Tom Wingo (Nick Nolte) a teacher and football coach in South Carolina, is called to New York to tend to his twin sister, Savannah (Melinda Dillon), who has attempted suicide. There, he meets with Savannah's counselor, Dr. Susan Lowenstein (Streisand), with whom he recounts Savannah's and his own traumatic childhoods and falls in love.
This film provides examples of:
- Abusive Parents: The Wingo children all suffer from the abuse of their father.
- All Psychology Is Freudian: Dr. Lowenstein's therapy emphasizes childhood trauma and dream interpretation.
- Big Brother Worship: Tom always felt that he didn't need to be strong since his older brother Luke, who looked after them and even would defend the family against their father and rapists.
- Bitch in Sheep's Clothing: Tom's stepfather is this. He appears to be a genteel and wealthy Southern Gentleman, but raises a bully and doesn't hesitate to hit Tom and threaten him and his family.
- Bittersweet Ending: Savannah recovers and Tom returns home to his wife, leaving Dr. Lowenstein behind.
- Broken Bird: Savannah, after a childhood of abuse from her father and the rape she experienced with her twin brother and mother.
- Bungled Suicide: Savannah goes into a coma, but does not successfully kill herself Tom says this was not her first time.
- Deadpan Snarker: Tom
- Driven to Suicide: Savannah's latest attempt kickstarts the plot.
- Everything Sounds Sexier in French: Tom remarks that there is nothing sexier than a beautiful woman ordering food in French.
- First Girl Wins
- Jewish Mother: Downplayed. Dr. Lowenstein is one of these, which is Lampshaded by Tom.
- Polar Opposite Twins: Downplayed. Tom is an energetic, snarky football coach and Savannah is a suicidal poet.
- Precision F-Strike: Dr. Lowenstein gets a good one when she calls out a dinner guest for fucking her husband.
- Rape as Drama/ Rape as Backstory: Tom's recovery of his repressed childhood memory of this leads to a mental breakdown.
- The Shrink: Dr. Lowenstein is a Type 3.
- Stepford Snarker: Tom, states that laughing off one's own issues is "the Southern way".
- Your Cheating Heart: Sally begins an affair because Tom is emotionally distant, and Herbert is implied to be sleeping around as well.