After suffering a series of mysterious anxiety attacks, New Jersey mob boss Tony Soprano agrees to see a psychiatrist, Dr. Jennifer Melfi. As he opens up to the doctor, Tony reveals details about his problems at home and at work that involve his wife Carmela, his kids Meadow and Anthony Jr., his Uncle Junior and his domineering mother Livia.

Tony seeks to find a peace with the Leotardo crew while dealing with rumors a member of his own crew may have flipped. A.J. makes a decision regarding his future and Junior's slide into dementia continues.