By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

Other Places to listen: iTunes, Spotify

Article Authors: David Puder, MD

Note: Contains spoilers

David Puder, Rachel Blackston and Eric Bender have no conflicts of interest to report.

Introduction

In this write-up, I reflect on and expand upon insights that emerged from our podcast episode on Inside Out 2. The podcast guests are Rachel Blackston, mother of three and co-owner of a thriving group practice with over 20 therapists in Orlando, and Eric Bender, a psychiatrist who works with adolescents in the San Francisco area and previously joined me in discussing “The Shrink Next Door.”

In Inside Out 2, Riley transitions from childhood into adolescence. The movie introduces new emotions, representing the turbulence and heightened self-consciousness that many teenagers face during this pivotal stage of development.

Setting the Stage: Adolescence and Emotional Transitions in Inside Out 2

One of the central themes of Inside Out 2 is the emotional upheaval that accompanies adolescence. As Riley transitions from childhood to her teenage years, we witness the introduction of new emotions—Anxiety, Envy, Embarrassment, and Ennui (Boredom)—which reflect the increasingly complex emotional landscape teens must navigate. This emotional expansion is chaotic but essential to development of internal reflectiveness.

Rachel Blackston shared her personal experience of adolescence within her family, illustrating how accurately the film captures this transition:

“I felt it. A wrecking ball comes into the scene and starts dismantling and disrupting, and that’s sort of what it’s felt like in my household. It’s like Family Island, that used to be the center of everything, gets pushed into the background as Friend Island takes over. Suddenly, as a parent, you’re not the central figure anymore, and that’s a really disorienting experience.”

Family Island—once stable and reliable—begins to fade in importance as Riley’s relationships with peers grow. The metaphor of islands shrinking or growing reflects the real-world shift in a teenager’s priorities as they move through adolescence. A secure attachment with parents provides the emotional foundation needed for teenagers to confidently explore new friendships and navigate the shifting priorities of adolescence.

Adolescence is all about the evolution of identity. The new emotions—Anxiety, Envy, and Embarrassment—are particularly powerful because they represent a teenager’s increasing awareness of how they’re perceived by others. For example, the anxiety Riley feels about how she fits in with her friends and the envy that arises when she sees others doing better or fitting in more easily. These emotions aren’t just disruptions—they’re signs that her self-concept is shifting and expanding.

Dr. Eric Bender added a clinical perspective, connecting these emotional changes to adolescent mental health:

“I see this all the time with my patients. Anxiety especially starts to ramp up as kids hit adolescence. It’s not just that they’re suddenly more emotional—it’s that they’re beginning to realize how others see them, and that’s a massive shift. The fear of not fitting in, of not being good enough, becomes a driving force in their emotional lives. Envy is another big one. It’s natural to compare yourself to your peers, but it can spiral into something destructive if it’s not balanced with a healthy sense-of-self. What I love about Inside Out 2 is that it doesn’t shy away from showing how complicated these feelings can be, especially during this crucial stage of development.” — Dr. Eric Bender

Through these reflections, we see that Inside Out 2 effectively externalizes the complex emotional journey of adolescence, making it easier to visualize and understand. 

The Transition To Puberty In Inside Out 2

At the beginning of the film, Joy introduces a machine designed to throw bad memories to the back of Riley’s brain (representing the unconscious) as a way to protect her from negative emotions. Joy’s mantra was, “Keep the best, toss the rest.” Now 13 years old, Riley is transitioning to a new school and early in the movie she learns that her friends, Brie and Grace, won’t be attending the same school as her. This revelation shakes her world, marking a significant emotional challenge as she navigates the complexities of adolescence.

Then, the puberty team arrives and causes chaos in headquarters, destroying Joy’s new machine in the process. Riley begins grappling with attachment fears: “I’m not going to be with my friends. What’s going to happen?” A new set of emotions, including Anxiety, enter the scene, adding to her turmoil.

As difficult as this process is for parents—often bringing a sense of grief—it’s essential for them to remain stable through the storm. This development is a crucial part of a child’s sense-of-self and formation of a separate identity from their parents. Without it, kids can become emotionally “stuck.” Parents may long for the days of Inside Out 1, when Riley’s core memories—centered on family moments like ice skating with her parents—were at the forefront, but these memories naturally fade to the background as she grows and new priorities emerge.

The concept of a "sense-of-self" is introduced in Inside Out 2. Before puberty and the Anxiety takes over, Riley’s sense-of-self is built from Joy’s carefully selected memories—all positive, reinforcing the idea that she is a good friend and a good person.

It’s essential for everyone to recognize their inherent worth and value, while maintaining a balanced, reality-based understanding of the unique contributions they bring to relationships—whether as a friend, daughter, or son. These beliefs form the foundation of who we are and how we engage with the world. Because Riley’s childhood was largely positive, her core beliefs and sense-of-self remain stable as she navigates new challenges.

