Robert Dunn hires Shawn and Gus to root out the cause of Robert's problems, involving changing decor and disturbing feminine perfumes which materialize in his home.
Psych discovers that Robert himself suffers from dissociative identity disorder, or DID, which creates distinct alters with each having no memory or awareness of the activities of the other alters. Robert's 'alternate persona', Regina, has been rearranging the furniture and making herself at home, but Robert has simply 'woken up' to find things inexplicably and incomprehensibly different. Regina considers herself a transgender woman and has been trying to find a doctor to perform gender confirmation surgery.
Robert, however, is not responsible for killing the doctor who was to do this, as his third personality, Martin, objects violently to the idea of having his masculinity removed. The personality of Martin is shown from psychic deduction to be psychopathic and volatile, which is shown by his attempt to murder another doctor because his masculinity was scheduled to be removed. This pattern also shows that "Martin" lacks peaceful problem solving skills, as better ways to solve his problems could have been taken.