Bart develops a close bond with his psychiatrist, Dr. Stacey Swanson, who uses a Mad Libs-like game and violent video games like, Death Kill City II: Death Kill Stories to get Bart to open up.
When his sessions end, Bart starts to miss the time he spent with her and enters into a state of depression in which he talks about his problems to an empty chair while lying on his bed. He peeks into her window and sees her counseling Milhouse Van Houten. He hangs his head while biking in the rain when he looks through a window and sees her dancing with a married owner of the Chinese restaurant next door to her office.
Marge, worried, pays for one more session with Dr. Swanson. When it ends, Bart feels that he has been able to get everything off his chest. As Bart says goodbye, Dr. Swanson starts to miss him and begins to obsess over him. While seeing her own psychiatrist, it is revealed during their session that "Dark Stanley" was in fact real, and had killed her own son.