However, not all individuals are as fortunate as Riley in developing a stable sense-of-self. In psychodynamic literature, identity diffusion refers to the difficulty in forming a cohesive and consistent identity, often rooted in early attachment disruptions or unresolved emotional challenges. When this foundational development is interrupted—whether due to trauma, neglect, or inconsistent caregiving—individuals may struggle with a fragmented sense of who they are. Instead of having a stable core identity, they might experience fluctuating self-images, rely heavily on external validation, or feel chronically unsure about their roles, values, or relationships. This lack of a clear identity can lead to emotional instability, poor boundaries, and difficulties in forming meaningful connections. In adolescence, this struggle becomes particularly pronounced, as the natural developmental task of solidifying one’s identity clashes with unresolved emotional wounds from the past.

How Inside Out 2 Could Explore Emotional Trauma and Adverse Childhood Experiences

Many adults and children have not had the opportunity to properly develop emotionally due to experiencing adverse childhood events (ACEs)—including physical, sexual, or emotional abuse, neglect, domestic violence, or witnessing substance abuse. Research shows that these experiences can lead to long-term changes in the brain and body, such as dysregulation of the HPA axis, heightened amygdala reactivity, and epigenetic changes. These physiological shifts often contribute to emotional and psychological difficulties later in life, including identity diffusion, emotional dysregulation, and challenges in forming healthy relationships (Puder, 2024).


In contrast, Riley from Inside Out does not face significant trauma. Her emotional development follows a normal path, allowing her to form a stable sense-of-self. This is evident in the film, where she successfully navigates early developmental tasks, supported by positive role models and a secure attachment with her parents. As a result, Riley’s core sense-of-self remains intact, and she avoids the deep internal struggles around self-worth and identity that are common among children who experience trauma. In children who have faced early abuse or neglect, thoughts like “I am bad” or “I am worthless” often become deeply ingrained, especially if they enter adolescence without stable role models to help them develop their core identity.


Children who experience disorganized attachment—often due to caregivers who are inconsistent, frightening, or unable to provide reliable comfort—are particularly vulnerable to identity diffusion. Without a secure foundation, these children struggle to form a cohesive sense-of-self and may develop disorganized attachment patterns. As they grow, this can lead to emotional fragmentation, where they lack a stable internal framework to manage their emotions or maintain relationships. This disorganization can result in identity diffusion, where the child feels unsure of who they are, fluctuating between different self-images and relying on external validation to define themselves. Over time, this can manifest as emotional dysregulation, identity disturbance, and dissociative states (Episode 087, Episode 088).


If Inside Out 2 were to explore a character with a high ACE score or disorganized attachment, the emotional landscape would be markedly different from Riley’s. Rather than having a well-developed sense-of-self, a child with a history of trauma would likely experience fragmented emotions, identity confusion, and chronic feelings of emptiness. These symptoms are often seen in individuals with borderline personality disorder (BPD), where identity diffusion leads to unstable emotions, chaotic inner conflicts, and impulsive behaviors as coping mechanisms. This character’s inner world would be far more turbulent, reflecting the complex interplay of trauma, attachment issues, and emotional dysregulation. Where Riley’s emotions are able to coexist and integrate, a traumatized child might find their emotions at odds, leading to inner chaos and difficulty navigating the social and emotional challenges of adolescence (Episode 115).


Exploring such a character would highlight the profound effects of early trauma on emotional development and identity formation, offering a more nuanced portrayal of the struggles faced by children who grow up without the secure attachments and positive experiences that Riley had. It could also provide an opportunity to examine how healing and growth occur, perhaps depicting the character developing resilience through therapeutic relationships, mentorship, or other supportive interventions that help foster a more cohesive sense-of-self.

How Inside Out 2 Depicts Anxiety And Emotional Fragmentation During Adolescence

By the end of Inside Out, the theme of emotional integration is fully realized as different emotions coexist and contribute to Riley’s sense-of-self. This mirrors real life, where core beliefs like “I’m a good person” and “I’m not good enough” often sit side by side. In Riley’s case, her anxiety inadvertently leads to the emergence of a new critical belief: “I’m not good enough.” These conflicting beliefs coexist within all of us, shaping our identity. The tension between positive and negative self-perceptions is a normal part of emotional development, especially during adolescence when identity formation becomes more complex.


In contrast, individuals who haven’t developed positive core beliefs often experience an imbalance in their self-concept. Instead of holding a mix of positive and negative beliefs, they may internalize a single, dominant thought: “I am bad.” This is particularly common in children who experience neglect or inconsistent caregiving. According to Bowlby’s attachment theory, when children feel abandoned or unworthy due to caregiver neglect, they often internalize a deep sense of shame and inadequacy, believing they are inherently unworthy of love. This can lead to chronic low self-esteem and difficulties in forming secure relationships later in life.


Additionally, as Kohut often emphasized, the absence of empathetic validation from caregivers can result in a fragmented sense-of-self. Children who do not experience emotional attunement may come to believe, “I must need too much” or “I’m overwhelming,” as a way of rationalizing why their needs weren’t met. Without positive role models or emotional support, this narrative of unworthiness can dominate their internal world, setting the stage for emotional dysfunction and relational difficulties in adulthood.


