Patch visits Arthur to find out the answer to his question, "how many fingers am I holding up?" When others guess the correct answer, Arthur states that they're wrong. Arthur suggests that Patch look at a different way of approaching the problem and stresses the importance of thinking differently.
Marge is put under a lot of stress with all of her responsibilities, which include solving the problems of the rest of the family. She gradually is negatively affected by all the stress and ultimately reaches her tipping point, causing her to put herself and Maggie in danger. Her handling of the situation suggests she has poor stress management skills.
Leo asks Josh about his day with Stanley, a psychotherapist. He uses a metaphor to describe Josh's PTSD situation and states that he'd like to help him. After Josh leaves the office, the carolers trigger Josh's PTSD.