The notion of care is a fundamental and constitutive element of any conception of therapy. It is present throughout history in diverse therapeutic practices, from the philosophical schools of antiquity, to Christian ascetic rituals and exercises, to modern psychotherapeutic, psychoanalytic and psychiatric discourses. These practices are in turn based on certain technologies of the self, which shape and determine the notion of care at stake in each case. Among these technologies, confession–the evolution and history of which Foucault calls ‘hermeneutics of the self’–seems to have gone through a particularly complex evolution, making it especially relevant to the various permutations of therapy and care. This article tracks Foucault’s genealogy of the practice of confession through the three main therapeutic configurations in the history of Western culture (ancient philosophy, the Christian religion, the early psy-sciences), in order to 1) bring to light the interconnections and reciprocal influences between the hermeneutics of the self and the notions of care and therapy; 2) identify both the differences and the similarities between these three versions of therapy and care; and 3) evaluate the development in question and discuss the current relevance of Foucault’s criticism for contemporary psychotherapeutic practices of the self.