Riley’s sense-of-self, initially rooted in positive core memories, is shaped by Joy’s efforts to maintain her emotional balance. However, as Anxiety enters the picture, Riley’s focus shifts away from her past experiences, and her emotional landscape becomes dominated by fear of the future. Anxiety’s attempt to “build a better Riley”—as seen when she launches Riley’s core sense-of-self to the back of her mind—illustrates the dangers of allowing anxious thoughts to reshape one’s identity. As Nancy McWilliams has often pointed out, anxiety can distort the self-concept, leading individuals to construct identities based on external pressures rather than authentic desires and values. This mirrors how Riley’s authentic self is pushed aside in favor of a version more focused on social acceptance and external validation.


Erik Erikson’s theory of psychosocial development highlights adolescence as a critical period for identity formation, where the conflict between identity and role confusion is central. Adolescents, like Riley, are tasked with forming a stable sense-of-self while navigating external pressures from peers and society. When anxiety takes control, as it does for Riley, it can lead to identity confusion—a state where the individual prioritizes social conformity over personal authenticity. Rather than exploring her true desires, Riley’s anxiety shifts her focus toward constructing an identity shaped by fear and the need for social acceptance, ultimately disrupting the healthy process of identity formation.


This act of emotional suppression fragments Riley’s identity, leaving her disconnected from her authentic self. It serves as a powerful metaphor for how unresolved emotions, especially those driven by anxiety, can take control of our internal landscape, leading to inner turmoil. Anxiety often distorts one’s sense-of-self by introducing fears of inadequacy and a need for external validation, as we see in Riley’s struggle. By prioritizing social acceptance over personal authenticity, her sense-of-self begins to fracture, resulting in emotional confusion and insecurity.


We witness Riley’s emotional fragmentation most clearly when her core memories—representing key aspects of her identity—are literally sent to the back of her mind. This displacement reflects her vulnerability as she tries to navigate new peer relationships without a fully integrated self-concept. Inside Out 2 powerfully illustrates a common experience of adolescence, where shifting social dynamics and increasing self-awareness create internal conflicts that can destabilize one’s identity. The process of forming a cohesive sense of self is complicated by these emotional upheavals, but also represents the essential developmental task of adolescence: integrating these conflicting emotions and experiences into a stable, authentic identity.

Inside Out 2: How Joy’s Anxiety Foreshadows Riley’s Emotional Struggles

Interestingly, before Anxiety officially takes control, Joy’s actions already reveal underlying anxiety. By using a machine to eject bad memories, Joy attempts to protect Riley from negative emotions, but this, in itself, is an anxious response. Joy fears what will happen if Riley retains these difficult memories, reflecting a common human tendency to suppress negative experiences in hopes of securing a better future. This behavior mirrors broader societal pressures to prioritize happiness and avoid discomfort, highlighting the cultural tendency to reject emotional complexity. Joy’s anxious actions foreshadow Anxiety’s role, which centers on planning for and controlling the future to protect Riley from potential pain.


When Anxiety takes over, she believes that Riley can secure her place in social circles, avoid rejection, and ultimately thrive by being overly cautious and strategic in her relationships. Anxiety fixates on ensuring Riley has friends and social acceptance, assuming that by planning and worrying, she can secure Riley’s future success.


In life, we often “send memories to the back” when they feel too overwhelming to confront. These memories, when labeled as negative or painful, can become dissociated or denied, pushed deep into the subconscious. While suppression and denial may work as short-term strategies to cope with overwhelming emotions, these defenses prevent emotional integration, leaving unresolved feelings to resurface in maladaptive ways. They don’t disappear; they resurface in dreams, slips of the tongue, or intense emotional reactions. Inside Out 2 vividly illustrates this process when Anxiety, in an effort to protect Riley from future pain, launches her sense-of-self to the back of her mind. Anxiety’s plan, driven by fear, is to create a “better” Riley—one that is more socially accepted and successful. As Anxiety states, “We build her a new sense-of-self, a brand new her.”


This act of emotional suppression fragments Riley’s identity, leaving her disconnected from her authentic self. As Freud suggested, suppressed memories don’t vanish; they continue to influence behavior from the unconscious. In Riley’s case, the anxiety that pushes her core memories aside reflects a defense mechanism leading to deeper emotional conflict. Nancy McWilliams would argue that anxiety distorts Riley’s self-concept, shifting her focus toward external validation rather than authentic self-expression. Erik Erikson’s theory highlights that adolescence is a time when external social pressures, such as fitting in with peers, exacerbate identity confusion—exactly what we see in Riley’s journey, as her anxiety shifts her focus from personal authenticity to social acceptance.


