Cultural phenomenon Rick and Morty has not been afraid to include gnarly real-life scenarios into its programming, including gonorrhea battles, self-burial, and existential crises. Season three will be no different: The newest teaser trailer, released Monday, introduces the very real phenomenon of coprophagia — otherwise known as eating poop.

The 15-second promo shows an encounter between the Smith family (“minus a dad”) bumping into Morty’s math teacher Mr. Goldenfold in a therapist’s waiting room. Dr. Wong, a new character who doesn’t appear in the scene is a therapist both for troubled families and for poop eating. That’s not subtext: Presumably the patient before the Smiths, Mr. Goldenfold asks them, “How long have you all been eating poop?” Behind him, the sign on the door reads: “Dr Wong: Family Therapy, Coprophagia Recovery.”

While poop is funny, coprophagia is a really awful condition. In fact, if Dr. Wong existed IRL, he’d be highly sought after, as effective treatments for coprophagia are hard to come by. Coprophagia in nonhuman animals — particularly dogs — is not particularly uncommon and is typically a sign of underfeeding or of a medical condition, like parasites or digestive enzyme deficiencies. But in humans, the condition is rare and not well understood.

When it does occur in people, it’s usually associated with severe mental conditions, like mental retardation, schizophrenia, dementia, hypothyroidism, and depressive psychosis. Sometimes, people with coprophagia also show symptoms of pica, a mental disorder characterized by an appetite for non-nutritional items like hair, soil, or paper.

It’s not just a mental condition. A team of scientists at the Mayo Clinic showed in 2016 that dementia patients with coprophagia had serious neurodegeneration: in their examination of 67,000 patients with dementia, about 1 per 10,000 people demonstrated coprophagia symptoms. In a statement, the study lead Dr. Keith Josephs said that coprophagia is rare in humans, but it’s probably underreported as well.

Coprophagia treatment: a real and much-needed thing.

The most effective way to treat coprophagia, Josephs reports, is with an antipsychotic medication called haloperidol, which is also used to treat behavioral problems like extreme aggression. Treatment with this drug was more effective than using restrictive clothing or antidepressant drug therapy.

But there’s certainly room for specialists like Dr. Wong in coprophagia treatment, as psychiatrists from the University of Nebraska Medical Center found in 2011. In a study published in the Journal of Applied Behavior Analysis, they showed that automatic reinforcement — when a person continues to engage in certain behaviors without receiving external encouragement — led a 6-year-old girl with autism to continually eat fake feces, made of flour, water, and food color. But when a therapist offered non-contingent positive reinforcement to the child, such as speaking with her, offering toys, but not explicitly reprimanding her behavior, then coprophagia tendencies decreased. To the study authors, it was a sign that therapy could be an effective treatment.

Ricky and Morty’s Dr. Wong is a gag — and a good one — but his real-life counterparts are doing decidedly non-shitty work.