

Sam is doing a cardio test on Pete. He's liking what he's seeing. He's back. Pete thinks it's over in 10 years, but Sam reminds him that there are a lot bypass patients that live 20 to 25 years past the surgery. With these numbers, he can be one of them. Sam says he's been given a second chance to live a long happy life, so he should do that. 

Cooper informs Jim that Toby is doing worse because the lupus has triggered a condition that causes Toby's immunity system to attack his own body. It's aggressive and he's going to have to receive a stem cell transplant, meaning he'll have to stay in the hospital for a few weeks. Toby could die if they don't find a match soon. Cooper once again urges Jim to find a foster family because Toby can't go through this alone. Jim says he's doing what he can and says he'll come by as much as he can.

Sam and Pete watch Violet and Addison talking in Addison's office. Sam figures out they're talking about Addison doing another round of IVF treatment. Pete wishes Sam good luck, because now filling Addison's uterus has become a sport for Violet. Violet and Addison leave the office, with Violet assuring Addison that it sounds like she's made the right decision. Violet offers Addison to come with, but Addison says she'll go alone. Addison informs Sam that she's going to see Jake. Sam watches her as she walks up to Jake's office.

Addison has come up with a plan that would ensure a pregnancy, but it's a combination of many things that Jake deems it crazy. Jake says she doesn't have to do this yet as she has two frozen embyros left, but Addison wants to take one last shot with fresh sperm and fresh eggs. She wants the best possible odds. In that case, Jake advises her to relax.

Day 21

Sam walks into Addison's office, catching Violet giving Addison a hormone shot. He asks if he can help, but Violet says it's a little late now after having completely ignored the most important thing in Addison's life for the last two weeks. Violet thinks he should be with her because they're in a committed relationship, but Addison makes her see she's projecting her own marriage onto their love lives. Sam asks her about her and Pete. Violet admits they just flat-out suck. Violet wishes they hadn't let it get to this place. They're so far from the couple they used be that she's unsure if they ever can get back to that. They haven't tried counseling yet, because that would require actually talking to one another.

At the serenity center, Hailey says she doesn't want to leave this place. Amelia says it's not real in here. Staying sober here is like feeling happy at Disneyland. It's easy, but the real world, which got them there in the first place, is a whole other challenge. Hailey says she's awfully quiet about her own crap for the girl with all the answers. Amelia hasn't shared a lot, which she should since she's one of them. Dr. Dave sides with Hailey, who reminds Amelia that she did not kill Ryan. He took the drugs himself. Hailey says Amelia has to get that before Hailey leaves this place, or the guilt she feels now will eat her alive. Hailey needs her to make it. Amelia starts sobbing, which Hailey takes as a sign that she can leave now.

Pete comes home. Violet tells him Lucas is napping. Pete remains silent for a while and then says he's gonna shower. Violet doesn't know what to say.

Cooper and Mason are rehearsing. Erica reminds Mason he has other homework. Mason wonders what he should do if he forgets his lines. Cooper says he should look at him in the audience, so he can pretend it's just the two of them, like it is now. He promises Mason he'll be sitting in the front row.

Amelia walks Hailey to the exit. They hug and Amelia tells her not to use drugs. Hailey tells her to let her friends in. Hailey takes her bag and gets in the cab waiting for her.

Addison tells her therapist she wants a baby and Sam doesn't. They can talk around or about it, but that won't change the fact that she's in and Sam's out. The therapist says bringing Sam was a first step and he asks Sam what he thinks. Sam confesses he doesn't think this is useful for him. He's always been honest about not wanting a baby and now Addison is risking anything in order to get a baby. He loves her and wants her to be happy and he wants a life together. He doesn't want to throw that away because of a problem that's not even there yet. Addison says it will be there soon and even though she'll be taking care of the baby, he has to want the baby in his life. Sam says he wants her and walks out.