Winnicott’s concept of the True Self vs. False Self is evident in Anxiety’s attempt to build a “better” version of Riley. By pushing her True Self to the background, Riley becomes disconnected from her emotional core, increasing her vulnerability to instability. Ultimately, the film shows that emotional growth is not about avoiding or erasing painful memories, but about integrating them into a cohesive sense-of-self. As Erikson and Winnicott suggest, emotional resilience comes from embracing all aspects of our experience—both joyful and painful—and learning to live authentically within this complexity.

How Inside Out 2 Shows Parents Unintentionally Suppressing Adolescent Emotions: Lessons In Emotional Expression

As parents, there’s often a temptation to rescue our children from difficult emotions or to push for them to always be happy and well-adjusted. In doing so, we might unknowingly encourage emotional suppression—the conscious avoidance of uncomfortable feelings—in an attempt to protect them. This is illustrated in Inside Out 2, where Riley expresses fear about hockey camp, saying, “I’m never gonna make this team. I’m not gonna do well.” Her parents respond, “Don’t think that way,” instead of allowing her to sit with and express her worry. This instinct to soothe or fix emotions is natural but can inadvertently teach children to suppress, rather than confront, their feelings.


While suppression may seem helpful in the short term, if these emotions are never addressed, it can lead to more primitive defenses like denial, where children unconsciously reject their emotions altogether. Over time, instead of simply avoiding difficult feelings, they may lose touch with them, acting as though those emotions don’t exist. In extreme cases, they might develop defenses like projection (blaming others for their feelings) or splitting (seeing situations as entirely good or bad). Helping children acknowledge and process their emotions is essential to prevent the slide into these more primitive, maladaptive defenses.


As therapists, we understand the importance of helping our patients sit with difficult emotions and work through them. But when it comes to our own children, we’re more deeply invested, which makes it harder to follow this same approach. Parents tend to shield their children from discomfort, wanting to reassure them or fix their emotional struggles. However, avoiding these emotions or disavowing them can cause long-term emotional suppression, complicating their ability to process feelings later on.


In a previous episode with Paul Wachtel on disavowed emotions, he explained, “Disavowed emotions do not disappear. They get expressed in ways that are often more destructive than if they were acknowledged and addressed directly.” When parents inadvertently teach their children to suppress or disavow their emotions, those feelings don’t go away—they show up in indirect or harmful ways, such as anxiety, outbursts, or emotional withdrawal.


In Inside Out 2, Riley’s parents unintentionally disavow some of her darker emotions as she navigates adolescence, which fragments her developing sense-of-self. Without a space to express these emotions, Riley begins to internalize that certain feelings are unacceptable or must be hidden. This fragmentation of her emotional experience illustrates how suppressed emotions can resurface in less healthy forms, complicating her emotional development.


There’s a powerful scene in Inside Out 2 when Riley arrives at camp and learns that her friends Brie and Grace won’t be attending the same school as her. The emotions in her head initially urge her to “keep it together,” reflecting the common pressure to suppress sadness and maintain composure. But eventually, her emotions allow Sadness to have a moment to express herself, demonstrating the importance of acknowledging difficult feelings rather than bottling them up.


This scene highlights the psychological truth that if we don’t express our emotions when they arise, they don’t simply disappear—they come out in other, often less healthy ways. It’s like trying to hold a beach ball underwater: the more you push it down, the more forcefully it pops up, often in unexpected and disruptive directions. By not addressing her sadness directly, Riley risks having those unacknowledged feelings manifest in ways that could negatively affect her emotional well-being.


Naming and honoring emotions reduces their power over us. This concept is mirrored in Harry Potter, where Dumbledore encourages Harry to stop calling Voldemort “He Who Must Not Be Named,” saying, “Will you stop that? Just, just name it. Otherwise, it has too much power over you.” The same is true of our emotions: when we refuse to name or acknowledge them, they gain control over us. But when we name and confront our emotions, we take the first step toward processing them in a healthy way.

How Anxiety Hijacks Creativity: Lessons From Inside Out 2 And A Beautiful Mind

The character of Anxiety is intentionally uncomfortable and difficult to watch, reflecting how distressing real-life anxiety can be. As Anxiety takes over more of Riley’s mind, the more unsettling it becomes for both Riley and the audience, mirroring the way anxiety feels overwhelming in real life. Watching Anxiety on screen mirrors the frustration and discomfort many people with anxiety experience—constantly wondering, “When can I stop worrying? When will this calm down?” At one point, Joy asks anxiously, “How do we get rid of anxiety?” followed by the somber realization, “Maybe we can't.” This simple yet profound exchange captures a truth at the core of anxiety: it’s not always about eliminating the worry, but learning to live with it.


In the movie, Riley’s mind leads Joy, Sadness, and Disgust to the Imagination Station, a place that symbolizes her creative powers. However, as they enter, they realize that Anxiety has taken over this space, using Riley’s imagination to spin endless fear scenarios—just as anxiety hijacks our thoughts, making us obsess over potential threats and mistakes. Anxiety, standing in front of a large screen and a group of workers, commands, “Great! We need to help Riley prepare. Now is the time to send up every possible thing that could go wrong. We are looking to the future. Every possible mistake she could make…” Riley misses an open goal, and the coach writes about it in her notebook. “Yes! More like that.” The workers, driven by Anxiety, begin churning out these worst-case scenarios, one after another, while Riley, caught in the grip of these imagined fears, tosses and turns in bed, her face showing mounting distress.


