"I'm the motherfucking fucking one who calls the shots."
While that statement may be of questionable taste, its accuracy is indisputable. He tells the IRS that he's in the waste management business, but Anthony Soprano is the acting boss of the DiMeo family, the most powerful criminal organization in New Jersey. A second generation wise guy, Tony is the son of the late Johnny Boy Soprano, a DiMeo capo who brought his boy into his profession and showed him the ropes. After Johnny's death, Tony was mentored by his old man's closest associates, Hesh Rabkin, Jackie Aprile, and Pussy Bompensiero, as well as Johnny's older brother, Corrado "Junior" Soprano.
Tony was born in 1959 and grew up in Newark and West Orange, New Jersey. Violence was a standard component of his childhood: he once witnessed his dad and uncle chase down and viciously beat a guy for being late with a numbers payment; another time he watched Johnny Boy amputate a debtor's finger with a meat cleaver. Johnny Boy utilized his fists at home, too; although he never struck his two daughters, when Tony transgressed his father would send him flying. Tony's mother, Livia, dealt emotional beatings; depressive and paranoid, she was incapable of affection - she once threatened to plunge a fork into his eye - and constantly told Tony he'd never amount to anything. But the coup de grace came years later when Tony put her into a nursing home, she conspired with Junior to have him killed.
As the head of his professional and personal families, Tony, to put it mildly, has his hands full. At work, he finds that the perks of being the boss come at a high price: when Pussy, whom he loved like a brother, turned out to be a government informant, Tony was forced to kill him; when Jackie Aprile's son ran afoul of the organization, Tony had no choice but to sanction his death as well. At home, his marriage is severely strained by his inability to remain faithful to his wife, Carmela. His college student daughter, Meadow, thinks he's a hypocrite and will barely speak to him. His son, Anthony, Jr., is a mentally and physically undisciplined high school student; Tony has serious doubts the boy could succeed in his profession - or any other.
It should come as no surprise, then, that Tony needs professional - as in medical - help; he's been seeing psychiatrist Dr. Jennifer Melfi for over three years. Despite the raised eyebrows among his business associates, Tony seeks treatment for debilitating anxiety attacks that are just like the ones suffered by his father and now his son. According to Melfi, the anxiety is rooted in Tony's anger, grief and guilt, and odds are it won't be going away anytime soon.