Day 32

Amelia and Sheldon are strolling through the garden. He's glad she agreed to see him. She asks why he doesn't hate her after all she said. Sheldon couldn't hate her if he tried. She doesn't know where to go from here, because she burned her entire life down. She doesn't know where to go once she leaves this place. She's not ready to face everyone to make amends. She can barely even look at him. Sheldon points towards a sign that reads "One day at a time" and says that's as good as an answer he can come up with.

Cooper finds Charlotte in the kitchen and asks her to go to Mason's school to save him a seat in the front row for Mason's play. Charlotte refuses to, thinking that's going too far. He promises to meet her there, but she's the only option left as Erica's working backstage with the costumes. She then agrees to do it, but he owes her. As she walks out, Addison walks in. Charlotte says Addison looks bad. Addison takes water from the fridge and says she just skipped breakfast. Sheldon comes in and informs them Amelia is making some real progress. As Sheldon mentions that they're all going to have to go a group therapy session together soon, Addison collapses. Sam orders Sheldon to go get Jake as he and Violet tend to Addison.

Cooper finds Toby struggling. He doesn't want to be sedated, which is required before they can put in the central line for the stem cell infusion, because he thinks he's never going to wake up. Toby says he doesn't want to die. Cooper wonders where he got that. Toby says he overheard Cooper say it to Jim. Cooper explains they were talking about risks. Toby calms down and asks Cooper to stay as well. Cooper and Jim watch as the other doctor sedates Toby.

Pete finds Sam sitting outside Addison's room. He explains it was a side effect from the hormones. Violet's in there with Addison, so Sam doesn't think there's place for him. Pete wonders if Violet's planning on raising the baby with Addison too, because then he could take Lucas. Sam reminds him he has a wife he loves too. Pete says that when he heard he had 25 more years, it made hem happy to think that he'd actually be able to dance at his son's wedding, but then he thought it meant another 25 years with Violet, and he doesn't know if he wants that. Sam says he's sorry. Pete says he won't leave as he doesn't have it in him.

Cooper finds Mason, Charlotte, and Erica. The play's already over. Erica says he was terrific, but that he missed his dad. Cooper tries to explain he had an emergency at work. Mason says he forgot his line because he couldn't find Cooper in the front row. Everyone noticed and they all laughed at him. Cooper offers to go get some pizza, but Mason wants to be left alone. Charlotte also walks past Cooper, judging him.

Addison hears her abdomen filled with fluid secondary to the fertility treatment. Once Jake has drained the fluid and she has gotten a few days rest, they can try again. Sam is watching them from outside the room. Violet walks up to him and Sam tells her that Jake told him it was a complication. Jake comes outside and tells Sam he can go in, but Sam wants to give her some rest. He says she knows he's there.

Amelia and the doctors of the practice have gathered at the serenity center. Amelia has named all of them family. Amelia doesn't know how to apologize. She wants to take back everything she said. She was sick and scared and she didn't mean it. She wanted to hurt them and she thinks she succeeded. If she could go back and unsay it all, she would. The drugs didn't bring out the truth, but lies and cruelty and viciousness instead. Those things are not her. The real her is the person before the drugs, the person who's sitting therer know. She hopes they believe her when she says how sorry she is. Even if they don't, she has to say it anyway, because she wants to live. The man she loved died and he would be so pissed if she died too, so she hopes she can forgive herself. She can't take it back, but she's going to try to move forward and do better. She's gonna try not to hurt any of them ever again.

Cooper walks into Mason's bedroom and offers to help, but Mason can do it by himself. He also doesn't want to hang out with Cooper afterwards. Cooper knows he's mad at him for missing the play, but he can't promise it won't ever happen again because he's a doctor for kids, and they need him when they're really sick. Cooper knows he must have been scared on that stage, but Cooper knew he was safe on that stage, unlike Toby. Toby doesn't have anybody. He tells Mason he loves him and leaves him to work.