It’s a vivid depiction of how anxiety dominates our mental space, often overshadowing other emotions. Anxiety can hold joy, sadness, and other feelings hostage, leaving us focused entirely on what could go wrong. The Imagination Station is turned completely orange—the color of Anxiety in the film. 


As I reflected on the Imagination Station scene, it resonated deeply with my own experience of anxiety taking control of my imagination. In the movie, Anxiety hijacks Riley’s creative powers to churn out endless worst-case scenarios, and I know firsthand what that feels like. When anxiety takes over, your mind becomes a factory of potential bad outcomes, constantly spinning up fear scenarios and trying to plan or predict how to handle them. It’s like being your own worst prosecutor—your imagination, once a powerful creative force, turns against you, and it feels as if there is no way to turn it off. You wake up in the middle of the night or early in the morning with your mind relentlessly churning out all the ways things could go wrong. That’s what happens to Riley when the Imagination Station is overtaken by Anxiety—her powers of creativity are completely enveloped by fear and worry, making it difficult to focus on anything else.


In the 2001 film A Beautiful Mind, the highly intelligent protagonist, John Nash, suffers from schizophrenia, creating paranoia that is both nuanced and believable due to his intelligence. His delusions, like working for the Department of Defense to crack secret codes, are so detailed that even he cannot distinguish them from reality. This reflects what we see in highly intelligent individuals with anxiety or psychosis—their imaginative and intellectual abilities make their fears more sophisticated and harder to detect. Nash’s “internal prosecutor” is powerful, as his mind turns against him, weaving intricate, convincing narratives, much like the brutal impact of imagination turned inward in many clients I have seen. His hallucinations and delusions echo the complexities of mental health struggles, where intelligence amplifies the believability of one’s fears.

As Anxiety takes over the Imagination Station, Joy grabs a pen and tries to counter it by drawing positive scenarios for Riley’s future. She imagines Riley scoring the winning goal, surrounded by cheers and celebration. Disgust adds her own flair, sketching Riley painting her nails to match her jersey, making her the trendsetter everyone wants to copy. Fear, ever cautious, shows Riley wearing knee pads for protection, while Anger, in a rare gesture of kindness, draws Riley buying flowers for the losing team as a show of sportsmanship.

Meanwhile, frustrated by Fear’s growing agitation, Embarrassment throws a button away and presses another, causing Riley to focus on these lighter, imaginative scenarios. Joy then rallies the workers to keep creating positive futures, and as the room fills with hopeful images, a pillow fight breaks out. The playful scene finally allows Riley to relax and fall asleep, her mind soothed by the shift away from anxiety-driven fears.

During periods in my life where I wake up at 4 a.m., with my "Imagination Station" running on overdrive, I’ve learned to manage the anxiety by fully waking up my mind and body. Sometimes, I’ll do this with exercise or a cold plunge, a shock to the system that helps me reset. Over the years, I’ve also developed mental “tools” to deal with these moments. I use cognitive therapy techniques, identifying and challenging any cognitive distortions that might be feeding my anxiety. I might lean on logotherapy, refocusing on my deeper meanings and values, or invite my spiritual side into these negative moments to find calm. Sometimes, I distract myself by sublimating my anxiety into meaningful work—taking advantage of the early hours to focus on productivity, perhaps related to the anxiety. On occasion, I’ll reach out to mentors by email, asking for their thoughts, reflections, or prayers, seeking perspective and connection to ground myself.

Examples Of Microexpressions In Inside Out 2: Adolescence and Self-Doubt

In Inside Out 2, the film vividly portrays the self-doubt that begins to emerge during adolescence, often triggered by anxiety and social pressures. Riley’s sense-of-self glows when she’s around her friends, showing how secure and confident she feels in those moments. For example, when she helps Grace pick up pennies, her sense-of-self blossoms, reminding us that being her authentic self strengthens her friendships. However, as she navigates adolescence, self-doubt starts to creep in—something typical of this developmental stage, where kids question their identity and their place in social groups. Adolescents often need reminders that their friendships originally formed because they were true to themselves. As Dr. Bender suggests, a helpful reminder for teens could be, “You made these friends by being yourself. Maybe it’s worth trying to be yourself again—some people might not like you, and that’s okay.”

Microexpressions: Subtle Emotional Cues in Adolescence

The film also highlights how adolescents internalize self-doubt through subtle emotional cues, specifically microexpressions. As Riley’s friends begin to look uncertain, Riley instinctively picks up on their facial expressions (a microexpression of fear, eyebrows going up and together with tension) before they even verbalize their decision not to attend the same school as her. This is an excellent example of microexpressions in action—quick, subconscious flashes of emotion that last for only a fraction of a second. Long-time listeners of this podcast will remember previous episodes on microexpressions, which are 1/10th-of-a-second glimpses of emotion that appear on someone’s face. Inside Out 2 visually captures this moment as Riley’s mind zooms in on her friends’ faces, revealing slow-motion flashes of fear. These microexpressions suggest that Riley sensed what was happening before she fully realized it consciously.

