Altman made considerable changes to Christopher Durang's screenplay adaptation of his own play. Durang later described the film as "a very unhappy experience and outcome".
Robert Altman was living in Paris at the time and decided to make the film there, even though it was set in New York.
Bob asks Prudence if she's ever seen "Sunday Bloody Sunday", starring Peter Finch and "that English actress." The English actress is Glenda Jackson, who appears in this film as Charlotte. In the play, Bob says Glenda Jackson's name instead of calling her "that English actress."
Some movie posters for the film had a long text preamble that read: "It doesn't matter whether you're the doctor. Or the patient. In order to establish a successful psychiatric relationship , both sides have to be committed. BEYOND THERAPY. Comic relief for incurable romantics".