Synopsis by Mark Deming

A tortured man finds himself caught in a middle-ground between hallucination and reality in this supernatural thriller, scripted by Bruce Joel Rubin of Ghost (1990) and My Life (1993). Jacob Singer (Tim Robbins) is a soldier stationed in Vietnam who undergoes a traumatic experience on the battlefield - the nature of which is initially unclear. The film then moves into his post-Vietnam experience in 1970s New York, where he feels consistently traumatized, but can never quite remember exactly what happened to him in Southeast Asia or to free himself from his anxieties over the recent tragic death of his young son (Macaulay Culkin). Though well educated, Jacob works as a letter carrier for the U.S. Postal Service and has become romantically involved with one of his co-workers, Jezzie (Elizabeth Pena), after divorcing his wife. Soon, Jacob's tenuous hold on reality starts to slip as horrifying events befall him; he is nearly run over by a subway train, pursued by faceless demons in cars, and spots reptilian tails and horns protruding from the bodies of those he encounters. Jacob also suffers severe panic attacks related to the chaos that may be reality, or may exist only in his mind. He seeks counsel from Louis (Danny Aiello), a kindly chiropractor, as his ex-wife Sarah (Patricia Kalember), fellow Vietnam vet Paul (Pruitt Taylor Vince), and enigmatic stranger Michael (Matt Craven) all try to help the tortured soul. Jason Alexander, Ving Rhames and Eriq LaSalle highlight the supporting cast.

http://www.allmovie.com/movie/jacobs-ladder-v25743