- "Things have been pretty fucked up."
- — Michael De Santa
Fucked Up is unlocked after the mission Minor Turbulence. Dr. Friedlander will send a text message to Michael saying that their last session was very concerning and they should have another chat. The mission can be completed at any time by calling Dr. Friedlander and will be available until Reuniting the Family.
Isiah will ask how Michael is doing, to which Michael will say that things have been "pretty fucked up". Isiah says that Michael looks confused, and asks Michael to tell him why. Michael's response will depend on the last mission that the player did before the session:
- Derailed - Michael says that things have been bad for him and that he is suffering. He says that he lost everything and that he is hanging with a maniac that will probably kill him, if the government doesn't kill him first. Michael also says that he wants his family back, but wants them to be different, as well as himself to be different and the world to be different. Dr. Friedlander says that being obsessed with things that we throw away is an easy avoid technique.
- Fresh Meat - Michael says that things have been a mixed bag for him. He says that he took some time to reflect about his life (referring to the time that he was being kidnapped by the Triads) and he finally knows what he wants: his family back. Michael says that he is going to pay his last debts and get out of his criminal life. Dr. Friedlander says that this looks like a progress for Michael and asks him to not underestimate all the time they spend on his sessions.
Isiah then asks if Michael had any other violent outbursts. Michael's response will depend on the player's actions in the game, sometimes Michael will say that he feels like two different people and that he doesn't like either of them, he can also say that he hurts other people without thinking and then feels bad about what he did, and other times, he might say that he killed someone on the way to the clinic and that he is a sick hypocrite. Regardless of what Michael will say, Friedlander will give advice that the player can accept or reject.
- Reject advice - Michael says that he never claimed that he was a saint, and that he "fucked up".
- Accept advice - Michael says that he just wants to be happy.
Friedlander then asks Michael about his sexual behavior, again Michael's response depends on the player's actions: if the player did not sleep with any prostitute or booty call, Michael will say that he had thoughts but didn't have any problems or he may say that he has been a good boy and didn't have any problems at all. On the other hand, if the player slept with a prostitute or booty call, Michael will say that he got lonely and called a girl. Friedlander will repress Michael if he confesses this.
The phone session continues with Michael saying that since he pulled Martin's house apart, he has not been the same again. Dr. Friedlander also mentions how they tried to use pharmaceutical solutions years ago to control Michael, and how that only made Michael wet himself, sleep during dinner and keep howling during the night. Isiah says that for the next session, they should meet in his office again and that his face to face sessions have got a little more expensive again.
The session ends and Michael pays $1,500 to Dr. Friedlander.
- The name of this mission can only be seen if the player completes the phone session with the autosave enabled or saves the game manually after the session ends. Then go to the load game option in the pause menu, and the name of the mission will be displayed in the last save.