The film Opens with Dr. Jane Mathis (Vanessa Shaw), a trauma psychiatrist, working late into the evening hours (with Holiday music playing in the background) calling in prescription updates and performing patient checkup calls. Alone in her building, she sees the clock approaching midnight and goes to brew a pot of coffee when she hears a loud crashing sound from down the hall. She walks into the waiting room to see her patient, Nora (India Eisley), cutting her own wrists and hands with a shard of glass. Nora tells Mathis that she "Did what she told her to do..." and that she was wrong, then proceeds to attack Mathis with the shard of glass and then slits her own throat. Fast forward two years. The scene opens with Dr. Mathis, apparently still dealing with the trauma of the attack, sitting in her car outside of her own therapist's office taking a prescription pill with coffee. She is seeing a friend and fellow therapist, Terry (William Atherton), to recover from the event, but her sessions are void of true emotion and guarded. She expresses to Terry that she wants to resume helping people who are recovering from traumatic events but then confesses that she is not ready to "go see Nora" yet (which tells the viewer that Nora is not dead) and then changes the subject. She also mentions that she's began a relationship which seems to impress Terry. Mathis sees quite a few patients in her home, but not those suffering from Trauma. The montage that presumes shows a bored and disconnected Mathis with her patients, doodling on her notepad rather than making notes and being frustrated with the lack of stimulation. One patient in particular glances at her prescription pad on the coffee table and requests something for anxiety. She tells the patient to try a few more sessions before she is willing to write a prescription (insinuating that she is now against prescribing meds to her patients). A new patient, who identifies himself simply as Alex, calls Dr. Mathis and begs her take him on as a post trauma patient and she agrees. That evening she self-medicates (notably not needing the water that she had turned the facet on in the bathroom to swallow) and goes to bed with the TV on. She awakes in the middle of the night to a crashing sound outside and goes to investigate. She discovers her trash can pushed over and while picking up the contents sees the bushes outside her house rustle. Walking towards the bushes to see the cause a figure flashes by and footsteps are heard running off, away from the house. She resumes cleaning up the spilled trash. Over her shoulder, Nora appears on the porch behind her but Mathis doesn't see her. She is gone when Mathis turns around and re-enters her home. Alex shows up to Jane's house for his first session, commenting on how he appreciates her lack of holiday decor. His face is terribly disfigured and he expresses frustration with his previous therapists and psychiatrists in general and that he doesn't see himself when he looks in the mirror. Alex states that he'd like something for his anxiety but Mathis refuses to prescribe him anything stating that drugs make things worse and that she isn't like the others and cares about the patients first. She states that she believes talking and exposing the issues that are affecting her patients helps the most. Later (presumably the next day) Jane and her friend Clara(Sydney Tamiia Poitier) go for a jog and Jane sees Nora in the woods along the side of her trail and becomes unnerved. Later Clara expresses to Jane that she's happy that Jane has resumed their jogging routine and states she's proud of her for her progress. The camera pans out and you see the two conversing from behind a tree, as if they are being watched, and can hear labored breathing. Later that evening Jane is home eating dinner with her boyfriend Miles (Aaron Stanford), a police officer, when he notices that she isn't eating. She blames the time of year but is remembering the scene in the woods in her mind during the discussion and the two joke about therapy to get work off their brains. Alex returns for a visit and explains that while shopping one day a child stared at him and made him feel like a freak. Alex talks about receiving a new face and how he doesn't feel like himself. Dr. Mathis tells him he needs "exposure therapy" to return to the accident and confront what happened to him. Alex tells Mathis he was on his way from work when he came upon a vehicle that had crashed but then states his memory is fractured and has a panic attack, failing to revisit the entire event. Dr. Mathis brings him out of the attack and teaches him a breathing exercise to use when he has attacks. Mathis re-tells a nightmare she had to Terry on her next visit about Nora and explains that when she work up, she felt, "heavy". Terry questions her about sleep paralysis and offers a script which she declines. He questions Mathis about her lack of progress, telling her that she is keeping something from him. She confesses that she has taken on a trauma patient that had been disfigured a few years ago and Terry reprimands her for taking on such a case. She tells Terry that trauma patients are what she's good at and she feels she's already helping Alex. That night Mathis is lying in bed when she hears crashing sounds from downstairs and calls Miles for help. She investigates to discover a sleepwalking Alex in her home and slaps him to wake him up. She declines to press charges against him but refuses to see Alex anymore as a patient despite his pleas and asks Miles to spend the night with her. She has a dream about Nora's first session where she asks if anyone would know that she was seeing her as a patient (which Mathis assures her that no one would) and then wakes up in an episode of sleep paralysis. This startles Miles, which Jane then explains and that she's ok, however for the remainder of the evening Jane fails to sleep and has flashbacks of the incident with Nora. No longer seeing Alex, Jane resumes therapy with her other patients (as well as her seemingly frustrated and disconnected disposition to them) until right before Christmas. Miles brings a tree to Jane's house which she and Miles decorate. He tells Jane that she can talk to him about anything and that it isn't going to scare him off. As they share a moment Jane's phone rings with Alex on the line, he