McNamara/Troy's new on-site psychologist (guest star Kevin Chamberlin) creates conflict between Sean and Christian, while at the same time Sean grows interested in an independent shrink, Dr. Grace Santiago, both professionally and personally. Christian's feelings for Julia begin to affect his sex life. Julia attempts to create direction in her life, and comes to terms with her recent actions. Matt worries about sex with his girlfriend Vanessa (guest star Kate Mara) and her possible reaction to his uncircumcised penis, leading him to self-mutilation. Sean tries to encourage Liz (guest star Roma Maffia) to return to work. Sean and Christian operate on identical twin sisters, who request surgery to look different from one another.