When a psychologist comes to P.S. 118, she notices Helga's aggresive behavior, so she calls Helga for a session. Reluctantly, she goes and tells the psychologist about her family life and why she behaves this way.
Principal Wartz welcomes the school's new child psychologist, Dr. Bliss, to P.S. 118. Although she is meant to come after school on Tuesdays and Thursdays, she says that she came to spend the day observing the students. Wartz welcomes her to do so, but doesn't think she'll find anything interesting, saying that "unlike P.S. 117 and P.S. 119, P.S. 118 is the picture of mental health."
Ironically, Helga, who is walking down the halls and wearing her usual angry scowl, walks by Wartz's office right as Dr. Bliss walks out. Dr. Bliss notices Helga roughly push a kid aside and speaks rudely to another. It's clear that she has taken an immediate interest in Helga, and then follows her all the way to Mr. Simmons's class room. After briefly speaking with Mr. Simmons, he introduces Dr. Bliss as the new school district psychologist, and that she has randomly chosen to observe their class. During the morning, Helga is acting like she usually does with Arnold (who is sitting in front of Helga): throwing spitballs at him, causing him to turn around and glare at her. Dr. Bliss notices all of this and writes a lot of notes on her clipboard.
When the bells ring, Helga goes to her locker, sees Arnold walk by, then goes into one of her dramatic soliloquies about her love for him. As usual, Brainy appears behind her at the very end, wheezing and then she punches his face. Dr. Bliss sees Brainy on the floor following this, and Helga gets sent to Wartz's office. Dr. Bliss is also there, and tells Helga she wants to meet with her for sessions on Tuesdays and Thursdays after school. Dr. Bliss assures Helga that the point isn't to punish her but to discuss these aggressive tendencies and examine possible strategies for improvement. She believes that her behavior may be covering up more important issues, and wants to try to get to the root of the matter. Helga nervously glances at her textbook, where her mini figure of Arnold is hiding.
Helga starts panicking as she walks home, then crashes into a lemon stand and imagines the lemons as Arnold. She freaks out even more and starts running home. Once Helga gets home, her parents confront her because they have just received the news that Helga has been recommended for therapy. Bob complains that this never would've happened to Olga. He harshly tells Helga not to blab anything about them "to some school shrink," and Miriam has very little words of encouragement. As soon as Helga leaves the room, her parents both still complain how this never would have happened with Olga. As she prepares for bed and goes to see her Arnold shrine in her closet, Helga becomes determined not to reveal her secret love for Arnold to Dr. Bliss, no matter what.
The next day, Helga gets off a bus at the Hillwood Medical Center wearing a disguise consisting of a trench coat and hat; obviously trying to hide the fact that she is undergoing therapy. Once in Dr. Bliss's office, Helga is still acting hostile and denying that she is angry. She starts asking Dr. Bliss lots of questions, including if she read all of the books on her shelves, how many you have to read to be a shrink, and if Dr. Bliss is an "actual" doctor. Helga also recognizes that the paintings hanging on the walls in Dr. Bliss's office are done by Edward Hopper. Dr. Bliss seems impressed with what Helga knows, calling her recognition and critical analysis as "pretty astute for a fourth grader".
Helga starts to share with Dr. Bliss about the dysfunction in her household, mentioning that her sister Olga is perfect because she gets straight A's at Bennington College, all the boys wanna go out with her and that their parents shower her with attention.
Helga then tells of what happened the last time Olga came home. She served Bob and Miriam some coffee she made, and they shower love and attention on her like they always do. Then Helga comes into the room and Miriam admits that she forgot to pick up her winter coat from the cleaners, but says not to worry because the weatherman said it should stay above freezing for most of the day. Helga just scowls and growls and goes to pack her lunch, then stomps out while her parents only keep their eyes and ears on Olga, who's telling them all about Alaska. She opens the door to find it actually cold and snowy outside, then announces she's going to school, but Olga and their parents don't even hear Helga. She then leaves and walks off alone in the streets without any coat or hat to keep her warm.
Back to the present, Helga complains about how nobody in her house even knows she exists. "I think I'd go crazy if it wasn't for Arno-…" She stops abruptly, catching the interest of Dr. Bliss. Realizing she was just about to say "Arnold," Helga immediately tries to change the subject, saying it's hot in the building. She refuses to say anything more and starts to walk out. But Dr. Bliss says that there's still a lot of time in the session and says they can talk about other things besides her family…including Arnold. Helga starts to walk out, but immediately halts when she hears that word.