Mentalizing and Misreading Emotional Cues

Mentalizing—the ability to understand and interpret others’ emotions and thoughts based on their facial expressions and actions—can be particularly difficult for individuals with borderline personality disorder (BPD). People with BPD often struggle with mismentalizing, misinterpreting others’ emotional cues, especially when their fear of abandonment is triggered. They may overread microexpressions, perceiving neutral or ambiguous expressions as negative or rejecting. Anxiety can heighten this hyperawareness, causing them to constantly try to “read” others, often resulting in misjudgments.


In therapy, part of the process involves helping patients reduce the intensity of hyper-mentalizing and teaching them to interpret emotional cues more accurately without projecting their fears. In Inside Out 2, we see a more adaptive approach in Riley’s response to her friends’ expressions, as her concern prompts her to ask more questions rather than jumping to conclusions. However, if Riley had a history of neglect or trauma, she might misread expressions more frequently, perceiving rejection or disapproval in situations where none exists.

The Normalization Of Self-Reflection And Emotional Integration

Adolescence brings significant changes in the brain, including maturation of the prefrontal cortex, which enhances self-reflection and emotional regulation. At the same time, heightened activity in the limbic system increases sensitivity to social and emotional cues, contributing to social anxiety. Inside Out 2 normalizes these changes, showing that the internal turbulence of adolescence is universal. In today’s TikTok culture, where self-diagnosis is common, there is a tendency to pathologize normal developmental experiences. Yet, as the movie illustrates, self-reflection and emotional integration are natural parts of growing up.


Our sense-of-self is at its most authentic when we can simply be ourselves. This authenticity 

fosters deeper connections with others and strengthens relationships. However, as the film shows, anxiety can often overshadow this authenticity, acting like a blanket that smothers everything, making it difficult to truly connect.


One of the film’s most powerful moments occurs when Riley experiences a panic attack in the penalty box. As she holds her hockey stick and focuses on sensory details—the sunlight, the sounds of the ice—she begins to ground herself. This moment marks the integration of her shadow side, where she allows the return of negative memories and confronts the complexity of her self-image. Riley begins to reconcile conflicting beliefs about herself: “I am a good person, and sometimes I’m selfish”; “I am good enough, and sometimes I’m not.” This emotional integration is further deepened through her repair with Grace and Brie, leading to a resurgence of Joy, not just as an emotion, but as a sense of self-compassion. It is in this moment of self-acceptance that Riley’s sense-of-self returns, allowing her to feel joy and connection once more.


When things calm down, true emotional integration occurs. Riley realizes that she doesn’t need to cling to her old sense-of-self, as Joy had desperately tried to do. Instead, she can embrace the complexities of her emotions—her anxiety, her moments of self-doubt, and her moments of confidence. This recognition—that we can hold multiple, sometimes contradictory, feelings—is part of what it means to be human. While emotional integration takes much longer than a three-day hockey camp in real life, Pixar’s magic reminds us that growth and self-compassion are within reach.

Ennui: The French Art Of Boredom

In Inside Out 2, a new emotion, Ennui, is introduced, perfectly embodying the teenage struggle with boredom and disillusionment. Ennui, too cool for school, lounges on the couch, glued to her iPhone, showing little interest in anything around her. Her indifference only breaks when she loses her phone, and she’s half-heartedly dressed, with one sock barely on, illustrating a complete disengagement from life. Ennui reflects the pressure teens often face to appear aloof and indifferent as a way to fit in with the “cool” crowd.

As adolescents grow, they begin to notice social cues from their peers, learning what is deemed “cool” or “acceptable,” and this creates tension between being authentic and adopting superficial identities. In Inside Out 2, Riley faces this tension directly in a scene where she must decide whether to help someone who drops their coins or ignore them to maintain her cool status. The voices in her head reflect the struggle: one urges her to prioritize her social image, while the other encourages her to help. When Riley chooses to help, it becomes a defining moment for her. The act reinforces her sense-of-self, built on kindness and authenticity, and deepens her connection with others.

This scene underscores a critical lesson for adolescence: while peer pressure may tempt teens to adopt a detached, “too cool” persona, true growth and self-development happen when they stay grounded in their values. Riley’s decision to help shows that embracing authenticity and kindness leads to stronger relationships and a deeper sense-of-self—an important contrast to the apathetic Ennui.

The Split In The Adolescent Mind

Throughout Inside Out 2, there are moments when Riley lies to fit in with her new group of friends. Every time Riley lies to fit in, an earthquake creates a chasm in her Deep Mind, symbolizing the growing gap between her core emotions and sense of self. This crack, labeled 'sarcasm,' distorts communication between her authentic feelings and outward behavior. When Joy shouts, “You guys are the best crew ever,” the workers on the other side misinterpret her words as sarcastic. This visual metaphor represents Riley’s growing difficulty in staying true to herself, as the divide between her authentic emotions and her outward behavior widens.


