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In Psycho II, Mrs. Spool, the cook at a diner in Fairvale, California urges owner Ralph Statler to make Norman Bates (Anthony Perkins) — newly released from the mental institution he was institutionalized in during the original film — the cook’s helper. Statler accepts and Norman meets with Mrs. Spool. At about this time, a series of brutal murders occur that bear a similarity to the ones Norman committed years before.
In the film's final scene, Mrs. Spool comes to visit Norman and reveals to him that she is his real mother. She tells him that she had him when she was very young and out of wedlock. She was put away by the state and her sister, Norma, took Norman in her care, raising him as her son. Mrs. Spool, while telling him this, is unaware she is actually sipping tea which Norman has poisoned. The poison takes effect and Mrs. Spool begins to cough. Norman picks up a nearby shovel and hits her on the head, killing her.
Norman takes his new “Mother” upstairs, and begins talking to himself in Spool's voice, recreating his murderous "Mother" persona.