Dr. Bliss asks if Arnold is special to Helga, though she immediately denies it. She remembers everything that Helga did to Arnold in school yesterday, with the spitballs, the rude insult, and staring at him. Helga says she is not angry at Arnold, and claims that she did all that because it was "Arnold Day" on her calendar. Dr. Bliss then decides to move on and do some tests with Helga, including ink blots and word association. Helga tries not to think about Arnold, but she ends up seeing all of the blots as Arnold and associating every word Dr. Bliss says with something that relates to Arnold. (i.e., "Monday." "Night football.") After the tests, Dr. Bliss brings up how Helga said that no one at home notices that she existed. Helga admits that her mom wouldn't notice her if she was an alien pod person chanting Hare Krishna and spitting nickels.
The next memory shows Helga in her kitchen from the other morning, searching for her lunch and she is already late for school. She yells for her mother, who is asleep on the couch. Miriam admits that she did make Helga's lunch, but can't remember where she put it. Miriam wanders aimlessly in the kitchen before finding Helga's lunch in the oven. Helga is unimpressed with it: "Moist towelettes, an individual packet of crackers, and a can of shaving cream?" Miriam realizes that if the shaving cream is in the lunchbox, she must have put the cheese fizz meant for Helga's lunch in Bob's medicine cabinet. Sure enough, Bob is up the bathroom, getting ready to shave, and now has cheese all over his face, yelling, "How am I supposed to run a beeper empire with my face smelling like hickory smoked cheddar, Miriam?" Helga tells Dr. Bliss that she did get to school and during lunch, she traded the shaving cream with Harold for a Mr. Fudgie Bar, as he thought it was some kind of whipped topping. She also admits how much worse her father is in not noticing her, since all he cares about is Olga, because she's so perfect.
Back into Helga's past, to the day of her first day of preschool. Miriam and Bob are standing over Olga as she plays the piano praising her for being so bright and talented, and having won every spelling bee in the city. Helga demands to know who's taking her to preschool, but Bob just tells her to go play outside while Miriam and Olga pay no attention to her, either. Helga decides to go to school, even if she has to go alone. So Helga walks to school alone; it starts to rain and she has no coat or umbrella, there are scary-looking people in the streets, she gets splashed with mud by a passing car, then a big and vicious stray dog steals her lunch box. After listening to Helga's recap, Dr. Bliss asks if anybody's ever noticed her, pointing out that it must get pretty lonely being ignored all of the time. Helga answers, "There was someone…"
Helga arrives at the school, then sees an umbrella being held over her head. Its owner is a little boy with a football-shaped head, none other than Arnold. It shows that Arnold was really the first person to actually notice Helga or show her any sort of kindness. His compliment about her bow shows it was the first thing he ever noticed about her, and her bewildered phrase implies that no one has ever complimented her before, or even done or said something so kind to her. Helga reaches up to her bow and smiles, then gazes lovingly at him after he goes inside.
Later that day, she is still watching him from afar, and when she is distracted, Harold steals her snack of graham crackers and laughs at her as he quickly devours them. Helga's lip starts trembling and her eyes fill with tears, but then Arnold comes to the rescue and offers her his own crackers. She takes them, and obviously seems very surprised that someone would be so kind to her. As he walks away and waves to her, she waves back, then sighs and swoons.
Unfortunately, her classmates at the table, which consists of Rhonda, Sid, Stinky, and Harold, all saw what she did and start laughing at her and mocking her. Helga becomes angry from the teasing and immediately stops it by violence; she pushes Harold down and threatens him with her fists: Old Betsy (the left one) and the Five Avengers (the right one). Subsequently, she threatens the other kids if they dare tease her or stand in her way. But when she sees Arnold, her face brightens and she smiles lovingly at him. She ducks behind a trash can and pulls out a pink paper heart with Arnold's picture on it. Brainy stalks her after saying "Oh, Arnold. I love you and I want to marry you.", and then she punches him.
Helga has been telling Dr. Bliss everything about her past and ends with saying how Brainy appeared behind her for the first time. Helga acts hostile when Dr. Bliss asks her why she wanted the moment alone, and admits that she does get angry because of her "lame mom, blowhard dad, and perfect sister." She repeats her claim that she is not angry at Arnold, even though Dr. Bliss says she's seen Helga direct more of her anger at Arnold than anyone else. Thinking that Helga may be hiding something big about Arnold, she tells her that now is a good time to get it out of her system, but what she says will be kept in confidence and that Dr. Bliss will not speak of it.