This chasm of sarcasm symbolizes the growing tendency for adolescents to hide their true selves in social situations. As Riley distances herself from her core identity, we see how lying to fit in gradually disconnects her from her authentic self. Anxiety pushes her to conform, while her inner self—a reflection of who she has been up until now—reminds her of what she values. It is common during adolescence to experience this inner conflict, where old interests, like Riley’s affection for boy bands, now seem embarrassing or childish. This split reflects the pressure adolescents face to leave behind what once brought them joy, to appear more mature or fit in with peers.


In adolescence, this kind of internal splitting is normal, but it doesn't have to mean completely losing one’s authentic self. Adolescents often feel the need to justify or hide what is meaningful to them in order to be accepted by others. It’s important for them to realize that it’s okay to still like what they used to love, even if it’s no longer “cool.” Encouraging teens to embrace their true interests, rather than disavow them for the sake of fitting in, can strengthen their self-confidence and sense of identity.


For many parents, this split is observable on a daily basis. Adolescents can shift between their “cool” social persona at school and their authentic, silly selves at home, where they feel safer to express who they really are. Providing this safe space for teens allows them to explore both sides of their identity—the part of them that conforms to fit in and the part of them that feels true to who they are. It’s a back-and-forth crossing of the chasm, one that happens even daily, and as parents, it’s essential to champion their authentic selves during these moments.

Adolescents And The Development Of Social Veneers

Even if the side of themselves that our kids display when coming home from school isn’t always their silly side—it might be their unpleasant side—in a way, this is complementary to us as parents because it suggests that they believe we can handle them and shows they are not worried about us crumbling if they aren’t the perfect, nicest kid. They have been trying to hold it together all day and there are many different ways they can show up as their true selves at home, allowing themselves to feel things that they wouldn’t want to share with others.


On the other hand, something to acknowledge is that individuals with different degrees of reflective functioning may find it more or less challenging to navigate these various social contexts. Mentalization, or the capacity to understand and interpret others' emotions and thoughts, plays a key role in how adolescents shift between environments. Individuals with autism spectrum disorder (ASD), for instance, often struggle with this theory of mind, making it difficult for them to read social cues or adapt their behavior to fit different settings. They may not have the capacity to discern what might be appropriate or how their “audience” could interpret certain information.


In this same way, how our kids respond to their friends might not be the same way they respond to a teacher, which might not be the same way they talk to a parent. It’s almost like code-switching, testing how they can be themselves in various settings. Adolescents with a strong sense of theory of mind will learn to adapt their presentation based on context, while those who struggle with reflective functioning might reveal too much or fail to understand how their behavior affects others. For example, children with ASD may share facts without emotional context, a behavior that requires focused therapeutic work to help them understand and navigate social expectations.


As therapists, we often coach our patients on how to gate or filter aspects of their emotional experiences in different environments to help them achieve their goals. Others may need encouragement to be more vulnerable in relationships. Either approach can be beneficial, depending on the individual’s context and needs. Therapy often fosters reflective functioning by helping patients evaluate how their behavior might be interpreted by others, allowing them to manage social situations more effectively.

Techniques For Managing Panic Attacks Seen In the Film

Moving through the film, Riley gets to the point where she is so overcome with anxiety that she experiences a panic attack in the penalty box at her hockey game. We can witness, as she's coming out of the panic attack, this moment of integration of herself. This isn’t necessarily typical for someone to feel in the middle of a panic attack, but for the purposes of the film, we can see how it is illustrated that she has a coming together of the competing sides of herself— “I can be anxious. I can be good. I can feel bad about myself and I can feel good about myself.” All of that coming together helps her panic subside. 


A method they also portray Riley using is the 3-3-3 rule in treatment for panic attacks, which is about observing three things—touch three different things or move three different body parts, etc. We can see Riley actually hearing the skates on the ice and we see a picture of a skate. She observes that she is touching the side rail in the penalty box. This is a grounding technique that helps her come back to the present and realize she is going to be ok. She becomes able to sit with the fact that she hasn’t been good to her friends at hockey camp. She's also doing some great relaxation breathing, inhaling through her nose and exhaling twice as long through her mouth. These are common techniques used to calm panic. 


Tying this situation back into the importance of the secure sense-of-self, it is so helpful that Riley had that to draw on during this time of utter panic. Her inner world became so hijacked that she had to go to her outer world to calm down, and the faces of her secure relationships, her friends with whom she had such history, helped remind her of who she was. Mirror neurons, which allow us to resonate with and mirror the emotional states of others, play a significant role in this process of co-regulation. Riley’s ability to ground herself is likely reinforced by the calming, empathic presence of her friends, whose emotional states help reflect a sense of calm and safety back to her.


