Lena said on the "Inside the episode" feature that they used a prosthetic tongue. But she got that piercing herself when she was younger.

That scene was so brutal but when Cleo starting saying "ow" really loudly and Hannah was gagging, I was laughing so hard. It was a very confusing time…

That's strange because I saw this as one of the more followed through sort of things that's been on the show. We were introduced to Elijah's opinion on Hannah's dad three episodes in. At the time, the audience didn't take his accusation seriously, but now we obviously have to reassess.

Sorry - this is a bit off topic, but your comment reminded me that one of my favorite line deliveries last episode (Sit-In) was from Jemima Kirke when Hannah asks Jessa what Adam says at the AA meetings. And the ways she says that it's private is such a rubbing it in Hannah's face moment - like you can tell that Jessa…

She was definitely quoting Woody Allen - "the heart wants what the heart wants" is how he justified his relationship with his step-daughter.