Some people just need to see a therapist. So lost in neurosis are these people that nearly every action is questioned through the lens of their personal despair. Time spent on a psychoanalyst's couch would spare the people around them having to undergo the same suffering.

Writer/director Nicole Holofcener has built a career on the backs (and in the minds) of people such as this. Please Give is her latest dose of neurotics of every stripe and is a sharp, pointed dramady about human relationships and the tolls of urban living.

At the center of Please Give is Holofcener alter-ego Catherine Keener as Kate, a New Yorker who would appear to be successful on the surface. She owns a modern, hip antique furniture and design store with her husband Alex (Oliver Platt). They get along thanks to the dulling of years spent together and live in a great apartment. What's to complain about? For Kate, a better question is: What is there not to complain about?

Kate is nearly crippled by a sense of guilt regarding everything connected to her life. Kate feels shame about such things as how the store acquires its goods (from the relatives of elderly people when they die), the homeless that line the city sidewalks or the fact her teenage daughter desperately wants a pair of $200 jeans. It's all a storm of inner turmoil for Kate.

Kate isn't happy with the fact her life feels so empty. She spends time trolling websites looking for volunteers and photographs of deformed children to really stick the blade in herself. She's continually apologizing and states repeatedly how "guilty" or "terrible" she feels. The guilt is suffocating herself, her husband and her daughter.

When she actually tries to volunteer, she fails at that too, becoming paralyzed by an embarrassing sadness regarding the people she's supposed to be upbeat for. Optimism is not an emotion that Kate recognizes in herself.

Sharing the story with Kate and Alex is Rebecca (Rebecca Hall), a plain, pessimistic radiology technician and her superficial, materialistic sister Mary (Amanda Peet). When their opinionated and difficult grandmother dies, Kate/Alex take ownership of the apartment, to knock down walls and expand their living space. Mary, tanned, opinionated and full of blunt talk, bonds with Alex over their shared love of the crass antics of Howard Stern and a casual affair begins.

Please Give is the kind of movie where every character spouts whatever is on their minds. It makes for repeated scenes of awkward moments and inappropriate conversations. There is no off switch as characters talk. They are even more harsh when talking about other people. Kate and Alex openly long for the 91-year-old grandmother to kick the bucket, so they can get to enlarging their apartment. No person is spared verbal abuse or exhaustive self-reflection.

This straight talk between all of Holofcener's characters is true to her style. Her previous three films Walking and Talking (1996), Lovely and Amazing (2001) and Friends With Money (2006) have the common element of people sharing all sorts of painful observations with loved ones and virtual strangers. It's not so much mean spirited but an attitude of brutal honesty. Holofcener is continuously weaving her way around the invisible line between emotional cruelty and truthfulness in her films.

The most vivid example of Holofcener candor takes place in Lovely and Amazing. Emily Mortimer plays Elizabeth, a struggling actress plagued by low self-esteem about her image. Rather than bury her apprehensions, Elizabeth attempts to face them head-on by asking a man who she recently met to judge her naked body with complete and utter sincerity. Mortimer, standing in front of him, fully nude, with every tiny fault being criticized with aggressive honesty, is the perfect scene offering up Holofcener's trademark. It's a memorable and courageous bit of acting by Mortimer that has branded me a fan ever since.

In Holofcener's world, inner torment never ends no matter how successful you appear, your age, your job or where you live. Life is miserable in a myriad of ways to these people. Even when there is no real justification for the misery, Holofcener's characters find a way to wallow in the anguish. It shouldn't be entertaining to watch an endless parade of these people, yet it's so unrelenting and pure that it sucks you into its vortex. The fact every character is unlikeable is irrelevant. Maybe I'm drawn to the material because I'm a negative neurotic myself? I hate to admit it, but there might be some truth there.

Please Give, similar in tone to the recent Noah Baumbach film Greenberg, shouldn't be as fun as it is. Watching people immersed in their own crippling neurotic behavior doesn't sound like a good time, but it is. What makes it work is the knife-edged script by Holofcener, her languid pace as a director and the wonderful natural cast. A lot of people seeing Please Give might cause a spike in appointments to therapists to quell their own neurosis, I know I'm tempted to pick up the phone and get on that couch after seeing it.