The film could have shown more of the impact of co-regulation, depicting her interacting with another person’s mind and influencing her during that moment, because we know that our minds are not fully independent. The role of mirror neurons in empathy is part of how this connection works. We can imagine a picture of how the softness of a friend’s love for her helps calm her flying amygdala, displaying the incredible power of co-regulation during such a moment.


She is able to reconnect with the realization that these are her friends, they genuinely care about her, and she can be honest with them. At first, Riley tries to tell her friends that she’s okay, but soon admits that she isn’t, revealing her vulnerability and showing a part of her true self. This moment of honesty allows her to let go of the facade she’s been maintaining, leading to a deeper, more authentic reconnection with her friends. By acknowledging her emotional state and sharing it with them, Riley strengthens her bond with her friends, demonstrating the healing power of vulnerability and authenticity in relationships.

Treating Panic In A Therapy Setting

The sequence of events was accurate, too, in that she really needed to connect to her own body and become grounded before she was able to receive from her friends. In life, we cannot simply look to other people to solve our problems. With patients, we want them to learn both. In instances of working with suicidal patients, we will make a plan where they will first attempt a specific pleasurable activity, and then they will call a friend, then they will get some exercise. It’s really a progression of things that are positive that they could do in the midst of the panic.


If Riley was a patient of ours and she was talking about this panic attack later, we might start by just asking her what it was like, acknowledging that it sounds like a horrible moment, and have her go through it. As she tells her experience, and relives it to some degree, she can walk through it again feeling that she wasn't alone with it—that she actually has somebody else with her who understands this, as we bear witness to her experience and offer empathy through voice and facial expressions. She was so isolated in her own head once anxiety flooded her that it really disconnected her. Resuming some of the disconnected attachment (connection) in the therapy room is the absolute starting place. This can speak to any disavowed part of the experience, as well. If she feels guilty about something, for perhaps pushing her friend over while she was trying to make a shot, or for hogging the ball, we can make room for normalizing those experiences.


Anxiety is often really tricky. It masks other hard feelings, so we can wonder what else is being experienced or repressed in Riley (or a patient). Some of those feelings might be anger, sadness, guilt, embarrassment. If we can recognize that, we can get to what was underneath of it. Maybe she did feel guilty. She ran into Grace and didn't have any remorse on the ice. Or maybe she was so worried about being accepted and felt like she needed to score, as Anxiety kept telling her to do. So we could back up and examine what other emotions were going on previous to the culminating moment of panic. “What were you feeling? What else was in there?” And going from there to understand more and say, “It sounds like that was really hard to feel and it came out in this way. I wonder if there's a way for it to come out differently. Can you tell yourself, ‘I'm really worried I'm not going to be accepted. I'm really worried I'm not going to make the team.” We can help them start putting the feelings into words that allow for expression of the feeling so it doesn't have to build to an uncontrollable moment.


The more Riley’s panic subsides, we see a shift towards her finding meaning in the suffering of what she went through and what she experienced. That can be the place where she comes to terms with the fact that she lost sight of herself in some places in her friendships at the cost of trying to make the team and fit in, and maybe it’s a sadness that she had hurt her friend. Ultimately, it all started with the grief of losing her friends to another school and grew from there.

Conclusion

The final scenes of Inside Out 2 show Anxiety settling into a special chair, complete with a foot massager and a cup of tea—a humorous yet poignant reminder that anxiety, too, has its rightful place. Anxiety can serve a purpose: helping us plan, protect, and prepare for the future. Yet it’s crucial to ensure that anxiety stays within bounds, not overwhelming other emotions or distorting our sense of self. This is an ongoing task, not only for our patients but for ourselves. As mental health professionals, we help our clients find balance, while we ourselves rely on community, supervision, quiet time in nature, and even creative outlets to stay grounded.

Pixar ties up the movie with a hopeful resolution, yet it subtly hints at the ongoing, messy nature of human experience. Emotions like anxiety, embarrassment, and ennui are constants in life. They can challenge us, but also teach us when integrated into a balanced sense of self. For Riley, navigating adolescence meant experiencing and expressing a full range of emotions, learning how lying or performing for others can fracture the self, and realizing how microexpressions and the reactions of others play into her self-concept. Her ability to connect authentically with her friends, largely through empathy and mirror neurons, offers a window into the power of shared emotional resonance.

This visual portrayal of complex themes offers a valuable reminder for therapists, parents, and adolescents alike: all emotions have value, and each part of the self deserves acknowledgment. By maintaining awareness of our own internal “dashboard,” we create a space where we, too, can observe, accept, and integrate all parts of our experience. For viewers young and old, it’s validating to see that emotions—no matter how contradictory or uncomfortable—are universal. Art, like Pixar’s work, reminds us that understanding and embracing our full emotional lives can lead to healing, resilience, and, ultimately, connection with ourselves and others.

Previous
Previous

Episode 226: Burnout in Healthcare: How Depersonalization and Dissociation Manifest, and How to Overcome Them

Next
Next

Episode 224: Understanding Borderline Personality Disorder (BPD) Medications & Treatment