Violet tells Addison she and Pete just co-exist. There are stages in his recovery that mirror the stages of grief and they can be really hard to get through. She's walked many patients through it. It can rip families apart or bring them together. She's waiting for the stage where they're through it, and can look back on it. However, she doesn't see any sign that that's what Pete wants. She then realizes something, but Sam comes in before she can say what. Sam tells Addison he doesn't want her to do the embryo transfer. Violet leaves to go talk to Pete. Sam says what happened to her really scared him. Addison says she already did it this morning. She was going to tell him tonight, but this is it. No more hormones or IVF. She's either pregnant or she's not. Sam says okay and they hold hands.

Violet walks into Pete's office and says she doesn't want to be Anna, his first wife. He hated her, but he stuck. She doesn't want to stuck and hate her. She knows he prides himself on sticking no matter what, so she knows he'll stick, but she doesn't want that. It's no life for her or Lucas. So, she'll leave him if he can't do it but wants it. If he doesn't love her anymore, he has to ask her to leave, and she will. She'll do that for him, for them. They'll figure out how to make it okay for Lucas. She still loves him, but this is not what she wants. He can take some time, but she wants him to know she means it. She asks to nod if it's okay. He can't look at her, but nods.

Amelia is walking down the hall as she sees Hailey being readmitted.

Day 50

Erica and Mason swing by Charlotte's office. Mason was hoping to find Cooper. Charlotte says he's at the hospital to help kids, but she was just heading over there. She bets they can find him together. Erica tells Mason to thank Charlotte, so he does.

Pete is reading the paper. Violet is sitting across him. They look at each other and she asks if he's thought about it. He tears up and says he's sorry. She says okay and gets up.

Cooper walks into Toby's room. Toby's getting stronger every day. Cooper says his T-cell count is returning to normal. Mason appears in the doorway and Cooper introduces him to Toby. Mason shows him his Pokémon cards and says he's sure Toby will get better soon, because his dad treated him.

Violet comes down the stairs with a bag. Lucas is asleep and she's gonna go to the hotel. She'll be back in the morning to make Lucas his breakfast so Pete can go for his morning run. They'll make it as normal for him as can be. She feels they should still go together to Addison's Thanksgiving tomorrow as planned, as it'll be the normal thing. Then they can talk about how they're going to make it work. Violet then leaves the house.

Amelia is about to leave the center. She and Hailey hug at the door. Hailey tells her not to do drugs. Amelia tells her she became sober for the first time around Hailey's age and she became a doctor, saving lives, so if Hailey stays clean, she can go on to do anything. Hailey is beautiful, inside and out, and she's smart and capable. Amelia's her family now and she wil help her. They hug and Amelia gets in the car waiting for her. She and Hailey wave at each other.

At Addison's house, everyone is preparing the dinner. Erica and Charlotte are watching Cooper play with Mason and Lucas. Charlotte tells Erica it meant a lot to Cooper to have Mason here, so she thanks Erica. She and Erica took the food to the deck.

Sam tells Sheldon it seems like a minute ago that he was playing with Maya like that. Sheldon says Addison may get to experience the same thing.

Out on the deck, Jake tells Pete it's nice to be with everyone. Sheldon comes out and asks if there are assigned seats. There aren't. Everyone takes a seat as Amelia appears on the deck, asking if there's room for one more. Charlotte says they will make room. Sheldon says there's an open seat right next to him. As everyone has taken a seat, Violet wonders where Addison is.

Up in the bathroom, Addison is counting down the seconds before she can read the result of her pregnancy test. She takes the stick, reads the result and looks at herself in the mirror.


  • Addison Montgomery
  • Pete Wilder
  • Jake Reilly
  • Cooper Freedman
  • Charlotte King
  • Sheldon Wallace
  • Amelia Shepherd
  • Sam Bennett
  • Violet Turner
  • Hailey
  • Erica Warner
  • Jim Davies
  • Therapist
  • Mason Warner
  • Joan
  • Dr. Dave
  • Dr. Berman
  • Toby
  • Counselor
  • Woman
  • Lucas Wilder

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Amelia ShepherdEdit

  • Diagnosis:
    • Drug addiction
  • Treatment:
    • Rehabilitation
    • Group therapy

Amelia went to rehab to get help for her drug addiction. On Day 10 in rehab, she was past withdrawal. On day 21, in group therapy, the other patients said she wasn't sharing. Hailey also told her that she needed to admit that she didn't kill Ryan. He took the drugs himself. On Day 32, she finally allowed Sheldon to visit her. On Day 41, Amelia invited the other doctors to rehab for a group session to make amends. She was later discharged from rehab to go home in time for Thanksgiving.

