Psychiatrist Ann Hecker Annabella Sciorra runs a thriving practice in Manhattan. During a session with Eve Abergray Deborah Kara Unger, a disturbed art gallery owner, Eve recounts a recent sadomasochistic encounter she had with her male lover. The next day, one of Ann's patients, Johnny John Leguizamo, a painter, mentions he passed by Eve on his way out of the office the day before, and that her beauty sparked violent fantasies in him. Ann’s world begins to tilt as she starts dreaming in vivid, unsettling scenes drawn from Eve’s stories.
Seeking guidance, Ann turns to her former medical school instructors, Leo Green Alan Alda and his wife Sarah Green Jill Clayburgh, both psychologists, to help interpret the recurring dreams. Meanwhile, she also begins dating Doug McDowell Jamey Sheridan, a former Air Force pilot who works in her building.
During another session with Eve, Ann is shocked when Eve insists on undressing and confesses that she has fantasized about masturbating in front of Ann. She also recounts a disturbing sexual encounter with her lover, in which he placed a noose around her neck and threatened to hang her. Despite the disturbing nature of the memory, Eve says she found it profoundly erotic. A short time later, Ann sees Doug having lunch with Eve at a restaurant where Eve has claimed to meet her unnamed lover. During Eve’s next session, Eve reveals that her sadomasochistic lover’s name is Francis Douglas McDowell. Ann responds by suggesting that Eve find another psychiatrist.
Later, Doug accosts Ann in the building’s lobby, an event witnessed by Eve. Eve confronts them, accusing Ann of seeking out Doug to fulfill sexual fantasies spurred by Eve’s stories. She also informs Ann that she stole her file from the office, including numerous tapes Ann had kept reflecting on their sessions. The next day, Ann goes to visit Eve in an attempt to reason with her, only to find Eve’s corpse hanging from a rafter in her apartment. Detective Morgenstern [Anthony LaPaglia] informs Ann that Eve died from a skull fracture, not from the hanging, suggesting murder.
Morgenstern presents the theory that Johnny murdered Eve, given that Johnny’s artwork was featured at Eve’s gallery and that he has a history of violent attacks on women. Shortly after, Johnny breaks into Ann’s apartment, binds and gags her, and accuses her of helping Morgenstern frame him. He smashes Ann’s window and climbs onto a ledge, threatening suicide. Morgenstern arrives and tries to reason with Johnny, who claims he has an alibi for Eve’s murder; when Ann convinces him to come off the ledge, Johnny accidentally falls to his death. Leo and Sarah console Ann, who is reminded of her father’s suicide during medical school.
Doug visits Ann after hearing of Johnny’s death and invites her to accompany him to visit his family in Iowa. In conversation with Doug’s mother, Ann is disturbed to learn that his ex-wife, Jenny, hung herself several years before on Christmas. Back in New York, Morgenstern warns Ann that he now believes Doug to be Eve’s killer, but she rebukes him. Later, Ann goes to meet Doug at an air hangar to go on a flight, only to find him with Morgenstern’s dead body. Doug claims he found him there, but Ann flees in terror. Doug chases after her, only to be struck by a passing car, severely injuring him.
Ann travels to a beach house in Cape Cod with Sarah and Leo to convalesce. There, Ann discovers a cache of tapes Leo had kept from sessions during her medical school days. Leo returns during a dinner—drunk—and openly admits to having killed Eve, and claims he had gone to Eve’s home to retrieve Ann’s stolen tapes. The revelation shocks Sarah, and Leo proceeds to bludgeon her with a wine bottle, rendering her unconscious. He also admits to murdering Morgenstern. Ann flees to the beach, pursued by Leo, who trips her with a pole hook on her leg before attempting to drown her. In the struggle, Ann seizes the hook and uses it to strike back, delivering a fatal blow to Leo’s forehead.
Some time later, Ann and Doug visit the air hangar together, reuniting as Ann begins taking aviation lessons herself.
