The language barrier between Joe and, IIRC, his Italian girlfriend wasn't completely daunting to me. People can glean a lot about each other just by the way that they say their words, then there's body language. Maybe the girlfriend has a really good E.Q. and can tell that Joe is in a lot of emotional pain just by being in the room with him. It's the specifics of what Joe's saying that she must've missed, if you ask me. Anyway, this scene was a gutsy move on the part of the filmmakers.