tells her that he has taken too many pills and she rushes out to see him. Alex lets her into his home and appears disoriented from taking too many sleeping pills. He tells Mathis that he doesn't want to "live like this" and that he "keeps thinking about her" and then passes out. Mathis gives Alex a shot which brings him to consciousness but also makes him ill. He begs Mathis to not give up on him and assumedly she agrees as they resume sessions. The next session he tells Mathis the breathing exercises are helping and admits he had taken the pills in an attempt to commit suicide and not just to sleep. They attempt to relive the accident but Alex stops. Mathis comes close to telling him about Nora but stops herself and Alex storms out mid-session. That evening Mathis later takes more pills while drinking a glass of wine when Alex calls and apologizes for storming out. They agree to have another session the following week. That evening Nora shows up at Mathis's house, luring her outside, then entering the house and turning on her Christmas music before running off. Mathis then visits the mental institution where Nora had been held and she was advised that Nora had been released. The Dr. at the hospital tells Mathis that Nora's father died a couple years ago so there was no one to notify that she had been released. Mathis watches a video of Nora's sessions where she tells the physician there that the night she had broken into Mathis's office she had confronted her abuser and describes what presumably was an additional rape by him.In Alex's next session Dr. Mathis tells Alex about Nora and why she doesn't prescribe drugs then they revisit Alex's the accident and he tells Dr. Mathis that he had stopped to pull two people out of a wrecked car when he was hit by a vehicle and that his daughter was in his own car when he had stopped, that she'd be alive if it wasn't for the fact that he had stopped to help with the wreck. The two cry and comfort each other. That night Jane is trying to sleep and cannot, she goes through her bathroom cabinets and finds several empty boxes of meds (presumably to have taken them all) and is left with insomnia. While in the kitchen getting a snack she hears a noise and finds a window open with blood on it. She returns to her bedroom to see blood soaked all over her bed and calls the police (and Miles). They come and review her surveillance system in her home and discover it has been tampered with, several hours time having been deleted. Upon her next visit to Terry she expresses concern that she is afraid and hasn't been sleeping. Terry advises her to stay with him but she declines stating that she will be staying with Clara and asks for a glass of water. While Terry is in the other room Jane rips several prescription papers from Terry's prescription pad. She doesn't go to Clara's, but returns home with several prescriptions in hand to find an oblivious Alex on her front porch. She becomes agitated with Terry and advises him that she is not seeing patients. He states he was in the neighborhood and thought he'd visit, feeling that they had made a connection. She recommends Alex to Terry and goes inside, taking her prescriptions and then lies down on the couch, checking her cell phone to see several missed calls from Miles. She falls asleep. Sometime later, she has a nightmare that Nora is in her home attacking her, she awakes to find her lamp knocked over, the light flickering and Norma actually in her home. They have a scuffle in the kitchen and she plunges a cork screw into Norma's skull, killing her. Sometime later she awakes in the same mental hospital that Nora had been held in, cuffed to the bed and seemingly unaware of her surroundings. She sees the attending physician that Nora had seen and Terry (who has come on her behalf). Terry tells her that her blood tests had come back and he asks her how long she had been taking prescriptions from his pad in which she responds with an apology. They show her the surveillance video of the evening in which she had killed Nora, where she discovers she had actually killed Miles (who had come to her home to check on her in response to all of her missed calls). Her Dr. tells her that Nora was found that day, having hung herself in her apartment. Clara visits Nora in the hospital. When she gets into her car she is stunned by someone in the back seat. Meanwhile in the hospital Jane is having hallucinations and nightmares now about both Nora and Miles. In her next session she tells her Dr. that Nora drugged her and that she didn't drug herself and kill Miles. The Dr. responds with a recant of Nora's story about her treatment there and what she thought and didn't think. During his recant he re-mentions that she was "convinced" her father was dead, that SHE had killed him. In answering Jane's inquiry he admits that he had spoken to Nora's father and that he was paying for her treatment. She asks what Nora had done to her father, to his face, and he asks her how she knew? She realizes that Alex is both Nora's abuser and her father, and escapes from the hospital. When she reaches the parking lot she is electrocuted. Jane comes to, tied up in her home with Alex interrogating her. He admits that HE was the one who snuck into her home and drugged her, causing her to hallucinate and kill Miles. Admitting that he wasn't actually injured in his car accident but that it was Nora who had cut up his face the night she broke into Jane's office and tried to commit suicide. He admits that he was Nora's abuser, blaming Mathis for the fact that Nora realized that he was her abuser and causing her to confront him Christmas eve two years prior and that the car accident was on purpose to cover up how he had initially been injured. He faked his own death to disassociate himself with Dora's case so that he could seek revenge on Mathis. Mathis frees her hands from the ropes and stabs Alex in the neck with an ornament from the tree. She's tied in and gets away upstairs where she finds the bodies of Terry and Clara. Alex talks to her through the door and breaks into the room. They fight and she escapes through the window, disfiguring Alex's face again with her fingernails as she falls the first floor. She comes to on the lawn and re-enters the house to find Alex's lifeless body seated on the couch having succumb to his neck wound.