Helga asks her several times if she's sworn not to tell and Dr. Bliss assures her yes, and after a moment of hesitation, Helga breaks down and confesses that she loves Arnold.
This aftermath makes Dr. Bliss understand that Helga is afraid to tell Arnold the truth about her feelings because she doesn't want him to reject her, as he is the one she truly loves and wants more than anything. She tells Helga that she doesn't know how Arnold will truly feel unless and until she tells him, but assures her it's okay to wait until she's ready. While Helga's poetry and shrines dedicated to Arnold are a little weird, they're just ways of expressing her creativity, and Dr. Bliss says it's okay to do it this way as long as she doesn't hurt anyone. She tells her not to hurt Brainy, though, as it's why she was here in the first place. She then announces that the session's over, and Helga is disappointed since they were just starting to make some progress, but Dr. Bliss assures her that they can talk again. Helga happily runs out, then comes back and gives Dr. Bliss a quick hug before running off again.
Helga gets off a bus, and she feels great after having confessed, saying that confession is good for the soul. She happily walks down the street, then crashes into Arnold at a corner. He apologizes and offers his hand to her, then she rudely tells him to "watch where you're going, football head!" She runs behind a nearby alley and laughs at him as he walks away, seeing at how dense he is that he can't tell how she truly feels. Brainy then appears behind her, wearing a white bow tie and buttoned shirt and gives her a plastic ring. Helga just chucks the ring and questions him as to how he is standing behind her again. Then she pats his cheek and he smiles as he puts his hand there.
As she starts walking again, she passes the same lemon stand, and the lemons, again, morph into Arnolds and say, "Hey Helga. How you doin'? Lookin' good!" Then she turns around and winks and points at them as she continues walking home.
This episode was produced as a way to explain to kids why Helga is the way she is, by having her do a therapy session. At the time this episode was produced, the production staff knew Helga's character inside and out, and decided to make this episode to make her character more human and real than ever. This episode was also another opportunity for Helga to have an emotional love confession like the one in "School Play", before the face-to-face confession with Arnold in the movie.
This is often considered one of the most memorable episodes of the series, for exploring Helga's motivations and explaining her backstory. Craig Bartlett has said that this is the episode he likes best, and many fans label it as one of the "must-see" episodes of the show. It's also gotten praise from internet critics such as MysteriousMrEnter for delving into mature themes, such as parental favoritism and the reasons young children become bullies.
- Dr. Bliss is voiced by Emmy award winning actress Kathy Baker. Baker has appeared in numerous films including Edward Scissorhands, The Right Stuff, Street Smart, Jacknife and Cold Mountain.
- Little Arnold is voiced by then-child actor Rusty Flood. He also voices Baby Arnold in the episode "Parents Day".
- Little Helga is voiced by Katie Bartlett, Craig Bartlett's daughter, who was in third grade when this episode was recorded. She can also be found in the episode, "Chocolate Turtles," where she voices Timberly, Gerald's little sister, for a short clip of giggling.
- Before Helga reveals her feelings for Arnold to Dr. Bliss, she questions whether her secret will be kept even under torture, the specific example being "if someone stuck [Dr. Bliss'] head in a cage with a starved rabid rat." This is in reference to George Orwell's 1984.
- The art print Helga comments on at Dr. Bliss' practice is entitled Summertime by Edward Hopper. She remarks that Hopper's work is "simple" and wonders "what's his deal with women?" Hopper chose women as the subject for most of his paintings.
- Being a special episode centered around Helga, the end credits feature a special theme by Jim Lang (This theme also plays during the credits of "Married") and a Special Thanks dedicated to "Franny".
- It's assumed that Helga would have continued having sessions with Dr. Bliss right up to the planned spin-off series The Patakis, as Dr. Bliss was mentioned as one of the starring cast.
- This is one of two episodes where Olga doesn't cry (the other being "Arnold's Christmas").
- During the flashback when Helga was going to preschool for the first time, she passes Tony B. and Philly D., Frankie G.'s friends who were seen in "Cool Jerk". Grubby from "Das Subway" is also seen sleeping during the flashback.
- Olga's teaching career in Alaska is mentioned.
- Helga owns(or owned) a Charlie's Angels lunchbox.
- Harold is 4 years older than all of his 4th grade classmates, and yet, this episode shows him attending preschool with everyone else.
- When Helga initially imagines the lemons as multiple Arnold heads, they are completely yellow and have Arnold's usual voice, albeit slightly higher-pitched. At the end, when she imagines the lemons aa Arnold again, they are now Arnold's regular colors, and have much lower voices.