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.

When Tony's first hit is about to be unearthed, he and Paulie flee to Florida, where Tony contemplates their friendship. Junior organizes a poker game at the institution. The New York power struggle continues.