The theatricality of the psychotherapeutic encounter has been evident since its origins: Freud complained in 1914 that the patient in the grip of transference-love “gives up her symptoms or pays no attention to them; indeed, she declares that she is well. There is a complete change of scene; it is as though some piece of make-believe had been stopped by the sudden irruption of reality – as when, for instance, a cry of fire is raised during a theatrical performance” (“Observations on Transference-Love”). In the century that followed Freud's observation, the theatre has shown a reciprocal interest in the dramatic possibilities of psychotherapy – the imbalances of power, incomplete access to knowledge and history, and confessional styles of narrative revelation. This theatrical interest in the dynamics of therapy is particularly striking in that it inevitably becomes self-reflexive, an examination of the negotiation of power, knowledge, and autonomy between therapist and patient, analyst and analysand, that ultimately uncovers anxieties about the spectator–actor relationship. In this article, three works from the millennial moment in the United Kingdom and Ireland – Sarah Kane's 4.48 Psychosis, Joe Penhall's Blue/Orange, and Conor McPherson's Shining City – reveal a shifting conception of how psychotherapy works as a theatrical and a metatheatrical device. Kane and Penhall's plays are produced in a historical context in Britain that is equally sceptical about the institutions of psychiatry and the idealism of anti-psychiatry, and McPherson's characters inhabit an Ireland caught in the ambiguous space between the sanitized, globalized conventions of weekly psychotherapy and the ghostly consolations and convictions of spirituality. All three plays suggest that psychotherapy in drama can function metaphorically and metatheatrically by leading us to examine how performances of identity, narrative-making, and interpretation play out both in the theatre and in life.