NOTE: This spoiler was submitted by Jeremy

The film starts in the bedroom of a woman who has recently overdosed. Her young daughter enters her room and witnesses her mother’s body laid among the mess.

In the present day, the daughter, Rose Cotter (Sosie Bacon) is a therapist, going about her day at work. She deals with a manic patient named Carl (Jack Sochet). He continuously mutters about people dying, and that he is going to die. Rose attempts to comfort him, but Carl continues with his episode.

Rose then receives a call for an appointment with a young woman, Laura Weaver (Caitlin Stasey). When Rose meets her, Laura is distressed after a recent incident where she witnessed her professor bludgeon himself to death. Since then, Laura claims to have been seeing an evil presence that takes the form of others. After turning away from Rose and looking back, Laura begins panicking and freaking out. Rose calls for help, but she looks back to find that Laura has picked up a broken shard from a vase and is now flashing an unsettling grin. Laura slashes her throat before help arrives, leaving Rose in shock.

Rose speaks to two detectives, one of whom is her ex Joel (Kyle Gallner) for details on the event. She explains what she saw and also talks to her boss, Dr. Morgan Desai (Kal Penn). Later, Rose goes to her home that she shares with her fiance Trevor (Jessie T. Usher) and their cat Mustache. Rose and Trevor go to dinner with Rose’s sister Holly (Gillian Zinser) and her husband Greg (Nick Arapoglou), but Rose is so traumatized from Laura’s suicide that she snaps at Holly when she chastises Rose about forgetting Holly’s son Jackson’s (Matthew Lamb) upcoming birthday.

Rose attempts to go back to work and move on. She receives a call from Holly, as they both apologize for the argument, and Holly asks Rose to at least get Jackson a birthday gift. While they talk, Rose looks out the window and appears to see what looks like Laura in the distance. When Rose walks by Carl’s room, he is seen with a disturbing smile like Laura and begins to repeatedly tell Rose “You’re going to die!” She calls for help and Carl gets restrained by orderlies.

When Rose goes to buy a gift for Jackson, she sees an apparition of Laura again, still grinning. At home, she cannot find Mustache and is startled when the security alarm goes off. She gets a call from the security company, but it turns out to be a malicious entity that taunts Rose.

Over the weekend, Rose goes to Jackson’s birthday party. When it is time to give out gifts, he takes Rose’s, which is supposed to be a toy train. Instead, Jackson opens the box and finds Mustache’s corpse. Everyone freaks out, and Rose tries to assure everyone that she did not do this, but she sees one of the other moms appear to have the entity’s evil grin. Rose stumbles backwards and falls through a glass table, severely injuring her arms.

Rose is brought to the hospital for medical attention. Morgan visits her after becoming aware of her episode and suggests she take time off work. When Trevor brings her home, Rose tries to explain herself, but he thinks she is losing her mind and that she really did kill Mustache. Rose also has a session with her own therapist, Dr. Madeline Northcott (Robin Weigert), who helped her get through the trauma of her mother’s suicide.

Rose begins to do some investigating. She plays audio recorded from her session with Laura and hears what sounds like a faint breathing noise. She also looks up Laura’s professor, Gabriel Munoz (Felix Melendez Jr.), and tracks down his widow Victoria. She tells Rose that Gabriel had claimed to have seen visions of something haunting him, just days after he witnessed another woman named Anna Powell commit suicide. When Rose claims that she is experiencing what Gabriel did, Victoria thinks that Rose is mocking her tragedy and she orders her to leave.

Rose visits Joel for help in her investigation, despite his initial reluctance. He looks up Anna Powell and finds that she died by gouging her eyes out. It is also reported that Anna saw a man commit suicide too, which is shown in security footage from a gas station where the man is seen with the creepy smile before he impaled himself in front of Anna.

When Rose returns home, she finds that Trevor has called Madeline to provide a house call session since they are concerned for Rose’s mental state. Rose snaps at Trevor, saying that he is more concerned with how she is going to make him look, leading to her storming out and breaking up with him. Rose also goes to visit Holly in an attempt to explain herself about the birthday, but Holly will not forgive Rose and says that she is spiraling like their mother did. Rose fires back that Holly never attempted to be there for their mother and that she had to take care of her until the end. Rose goes back to the car and appears to see Holly walk back to her, but it is just the entity haunting her.

Joel escorts Rose to a prison where she meets the sole survivor of the curse, Robert Talley (Rob Morgan). He tells Rose that the entity latches itself onto people’s trauma and spreads itself to new victims. Each of the victims witnessed a suicide, and they became the next victims, so Robert killed someone to prevent the entity from killing him. When Rose tells him that she cannot kill anyone, Robert freaks out and thinks that Rose brought the entity with him, forcing him to be restrained.

Rose goes back home and tries talking to Madeline, seeing her at home on her own accord. This turns out to be the entity in disguise, since Madeline calls her for real moments later. The entity (as Madeline) grins at her and says Rose’s time is coming.

Fearing she has no choice, Rose drives to her job with a knife. She goes into the building and finds Carl’s room, where she goads him into freaking out. Morgan runs in and sees Rose stabbing Carl repeatedly. He screams and appears to tear his face off…but this is just a nightmare that Rose had after she passed out in her car. She drives away when Morgan sees her, along with the knife in her car.

Rose calls Joel and tells him that she has to isolate herself in order to stop the entity from spreading to anybody else. She drives up to her childhood home where her mother died. When it is dark, the entity appears to Rose as a tall, long-haired monstrous version of her mother that is always smiling. Rose expresses her anger toward her mother for how she behaved due to her illness and how she never got the help she needed. The entity follows and taunts Rose until she sets it on fire and runs out of the house as it burns. She then goes to Joel’s apartment and claims that she finally got rid of it. Then Joel tells her that she can never get rid of it…and he flashes a creepy smile.

Once again, Rose was dreaming. She is still back at the house. The entity finds her and tears its face off before stretching Rose’s jaw open and climbing into her mouth. Joel shows up and enters the house, only to find Rose dousing herself with kerosene. She turns around, flashing her own creepy smile, and she lights herself on fire in front of a horrified Joel.

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Dr. Rose Cotter is a therapist whose patient Laura Weaver dies by her own hand after claiming to have been haunted by an evil entity that smiles at its victims before possessing them to commit suicide. The entity kills Rose's cat and its presence causes Rose to appear insane to her fiance, sister, and her boss.

Rose gets help from her detective ex Joel, who learns about the link between the entity and others who committed suicide after they witnessed suicides days before. One man, Robert Talley, survived because he killed someone, as that is the only way to prevent the entity from taking its victim. Rose contemplates killing one of her more disturbed patients, but she knows she can't. She drives to her childhood home to try and isolate herself so the entity will not pass onto anybody else. Although Rose thinks she has killed the entity, it tricks her and ends up possessing her to kill herself in front of Joel, meaning he will now suffer the curse