Addison Forbes MontgomeryEdit

  • Diagnosis:
  • Doctors:
  • Treatment:
    • Talk therapy
    • Hormone therapy
    • Fluid aspiration

Addison talked to her therapist about the situation with Amelia and how Amelia's mom is an excellent mother, but Amelia still ended up addicted to drugs. Jake also told her she was not pregnant. Addison went back to Jake with some ideas for ways to increase her odds. She continued her hormone therapy, but Jake said there was no use in the additional measures. She still had two more frozen embryos. But Addison said she wanted fresh eggs and fresh sperm. Sam joined Addison for one of her therapy sessions, in which he talked about how he doesn't want a baby while Addison does want one. Addison fainted at the practice as a side effect of the hormone therapy. Her abdomen had filled with fluid, so Jake aspirated it and transferred two more embryos. She said it would be her last attempt to get pregnant.


  • Diagnosis:
    • Lupus
    • Nose bleed
    • Liver failure
    • Hemophagocytic lymphohistiocytosis
  • Treatment:
    • Chemotherapy
    • Stem cell transplant

Toby had developed stomach pain and then developed a fever, so Cooper examined him. He had been diagnosed with lupus, but Cooper wanted to run more tests. He also had a nose bleed. Cooper admitted to the hospital and said he was showing signs of liver failure because the lupus had triggered hemophagocytic lymphohistiocytosis. Cooper said he'd need chemo and a stem cell transplant or Toby could die. Cooper also advised Toby's social worker than he needed to find him a foster family to get him through this. Cooper was later paged to the hospital because Toby was resisting his treatment. Cooper stayed with him while he got the stem cell transplant. After his treatment, his T cell count was up and he was feeling better.


  • Diagnosis:
    • Drug addiction
  • Treatment:
    • Rehabilitation
    • Group therapy

Hailey, 18, was in rehab with Amelia. She told Amelia that she'd had a boyfriend and a best friend who had died. In group therapy, Hailey said she wished she could stay longer, but Amelia said being sober in rehab means nothing if you can't live in the world sober. She left rehab to go home. She later returned to rehab when she relapsed.

Pete WilderEdit

  • Diagnosis:
  • Treatment:

Pete had cardiac studies. Sam said everything looked great.


Song Performer Scene
"No Condition" Mary J. Blige
  • Amelia and Hailey go through withdrawal symptoms together.
"Empty Prayers" Mary J. Blige
  • Pete and Violet have an awkward moment.
  • Cooper and Mason are rehearsing for the play. Cooper promises to be in the front row.
  • Hailey leaves the treatment center and says goodbye to Amelia.
  • Sam joins Addison in therapy, but soon leaves. He refuses to let her go, but she doesn't know how to make it work.
"The Living Proof" Mary J. Blige
  • Mason and Toby talk, with Cooper, Erica, and Charlotte watching them.
  • Violet leaves her house to go to a hotel.
  • Hailey says goodbye to Amelia as she leaves the center. Amelia tells her she can still change her life if she stays clean.
  • The doctors have a Thanksgiving dinner at Addison's house, with Erica and Mason. Amelia joins them.
  • Addison waits for the result of her pregnancy test.

Notes and TriviaEdit

Private Practice - 5x08 and 5x09 - Who We Are and The Breaking Point

Private Practice - 5x08 and 5x09 - Who We Are and The Breaking Point

  • This episode scored 7.23 million viewers.
  • This episode is the second part of a two-hour Private Practice event, the first part being Who We Are.


Episode StillsEdit

Behind the ScenesEdit


Addison: It's hard to fathom that you can do everything right, and you still can't control what happens to your kid.

See AlsoEdit

A complete overview of this episode's crew can be found here.